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The objective of this study was to assess the impact of COVID-19 pandemic worries (e.g., fear of contagion) and previous exposure to natural disasters (e.g., hurricanes) on Healthcare Workers (HCWs) mental health in Puerto Rico. Participants completed a self-administered online survey including items on sociodemographic information, working conditions, fears, and worries about the COVID-19 pandemic, past natural disaster experiences, depressive symptoms, and resilience. Logistic regressions models were performed to explain the relationship between depressive symptomatology and COVID-19 experiences and worries. 40.9% (n = 107) of the sample were classified as having some level (mild to severe) of depressive symptomatology (PHQ-8 ≥5). Results reflect normal to high levels of psychological resilience (BRS; M = 3.7, SD = 0.7). A significant association was found between depressive symptomatology and psychological resilience (OR = 0.44, 95% CI: 0.25-0.77). The odds of having depressive symptomatology were almost five times higher (OR = 4.79, 95% CI: 1.71-13.44) among those who reported emotional coping difficulties during the pandemic after experiencing a natural disaster compared to those that did not, when adjusting for psychological resilience and residence region. Despite normal to high psychological resilience levels, HCWs who reported emotional coping difficulties due to previous disasters were at risk of developing depressive symptomatology. Results suggest interventions to address the mental health of HCWs could benefit from considering other individual and environmental factors beyond resilience. Findings could inform future interventions to promote HCWs' well-being before, during, and after a natural disaster or pandemic outbreak.
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DNA barcode datasets are a useful tool for conservation and aid in taxonomic identification, particularly in megadiverse tropical countries seeking to document and describe its biota, which is dropping at an alarming rate during recent decades. Here we report the barcodes for several low elevation bird species from northern Colombia with the goal to provide tools for species identification in this region of South America. We blood-sampled birds in a lowland tropical forest with various degrees of intervention using standard 3 × 12 m mist-nets. We extracted DNA and sequenced the COI barcode gene using standard primers and laboratory methods. We obtained 26 COI sequences from 18 species, 10 families and three orders and found that barcodes largely matched (but not always) phenotypic identification (> 90%) and they also facilitated the identification of several challenging passerine species. Despite our reduced sampling, our study represents the first attempt to document COI barcodes for birds (from blood samples) in this part of Colombia, which fills a considerable gap of sampling in this part of South America.
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Introducción. La tomografía corporal (TC) total en la evaluación de pacientes con trauma grave, puede ser una herramienta eficaz y segura para decidir entre un tratamiento quirúrgico y uno no quirúrgico, pero aún no son claras las implicaciones diagnósticas y los riesgos asociados con esta técnica.Métodos. Se incluyeron pacientes mayores de 15 años con trauma grave que fueron sometidos a TC total. Se evaluaron la seguridad, la efectividad y la eficiencia por medio de los parámetros de incidencia de nefropatía inducida por los medios de contraste, dosis total de radiación por paciente, proporción de casos en los que la TC total cambió el manejo, y el retraso en el diagnóstico. Resultados. Se incluyeron 263 pacientes, 83 % sufrieron trauma cerrado y 17 % sufrieron trauma penetrante. La gravedad de la lesión fue mayor en estos últimos y, sin embargo, el trauma cerrado con inestabilidad hemodinámica se presentó con mayores grados de choque. El 65 % de los pacientes recibió tratamiento selectivo no operatorio. Entre los subgrupos, no hubo diferencias significativas en el tiempo entre el ingreso a la sala de urgencias y la toma de la TC total (p=0,96) y, en la mayoría de los casos, el tiempo entre la práctica de la TC total y el diagnóstico de presencia o ausencia de heridas fue menor de 25 minutos. La mediana de radiación total estuvo por debajo de 20 mSv en todos los grupos. No hubo diferencias significativas en la mortalidad (p=0,17). Conclusión. La TC total es una herramienta segura y eficiente para decidir entre un tratamiento quirúrgico y uno no quirúrgico en los casos de trauma grave, independientemente del mecanismo de la lesión o la estabilidad hemodinámica al ingreso
Introduction: Total body tomography (CT) in the evaluation of patients with severe trauma may be an effective and safe tool to decide between a surgical or non-operative management, but the diagnostic implications and risks associated with this technique are still unclear.Methods: Patients older than 15 years with severe trauma who underwent total CT were included. Safety, effectiveness and efficiency were evaluated through the parameters of incidence of contrast-induced nephropathy, total radiation dose per patient, proportion of cases in which the total CT changed the management, and the delay in the diagnosis.Results: 263 patients were included, 83% presented with blunt trauma and 17% with penetrating trauma. The severity of the injury was higher in the latter, however, the blunt trauma with hemodynamic instability presented with higher degrees of shock. Non-operative management was selected in 65% of patients. Among the subgroups, there was no significant difference in the time between admission to the emergency room and taking the total CT (p=0.96), and in most cases, the time between the total CT and the diagnosis of presence or absence of injury was less than 25 minutes. The median total radiation was below than 20 mSv in all groups. There were no significant difference in mortality (p=0.170. Conclusion: Total CT is a safe and efficient tool to decide between a surgical and a non-operative management in patients with severe trauma, regardless of the mechanism of injury or hemodynamic stability at admission
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Humanos , Heridas y Lesiones , Tomografía , Diagnóstico , Tratamiento ConservadorRESUMEN
SUMMARY The genus Brucella is a globally distributed intracellular pathogen that affects animals and humans and presents low genetic variability, which is a challenge for its phylogenetic reconstruction. Genus differentiation originally occurred due to its preference for a certain host and analyses throughout the years to classify the genus Brucella and its strains, depended on the techniques used, the number of strains or the methods of phylogenetic reconstruction. Its history goes from recognizing the entire genus as unique B. mellitensis species with multiple varieties, to recognizing more than ten species. This review shows the journey through the techniques that have been used to differentiate the genus Brucella, which, although they have generated clarity in the grouping of some species, still leaves doubts in related to the oldest species, their divergence and the type of grouping of the new species discovered. The application of new technologies such as phylogenomics is contributing to solve these questions.
RESUMEN Las especies del género Brucella son patógenos de distribución mundial que afecta, tanto a los animales como al hombre, los cuales, presentan baja variabilidad genética, convirtiéndolo en un reto para su reconstrucción filogenética y diferenciación. La diferenciación originalmente se dio, debido a su preferencia por cierto hospedero. A través de los años, se han realizado diferentes análisis para clasificar el género Brucella y las variaciones que presenta, que dependen de las técnicas empleadas para su clasificación, las especies, el número de cepas o los métodos de reconstrucción filogenética. La historia pasa desde reconocer a todo el género como una única especie B. mellitensis con múltiples variedades, a reconocer más de diez especies. En esta revisión, se hace una travesía, a través de las diferentes técnicas que se han utilizado en el tiempo, para clasificar el género Brucella que, aunque han generado claridad en el agrupamiento de algunas especies, aun dejan dudas en relación a las especies más antiguas, su divergencia y el tipo de agrupación de las nuevas especies descubiertas. La aplicación de nuevas tecnologías, como la filogenómica, está contribuyendo a resolver estos interrogantes.
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Background: recently, isolates of Brucella canis (B. canis ) were classified into two groups, Group 1 and Group 2, based on a 794 bp deletion in the polysaccharide deacetylase gene in Group 1, or absence of this deletion in Group 2. In Colombia, B. canis was first isolated from sick or clinically healthy seropositive dogs in 2005. Objective: to determine Brucella canis genotype in isolates from Medellín Metropolitan Area. Methods: 49 isolates from a study involving 193 dogs in 10 kennels were analyzed by Polymerase Chain Reaction (PCR) using three primer pairs of eight previously reported. Results: all isolates were positive for 152, 272, and 794 bp fragments, indicating that they belong to Group 2. Conclusion: this article presents strong evidence based on the new molecular marker used to classify B. canis isolates from Medellín (Colombia) into Group 2. This is a pioneer molecular study on the presence of B. canis in Colombia and it would be interesting to apply this method to characterize the infection epidemiology and explore its domestic clinical dynamics.
Antecedentes: recientemente, las cepas de Brucella canis (B. canis ) fueron clasificadas dentro de dos grupos, Grupo 1 y Grupo 2, de acuerdo a la presencia o ausencia de una deleción de 794 bp en el gen de la polisacárido deacetilasa, respectivamente. En Colombia Brucella canis se aisló por primera vez en 2005 de perros seropositivos, enfermos o clínicamente sanos. Objetivo: determinar el genotipo de aislamientos de Brucella canis provenientes del Area Metropolitana de Medellín. Método: 49 aislamientos de un estudio con 193 perros en 10 criaderos fueron sometidos a tres Reacciones en Cadena de la Polimerasa (PCR) simple, empleando 3 pares de cebadores de 8 previamente reportados. Resultados: todos los aislamientos amplificaron los fragmentos de 152, 272 y 794 bp, indicando que pertenecen al Grupo 2. Conclusiones: este artículo presenta evidencia sólida para clasificar las cepas de Brucella canis aisladas en Medellín (Colombia) en el Grupo 2, basado en el uso del nuevo marcador molecular. Este es un estudio molecular pionero de B. canis en Colombia y sería interesante aplicar este método para caracterizar la dinámica epidemiológica y clínica de la infección en el país.
Antecedentes: atualmente, as cepas de Brucella canis foram classificadas em dois grupos, chamados de grupo 1 e 2, de acordo com a presença de uma deleção de 794 pb em seu genoma. No ano 2005, isolaram-se a Brucella canis pela primeira vez na Colômbia, obtida de cães doentes e soropositivos. Neste artigo descrevem-se a classificação de cepas de B. canis isolados em Medellín (Colômbia), de acordo com a nova norma. Objetivo: determinar o genotipo de isolamentos de Brucella canis a partir de amostras da Área Metropolitana de Medellín. Métodos: neste estudo utilizaram-se 49 isolamentos obtidos de 193 cães de 10 criadouros diferentes, os quais foram submetidos para três analises de Reação em Cadeia da Polimerase PCR simples com a utilização de três pares primers dos anteriormente informados. Resultados: todos os isolamentos analisados amplificaram fragmentos de 152, 272 e 749 pb, comprovando que pertencem ao grupo 2. Conclusões: este artigo apresenta evidencia solida para clasificar as cepas de Brucella canis isoladas em Medellín (Colombia) no grupo 2, baseados no uso do novo marcador molecular. Seria de grande importância que os estudos de epidemiologia molecular ampliarem-se para outras áreas de pesquisa na Colômbia, com a finalidade de seguir os patrões das infecções e fazer as correlações clinicas.
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Entre los agentes contagiosos que inducen mastitis severas en la vaca, se encuentra el Staphylococcus aureus (S. aureus), de difícil cura bacteriológica y alta resistencia antimicrobiana. Debido a que el cultivo microbiológico de las muestras clínicas, solo ofrece resultado en un 50% de los casos (1) el diagnóstico por PCR es una alternativa. El objetivo de este estudio fue probar si los cebadores descritos por Cremonesi et al. (2) para el diagnóstico de S. aureus, como de buena sensibilidad y especificidad, sirven para ser usados en muestras clínicas. Los resultados demostraron que las siguientes secuencias de nucleótidos como cebadores: F 5' AGC TGT GGA TTG TCC TTT GG 3' y R 5' TCG CTC GCT CAC CTT AGA A 3', para obtener un amplificado de 499 pb no sirven en muestras clínicas por su baja especificidad (62,95%). Se requiere buscar nuevos cebadores que amplifiquen regiones del S. aureus que no se compartan con otras bacterias, en especial aquellas que producen mastitis en vacas productoras de leche.
Staphylococcus aureus (S. aureus) is one of the infectious agents that induce severe mastitis in cows with a difficult bacteriological cure and high antimicrobial resistance. Because the microbiological culture of clinical samples only shows results in 50% of the cases (Koskinen et al., 2009), diagnostic through PCR is an alternative. The aim of this study was to prove if the primers described by Cremonesi et al. (2006) for the S. aureus diagnosis, with good sensitivity and specificity, could be used in clinical samples too. The results showed that the following nucleotide sequences can be used as primers: F 5' AGC TGT GGA TTG TCC TTT GG 3' and R 5' TCG CTC GCT CAC CTT AGA A 3' in order to obtain a 499 pb enlargemenr are not useful in clinical samples due their low specificity (62.95%). It is required to search new primers to amplify S. aureus regions not shared with other bacteria, especially those cauding mastitis in dairy cows.
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El hidradenoma papilífero es una neoplasia benigna, quística y papilar, poco frecuente que por lo general aparece en la vulva, aunque también se ha descrito en otras zonas. Presentamos el caso de una mujer de 74 años con uno localizado en región perianal, cuyo diagnóstico clínico inicial fue sarcoma de Kaposi. El interés de este informe radica en recalcar que esta afección puede aparecer en una zona diferente a la vulva, para evitar diagnósticos erróneos...
Papillary hidradenoma is a rare benign neoplasm characterized by the presence of cystic and papillary structures that usually occurs on the vulva but has also been described in other locations. We report the case of a 74 year-old woman with a perianal papillary hidradenoma. An initial diagnosis of Kaposi´s sarcoma was made. In order to prevent mistaken diagnoses, this report aims to emphasize this lesion is not limited to the vulva and may appear in other locations...
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Humanos , Femenino , Anciano , Adenomas Tubulares de las Glándulas Sudoríparas , Acrospiroma , Neoplasias , Glándulas Perianales , Perineo , VulvaRESUMEN
Introduction: malaria is considered one of the most important tropical illnesses in public health causing millions of infections and deaths each year. Many studies have tried to establish an association between the severe form of the disease and the ABO-blood group type. In Colombia, a country with large endemic zones for malaria there are not enough studies or statistic data about this possible association. Methods: a retrospective case-control study of patients with severe and uncomplicated malaria in the endemic zone of Apartadó, Colombia, was performed between January 2000 and June 2006. Only the clinical records with blood group ABO and Rh classification were included. Results: a total sample of 92 patients was obtained: 49 with severe malaria and 43 with uncomplicated malaria. From the total sample, 68.5% were women and the median age of 21.5 years (min 1-max 80). Of the patients with diagnosis of severe malaria, 59.2% were women. The more frequent parasite species was Plasmodium falciparum. Severe malaria was more frequent among patients classified with blood group O (65.3%) and positive Rh (93.9%), but this association was not statistically significant. Conclusion: even though severe malaria was more frequent among patients classified with blood group O and positive Rh, an association between blood group and severe malaria could not be established. The controversial association of these variables previously found in other populations could be probably explained by the demographic distribution and characteristics of those.
Introducción: la malaria es considerada una de las más importantes enfermedades tropicales en salud pública, causando millones de infecciones y muertes cada año. Muchos estudios han tratado de establecer una asociación entre la forma grave de la enfermedad y la clasificación sanguínea ABO. En Colombia, un país con grandes zonas endémicas de malaria, no existen suficientes estudios y datos estadísticos acerca de esta posible asociación. Métodos: se realizó un estudio de casos y controles de pacientes con malaria severa y no complicada en la zona endémica de Apartadó, Colombia y ejecutado entre enero de 2000 y junio de 2006. Sólo las historias clínicas con información acerca de la clasificación sanguínea ABO o Rh fueron incluidas. Resultados: la muestra total fue de 92 pacientes, 49 con malaria grave y 43 con malaria no complicada. De la muestra total, 68,5% eran mujeres y la edad media de 21,5 años (mínimo1-máximo 80). De los pacientes con diagnóstico de malaria grave, 59,2 % eran mujeres. El parásito más frecuente fue la especie de P. falciparum. La malaria grave fue mas frecuente entre los pacientes clasificados con grupo sanguíneo O (65,3%) y Rh positivo (93,9%), pero esta asociación no fue estadísticamente significativa. Conclusión: aunque la malaria severa fue mas frecuente en pacientes con grupo sanguíneo O y Rh positivo, una asociación entre la severidad de la malaria y la clasificación sanguínea no pudo ser establecida. La controvertida asociación entre estas variables previamente encontrada en otras poblaciones, probablemente puede ser explicada por la distribución y características demográficas de dichas poblaciones.
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Antígenos de Grupos Sanguíneos/clasificación , Epidemiología , Malaria/dietoterapia , Malaria/epidemiología , ColombiaRESUMEN
The effect of vesicles of purified egg yolk phosphatidylcholine on the fertilizing capacity and acrosome breakdown of amphibian spermatozoa was studied. When Bufo arenarum spermatozoa were incubated with either small unilamellar vesicles (prepared by sonication) or with large unilamellar vesicles (prepared by reverse-phase evaporation) a decrease in the fertilizing capacity of spermatozoa was found. At the same phosphatidylcholine concentration, large unilamellar vesicles were more inhibitory than small unilamellar vesicles. The inhibition was dependent upon the phospholipid concentration and the length of the incubation period. Small unilamellar vesicles did not modify the time course of acrosome breakdown in Leptodactylus chaquensis, while large unilamellar vesicles markedly accelerated the rate of acrosome breakdown. In both biossays, the charge of the vesicles (made either positive or negative by the addition of 5% stearylamine or 5% phosphatidic acid) did not influence their biological effect. Multilamellar vesicles did not alter the fertilizing capacity nor the acrosome breakdown. We conclude that the size and the structure of the vesicles are important parameters in determining the inhibitory capacity of phosphatidyl choline on amphibian fertilization.