Within-Host Rhinovirus Evolution in Upper and Lower Respiratory Tract Highlights Capsid Variability and Mutation-Independent Compartmentalization.

BACKGROUND: Rhinovirus (RV) infections can progress from the upper (URT) to lower (LRT) respiratory tract in immunocompromised individuals, causing high rates of fatal pneumonia. Little is known about how RV evolves within hosts during infection. METHODS: We sequenced RV complete genomes from 12 hematopoietic cell transplant patients with infection for up to 190 days from both URT (nasal wash, NW) and LRT (bronchoalveolar lavage, BAL). Metagenomic and amplicon next-generation sequencing were used to track the emergence and evolution of intrahost single nucleotide variants (iSNVs). RESULTS: Identical RV intrahost populations in matched NW and BAL specimens indicated no genetic adaptation is required for RV to progress from URT to LRT. Coding iSNVs were 2.3-fold more prevalent in capsid over nonstructural genes. iSNVs modeled were significantly more likely to be found in capsid surface residues, but were not preferentially located in known RV-neutralizing antibody epitopes. Newly emergent, genotype-matched iSNV haplotypes from immunocompromised individuals in 2008-2010 could be detected in Seattle-area community RV sequences in 2020-2021. CONCLUSIONS: RV infections in immunocompromised hosts can progress from URT to LRT with no specific evolutionary requirement. Capsid proteins carry the highest variability and emergent mutations can be detected in other, including future, RV sequences.

Features and outcomes of rectal cancer patients treated in a hospital in Bogotá, Colombia: a retrospective cohort study.

Rectal cancer is an increasing disease worldwide. The outcomes of its treatment are related to the preoperative characteristics of the patient. The objective of this study was to describe sociodemographic, clinical and surgical characteristics and outcomes of patients operated on for rectal cancer at Hospital Universitario Mayor Méderi (HUM) during the period within 2013-2017.A retrospective descriptive cohort-type study was carried out by consulting the clinical records of patients above the age of 18 years with a clinical/histopathological diagnosis of rectal cancer and an institutional follow-up in those who underwent surgery with laparoscopic anterior resection of the rectum carried out by the coloproctology service of the HUM between 2013 and 2017. For statistical analysis, the SPSS V22 program was used.Data from 133 patients were collected during the study period, most of them male, with more frequent involvement of the lower rectum. Complications occurred in 25% of the patients. Conversion rate to open surgery was 8.6%, in-hospital death was associated with cardiovascular comorbidity, corticosteroid uses and with the presence of complications. Sociodemographic characteristics of the patients were similar to the world population. The institution has a low prevalence of anastomotic dehiscence, global complications are comparable with international statistics.

Chronic Diarrhea Due to Intestinal Spirochaetosis in an HIV-Positive Patient: Case Report and Literature Review

Intestinal spirochaetosis refers to the colonization of the colorectal epithelium by anaerobic spirochetes of the genus Brachyspira. It is more frequently identified in developing countries or when sanitation conditions are suboptimal. It can affect anyone, although it is more common in gay men, particularly those infected with the human immunodeficiency virus (HIV). Its most common symptom is chronic watery diarrhea. A colonoscopy may be expected. We present the clinical case of a young male patient with chronic diarrhea of several years of evolution resolved by specific treatment. In addition, a review of the literature on this disease is provided.

La espiroquetosis intestinal se define como la colonización del epitelio colorrectal por espiroquetas anaerobias del género Brachyspira. Se identifica con mayor frecuencia en países en vías de desarrollo o cuando las condiciones de salubridad son subóptimas. Puede afectar a cualquier persona, aunque es más común en hombres homosexuales particularmente infectados por virus de la inmunodeficiencia humana (VIH). Su síntoma más frecuente es la diarrea crónica acuosa. La colonoscopia puede ser normal. Se presenta el caso clínico de un paciente masculino joven con diarrea crónica de varios años de evolución que se resuelve al brindar tratamiento específico. Además, se realiza, una revisión de la literatura sobre esta enfermedad.

Within-host rhinovirus evolution in upper and lower respiratory tract highlights capsid variability and mutation-independent compartmentalization.

Background: Human rhinovirus (HRV) infections can progress from the upper (URT) to lower (LRT) respiratory tract in immunocompromised individuals, causing high rates of fatal pneumonia. Little is known about how HRV evolves within hosts during infection. Methods: We sequenced HRV complete genomes from 12 hematopoietic cell transplant patients with prolonged infection for up to 190 days from both URT (nasal wash, NW) and LRT (bronchoalveolar lavage, BAL) specimens. Metagenomic (mNGS) and amplicon-based NGS were used to study the emergence and evolution of intra-host single nucleotide variants (iSNVs). Results: Identical HRV intra-host populations in matched NW and BAL specimens indicated no genetic adaptation is required for HRV to progress from URT to LRT. Microbial composition between matched NW and BAL confirmed no cross-contamination during sampling procedure. Coding iSNVs were 2.3-fold more prevalent in capsid over non-structural genes, adjusted for length. iSNVs modeled onto HRV capsid structures were significantly more likely to be found in surface residues, but were not preferentially located in known HRV neutralizing antibody epitopes. Newly emergent, serotype-matched iSNV haplotypes from immunocompromised individuals from 2008-2010 could be detected in Seattle-area community HRV sequences from 2020-2021. Conclusion: HRV infections in immunocompromised hosts can progress from URT to LRT with no specific evolutionary requirement. Capsid proteins carry the highest variability and emergent mutations can be detected in other, including future, HRV sequences.

Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients.

Background: Hartmann's procedure (HP) is used in surgical emergencies such as colonic perforation and colonic obstruction. "Temporary" colostomy performed during HP is not always reversed in part due to potential morbidity and mortality associated with reversal. There are several contributing factors for patients requiring a permanent colostomy following HP. Therefore, there is still some discussion about which technique to use. The aim of this study was to evaluate perioperative variables of patients undergoing Hartmann's reversal using a laparoscopic and open approach. Methods: The multicenter retrospective cohort study was done between January 2009 and December 2019 at 14 institutions globally. Patients who underwent Hartmann's reversal laparoscopic (LS) and open (OS) approaches were evaluated and compared. Sociodemographic, preoperative, intraoperative variables, and surgical outcomes were analyzed. The main outcomes evaluated were 30-day mortality, length of stay, complications, and postoperative outcomes. Results: Five hundred and two patients (264 in the LS and 238 in the OS group) were included. The most prevalent sex was male in 53.7%, the most common indication was complicated diverticular disease in 69.9%, and 85% were American Society of Anesthesiologist (ASA) II-III. Intraoperative complications were noted in 5.3% and 3.4% in the LS and OS groups, respectively. Small bowel injuries were the most common intraoperative injury in 8.3%, with a higher incidence in the OS group compared with the LS group (12.2% vs. 4.9%, p < 0.5). Inadvertent injuries were more common in the small bowel (3%) in the LS group. A total of 17.2% in the OS versus 13.3% in the LS group required intensive care unit (ICU) admission (p = 0.2). The most frequent postoperative complication was ileus (12.6% in OS vs. 9.8% in LS group, p = 0.4)). Reintervention was required mainly in the OS group (15.5% vs. 5.3% in LS group, p < 0.5); mortality rate was 1%. Conclusions: Laparoscopic Hartmann's reversal is safe and feasible, associated with superior clinical outcomes compared with open surgery.

Water quality in the Lachuá Ecoregion Landscape: Comparing streams from Forest, Milpa, and an Oil Palm plantation / Calidad del agua en el paisaje de la Ecorregión Lachuá: Comparando arroyos en bosques, milpa y palma africana

The hydrological network in the Lachuá Ecoregion (EL), Alta Verapaz, Guatemala, hosts high levels of biodiversity and supplies water to 44 Mayan communities. Despite this critical fact, this network has been threatened by scarcely monitored industrial activities including the rapidly expanding oil palm monoculture (Elaeis guineensisJacq). Regardless of Lachua's freshwaters importance, there is little information on how this monoculture impacts them. We compared water-quality properties from streams in oil palm plantations (P), paddock and milpa systems (M), and primary forests (F) in the EL. During 2015-2016, 13 rivers were sampled (5 times) for water temperature, pH, dissolved oxygen (DO), conductivity, hardness, chemical and biochemical oxygen demand (COD and BOD), and concentration of silica, nitrates, phosphates, and ammonia. Several parameters showed significant differences. P were 2.7 ºC and 1.8 ºC warmer than M and F and carried 1.4 mg/L more nitrates than F. F carried 10.8 mg/L and 11.8 mg/L more silica than M and P. M showed intermediate temperatures and silica concentrations, as well as 14.8 µS/cm and 8.9 µS/cm lower conductivities than P and F, respectively. Additionally, COD in M was 9.9 mg/L and 4.6 mg/L lower than P and F, respectively. We believe higher temperatures and lower silica in P are due to the loss of riparian forest and their role in buffering temperatures and recycling silicon. In addition, the existence of secondary forest (guamil) in M might explain the intermediate temperatures and silica concentrations. Our results highlight the contributions of forests to waterways and suggest potential water-quality depletion from the oil palm expansion in the EL.

La red hídrica en la Ecorregión Lachuá (EL), Alta Verapaz, Guatemala, alberga una alta biodiversidad y abastece de agua a 44 comunidades mayas. Sin embargo, recientemente se ha visto amenazada por actividades industriales escasamente monitoreadas, incluido el creciente monocultivo de palma africana (Elaeis guineensis Jacq) del cual se desconocen sus impactos en la EL. Este estudio explora la calidad del agua de arroyos en plantaciones de palma africana (P), bosques primarios (B), y sistemas de potrero y milpa (M) en Lachuá. Durante 2015-2016, se tomaron muestras de 13 ríos (5 veces) para medir la temperatura del agua, pH, oxígeno disuelto (OD), conductividad, dureza, demanda química y bioquímica de oxígeno (DQO y DBO) y la concentración de sílice, nitratos, fosfatos, y amoníaco. Varios parámetros mostraron diferencias significativas. P fue 2.7 ºC y 1.8 ºC más calientes que M y F y portó 1.4 mg/L más nitrato que F. F portó 10.8 mg/L y 11.8 mg/L más sílice que M y P. M mostró temperaturas y concentraciones de sílice intermedias y conductividades 14.8 µS/cm y 8.9 µS/cm menores que P y F. La DQO en M fue 9.9 mg/L y 4.6 mg/L menor que P y F. El aumento de temperatura y la disminución de sílice en P podría deberse a la pérdida de bosques ribereños los cuales amortiguan la tempe-ratura y reciclan el silicio. La presencia de bosque secundarios (guamil) en M podría explicar las temperaturas y las concentraciones de sílice intermedias resaltando la importancia de los bosques en la red hídrica. Se predice un posible deterioro en el agua resultado de la expansión de palma africana en la EL.

Synovial sarcoma of the transverse colon metastatic to the chest wall after 3 years of follow-up.

We report a fifth case of a transverse colon primary synovial sarcoma. A 31-year-old man with history of grade I obesity presented to an outpatient clinic reporting 6 months of intermittent colicky abdominal pain associated with haematochezia and rectal bleeding. Colonoscopy reported a partially obstructive intraluminal tumour lesion located in the transverse colon. There was no evidence of metastatic disease in the extension studies, so the patient was admitted to the hospital for a laparoscopic subtotal colectomy. Histopathology demonstrated intermediate-grade synovial sarcoma. At the third year of follow-up, the patient presented metastases on the chest wall, which required extensive resection and complementary oncological management.

Sildenafilo: Prevalencia y factores asociados a su consumo en estudiantes universitarios / Sildenafil: Prevalence and Factors Associated with its Consumption in University Students

Objetivo Determinar la prevalencia y los factores asociados al consumo de sildenafilo en estudiantes universitarios. Métodos Se realizó un estudio observacional analítico, en estudiantes de la Facultad de Ciencias de la Salud de Instituciones de Educación Superior del municipio de Tunja. La variable dependiente fue el consumo de sildenafilo, las variables independientes fueron: edad, semestre, universidad, estrato, procedencia, pareja estable, actividad sexual actual, actividad física, inicio de las relaciones sexuales, uso de métodos de barrera, asesoría en planificación y disfunción eréctil. Resultados La prevalencia de consumo de sildenafilo en universitarios fue del 19,25%. Los factores que aumentan el riesgo de consumo son: tener pareja estable, actividad sexual actual, inicio de relaciones sexuales antes de los 14 años y la presencia de disfunción eréctil; mientras se disminuye dicha probabilidad en: los primeros estratos socioeconómicos, no haber escuchado sobre el medicamento, asesoría del personal de salud, conocer las indicaciones, contraindicaciones, efectividad y reacciones adversas del medicamento. Conclusiones Una quinta parte de los universitarios usan o han usado el sildenafilo. Casi el 80% de ellos han presentado efectos adversos. El consumo frecuente de ese fármaco amerita seguir estudiando esa población universitaria, puesto que no es usual que a esa edad se presente disfunción eréctil, para conllevar a la automedicación del sildenafil por lo tanto, esa conducta debe desencadenar intervenciones desde el área de bienestar universitario, específicamente médica para que se creen estrategias de intervención que apunten a una orientación de sexualidad responsable, y prevenir su uso indiscriminado que puede llevar a riesgos demasiado graves para la salud tanto física como mental.

Objective To determine the prevalence and factors associated with the consumption of sildenafil in university students. Methods An analytical observational study was carried out in students of the Faculty of Health Sciences of Institutions of Higher Education in the municipality of Tunja. The dependent variable was the consumption of sildenafil, the independent variables were: age, semester, university, stratum, provenance, stable partner, current sexual activity, physical activity, initiation of sexual relations, use of barrier methods, planning advice and erectile dysfunction. Results The prevalence of sildenafil consumption in university students was 19.25%. The factors increase the risk of consumption are: having a stable partner, current sexual activity, initiation of sexual relations before the age of 14 and the presence of erectile dysfunction; while this probability is decreased in: the first socioeconomic strata, not having heard about the drug, advice from health personnel, knowing the indications, contraindications, effectiveness and adverse reactions of the drug. Conclusions A fifth of university students use or have used sildenafil. Almost 80% of them have presented adverse effects. Frequent consumption of this drug merits further study in this university population, since it is unusual for erectile dysfunction to occur at this age, leading to self-medication of sildenafil, therefore this behavior should trigger interventions from the university wellness area. , specifically medical, so that intervention strategies are created that aim to give a responsible orientation of sexuality, and prevent its indiscriminate use that can lead to too serious risks for both physical and mental health.

Procalcitonin as an early marker in the detection of anastomotic intestinal leak in a Universitary Hospital of Bogotá / Procalcitonina como um marcador precoce na detecção de vazamento anastomótico intestinal em um Hospital Universitário de Bogotá

ABSTRACT Introduction: Anastomotic leakage is a complication of intestinal anastomosis, with an incidence of 2%-7% in centers of experience. To be able to achieve an early detection, serological markers such as Procalcitonin were included. Methods: Descriptive retrospective cohort study of patients taken to colorectal surgery with intestinal anastomosis, the objective is to estimate association between procalcitonin (≥2 ng/dl) as an early inflammatory marker and anastomotic leakage in a Coloproctological Service of a highest level of health care hospital, between September 2017 and January 2019. Results: Cohort of 237 patients, 51% women (18-89 years), with multiple comorbidities in 81% of patients, colon cancer was the most operated pathology (53.1%). Laparoscopic approach was the most applied 60.34%, colorectal anastomosis was the most frequently performed (47.26%). Ileocolic anastomosis presented a higher frequency (43.75%-n:7) of dehiscence. Anastomotic leakage was associated with a serum procalcitonin positive 3 days postoperatively (p-value <0.05). Patients with a positive result had 4.28 times higher risk of presenting an anastomotic leak, compared to this risk in those patients with negative results 3 days postoperatively, this association was statistically significant 95% CI (1.34-14.16); p value <0.05. Conclusion: Anastomotic leakage is a source of morbidity in patients taken to intestinal anastomosis. It's necessary to guarantee an early diagnosis of this complication, prevent abscesses and secondary peritonitis, providing adequate treatment and even reducing the associated mortality. We recommend including the procalcitonin in the assessment protocol on the third day of postoperative follow-up.

RESUMO Introdução: O vazamento anastomótico é uma complicação da anastomose intestinal, com uma incidência de 2% a 7% em centros com experiência. Para conseguir uma detecção precoce, foram incluídos marcadores sorológicos como a Procalcitonina. Métodos: Estudo de coorte descritivo e retrospectivo de pacientes submetidos à cirurgia colorretal com anastomose intestinal, cujo objetivo é estimar a associação entre os níveis de procalcitonina (≥ 2 ng/dL) como marcador inflamatório precoce e vazamento anastomótico em um Serviço de Coloproctologia de alto nível de atenção à saúde hospitalar, entre setembro de 2017 a janeiro de 2019. Resultados: Coorte de 237 pacientes, 51% mulheres (18−9 anos), com múltiplas comorbidades em 81% dos pacientes, sendo o câncer de cólon a patologia mais operada (53,1%). A abordagem laparoscópica foi a mais utilizada, em 60,34%, e a anastomose colorretal foi a mais frequentemente realizada (47,26%). A anastomose ileocólica apresentou a maior frequência (43,75%, n = 7) de deiscências. O vazamento anastomótico foi associado a procalcitonina sérica positiva 3 dias após a cirurgia (p < 0,05). Pacientes com resultado positivo tinham um risco 4,28 vezes maior de apresentar vazamento anastomótico, em comparação com esse mesmo risco nos pacientes com resultado negativo 3 dias após a cirurgia, sendo essa associação estatisticamente significativa, (IC95%:1,34−14,16); p < 0,05. Conclusão: O vazamento anastomótico é fonte de morbidade em pacientes encaminhados para anastomose intestinal. É necessário garantir o diagnóstico precoce desta complicação, prevenir abscessos e peritonites secundárias, proporcionando tratamento adequado e até mesmo reduzindo a mortalidade associada. Recomendamos incluir a procalcitonina no protocolo de avaliação no terceiro dia de seguimento pós-operatório.

Cáncer colorrectal durante la pandemia COVID-19, recomendaciones de la Asociación Colombiana de Coloproctología / Recommendations of the Colombian Association of Coloproctology for Management of Colorectal Cancer during the COVID-19 Pandemic

Resumen La pandemia por el coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2), (coronavirus disease-19 [COVID-19]), ha alterado por completo toda la realidad mundial con repercusiones económicas, sociales y grandes compromisos de los sistemas de salud. La enfermedad ha afectado a todos los países en los 5 continentes; y en nuestro país, desde el primer caso, se han venido tomando medidas para prepararnos mejor ante esta crisis. Pese a que se trata de un virus respiratorio, se ha documentado su presencia en diferentes tejidos y órganos de los seres humanos. Aunque la presentación clínica en su mayoría tiene síntomas leves, se sabe que un porcentaje importante tiene manifestaciones graves que pueden llevar a complicaciones graves y la muerte. El cáncer colorrectal es un tumor prevalente en nuestra población y obliga a tener una mejor preparación para tratarlo durante este período. Desde la Asociación Colombiana de Coloproctología, basados en los diferentes reportes de la literatura, en las recomendaciones de las diferentes asociaciones internacionales y en nuestra propia experiencia, se realiza una revisión del cáncer colorrectal durante la pandemia de COVID-19 y se comparten algunas recomendaciones para el manejo de los pacientes con esta patología revisando las diferentes opciones de manejo según la presentación de la enfermedad.

Abstract The economic and social repercussions and the enormous commitment required of health care systems by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (coronavirus disease [COVID-19]) has completely altered world reality. The disease has affected all countries on all five continents. In Colombia, from diagnosis of the very first case, measures have been taken to better prepare ourselves for this crisis. Although it is a respiratory virus, its presence in various human tissues and organs has been documented. Despite the fact that its clinical presentation is most often in the form of mild symptoms, a significant percentage of those infected have severe manifestations that can lead to serious complications and death. Colorectal cancer is a prevalent tumor in our population, and this pandemic forces to prepare ourselves better to treat it during this period. The Colombian Coloproctology Association has reviewed reports in the literature and recommendations of various international associations and on our own experience with colorectal cancer during the COVID-19 pandemic. We present our recommendations for management of patients with this pathology and review management options according to disease presentation.

Reconstrucción del nervio alveolar inferior con aloinjerto de nervio acelular humano en resección mandibular / Reconstruction of the inferior alveolar nerve with human acellular nerve allograft in mandibular resection

La reconstrucción de nervios periféricos con aloinjertos nerviosos acelulares humanos en neurocirugía ha sido bastante estudiada estableciendo su predictibilidad y éxito en intervenciones principalmente en los nervios digitales de las manos. En cirugía maxilofacial existe una creciente investigación para poder restaurar el nervio alveolar inferior en cirugías de resección mandibular en donde la extirpación de esta estructura nerviosa es inevitable. El objetivo de esta publicación es mostrar un reporte de un caso en donde se realizó la reconstrucción del nervio alveolar inferior con aloinjerto de nervio acelular humano (Avance® Nerve Graft, Axogen) con microcirugía para poder proveer de sensibilidad a la región de la cara afectada en un paciente reconstruido con un injerto de fíbula microvascularizada posterior a una hemimandibulectomía por ameloblastoma plexiforme.

The reconstruction of peripheral nerves with allografts of human acellular nerves in neurosurgery is well studied, establishing its predictability and success in interventions mainly in the digital nerves of the hands. In maxillofacial surgery there is a growing investigation to be able to restore the inferior alveolar nerve in mandibular resection surgeries where the removal of this nervous structure is inevitable. The objective of this publication is to show a case report in which the reconstruction of the inferior alveolar nerve was performed with human acellular nerve allograft (Avance® Nerve Graft, Axogen) with microsurgery in order to provide sensitivity to the region of the affected face in a reconstructed patient with a microvascularized bone fibula graft after hemimandibulectomy due to plexiform ameloblastoma.

Apendicitis poscolonoscopia: reporte de caso y revisión de la literatura / Post-colonoscopy appendicitis: Case report and literature review

Resumen Presentamos el caso de una paciente de 83 años sin antecedentes de importancia, a quien se le realizó una colonoscopia de tamización 3 h antes del inicio de la sintomatología. La paciente consultó al servicio de urgencias por presentar dolor en la fosa ilíaca derecha de 12 h de evolución. En efecto, durante el examen físico, se encontró un dolor localizado en la fosa ilíaca derecha. Ante la sospecha de una complicación relacionada con la colonoscopia, se ordenó una tomografía de abdomen, la cual mostró signos tomográficos de apendicitis. Se realizó entonces una apendicetomía por laparoscopia, sin complicaciones, pero se evidenció un apéndice cecal perforado.

Abstract We present the case of an 83-year-old patient who had no significant medical history. A screening colonoscopy had been performed three 3 hours before onset of pain in the right iliac fossa. Twelve hours later, the patient to the emergency department. Physicians suspected that the pain was a complication related to colonoscopy and ordered an abdominal CT scan which showed tomographic signs of appendicitis. A laparoscopic appendectomy was performed and removed a perforated cecal appendix without complications.

Tropical freshwater ostracodes as environmental indicators across an altitude gradient in Guatemala and Mexico

Detailed knowledge of species ecological preferences and robust taxonomy of paleobioindicators are prerequisites for accurate paleoclimate and paleoenvironmental studies. This study aims to expand the knowledge of modern, Neotropical freshwater ostracode fauna, across an altitudinal gradient from the karst lakes in the lowlands of El Petén, Guatemala (100-500 m.a.s.l.), to the mid-elevation lakes of the Lacandón forest (500-1 000 m.a.s.l.), to the higher-altitude lakes of Montebello, Chiapas, Mexico (1 000-1 500 m.a.s.l.). Eighteen ostracode species were identified in 24 lakes. Ostracodes were absent in Lakes Amarillo and Lacandón (mid-altitude), and San Diego (lowlands); probably explained by a structural difference of habitats and species interactions. Statistical analysis indicated that the most abundant species, Cypridopsis vidua (O.F. Müller, 1776), Cytheridella ilosvayi (Daday, 1905), Pseudocandona antillana (Broodbakker, 1983), and Darwinula stevensoni (Brady & Robertson, 1870) have a continuous distribution along the entire altitudinal gradient. Some species display more restricted distributions, determined by temperature, precipitation and conductivity. For example, Eucypris sp. is restricted to the lowlands, Vestalenula sp. and Cypria sp. were found only at middle elevations. Species diversity is slightly greater in lakes at middle altitudes (Haverage = 1.09) than in water bodies in the lowlands (Haverage = 0.94) and in cooler lakes in the highlands (Haverage = 0.94), suggesting that mid-elevation lakes have a high potential for harboring microrefugia. Locally weighted scatterplot smoothing (LOESS regressions) provided ecological preference information for the four most frequent and widely distributed species, with respect to temperature, conductivity, bicarbonate (HCO3 -) concentration, precipitation, and pH. Darwinula stevensoni suggest an association more to cooler temperatures and lower conductivities proving its high tolerance range. Cypridopsis vidua is associated with warm and low-rainfall environments, such as recorded in the lowlands of Guatemala, and can be used as a paleobioindicator of vegetated littoral zones, because we found it always associated to this section of lakes. Cytheridella ilosvayi show preferences for warm and humid conditions, whereas P. antillana prefer colder and humid environments. Such quantitative-ecological information will improve ostracode-based paleoenvironmental reconstructions in Southern Mexico and Northern Guatemala. In addition, our approach serves as a model for future paleoecological studies that employ other aquatic bioindicators, such as testate amoebae, cladocerans, and chironomids.

Los ostrácodos son microcrustáceos acuáticos, que poseen un caparazón bivalvo de carbonato de calcio que se puede preservar en los sedimentos de los ambientes lacustres. Debido a su alta sensibilidad a cambios ambientales y su alta potencialidad de fosilización, los ostrácodos son una herramienta útil para el estudio paleoclimático y paleoambiental, abarcando una temporalidad de décadas hasta millones de años. El conocimiento ecológico de las especies, así como su taxonomía son prerrequisitos para estos estudios. Sin embargo, esta información es aún escasa en diferentes regiones del mundo, incluyendo los Neotrópicos. Hasta el momento, se han realizado únicamente estudios en los lagos kársticos de las tierras bajas de la Península de Yucatán, en el norte del Neotrópico. Sin embargo, los lagos en altitudes medias y altas permanecen poco conocidos. El objetivo de este trabajo es aportar conocimiento de ostrácodos no-marinos neotropicales a lo largo de un gradiente altitudinal que va desde las tierras bajas de El Petén, Guatemala (100-500 m s.n.m.), incluyendo los lagos de tierras medias de la Selva Lacandona (500-1 000 m s.n.m.), hasta las tierras altas de Montebello, Chiapas, México (1 000-1 500 m s.n.m.). Dieciocho especies de ostrácodos se identificaron en 24 lagos, pero estuvieron ausentes en los lagos Amarillo y Lacandón (tierras medias) y San Diego (tierras bajas). La ausencia de ostrácodos podría explicarse por la falta de un muestreo estacional o por variables que no se consideraron en este estudio como sustrato, cobertura vegetal acuática e interacciones interespecíficas. Los análisis estadísticos indicaron que las especies más abundantes son: Cypridopsis vidua (O.F. Müller, 1776), Cytheridella ilosvayi (Daday, 1905), Pseudocandona antillana (Broodbakker, 1983) y Darwinula stevensoni (Brady & Robertson, 1870), con una distribución continua a lo largo del gradiente altitudinal. Algunas especies presentan una distribución más restringida, determinada por la temperatura, precipitación y conductividad. Por ejemplo, Eucypris sp. está restringida a las tierras bajas; mientras que Vestalenula sp. y Cypria sp. se encontraron únicamente en elevaciones medias. La diversidad de especies es ligeramente mayor en lagos cálidos a altitudes medias (Haverage = 1.09) que en las tierras bajas (Haverage = 0.94) y que en lagos de agua más fría en las tierras altas (Haverage = 0.94), sugiriendo que los lagos de tierras medias tienen un alto potencial para albergar micro-refugios. Las regresiones LOESS muestran las preferencias ecológicas de las cuatro especies más frecuentes y altamente distribuidas con respecto a la temperatura, conductividad, HCO3 -, precipitación y pH. Darwinula stevensoni se asocia a temperaturas frías y conductividades bajas, lo que evidencia su alto rango de tolerancia. Cypridopsis vidua se asocia con ambientes cálidos y de baja precipitación, como los registrados en las tierras bajas de Guatemala, y puede usarse como paleobioindicador de zonas de vegetación litoral. Cytheridella ilosvayi es un indicador de condiciones cálidas y húmedas, mientras que P. antillana de frías y húmedas. Esta información ecológica-cuantitativa se podrá utilizar como una herramienta para las reconstrucciones paleoambientales basadas en ostrácodos en el sur de México y norte de Guatemala. Además, este enfoque sirve como modelo para futuros estudios paleoecológicos que emplean otros bioindicadores acuáticos, como las amebas testadas, los cladóceros y los quironómidos.

Factores asociados al retiro temprano del jadelle® en un programa de planificación familiar

Introducción: investigación que permitió determinar los factores asociados al retiro temprano de Jadelle® en las usuarias que asisten al programa de planificación familiar en la ESE Santiago de Tunja. La relevancia del estudio radica en la importancia de conocer los motivos y las causas de retiro que los profesionales de la salud deben informar a las usuarias para lograr una mayor comprensión y aceptación de las reacciones adversas, para así evitar el retiro temprano del implante. Métodos: estudio descriptivo, cuantitativo, de corte transversal. La información se recolectó mediante la revisión de historias clínicas de 678 usuarias que se retiraron el Jadelle® entre julio de 2013 y junio de 2017. Resultados: el porcentaje de retiro temprano del implante fue de 36,8%, con mayor número de retiro durante el periodo de uso entre 24 y 30 meses y entre 36 y 42 meses. La principal causa de retiro se asoció con la presencia de alguna reacción adversa por el uso del dispositivo, principalmente la hemorragia uterina disfuncional. Conclusión: es frecuente el uso del Jadelle®, especialmente en mujeres jóvenes, y la tasa de continuidad de este dispositivo se puede aumentar si se detectan y se vigilan los factores asociados al retiro temprano, principalmente las reacciones adversas.

Introduction: This research aimed to determine the factors associated with the early removal of Jadelle® in the users who are part of the family planning program at ESE Santiago of Tunja. This is a relevant study aim to identify the reasons and causes of removal which should be inform by health professionals to women in order to achieve a better understanding and acceptance of adverse effects, avoiding early removal of the implant. Methods: Descriptive, quantitative, cross-sectional study. The information was collected by analyzing medical records of 678 subjects who removed the Jadelle® between July 2013 and June 2017. Results: The percentage of the implant early removal was 36.8%, there was a greater amount of removals during the period between 24 and 30 months and 36 and 42 months of use. The main cause of removal was associated with the presence of an adverse reaction produce by the device, mainly dysfunctional uterine bleeding. Conclusion: The use of Jadelle® is common, especially in young women. The continuity rate of this device can be increased if the factors associated with early removal are detected and monitored, especially adverse reactions.

Introdução. Investigação que permitiu determinar os fatores associados à retirada antecipada do implante Jadelle® nos usuários que frequentam o programa de planejamento familiar na ESE Santiago de Tunja. Estudo importante para conhecer os motivos e as causas de retirada que os profissionais de saúde devem informar aos usuários para melhor compreensão e aceitação das reações adversas, evitando a retirada antecipada do implante. Métodos. Estudo descritivo, quantitativo, transversal. As informações foram coletadas através da revisão de registros médicos de 678 usuários que retiraram o Jadelle® entre julho de 2013 e junho de 2017. Resultados. A percentagem de retirada antecipada do implante foi de 36,8%, com maior número de retiradas no período entre 24 e 30 meses e 36 e 42 meses de uso. A principal causa de retirada foi associada à presença de uma reação adversa devido ao uso do dispositivo, principalmente hemorragia uterina disfuncional. Conclusão. O uso do implante Jadelle® é frequente, principalmente em mulheres jovens; a taxa de continuidade deste dispositivo pode ser aumentada se os fatores associados à retirada antecipada forem detectados e monitorados, especialmente as reações adversas.

Abandono, cambio o falla de los anticonceptivos hormonales en población universitaria / Dropout, change or therapeutic failure to hormonal contraception in university women

Resumen OBJETIVO: Estimar la prevalencia de abandono, cambio o falla de los anticonceptivos hormonales que derivan en embarazos no deseados en mujeres universitarias entre 17 y 30 años. MATERIALES Y MÉTODOS: Estudio observacional y transversal efectuado entre el 1 de agosto y el 30 de noviembre de 2018 en estudiantes de la Facultad de Ciencias de la Salud de la Universidad de Boyacá, usuarias actuales o pasadas de métodos de anticoncepción hormonal. Variables de estudio: datos sociodemográficos, causas de abandono del tratamiento, cambio de método de planificación y falla del anticonceptivo. RESULTADOS: Se recolectaron 615 encuestas, se eliminaron 4 por datos incompletos. El promedio de edad de las estudiantes fue de 20.5 años (DE ± 3.6). El 26.15% recibió asesoría por distintos sujetos y medios diferentes al personal de salud. De las sustancias con interacción con los anticonceptivos hormonales, 25% consumía alcohol. Las principales reacciones adversas fueron: cefalea, aumento de peso y sangrado uterino anormal. Principales motivos de abandono: efectos adversos. El 10.3% de las encuestadas experimentó falla del anticonceptivo. CONCLUSIONES: Si bien el estudio evidencia que la primera causa de abandono fue el cese de la actividad sexual, un alto porcentaje de usuarias tuvo reacciones adversas leves y, de acuerdo con la persona que les suministró la información, se advirtieron dificultades para el apego a los anticonceptivos hormonales.

Abstract OBJECTIVE: The objective of the study was the prevalence of abandonment, change and therapeutic failure, which could trigger unwanted pregnancies in university women between 17 and 30 years of age, who have used hormonal contraceptives as a method of family planning. MATERIALS AND METHODS: An observational, cross-sectional study was carried out during the period between August 1 and November 30, 2018, where students from the faculty of health sciences of the University of Boyacá. The variables studied corresponded to sociodemographic data, causes of treatment abandonment, change of planning method and therapeutic failure. RESULTS: The average age of the population was 20.5 years, evidence of the use of oral contraceptives and 26.15% were advised by personnel other than health. Alcohol was the main substance of consumption that interacts with hormonal contraceptives. The main adverse reactions were headache, weight gain and abnormal uterine bleeding. The main reasons for abandonment are related to the presence of adverse effects. The therapeutic failure was presented in 10.3% of the respondents. CONCLUSIONS: Although the evidence of the first cause of abandonment was the life of sexual life, there is a high percentage of users with adverse reactions and, according to the person who likes the information, it can be noticed that there is difficulty in the attachment to the use of this type of medication.

Iron Overload Exacerbates the Risk of Hemorrhagic Transformation After tPA (Tissue-Type Plasminogen Activator) Administration in Thromboembolic Stroke Mice.

Background and Purpose- Recanalization with tPA (tissue-type plasminogen activator) is the only pharmacological therapy available for patients with ischemic stroke. However, the percentage of patients who may receive this therapy is limited by the risk of hemorrhagic transformation (HT)-the main complication of ischemic stroke. Our aim is to establish whether iron overload affects HT risk, to identify mechanisms that could help to select patients and to prevent this devastating complication. Methods- Mice fed with control or high-iron diet were subjected to thromboembolic stroke, with or without tPA therapy at different times after occlusion. Blood samples were collected for determination of malondialdehyde, matrix metalloproteinases, and fibronectin. Brain samples were collected 24 hours after occlusion to determine brain infarct and edema size, hemorrhage extension, IgG extravasation, and inflammatory and oxidative markers (neutrophil infiltration, 4-hydroxynonenal, and matrix metalloproteinase-9 staining). Results- Despite an increased rate of recanalization, iron-overload mice showed less neuroprotection after tPA administration. Importantly, iron overload exacerbated the risk of HT after early tPA administration, accelerated ischemia-induced serum matrix metalloproteinase-9 increase, and enhanced basal serum lipid peroxidation. High iron increased brain lipid peroxidation at most times and neutrophil infiltration at the latest time studied. Conclusions- Our data showing that iron overload increases the death of the compromised tissues, accelerates the time of tPA-induced reperfusion, and exacerbates the risk of HT may have relevant clinical implications for a safer thrombolysis. Patients with stroke with iron overload might be at high risk of HT after fibrinolysis, and, therefore, clinical studies must be performed to confirm our results.

Relación entre áreas y variables ambientales espaciales con el atropellamiento y cruce de la fauna silvestre en la carretera de la Franja Transversal del Norte, Cobán, Guatemala / Areas and spatial environmental variables related with the trampling and wildlife crossing in the Northern Transversal Road in Coban, Guatemala

Dentro del Proyecto vial de la Franja Transversal del Norte en Cobán se planea asfaltar 10 km del trayecto en el Parque Nacional Laguna Lachuá. Esto impactará a la fauna de no considerarse medidas de mitigación del atropellamiento. La investigación evaluó los patrones espaciales del atropellamiento de vertebrados, la frecuencia de cruce de aves y categorizó las secciones de la carretera en dicho trayecto, según variables ambientales (humedales, usos del suelo, cobertura; y ancho, asfaltado y ubicación de la carretera) con el fin de determinar los sitios más eficientes para la aplicación de medidas de mitigación. En el 2016, se realizaron 20 recorridos, donde se georreferenció, fotografió e identificó a los individuos atropellados; tres recorridos en los meses de febrero, marzo y abril, cinco en mayo y seis en junio; 12 recorridos fueron realizados adicionalmente cuantificando el cruce de aves para determinar que sitios podrían ser futuramente impactados. Finalmente, para un análisis más completo, el trayecto de la carretera bajo estudio fue dividido en 19 secciones (T1-T19) de 550 m cada uno. Fueron empleadas: estadística descriptiva, análisis de componentes principales (ACP), correspondencia canónica (CCA) y análisis de correspondencia (AC), para relacionar variables ambientales con atropellamiento y frecuencia de cruce. La mayoría de atropellamientos (80 %) ocurrieron en zonas asfaltadas, los anfibios fueron los más atropellados (125 individuos, 75 %), seguido por reptiles 21 (12 %), mamíferos 11 (7 %) y aves 10 (6 %). La mayor frecuencia de cruce ocurrió en zonas con humedales y alta cobertura boscosa (T1, T3, T6, T7 y T10) siendo estas secciones prioritarias para mitigación.

The Franja Transversal del Norte road project in the Coban Province plans to pave a 10 km long dirt road inside the Laguna Lachua National Park. This will impact the fauna if no mitigation measure for wildlife-vehicle collision is considered. The research evaluated the spatial patterns of the vertebrate´s roadkills, the bird's road-crossing frequency, and categorized the road section based on environmental variables (wetlands, land use, coverture; and road's width, location, and paved or not paved) to determine the most efficient sites for the application of mitigation measures. In 2016, 20 treks were made to detect, geo-reference, photograph and identify road killed individuals, three treks in the months of February, March, and April, five in May and six in June; 12 additional treks were made to quantify birds' road-crossing to determine the sites that could be impacted in the future. Finally, for a further analysis, the road section under study was divided into 19 segments (T1-T19), 550 m long each. A combination of descriptive statistics, principal component analysis (PCA), canonical correspondence analysis (CCA) and correspondence analysis (CA) were employed to relate the spatial environmental variables with roadkill and road-crossing frequency. Eighty percent of the roadkill's occurred in the paved zones, the amphibians were the most affected (125 carcasses, 75 %), followed by reptiles 21 (12 %), mammals 11 (7 %) and birds 10 (6 %). The highest road-crossing frequencies were related to wetlands and high forest cover (T1, T3, T6, T7, T10) being priority areas for the application of mitigation measures.

Microglial HO-1 induction by curcumin provides antioxidant, antineuroinflammatory, and glioprotective effects.

SCOPE: We have studied if curcumin can protect glial cells under an oxidative stress and inflammatory environment, which is known to be deleterious in neurodegeneration. METHODS AND RESULTS: Primary rat glial cultures exposed to the combination of an oxidative (rotenone/oligomycin A) and a proinflammatory LPS stimuli reduced by 50% glial viability. Under these experimental conditions, curcumin afforded significant glial protection and reduction of reactive oxygen species; these effects were blocked by the HO-1 inhibitor tin protoporphyrin-IX (SnPP). These findings correlate with the observation that curcumin induced the antioxidative protein HO-1. Most interesting was the observation that the glial protective effects related to HO-1 induction were microglial specific as shown in glial cultures from LysM(Cre) Hmox(∆/∆) mice where curcumin lost its protective effect. Under LPS conditions, curcumin reduced the microglial proinflammatory markers iNOS and tumor necrosis factor, but increased the anti-inflammatory cytokine IL4. Analysis of the microglial phenotype showed that curcumin favored a ramified morphology toward a microglial alternative activated state against LPS insult also by a HO-1-dependent mechanism. CONCLUSION: The curry constituent curcumin protects glial cells and promotes a microglial anti-inflammatory phenotype by a mechanism that implicates HO-1 induction; these effects may have impact on brain protection under oxidative and inflammatory conditions.

Episodios de ansiedad y depresión enuniversitarias de Tunja (Colombia): probable asociación con uso de anticoncepción hormonal. 2012 / Episodes of anxiety and depression in female university students in Tunja (Colombia): possible association with use of hormonal contraception. 2012

Objetivo: identificar la posible asociación entre el uso de anticonceptivos hormonales (orales, inyectables e implantes sub-dérmicos), y la ocurrencia de episodios de ansiedad y depresión en estudiantes universitarias de Tunja (Colombia), ajustado por otros factores identificados con la depresión y la ansiedad en la literatura científica.Métodos: estudio de prevalencia, observacional, con diseño de Corte Transversal, Analítico. La población: mujeres estudiantes del área de la salud, de dos universidades localizadas en Tunja; de ellas se extrajo mediante muestreo secuencial no probabilístico, una muestra de 538 mujeres, a quienes previo consentimiento informado se aplicó la Escala de Ansiedad de Hamilton y la escala de Depresión de Beck. El análisis se adelantó con el programa Epi-Info 2004.Resultados: la prevalencia global de depresión fue de 18,95% y la de manifestaciones de ansiedad de 52,04%. Se encontró asociación estadísticamente significativa entre el uso de métodos hormonales y depresión: OR= 3,31 (IC95%: 1,03-5,40; p= 0.0001). La estimación de probable asociación entre uso de métodos hormonales y ansiedad, también registró una asociación estadísticamente significativa, aunquemenos sólida: OR= 1,46 (IC95% 1,03-2,05; p> 0,018). Se encontró tambiénasociación entre las manifestaciones de depresión y edad (superior a los 20 años).Conclusiones: los hallazgos reportados muestran asociación positiva entre la anticoncepción hormonal, la depresión y la ansiedad, que sugiere la necesidad que los proveedores de salud consideren el estado mental de las jóvenes universitarias al momento de prescribir el uso de preparados hormonales, como método de anticoncepción.

Influence of acidic fibroblast growth factor on bone regeneration in experimental cranial defects using spongostan and Bio-Oss as protein carriers.

The objective of this study was to valuate 2 substances as potential carriers of fibroblast growth factor 1 (FGF-1) in a rat craniectomy model: gelatin sponge (Spongostan; Ferrosan A/S, Søborg, Denmark) and natural bone mineral (Bio-Oss; Geistlich Biomaterials, Wolhusen, Switzerland).Forty-eight adult male Sprague-Dawley rats were used. A 5-mm-diameter circular craniectomy was performed in the left parietal bone. Animals were divided into 6 experimental groups of 8 rats, each group receiving a different treatment: control (no substance added), Spongostan, Bio-Oss, FGF, FGF + Spongostan, and FGF + Bio-Oss. Animals were killed 12 weeks after surgery.Descriptive histology and stereology were used, the latter to measure the volumes of regenerated bone and Bio-Oss remaining in the defect. Analysis of variance was used to determine differences in bone regeneration between groups, and Mann-Whitney U test was used to compare the volume of remaining Bio-Oss particles.Histologically, the control defects behaved like critical size defects, showing incomplete bone regeneration. Only the FGF + Spongostan group achieved nearly complete bone regeneration. Bio-Oss particles seemed to reduce centripetal bone regeneration. Spongostan by itself did not interfere with spontaneous bone healing.Stereologic measurements of the volume of new bone growth, measured in cubic millimeter, were as follows: control group, 3.86 ± 1.03; Bio-Oss, 2.26 ± 1.06; Spongostan, 3.00 ± 0.81; FGF, 3.99 ± 1.85; FGF + Bio-Oss, 3.02 ± 1.88; and FGF + Spongostan, 8.93 ± 1.28. Analysis of variance showed a statistically significant difference between the FGF + Spongostan group and the other groups (P < 0.001). Comparison among the other groups did not show significant differences.Fibroblast growth factor 1 with a Spongostan carrier has shown great efficacy for bone regeneration in cranial critical size defects in rats. Bio-Oss did not produce a regenerative effect, either alone or with FGF-1.