Academic publishing requires linguistically inclusive policies.

Scientific knowledge is produced in multiple languages but is predominantly published in English. This practice creates a language barrier to generate and transfer scientific knowledge between communities with diverse linguistic backgrounds, hindering the ability of scholars and communities to address global challenges and achieve diversity and equity in science, technology, engineering and mathematics (STEM). To overcome those barriers, publishers and journals should provide a fair system that supports non-native English speakers and disseminates knowledge across the globe. We surveyed policies of 736 journals in biological sciences to assess their linguistic inclusivity, identify predictors of inclusivity, and propose actions to overcome language barriers in academic publishing. Our assessment revealed a grim landscape where most journals were making minimal efforts to overcome language barriers. The impact factor of journals was negatively associated with adopting a number of inclusive policies whereas ownership by a scientific society tended to have a positive association. Contrary to our expectations, the proportion of both open access articles and editors based in non-English speaking countries did not have a major positive association with the adoption of linguistically inclusive policies. We proposed a set of actions to overcome language barriers in academic publishing, including the renegotiation of power dynamics between publishers and editorial boards.

Genetics and the Evolution of Prezygotic Isolation.

The significance of prezygotic isolation for speciation has been recognized at least since the Modern Synthesis. However, fundamental questions remain. For example, how are genetic associations between traits that contribute to prezygotic isolation maintained? What is the source of genetic variation underlying the evolution of these traits? And how do prezygotic barriers affect patterns of gene flow? We address these questions by reviewing genetic features shared across plants and animals that influence prezygotic isolation. Emerging technologies increasingly enable the identification and functional characterization of the genes involved, allowing us to test established theoretical expectations. Embedding these genes in their developmental context will allow further predictions about what constrains the evolution of prezygotic isolation. Ongoing improvements in statistical and computational tools will reveal how pre- and postzygotic isolation may differ in how they influence gene flow across the genome. Finally, we highlight opportunities for progress by combining theory with appropriate data.

Synthesis and Scope of the Role of Postmating Prezygotic Isolation in Speciation.

How barriers to gene flow arise and are maintained are key questions in evolutionary biology. Speciation research has mainly focused on barriers that occur either before mating or after zygote formation. In comparison, postmating prezygotic (PMPZ) isolation-a barrier that acts after gamete release but before zygote formation-is less frequently investigated but may hold a unique role in generating biodiversity. Here we discuss the distinctive features of PMPZ isolation, including the primary drivers and molecular mechanisms underpinning PMPZ isolation. We then present the first comprehensive survey of PMPZ isolation research, revealing that it is a widespread form of prezygotic isolation across eukaryotes. The survey also exposes obstacles in studying PMPZ isolation, in part attributable to the challenges involved in directly measuring PMPZ isolation and uncovering its causal mechanisms. Finally, we identify outstanding knowledge gaps and provide recommendations for improving future research on PMPZ isolation. This will allow us to better understand the nature of this often-neglected reproductive barrier and its contribution to speciation.

Methodology for the prediction of paroxysmal atrial fibrillation based on heart rate variability feature analysis.

Atrial fibrillation (AF) is the most clinically diagnosed arrhythmia, as its prevalence increases with age, and its initial stage is paroxysmal atrial fibrillation (PAF). This pathology usually triggers hemodynamic disorders that can generate cerebrovascular accidents (CVA), causing morbidity and even death. The aim of this study is to predict the occurrence of PAF episodes in order to take precautions to prevent PAF episodes. The PhysioNet AFPDB prediction database was used to extract 77 heart rate variability (HRV) features using time domain, geometrical analysis, Poincaré plot, nonlinear analysis, detrended fluctuation analysis, autoregressive modeling, fast Fourier transform (FFT), Lomb-Scargle periodogram, wavelet packet transform (WPT) and bispectrum measurements. The number of features was reduced using the near-zero value, correlation, and recursive feature elimination (RFE) methods for time windows of 1, 2, 5, 10, and 30 min. Feature selection was performed using backwards selection, genetic algorithm, analysis of variance (ANOVA), and non-dominated sorting genetic algorithm (NSGA-III) methods, and then random forest, conditional random forest, k-nearest neighbor (KNN), and support vector machine (SVM) classification algorithms were applied and evaluated using 10-fold cross-validation. The proposed method achieved a precision of 93.24% with a 5-minute window and 89.21% with a 2-minute window, improving performance in predicting PAF when compared with similar studies in the literature.

Cortex cis-regulatory switches establish scale colour identity and pattern diversity in Heliconius.

In Heliconius butterflies, wing colour pattern diversity and scale types are controlled by a few genes of large effect that regulate colour pattern switches between morphs and species across a large mimetic radiation. One of these genes, cortex, has been repeatedly associated with colour pattern evolution in butterflies. Here we carried out CRISPR knockouts in multiple Heliconius species and show that cortex is a major determinant of scale cell identity. Chromatin accessibility profiling and introgression scans identified cis-regulatory regions associated with discrete phenotypic switches. CRISPR perturbation of these regions in black hindwing genotypes recreated a yellow bar, revealing their spatially limited activity. In the H. melpomene/timareta lineage, the candidate CRE from yellow-barred phenotype morphs is interrupted by a transposable element, suggesting that cis-regulatory structural variation underlies these mimetic adaptations. Our work shows that cortex functionally controls scale colour fate and that its cis-regulatory regions control a phenotypic switch in a modular and pattern-specific fashion.

Heliconius butterflies have bright patterns on their wings that tell potential predators that they are toxic. As a result, predators learn to avoid eating them. Over time, unrelated species of butterflies have evolved similar patterns to avoid predation through a process known as Müllerian mimicry. Worldwide, there are over 180,000 species of butterflies and moths, most of which have different wing patterns. How do genes create this pattern diversity? And do butterflies use similar genes to create similar wing patterns? One of the genes involved in creating wing patterns is called cortex. This gene has a large region of DNA around it that does not code for proteins, but instead, controls whether cortex is on or off in different parts of the wing. Changes in this non-coding region can act like switches, turning regions of the wing into different colours and creating complex patterns, but it is unclear how these switches have evolved. Butterfly wings get their colour from tiny structures called scales, which each have their own unique set of pigments. In Heliconius butterflies, there are three types of scales: yellow/white scales, black scales, and red/orange/brown scales. Livraghi et al. used a DNA editing technique called CRISPR to find out whether the cortex gene affects scale type. First, Livraghi et al. confirmed that deleting cortex turned black and red scales yellow. Next, they used the same technique to manipulate the non-coding DNA around the cortex gene to see the effect on the wing pattern. This manipulation turned a black-winged butterfly into a butterfly with a yellow wing band, a pattern that occurs naturally in Heliconius butterflies. The next step was to find the mutation responsible for the appearance of yellow wing bands in nature. It turns out that a bit of extra genetic code, derived from so-called 'jumping genes', had inserted itself into the non-coding DNA around the cortex gene, 'flipping' the switch and leading to the appearance of the yellow scales. Genetic information contains the instructions to generate shape and form in most organisms. These instructions evolve over millions of years, creating everything from bacteria to blue whales. Butterfly wings are visual evidence of evolution, but the way their genes create new patterns isn't specific to butterflies. Understanding wing patterns can help researchers to learn how genetic switches control diversity across other species too.

Highly Replicated Evolution of Parapatric Ecotypes.

Parallel evolution of ecotypes occurs when selection independently drives the evolution of similar traits across similar environments. The multiple origins of ecotypes are often inferred based on a phylogeny that clusters populations according to geographic location and not by the environment they occupy. However, the use of phylogenies to infer parallel evolution in closely related populations is problematic because gene flow and incomplete lineage sorting can uncouple the genetic structure at neutral markers from the colonization history of populations. Here, we demonstrate multiple origins within ecotypes of an Australian wildflower, Senecio lautus. We observed strong genetic structure as well as phylogenetic clustering by geography and show that this is unlikely due to gene flow between parapatric ecotypes, which was surprisingly low. We further confirm this analytically by demonstrating that phylogenetic distortion due to gene flow often requires higher levels of migration than those observed in S. lautus. Our results imply that selection can repeatedly create similar phenotypes despite the perceived homogenizing effects of gene flow.

Phase I, First-in-Human Study of the Probody Therapeutic CX-2029 in Adults with Advanced Solid Tumor Malignancies.

PURPOSE: PROCLAIM-CX-2029 is a phase I first-in-human study of CX-2029, a Probody-drug conjugate targeting CD71 (transferrin receptor 1) in adults with advanced solid tumors. Although the transferrin receptor is highly expressed across multiple tumor types, it has not been considered a target for antibody-drug conjugates (ADCs) due to its broad expression on normal cells. CX-2029 is a masked form of a proprietary anti-CD71 antibody conjugated to monomethyl auristatin E, designed to be unmasked in the tumor microenvironment by tumor-associated proteases, therefore limiting off-tumor toxicity and creating a therapeutic window for this previously undruggable target. PATIENTS AND METHODS: This was a dose-escalation, multicenter trial to evaluate the safety, pharmacokinetics, pharmacodynamics, and antitumor activity of CX-2029. The primary endpoint was to determine the maximum tolerated dose (MTD) and cycle 1 dose-limiting toxicity (DLT). CX-2029 was administered i.v. every 3 weeks. RESULTS: Forty-five patients were enrolled in eight dose levels. No DLTs were reported in the dose escalation through 4 mg/kg. At 5 mg/kg, there were two DLTs (febrile neutropenia and pancytopenia). Following expansion of the 4 mg/kg dose to six patients, two additional DLTs were observed (infusion-related reaction and neutropenia/anemia). Both the 4 and 5 mg/kg doses were declared above the maximum tolerated dose. The recommended phase II dose is 3 mg/kg. The most common dose-dependent hematologic toxicities were anemia and neutropenia. Confirmed partial responses were observed in three patients, all with squamous histologies. CONCLUSIONS: The Probody therapeutic platform enables targeting CD71, a previously undruggable ADC target, at tolerable doses associated with clinical activity.See related commentary by Oberoi and Garralda, p. 4459.

Digest: Gene flow timing uncovers a cloud forest downslope shift in warmer times.

Are the distributions of mountain species shifting up or downslope under climate change? Contrary to the long-held view of global warming forcing an upslope shift of montane ecosystems, Salces-Castellano et al. found that populations of a beetle tightly associated to cloud forests were isolated through the ice ages but in contact during interglacial periods, suggesting downslope shifts of cloud forest when temperature increases.

Percepción de los efectos COVID-19 en la educación presencial y a distancia en estudiantes universitarios del Perú / Perception of the COVID-19 effects in face-to-face and distance education in peruvian university students

La pandemia originó muchos cambios debido al distanciamiento social, uno de ellos es en cuanto a las clases virtuales universitarias. Por esto, el objetivo fue validar un instrumento que mida la percepción de los efectos del COVID-19 sobre la educación a distancia en estudiantes universitarios de las ciencias de la salud y otras carreras en el Perú. Se realizó un estudio instrumental y transversal. Participaron miles de estudiantes de ciencias de la salud y de otras carreras que estudiaban a distancia durante la primera ola del Coronavirus. Se diseñó y validó la encuesta sobre la percepción de que tiene de las repercusiones que causó la emergencia sanitaria sobre en la educación presencial y a distancia; además, se validó de forma exploratoria otra escala para medir la percepción de la propagación del coronavirus. El análisis arrojó alta confiabilidad y buena consistencia interna, con adecuados valores del alfa de Cronbach, para el Análisis Factorial Exploratorio (AFE) se empleó la prueba de Bartlett y el coeficiente Kaiser-Meyer-Olkin. Todos los ítems recibieron una evaluación favorable por parte de los expertos (V de Aiken > 0,70); esto con respecto de la relevancia, representatividad y claridad. Se identificó tres factores medios virtuales, su uso y la presencialidad, todos índices de saturación fueron superiores a 0,50. La encuesta demostró ser confiable y representativa, esto sobre todo por haber sido evaluada en estudiantes de los distintos departamentos peruanos; la cual puede servir para evaluar esto en diversas poblaciones semejantes(AU)

The pandemic caused many changes due to social distancing, one of them is in terms of virtual university classes. Therefore, the objective was to validate an instrument that measures the perception of the effects of COVID-19 on distance education in university students of health sciences and other careers in Peru. An instrumental and cross-sectional study was carried out. Thousands of distance learning students from health sciences and other careers participated during the first wave of the Coronavirus. The survey on the perception that it has of the repercussions caused by the health emergency on face-to-face and distance education was designed and validated; in addition, another scale was exploratory to measure the perception of the spread of the coronavirus. The analysis showed high reliability and good internal consistency, with adequate Cronbach's alpha values. For the Exploratory Factor Analysis (EFA), the Bartlett test and the Kaiser-Meyer-Olkin coefficient were used. All the items received a favorable evaluation by the experts (Aiken's V> 0.70); this with respect to relevance, representativeness and clarity. Three virtual average factors were identified, their use and presence, all saturation indices were greater than 0.50. The survey proved to be reliable and representative, this above all because it was evaluated in students from the different Peruvian departments; which can be used to evaluate this in diverse similar populations(AU)

Effects of Mild to Severe Hepatic Impairment on the Pharmacokinetics of Sonidegib: A Multicenter, Open-Label, Parallel-Group Study.

BACKGROUND AND OBJECTIVE: Sonidegib is a potent, selective and orally bioavailable inhibitor of the Hedgehog signaling pathway, primarily metabolized by the liver. In order to make dose recommendations for patients with hepatic impairment, we have assessed here the pharmacokinetics (PKs) and safety of sonidegib in subjects with varying degrees of hepatic function. METHODS: The primary objective of this phase I, multicenter, open-label study was to evaluate the PKs of a single oral 800 mg dose of sonidegib in subjects with impaired hepatic function compared with healthy subjects. PK parameters (e.g. area under the concentration-time curve from time zero to infinity [AUCinf], area under the concentration-time curve from time zero to the last measurable concentration [AUClast], maximum concentration [C max], apparent clearance [CL/F], and terminal half-life [t ½]) for parent drug and the metabolite were compared with the normal group, as the reference. Metabolite ratio, unbound PK parameters, and the relationship between specific PK parameters and liver function parameters were assessed. RESULTS: In total, 33 subjects entered the study and received sonidegib. Plasma concentrations peaked at approximately 2-3 h in all groups after dosing. Compared with the normal group, AUClast decreased by 35 and 23% and increased by 14% in the mild, severe, and moderate hepatic impairment groups, respectively. The C max values were lower in all groups with respect to the normal group (decreases of 20, 21 and 60% in the mild, moderate and severe hepatic impairment groups, respectively). Protein binding was independent of hepatic function, and similar trends in the PK parameters were observed for unbound sonidegib and the metabolite. Protein binding was similar across all groups. Weak to no correlation between specific PK and hepatic function parameters was found. CONCLUSIONS: Overall, sonidegib exposures were similar or decreased in the hepatic impairment groups compared with the normal group, and sonidegib was generally well-tolerated in all subjects. Dose adjustment is not considered necessary for subjects with mild, moderate, or severe hepatic impairment.

Effect of esomeprazole, a proton pump inhibitor on the pharmacokinetics of sonidegib in healthy volunteers.

AIMS: This study aimed to evaluate the impact of esomeprazole on the pharmacokinetics of sonidegib. METHODS: This Phase I study evaluated the impact of the proton pump inhibitor (PPI) esomeprazole on the oral absorption and pharmacokinetics (PKs) of a single dose of sonidegib under fasted conditions. A total of 42 healthy subjects were enrolled to receive either sonidegib alone (200 mg single dose) or sonidegib in combination with esomeprazole (40 mg pre-treatment 5 days and combination were given on day 6). Primary PK parameters assessed in the study were area under the concentration-time curve (AUC) from 0-14 days and 0-7 days and maximum observed plasma concentration (Cmax ). RESULTS: The plasma exposure (AUC0-14d, AUC0-7d and Cmax ) of a single 200 mg oral dose of sonidegib was decreased by 32-38% when sonidegib was co-administered with esomeprazole compared with sonidegib alone, with no apparent change in elimination slope and tmax . Baseline gastric pH was similar between the two arms. CONCLUSIONS: These results suggest a modest reduction in the extent of sonidegib absorption by esomeprazole. There was no obvious metabolic drug-drug interaction between the two agents. Both sonidegib and esomeprazole were well tolerated in the study population.

RICHNESS, CELLULOLYTIC ACTIVITY, AND FUNGICIDE SUSCEPTIBILITY OF FUNGI FROM A BIRD BIOLOGICAL COLLECTION / Riqueza, actividad celulolítica y susceptibilidad a fungicidas de hongos de una colección biológica de aves

Biological collections in natural history museums serve important purposes to the scientific community and the general public, however, their value and utility might be diminished by biodeterioration. We studied a biological collection that represents more than sixty years of avifauna sampling of Colombia, the country with the highest bird diversity. An initial inspection of the collection showed that the general appearance of some specimens was compromised by mold-like growth on their surfaces. We aimed at (i) identifying the taxonomic affiliation of these fungi, (ii) evaluating their cellulolytic activity, and (iii) probing chemical agents that could be utilized to control their growth. The most common fungi genera were Aspergillus, Penicillium, Chaetomium, and Trichophyton, most of which can degrade cellulose. Zinc chloride and salicylic acid showed to be effective fungicides. Based on this, we propose some actions to control the fungi-pest in this biological collection of birds.

Las colecciones biológicas en los museos de historia natural juegan un papel importante tanto para la comunidad cientifica como para el público en general. Sin embargo, su valor y utilidad pueden verse afectados por la biodeterioración de sus ejemplares. Se estudio una colección biológica de aves que representa más de sesenta anos de esfuerzo de muestreo de la avifauna del pais más rico en aves. Una inspección inicial mostró que la apariencia general de algunos de los especimenes de la colección se encontraba afectada por hongos. Los objetivos de este estudio fueron (i) identificar la afiliación taxonómica de los hongos, (ii) determinar la actividad celulolítica y (iii) probar agentes químicos que puedan ser utilizados para controlar su desarrollo. Los géneros de hongos más comunes fueron Aspergillus, Penicillium, Chaetomium y Trichophyton, de los cuales la mayoria presentan la capacidad de degradar celulosa. Adicionalmente, el cloruro de zinc y el ácido salicilico actuaron como fungicidas efectivos. De acuerdo con en estos resultados proponemos algunas acciones para controlar la contaminación por hongos en la colección de aves.

Phase 1 clinical trial of HER2-specific immunotherapy with concomitant HER2 kinase inhibition [corrected].

BACKGROUND: Patients with HER2-overexpressing metastatic breast cancer, despite initially benefiting from the monoclonal antibody trastuzumab and the EGFR/HER2 tyrosine kinase inhibitor lapatinib, will eventually have progressive disease. HER2-based vaccines induce polyclonal antibody responses against HER2 that demonstrate enhanced anti-tumor activity when combined with lapatinib in murine models. We wished to test the clinical safety, immunogenicity, and activity of a HER2-based cancer vaccine, when combined with lapatinib. METHODS: We immunized women (n = 12) with metastatic, trastuzumab-refractory, HER2-overexpressing breast cancer with dHER2, a recombinant protein consisting of extracellular domain (ECD) and a portion of the intracellular domain (ICD) of HER2 combined with the adjuvant AS15, containing MPL, QS21, CpG and liposome. Lapatinib (1250 mg/day) was administered concurrently. Peripheral blood antibody and T cell responses were measured. RESULTS: This regimen was well tolerated, with no cardiotoxicity. Anti-HER2-specific antibody was induced in all patients whereas HER2-specific T cells were detected in one patient. Preliminary analyses of patient serum demonstrated downstream signaling inhibition in HER2 expressing tumor cells. The median time to progression was 55 days, with the majority of patients progressing prior to induction of peak anti-HER2 immune responses; however, 300-day overall survival was 92% (95% CI: 77-100%). CONCLUSIONS: dHER2 combined with lapatinib was safe and immunogenic with promising long term survival in those with HER2-overexpressing breast cancers refractory to trastuzumab. Further studies to define the anticancer activity of the antibodies induced by HER2 vaccines along with lapatinib are underway. TRIAL REGISTRY: ClinicalTrials.gov NCT00952692.

[Respiratory symptoms associated with asthma prevalence and air pollution in preschool children]. / Prevalencia de síntomas respiratorios indicativos de asma y asociación con contaminación atmosférica en preescolares de Bucaramanga, Colombia.

INTRODUCTION: Increases in the air pollution levels has well-documented harmful effects on human health, especially exacerbating problems of asthma and other allergies. OBJECTIVE: The prevalence of symptoms associated with asthma was determined in preschool populations in zones with differing levels of air pollution. MATERIALS AND METHODS: A cross-sectional study was conducted in Bucaramanga, Colombia, comparing respiratory symptoms in 768 children under seven years in two urban zones with different pollution levels of particulate matter and ozone. Morbidity was evaluated for respiratory indicators of asthma by means of a questionnaire version previously validated in Spanish. RESULTS: The use of cigarettes (27.5%) and aerosols (22.7%) were the most frequent source of indoor air pollution. Wheezing prevalence was 25.6% (95% CI 23.2-29.8%) and diagnosis of asthma was 8.4% (95% CI 6.2-11.5%), with no differences between zones. The final multivariate model did not show an association between outdoor pollution and symptoms related with asthma. However, concrete flooring and presence of mold did show an association with these symptoms. CONCLUSIONS: Indoor air quality rather than outdoor air pollution may play a more important role in producing respiratory symptoms related with asthma in preschool children in the city of Bucaramanga, Colombia.

Extracción de paaguicidas en suelo empleando dióxido de carbono supercrítico-cosolventes / Extracton of pessticides in soil using supercritical carbon dioxide -co-solvents / Extracço de pragguicidas em solo utilizndo dióxido de carbono supercriitica- co-solvente

En este estudio se evaluó la eficiencia de tres solventes orgánicos (acetato de etilo, metanol y acetona) empleados como cosolventes en la extracción con fluidos supercríticos (EFS) de una mezcla de plaguicidas con diferentes características fisicoquímicas. Los análisis se realizaron por medio de cromatografía de gases con detección simultánea por microcaptura electrónica (µECD) y nitrógeno-fósforo (NPD) acoplados en paralelo. Se hicieron extracciones a muestras de suelo fortificadas con los plaguicidas empleando dióxido de carbono supercrítico (CO2SC) como fase extractante a 35 °C y 14 MPa adicionando 10 mL de cada cosolvente. Se encontró que el metanol ofrece la mayor eficiencia en el proceso de extracción obteniendo valores de recuperación entre 51,24 y 123,50%.

In this study, three organic solvents (ethyl acetate, methanol and acetone) were used as cosolvent in supercritical fluid extraction (SFE) of a mixture of pesticides with different physical and chemical properties present in soil. These pesticides were determined by gas chromatography with electronic microcapture detector (µECD) and nitrogen-phosphorus detector (NPD), coupled in parallel. The extractions were performed on spiked soil samples using supercritical carbon dioxide (CO2SC) as the extracting phase to 35 °C and 14 MPa, using 10 mL of each cosolvent and it was found that methanol offers the greatest efficiency in the extraction process obtaining recovery values between 51.24 and 123.50%.

No estudo se avaliou três solventes orgânicos (acetato de etila, metanol e acetona), como cosolvente em a extração com fluido supercrítico (EFS) de uma mixtura de praguicidas com diferentes propiedades física e química (organoclorados, or-ganofosforados, organonitrogenados e piretróides) presentes no solo, determinadas por cromatografia gaseosa com in-jecção pulsed splitless e detecção simultânea por µECD e nitrogênio-fósforo (NPD) acoplados em paralelo, as extrações foram realizadas em amostras de solo fortificadas, usando dióxido de carbono (CO2), como a fase de extração a 35 °C 14 MPa, com 10 mL de cada solvente e constatamos que o metanol oferece a maior eficiência da remoção de todos os pragui-cidas e obter recuperação valores entre 51,24 e 123,50%.

Prevalencia de síntomas respiratorios indicativos de asma y asociación con contaminación atmosférica en preescolares de Bucaramanga, Colombia / Respiratory symptoms associated with asthma prevalence and air pollution in preschool children

Introducción. Actualmente se sabe que el incremento de los niveles de contaminación atmosférica externa e interna se asocia con efectos nocivos para la salud, especialmente asma y otras alergias. Objetivos. Determinar la prevalencia de síntomas respiratorios indicativos de asma en la población preescolar y compararla entre zonas con diferentes niveles de contaminación atmosférica en Bucaramanga, Colombia.Materiales y métodos. Estudio observacional analítico de corte transversal que compara los síntomas respiratorios en menores de siete años de dos zonas de la ciudad con niveles diferentes de contaminación por material sólido en partículas y ozono. La morbilidad fue medida con un cuestionario sobre síntomas respiratorios indicativos de asma, validado al español. Resultados. Se estudiaron 768 niños distribuidos de las zonas de alta y baja contaminación. El uso de cigarrillos (27,5%) y aerosoles (22,7%) se encontraron como las fuentes de contaminación más frecuentes dentro de las viviendas. La prevalencia de ruidos respiratorios a lo largo de la vida fue de 25,6% (IC95% 23,2-29,8) y la de diagnóstico médico de asma fue de 8,4% (IC95% 6,2-11,5), sin diferencias significativas entre las zonas. El modelo final no mostró asociación entre la contaminación atmosférica y la presencia de síntomas respiratorios indicativos de asma. Por el contrario, la presencia de pisos de cemento y moho mostró una asociación significativa con estos síntomas. Conclusiones. Es posible que en Bucaramanga los factores de contaminación domiciliaria puedan tener un mayor efecto sobre la presencia de síntomas respiratorios indicativos de asma en menores de siete años que los contaminantes externos.

Introduction. Increases in the air pollution levels has well-documented harmful effects on human health, especially exacerbating problems of asthma and other allergies. Objective. The prevalence of symptoms associated with asthma was determined in preschool populations in zones with differing levels of air pollution. Materials and methods. A cross-sectional study was conducted in Bucaramanga, Colombia, comparing respiratory symptoms in 768 children under seven years in two urban zones with different pollution levels of particulate matter and ozone. Morbidity was evaluated for respiratory indicators of asthma by means of a questionnaire version previously validated in Spanish. Results. The use of cigarettes (27.5%) and aerosols (22.7%) were the most frequent source of indoor air pollution. Wheezing prevalence was 25.6% (95% CI 23.2-29.8%) and diagnosis of asthma was 8.4% (95% CI 6.2-11.5%), with no differences between zones. The final multivariate model did not show an association between outdoor pollution and symptoms related with asthma. However, concrete flooring and presence of mold did show an association with these symptoms. Conclusions. Indoor air quality rather than outdoor air pollution may play a more important role in producing respiratory symptoms related with asthma in preschool children in the city of Bucaramanga, Colombia.

Recurrent infections and joint pain.

A seven-year-old white male presented with recurrent bouts of paranasal sinusitis, streptococcal pharyngotonsillitis, lower respiratory tract infections, continuous low-grade fever, and conjunctivitis, which required frequent use of antibiotics over a period of two years. A careful review of systems also revealed a six-month history of arthralgia affecting his knees, elbows, and hands, which limited his daily activities. Prominent in the history were recurrent bouts of a generalized salmon-red, nonpruritic rash, which was most pronounced on the face and trunk and which was exacerbated by fever. His past medical history revealed severe bouts of gastroesophageal reflux disease, chronic intermittent bloody mucous diarrhea, and atopic dermatitis. A detailed review of the patient's family pedigree over five generations revealed a strong genetic predisposition for autoimmune diseases of several types. His physical examination revealed a thin, pale, chronically ill-appearing male, bilateral conjunctivitis, and pale nasal mucosae with no lymphadenopathy, organomegaly, arthritis, or rash. All laboratory results were unremarkable except for a positive rheumatoid factor and a suboptimal antibody response to immunization with pneumococcal vaccine. A diagnosis of juvenile rheumatoid arthritis of the systemic onset type was established, and, based upon his humoral immune deficiency, treatment with intravenous immunoglobulin was initiated with remarkable improvement in his symptomatology.

Current epidemiology of asthma: emerging patterns of asthma.

Asthma is a chronic disease associated with substantial morbidity, mortality, and health care use. Between 1980 and 1994, the self-reported prevalence of asthma increased 75% among all race, sex, and age groups in every region of the United States. Although an estimated 14.6 million persons had asthma in the United States in 1996, more recent studies have suggested a plateauing of the prevalence of the disease. Because establishing the diagnosis of asthma and characterizing the features of the disease have long been difficult for both the clinician and the researcher, studies determining the frequency of asthma across different countries and over time, seeking clues to the etiology of the disease, and monitoring for untoward variations provide the clinician with additional resources to manage patients with asthma. The purpose of this article is to provide a brief overview of the current and emerging national and international trends in the epidemiology of asthma.

Are attention deficit hyperactivity disorder and chronic fatigue syndrome allergy related? what is fibromyalgia?

Despite the progress made in the field of allergy-immunology in recent years, there are a group of diseases that the allergist-immunologist may be called on to manage in which their precise etiologies have not been identified but that appear to be initiated or exacerbated by allergic mechanisms. Attention deficit hyperactivity disorder (ADHD), chronic fatigue syndrome (CFS), and fibromyalgia (FM) fall into this category of disorders. Although the precise etiology of ADHD still remains unknown, the most prevalent theory is that it represents a neurobiologically based developmental disability leading to inadequate production of the neurotransmitter dopamine. In patients with CFS, there appears to be a fundamental dysfunction of the neuroendocrine-immunological system with deficiencies of immunological and neurological function, which, together with chronic viral infection, may lead to a sequence of events responsible for the symptoms of this disorder. FM appears to be a variant of CFS with a predominance of hypothalamic pituitary axis dysfunction. The disorder is characterized by chronic widespread pain and the finding of 11/18 tender points on examination. Now, there is emerging evidence to suggest that adverse reactions to foods or food components also may be associated with behavioral disturbances that may play a role in each of these disorders. An understanding of the interactive responses involved in the neuroendocrine-immunological network is essential for a comprehension of the pathophysiology of ADHD, CFS, and FM and the role of allergies appears to be an important triggering event in each of the disorders.

A phase I study of the safety of honeybee venom extract as a possible treatment for patients with progressive forms of multiple sclerosis.

Although several reports suggest that bee venom may be an effective treatment for patients with multiple sclerosis (MS), patients may be subjected to real risks of serious allergic reactions as well as emotional and economic costs. This study was conducted to evaluate the safety of bee venom extract as a possible treatment for patients with progressive forms of MS. A total of nine bee venom nonallergic patients with progressive forms of MS, who were 21-55 years of age with no other illnesses, were entered into four groups (A, B, C, and D) on a structured 1-year immunization schedule. Hyperreactivity to bee venom was evaluated by questionnaire, physical examination, and a battery of hematologic, metabolic, and immunologic tests. Responses to therapy were evaluated by questionnaire, functional neurological tests, and changes in measurement of somatosensory-evoked potentials. Although no serious adverse allergic reactions were observed in any of the nine subjects, four experienced worsening of neurological symptoms, requiring termination in the study; this could not be ascribed to side effects of the therapy. Of the remaining five subjects, three felt that the therapy had subjective amelioration of symptoms and two showed objective improvement. Although this preliminary study suggests safety, because of the small numbers studied, there were no definite conclusions regarding efficacy and therefore there was little evidence to support the use of honeybee venom in the treatment of MS. Larger and more carefully conducted multicenter studies will be required to establish efficacy.