Influenza needs an approach as a "one health" problem in Colombia / Influenza requiere un manejo bajo la perspectiva de "una salud" en colombia

RESUMEN La influenza es una infección viral de importancia y distribución mundial, cuyo agente causal es el Alfainfluenzavirus o influenza virus tipo A (IAV), el cual se caracteriza por poseer un genoma de tipo ssRNA segmentado, aspecto que le confiere una alta variabilidad y capacidad recombinante. Esto, sumado al amplio rango de huéspedes susceptibles y la posibilidad de transmisión entre especies, se constituye en un reto tanto para la salud humana como para la animal. El IAV es capaz de infectar una amplia variedad de huéspedes, incluyendo múltiples especies de aves y mamíferos, tanto domésticas como salvajes y al humano, así como a reptiles y anfibios, entre otros. Dentro de los Alphainfluenzavirus se reconocen 16 subtipos de Hemaglutinina (HA) y nueve de Neuraminidasa (NA), siendo su principal reservorio las aves silvestres acuáticas. Adicionalmente, se han reconocido dos nuevos subtipos en murciélagos (H17-18 y N10-11), los cuales se han denominado Influenza-like virus. Teniendo en cuenta lo anterior y conocedores de la riqueza en biodiversidad que posee Colombia, país en el que está demostrada la circulación del virus en cerdos y en humanos y hay resultados preliminares de la presencia de Orthomyxovirus en murciélagos, es imperativo estudiar y conocer los IAV circulantes en el medio, establecer factores de riesgo y analizar el efecto que han tenido y seguirán teniendo las condiciones asociadas al cambio climático, los factores sociodemográficos y el papel de diferentes especies en la ecología de este agente viral. Todo lo anterior bajo el contexto de "Una Salud" en la infección por IAV.

ABSTRACT Influenza is an important viral disease of worldwide distribution. It is caused by the Alfainfluenzavirus or influenza virus type A (IAV). A segmented ssRNA genome in the influenza viruses confers high variability and reassortment capability to the virus. That and the broad range of susceptible hosts, along with the possibility of inter-species transmission, represents a challenge to human and animal health. The IAV is able to infect a large variety of hosts such as several wild and domestic avian and mammalian species, including humans, as well as reptiles and amphibians, among others. There are 16 hemagglutinin (HA) and nine neuraminidase (NA) subtypes recognized until know, whose main reservoir are the wild aquatic birds. In addition, two new subtypes (H17-18 and N10-11) have been recognized in bats, and these have been designated as influenza-like viruses. Taking this into account and knowing the richness of biodiversity in Colombia, there is an imperative need to study and to know about the IAV circulating in the field in order to establish risk factors and to analyze the past, the current and the future effect that climate change, sociodemographic factors and the role that different species could play in the eco-biology of this viral agent. This should be considered under the one health concept of influenza virus infection as a whole, considering the fact that Colombia is a country in which the circulation of IAV has been demonstrated in the swine and human population and there are preliminary results of the presence of Orthomyxovirus in bats.

Prevalence of Post-traumatic Stress Disorder and Depression After the September 19th, 2017 Earthquake in Mexico.

BACKGROUND AND AIM: Natural disasters cause mental disorders, the most frequent are Post-traumatic stress disorder (PTSD) and depression, which should be quickly identified for immediate psychological care. The aim of this study was to estimate the frequency of these disturbances in a population with social security, located in the states hit by the earthquake that took place on September 19th, 2017 in Mexico. METHODS: To identify persons with PTSD and depression, a random sample of the population was screened (1-2 months' post-earthquake) in primary health care clinics at the Mexican Institute of Social Security (IMSS). A questionnaire for the detection of mental conditions (The Screening Questionnaire for Disaster Mental Health, SQD) was used to select people for group therapy and/or psychotherapeutic support, when identified with severe PTSD and high risk of depression. RESULTS: Over 44,855 persons (67.9% females, 32.1% males), residents of Mexico City, the State of Mexico, Puebla, Morelos were surveyed. The prevalence of severe PTSD was 11.9% and depression 9.2%. The highest prevalence of PTSD was observed in Mexico City (12.8%) the state with more material damage. Women were at higher risk for PTSD (OR, 2.08; 95% CI 1.97-2.19, p = 0.000) and depression (OR, 1.86; 95% CI 1.72-2.01, p = 0.000). CONCLUSIONS: The prevalence of PTSD and depression was higher in those states with severe damage caused by the earthquake; women were more susceptible to mental disorders.

Dosimetric evaluation of radionuclides for VCAM-1-targeted radionuclide therapy of early brain metastases.

Brain metastases develop frequently in patients with breast cancer, and present a pressing therapeutic challenge. Expression of vascular cell adhesion molecule 1 (VCAM-1) is upregulated on brain endothelial cells during the early stages of metastasis and provides a target for the detection and treatment of early brain metastases. The aim of this study was to use a model of early brain metastasis to evaluate the efficacy of α-emitting radionuclides, 149Tb, 211At, 212Pb, 213Bi and 225Ac; ß-emitting radionuclides, 90Y, 161Tb and 177Lu; and Auger electron (AE)-emitters 67Ga, 89Zr, 111In and 124I, for targeted radionuclide therapy (TRT). METHODS: Histologic sections and two photon microscopy of mouse brain parenchyma were used to inform a cylindrical vessel geometry using the Geant4 general purpose Monte Carlo (MC) toolkit with the Geant4-DNA low energy physics models. Energy deposition was evaluated as a radial function and the resulting phase spaces were superimposed on a DNA model to estimate double-strand break (DSB) yields for representative ß- and α-emitters, 177Lu and 212Pb. Relative biological effectiveness (RBE) values were determined by only evaluating DNA damage due to physical interactions. RESULTS: 177Lu produced 2.69 ± 0.08 DSB per GbpGy, without significant variation from the lumen of the vessel to a radius of 100 µm. The DSB yield of 212Pb included two local maxima produced by the 6.1 MeV and 8.8 MeV α-emissions from decay products, 212Bi and 212Po, with yields of 7.64 ± 0.12 and 9.15 ± 0.24 per GbpGy, respectively. Given its higher DSB yield 212Pb may be more effective for short range targeting of early micrometastatic lesions than 177Lu. CONCLUSION: MC simulation of a model of early brain metastases provides invaluable insight into the potential efficacy of α-, ß- and AE-emitting radionuclides for TRT. 212Pb, which has the attributes of a theranostic radionuclide since it can be used for SPECT imaging, showed a favorable dose profile and RBE.

Uptake route and resulting toxicity of silver nanoparticles in Eisenia fetida earthworm exposed through Standard OECD Tests.

Despite the increasing interest in silver nanoparticles toxicity still few works dealt with the hazards of nanosized Ag in soils (either dissolved in pore water or coupled to colloids) although disposal of biosolids in landfills has been reported as the major source of silver nanoparticles in terrestrial environments. Presently, Eisenia fetida was used to assess the toxicity of 5 nm sized PVP-PEI coated silver nanoparticles in soil through the implementation of different exposure media Standard Toxicity Tests (Paper Contact and Artificial Soil -OECD-207- and Reproduction -OECD-222- Tests) together with cellular biomarkers measured in extruded coelomocytes. In order to decipher the mode of action of silver nanoparticles in soil and the uptake routes in earthworms, special attention was given to the Ag accumulation and distribution in tissues. High Ag accumulation rates, weight loss, and mortality due to the disruption of the tegument could be the result of a dermal absorption of Ag ions released from silver nanoparticles (Paper Contact Test). However, autometallography showed metals mainly localized in the digestive tract after Artificial Soil Test, suggesting that Ag uptake occurred mostly through soil ingestion. That is, silver nanoparticles attached to soil colloids seemed to be internalized in earthworms after ingestion of soil and transferred to the digestive gut epithelium where at high doses they have triggered severe effects at different levels of biological complexity.

Stakeholder participation within the public environmental system in Chile: major gaps between theory and practice.

The main objective of this paper is to present a critical analysis of the stakeholder participation process within the Environmental Impact Assessment System in Chile, after ca. 14 years of being enforced. This analysis is sustained by the description and analysis of the stakeholder participation possibilities in a representative rural area of North-Central Chile. The Environmental Basis Act 19300, enacted in 1994, considers the participation of the local community in the environmental impact assessment of new projects. However, this possibility is very limited and difficult to exert, often resulting in frustration for the participants. This is due to a number of reasons, such as the imbalance of resources and knowledge among the majority of participating communities and project proponents, the complexity and administrative and legal constraints to participation, and the dominant interest of the Central Government in approving investments, specifically in energy and natural resources related projects, which generate wealth and jobs. Also, the State's rush to develop Internet-based communication and management systems has built a barrier for poor, traditional communities. This factor is clearly reflected in the case study considered. Results show that there is generally a significant lack of knowledge about institutions and participation tools. From this base, we intend to raise concern on these selected aspects that could be addressed to improve the effectiveness of the existing framework, both in Chile and in other developing countries, where immature environmental impact assessment and public management systems face similar pressures in relation to the sustainable use of their natural resources. Finally, some basic steps are proposed in order to make the community participation an effective tool for sustainable development.

Vertebral osteomyelitis: long-term disability assessment and prognostic factors.

In the present study, we quantified the long-term sequelae of a series of patients diagnosed with vertebral osteomyelitis during the period 1990-2002 in Albacete (Spain), using two validated questionnaires of spinal dysfunction and also one pain and one global health assessment. It was possible to interview 69 (78%) patients diagnosed with vertebral osteomyelitis, and an additional 90 "normal" people were recruited as controls to establish normal values. We also carried out a multivariate analysis to identify independent risk factors. We found only a 33% rate of spinal disability, only 3% severe, assessed by the Oswestry and HAQ for ankylosing spondylitis questionnaires, a median of 5.4 years after treatment. Pain and global health assessment did not correlate with spinal function questionnaires. Independent predictors of long-term disability were the followings: neurological impairment at the time of diagnosis (RR=7.1, 95% CI 1.3-10.2), time to diagnosis > or = 8 weeks (RR=4.4, 95% CI 1.5-7.9) and debilitating disease (RR=3.9, 95% CI 1.2-7.5). Standardized spinal function questionnaires are useful measures to assess long-term outcome of vertebral osteomyelitis that facilitates comparison between case series and identification of risk factors.

Principales motivos de consulta en niños de 0 a6 años del área del Rincón de Salas y Puente de Piedra de Grecia en el año del 2003 / Main reasons for consultation in children of 0 to 6 years of the area of the Rincón de Salas and Puente de Piedra of Grecia in 2003

Objetivo: En el año 2003 en el periodo de enero a diciembre, en el EBAIS (Equipo Básico de Atención Integral de Salud) de Puente de Piedra y Rincón de Salas de Grecia, las IVRS (Infecciones Vías Respiratorias Superiores) de origen viral fueron la primera causa de consulta. La mayoría de estas infecciones son causadas por virus y los niños pueden mejorar sin necesidad de utilizar los servicios médicos. Los padres de familia tienen conceptos erróneos acerca de sus causas, factores de riesgo y tratamiento, lo cual produce consultas médicas inncesarias. El objetivo de este estudio es determinar los principales motivos de consulta en niños de 0-6 años y conocer los conceptos que tienen los padres de familia acerca la IVRS. Metodología: Se trata de un estudio de tipo descriptivo donde se evaluaron los conocimientos de los padrs de familia acerca de las IVRS de origen viral. Se determinaron además los principales motivos de consulta de niños de 0-6 años y los factores que inciden en el aumento de la frecuencia de estas enfermedades. En el área de atracción de los EBAIS de Puente Piedra y Rincón de Salas habitan aproximadamente 391 niños entre los 0-6 años. Se seleccionó una muestra significativa aleatorizada de aproximadamente el 40 por ciento de esta población correspondiente a 170 niños. Sus familias contestaron en forma individualizada un cuestionario cuyos resultados fueron posteriormente analizadas con el programa informático Epi-Info 6. Resultados: De los 170 pacientes del estudio, 93 eran niños y 77 niñas, cuyas edades oscilaron entre el mes de nacido hasta los seis años de edad. La nacionalidad de la mayoría de los niños es costarricense y el 8.2 por ciento nicaragüense. Consultaron en 461 ocasiones al EBAIS. El primer motivo de consulta fue la gripe con 186 consultas, faringitis estreptocococcica en segundo lugar con 88 visitas y en tercer lugar el asma con 61. Los padres de familia afirman que las cuasas de la gripe son el clima (109), los virus (91) y las bacterias (25). El 78 por ciento consideraron necesario siempre o a veces el uso de los antibióticos para el tratamiento de la gripe. El 50 por ciento afirmó que las infecciones virales deben tratarse con antibióticos. Conclusiones: Los principales motivos de consulta fueron la gripe, la faringitis y el asma. Además el estudio reveló que los padres de familia conocen acerca de las causas de la gripe; sin embargo, tienen una idea equivocada sobre su tratamiento...