Age-Dependent Alterations in Meiotic Recombination Cause Chromosome Segregation Errors in Spermatocytes.

Faithful chromosome segregation in meiosis requires crossover (CO) recombination, which is regulated to ensure at least one CO per homolog pair. We investigate the failure to ensure COs in juvenile male mice. By monitoring recombination genome-wide using cytological assays and at hotspots using molecular assays, we show that juvenile mouse spermatocytes have fewer COs relative to adults. Analysis of recombination in the absence of MLH3 provides evidence for greater utilization in juveniles of pathways involving structure-selective nucleases and alternative complexes, which can act upon precursors to generate noncrossovers (NCOs) at the expense of COs. We propose that some designated CO sites fail to mature efficiently in juveniles owing to inappropriate activity of these alternative repair pathways, leading to chromosome mis-segregation. We also find lower MutLγ focus density in juvenile human spermatocytes, suggesting that weaker CO maturation efficiency may explain why younger men have a higher risk of fathering children with Down syndrome.

Delayed diagnosis of Loeys-Dietz syndrome revealed through atrial septal defect with pulmonary artery dilation.

Loeys-Dietz syndrome (LDS) is an autosomal-dominant connective tissue disorder associated with mutations in the transforming growth factor ß receptor. It is characterized by distinctive craniofacial changes, skeletal features, and cardiovascular complications. We present a case of a 24-year-old male with development delay and a one-year history of progressively worsening dyspnea on moderate exertion and orthopnea. Echocardiography revealed right atrial and right ventricle dilation, right ventricle hypertrophy, atrial septal defect, and aneurysmal dilation of the pulmonary artery trunk. This case underscores the importance of early detection and comprehensive imaging in patients suspected of having LDS, particularly considering the potential for atypical vascular manifestations.

Systematic Review and Meta-analysis of Deaths Attributable to Antimicrobial Resistance, Latin America.

Antimicrobial resistance is a pressing global health concern, leading to 4.95 million deaths in 2019. We conducted a systematic review and meta-analysis to assess the lethality attributed to infections caused by multidrug-resistant organisms (MDROs) in Latin America and the Caribbean. A comprehensive search of major databases retrieved relevant studies from 2000-2022. We included 54 observational studies, primarily from Brazil, Argentina, and Colombia. The most commonly studied organism was methicillin-resistant Staphylococcus aureus. The overall unadjusted case fatality rate related to MDROs was 45.0%; higher adjusted lethality was observed in persons infected with MDROs than in those infected with other pathogens (adjusted odds ratio 1.93, 95% CI 1.58-2.37). A higher lethality rate was seen in patients who did not receive appropriate empirical treatment (odds ratio 2.27, 95% CI 1.44-3.56). These findings underscore the increased lethality associated with antimicrobial resistance in Latin America and the Caribbean.

Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review.

BACKGROUND: Detailed information is needed on the dynamic pattern of antimicrobial resistance (AMR) in Neisseria gonorrhoeae in Latin America and the Caribbean (LAC). OBJECTIVES: To conduct a systematic review of AMR in N. gonorrhoeae in LAC. METHODS: Electronic searches without language restrictions were conducted in PubMed, Embase, Cochrane Library, EconLIT, Cumulative Index of Nursing and Allied Health Literature, Centre for Reviews and Dissemination, and Latin American and Caribbean Literature in Health Sciences. Studies were eligible if published between 1 January 2011 and 13 February 2021, conducted in any LAC country (regardless of age, sex and population) and measured frequency and/or patterns of AMR to any antimicrobial in N. gonorrhoeae. The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO-GASP) for LAC countries and Latin American AMR SurveillanceNetwork databases were searched. AMR study quality was evaluated according to WHO recommendations. RESULTS: AMR data for 38, 417 isolates collected in 1990-2018 were included from 31 publications, reporting data from Argentina, Brazil, Colombia, Peru, Uruguay, Venezuela and WHO-GASP. Resistance to extended-spectrum cephalosporins was infrequent (0.09%-8.5%). Resistance to azithromycin was up to 32% in the published studies and up to 61% in WHO-GASP. Resistance to penicillin, tetracycline and ciprofloxacin was high (17.6%-98%, 20.7%-90% and 5.9%-89%, respectively). Resistance to gentamicin was not reported, and resistance to spectinomycin was reported in one study. CONCLUSIONS: This review provides data on resistance to azithromycin, potentially important given its use as first-line empirical treatment, and indicates the need for improved surveillance of gonococcal AMR in LAC. Trial registration: Registered in PROSPERO, CRD42021253342.

Ablative 5-Fraction Stereotactic MRI-Guided Adaptive Radiotherapy for Oligometastatic Pancreatic Adenocarcinoma.

INTRODUCTION: Metastatic pancreatic ductal adenocarcinoma (PDAC) carries a poor prognosis and significant morbidity from local tumor progression. We investigated outcomes among oligometastatic PDAC patients treated with stereotactic magnetic resonance image-guided ablative radiotherapy (SMART) to primary disease. METHODS: We performed a retrospective multi-institutional analysis of oligometastatic PDAC at diagnosis or with metachronous oligoprogression during induction chemotherapy treated with primary tumor SMART. Outcomes of interest included overall survival (OS), progression-free survival (PFS), freedom from locoregional failure (FFLRF), and freedom from distant failure (FFDF). Acute and late toxicity were reported and in exploratory analyses patients were stratified by the number of metastases, SMART indication, and addition of metastasis-directed therapy. RESULTS: From 2019 to 2021, 22 patients with oligometastatic PDAC (range: 1-6 metastases) received SMART to the primary tumor with a median follow-up of 11.2 months from SMART. Nineteen patients had de novo synchronous metastatic disease and three had metachronous oligoprogression. Metastasis location most commonly was liver only (40.9%), multiple organs (27.3%), lungs only (13.6%), or abdominal/pelvic nodes (13.6%). All patients received either FOLFIRINOX (64%) or gemcitabine/nab-paclitaxel (36%) followed by SMART (median 50 Gy, 5 fractions) for local control (77%), pain control (14%), or local progression (9%). Additionally, 41% of patients received other metastasis-directed treatments. The median OS from diagnosis and SMART was 23.9 months and 11.6 months, respectively. Calculated from SMART, the median PFS was 2.4 months with 91% of patients having distant progression, and 1-year local control was 68. Two patients (9%) experienced grade 3 toxicities, gastric outlet obstruction, and gastrointestinal bleed without grade 4 or 5 toxicity. CONCLUSION: There was minimal morbidity of local disease progression after SMART in this cohort of oligometastatic PDAC. As systemic therapy options improve, additional strategies to identify patients who may derive benefits from local consolidation or metastasis-directed therapy are needed.

The M 1 -muscarinic acetylcholine receptor subtype may play a role in learning and memory performance in the hippocampus of neonatal monosodium glutamate-obese rats.

Here, we investigate the effects of obesity induced by monosodium glutamate (MSG) on cognitive impairment and whether this model induces any alteration in the affinity, density, and subtypes of muscarinic acetylcholine receptors (mAChRs) in rat hippocampus. Healthy rats were used as controls, and MSG-obese rats were selected via the Lee index > 0.300. The effects of MSG-induced obesity on hippocampal spatial learning and memory processes were evaluated by using the working memory versions of the Morris' water maze task and the evaluation of mAChRs by binding assay and their subtypes by immunoprecipitation assays. [ 3 H]Quinuclidinyl benzilate specific binding analysis showed that the equilibrium dissociation constant (K D ) did not differ between control and MSG, indicating that affinity is not affected by obesity induced by MSG. The maximum number of binding sites (B max ) obtained in MSG subjects was lower than that obtained from control rats, indicating a decrease in the expression of total mAChRs. Immunoprecipitation assays reveal a decrease in the expression of M 1 subtype of MSG when compared with control rats (M 2 to M 5 subtypes did not differ between control and MSG). We also observed that MSG promotes a disruption of the spatial working memory which was accompanied by a decrease in the M 1 mAChR subtype in rat hippocampus, thus suggesting deleterious long-term effects besides the obesity. In conclusion, these findings provide new insights into how obesity can influence spatial learning and memory that is hippocampal-dependent. The data suggest that the M 1 mAChR subtype protein expression is a potential therapeutic target.

Using a Simple Magnetic Adsorbent for the Preconcentration and Determination of Ga(III) and In(III) by Electrothermal Atomic Absorption Spectrometry.

A solid-phase dispersive microextraction procedure has been developed using ferrite (Fe3O4), an inexpensive magnetic material, as an adsorbent for the separation and subsequent determination of Ga(III) and In(III). The ions were removed from an aqueous solution by adsorption on Fe3O4, which was next easily collected from the medium by the action of a magnet. The analytes were then desorbed using 50 µL of 2 M NaOH or 50 µL of a 4:1 mixture of 0.1 M EDTA and 2 M HNO3 for the determination of Ga(III) or In(III), respectively. The level of the elements in the desorption phase was measured by electrothermal atomic absorption spectrometry (ETAAS) by injecting 10 µL of this phase into the atomizer. The enrichment factor was 163, and detection limits of 0.02 and 0.01 µg L-1 were achieved for Ga(III) and In(III), respectively. The reliability of the procedure has been verified by means of standard reference materials and by means of standard additions. Results are given for waters, soils and samples obtained from various electronic devices. It is of note that the procedure could be the basis for a useful way of recovering these valuable elements from different matrices for reuse.

Complete and simultaneous removal of ionic silver and silver nanoparticles by using an ionic liquid supported on a magnetic nanoparticle core.

The global pandemic situation due to COVID-19 has given rise to the massive use of disinfectant products, many of them based on silver atoms. After the use of these products, the silver passes into the aqueous effluents, becoming an emerging contaminant in waters. In this work, a novel procedure for the total and simultaneous removal of ionic and nanomeric silver in aqueous samples is introduced, employing magnetic nanoparticles wrapped with an ionic liquid (Fe3O4@IL) as a removal agent. Experimental variables such as pH, contact time, temperature, as well as pollutant and removal agent doses were studied to achieve the total elimination, exhibiting exceptional conditions for the removal of different concentrations of silvers species in water. The approach achieves 100% removal efficiency for the simultaneous removal of both silver species, goal not achieved previously. Also, 100% removal efficiency is reached for the both species separately, since ionic silver is adsorbed onto the Fe3O4, while nanomeric silver is extracted in the IL. Particularly, for concentrations within the range 50-200 µg L-1, total removal efficiency was reached for a wide range of temperatures and a pH range 7-9, achieved in just 15 min, for all cases. Additionally, the doses of Fe3O4@IL employed to remove all concentrations of silver were 13.7 mg. Characterization of Fe3O4@IL surfaces before and after the process was performed by means of Field Effect Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy. Fe3O4@IL was recycled by employing 100 µL of 1% HNO3 solution, allowing its use for 10 additional silver removal cycles without loss of efficiency. The study of adsorption kinetics and equilibrium isotherms reveal a Freundlich-type adsorption, which suggests affinity between sites in the complex surface of Fe3O4@IL, and Elovich kinetics, indicative of chemisorption onto a heterogeneous surface, while the temperature shows no effect on the results.

Effect of redo varicocelectomy on semen parameters and pregnancy outcome: An original report and meta-analysis.

Recurrence following varicocelectomy is an important cause of treatment failure and persistence of subnormal semen parameters. This original study was combined with a systemic review and meta-analysis aiming to evaluate the efficacy of redo varicocelectomy on male fertility potential and pregnancy outcome. The retrospective study included 32 patients who underwent microsurgical subinguinal varicocelectomy for patients with recurrent varicocele. Changes in semen parameters and hormone profiles before and after surgery were compared. The literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and included seven articles in addition to our original report. Results of the original study revealed statistically significant improvements in sperm concentration, progressive motility, total motile sperm count and normal morphology following redo varicocelectomy. The meta-analysis results echoed those reported in our original study and depicted significant improvements in sperm concentration (mean difference [MD] = +20.281 million/ml, p < 0.001), total motility (MD = +9.659%, p = 0.001), total motile sperm count (MD = +23.258 million sperm, p < 0.001) and normal morphology (MD = +4.460%, p < 0.001). Overall pregnancy outcome was reported in seven studies with a rate of 34.6%. No significant changes were noted in any of the collected hormone results both in this original report and in the meta-analysis. In conclusion, redo varicocelectomy has a beneficial role on male fertility potential and can be offered for men with recurrent varicocele as directed by their individual clinical condition.

Determination of Hg(II) and Methylmercury by Electrothermal Atomic Absorption Spectrometry after Dispersive Solid-Phase Microextraction with a Graphene Oxide Magnetic Material.

The toxicity of all species of mercury makes it necessary to implement analytical procedures capable of quantifying the different forms this element presents in the environment, even at very low concentrations. In addition, due to the assorted environmental and health consequences caused by each mercury species, it is desirable that the procedures are able to distinguish these forms. In nature, mercury is mainly found as Hg0, Hg2+ and methylmercury (MeHg), with the latter being rapidly assimilated by living organisms in the aquatic environment and biomagnified through the food chain. In this work, a dispersive solid-phase microextraction of Hg2+ and MeHg is proposed using as the adsorbent a magnetic hybrid material formed by graphene oxide and ferrite (Fe3O4@GO), along with a subsequent determination by electrothermal atomic absorption spectrometry (ETAAS). On the one hand, when dithizone at a pH = 5 is used as an auxiliary agent, both Hg(II) and MeHg are retained on the adsorbent. Next, for the determination of both species, the solid collected by the means of a magnet is suspended in a mixture of 50 µL of HNO3 (8% v/v) and 50 µL of H2O2 at 30% v/v by heating for 10 min in an ultrasound thermostatic bath at 80 °C. On the other hand, when the sample is set at a pH = 9, Hg(II) and MeHg are also retained, but if the solid collected is washed with N-acetyl-L-cysteine only, then the Hg(II) remains on the adsorbent, and can be determined as indicated above. The proposed procedure exhibits an enrichment factor of 49 and the determination presents a linear range between 0.1 and 10 µg L-1 of mercury. The procedure has been applied to the determination of mercury in water samples from different sources.

Phospholipid signaling pathway in Capsicum chinense suspension cells as a key response to consortium infection.

BACKGROUND: Mexico is considered the diversification center for chili species, but these crops are susceptible to infection by pathogens such as Colletotrichum spp., which causes anthracnose disease and postharvest decay in general. Studies have been carried out with isolated strains of Colletotrichum in Capsicum plants; however, under growing conditions, microorganisms generally interact with others, resulting in an increase or decrease of their ability to infect the roots of C. chinense seedlings and thus, cause disease. RESULTS: Morphological changes were evident 24 h after inoculation (hai) with the microbial consortium, which consisted primarily of C. ignotum. High levels of diacylglycerol pyrophosphate (DGPP) and phosphatidic acid (PA) were found around 6 hai. These metabolic changes could be correlated with high transcription levels of diacylglycerol-kinase (CchDGK1 and CchDG31) at 3, 6 and 12 hai and also to pathogen gene markers, such as CchPR1 and CchPR5. CONCLUSIONS: Our data constitute the first evidence for the phospholipids signalling events, specifically DGPP and PA participation in the phospholipase C/DGK (PI-PLC/DGK) pathway, in the response of Capsicum to the consortium, offering new insights on chilis' defense responses to damping-off diseases.

Analysis of DNA polymerase ν function in meiotic recombination, immunoglobulin class-switching, and DNA damage tolerance.

DNA polymerase ν (pol ν), encoded by the POLN gene, is an A-family DNA polymerase in vertebrates and some other animal lineages. Here we report an in-depth analysis of pol ν-defective mice and human cells. POLN is very weakly expressed in most tissues, with the highest relative expression in testis. We constructed multiple mouse models for Poln disruption and detected no anatomic abnormalities, alterations in lifespan, or changed causes of mortality. Mice with inactive Poln are fertile and have normal testis morphology. However, pol ν-disrupted mice have a modestly reduced crossover frequency at a meiotic recombination hot spot harboring insertion/deletion polymorphisms. These polymorphisms are suggested to generate a looped-out primer and a hairpin structure during recombination, substrates on which pol ν can operate. Pol ν-defective mice had no alteration in DNA end-joining during immunoglobulin class-switching, in contrast to animals defective in the related DNA polymerase θ (pol θ). We examined the response to DNA crosslinking agents, as purified pol ν has some ability to bypass major groove peptide adducts and residues of DNA crosslink repair. Inactivation of Poln in mouse embryonic fibroblasts did not alter cellular sensitivity to mitomycin C, cisplatin, or aldehydes. Depletion of POLN from human cells with shRNA or siRNA did not change cellular sensitivity to mitomycin C or alter the frequency of mitomycin C-induced radial chromosomes. Our results suggest a function of pol ν in meiotic homologous recombination in processing specific substrates. The restricted and more recent evolutionary appearance of pol ν (in comparison to pol θ) supports such a specialized role.

Surfactant properties of humic acids extracted from volcanic soils and their applicability in mineral flotation processes.

Surface Tension (ST) of water solutions of humic acids extracted from volcanic ash derived soils (soil humic acids, S-HA), were measured under controlled conditions of pH (13.0), temperature (25 °C) and ionic strength (NaOH 0.1M) to establish the Critical Micellar Concentration (CMC). All S-HA were characterized by elemental analysis, acid-base titration, Transmission Electronic Microscopy (TEM) micrographs, isoelectric point (IEP) and solid state 13C-NMR. After that, these humic acids were evaluated as potential biomaterials to be used in mineral flotation processes, where a series of experiments were conducted at different S-HA and molybdenite ratio (from 0.2 to 50 g ton-1) establishing the IEP of all resultant materials. The use of solid state 13C-NMR enabled the following sequence of intensity distribution areas of S-HA to be established: O/N Alkyl>Alkyl C>Aromatic C>Carboxyl. The experimental values of ST and the calculated CMC (ranging from 0.8 to 3.3 g L-1) revealed that for S-HA no relationship between the abundance groups and their behavior as surfactant materials was observed. In relation with IEP determined for all materials, the highest surface charge, which can be useful for flotation processes, was obtained with 0.2 g of S-HA per ton of molybdenite. Additionally, TEM studies confirm the formation of pseudoaggregates for all the S-HA considered. Finally, the S-HA could be considered as an alternative to chemical products and commercial humic acids materials in mineral flotation processes.

Oral health of pediatric liver transplant recipients.

To evaluate oral health conditions in pediatric liver transplant recipients, with special focus on caries, green staining of the teeth, gingival bleeding, and gingival overgrowth. 40 patients (mean age 11.6 years) were examined at a routine follow-up visit, 6 months to 16 years after liver transplantation at the Swiss Center for Liver Disease in Children. After the medical examination, participants were further examined for the presence of dental caries, periodontal disease, GE, and GTC. The mean decay, missing, and filled teeth (dmft/DMFT) score was 3.8. 45% of the participants presented at least one carious lesion. Two-third of the participants had more than 20% of sites with the presence of plaque and gingival inflammation. Signs of GE were found in 18% and GTC in 30% of the participants. A positive correlation was identified between GTC and peak serum bilirubin (P<.001) and primary diagnosis of cholestatic disease (P=.04). Gingival inflammation was associated with plaque (P<.001), use of immunosuppressive medication (P=.04), and was more pronounced in children with cholestatic disease (P=.007). Children and young adults with liver transplants presented a rather poor oral health status. Liver transplant physicians should counsel patients for regular dental follow-up in order to avoid serious dental infections.

Biomarkers for Predicting Response to Anti-HER2 Agents.

The HER2 receptor is amplified or overexpressed in approximately 20% of all breast cancers, but despite significant efforts of the clinical research community and a growing number of anti-HER2 agents, a significant number of patients with HER2-positive breast cancer either progress or suffer disease relapse within 5-10 years. The development of robust biomarkers that predict response to anti-HER2 agents is therefore an important clinical need to prevent overtreatment and to enable earlier assignment of patients to more optimal therapies. Here we review some of the recent advances in the field by focusing on pathways mediating resistance to anti-HER2 therapies, and the role of the immune system and cancer stem cells in therapy response. We also review preoperative treatment strategies and research paradigms that show promise in identifying novel biomarkers of response while also enabling the delineation of the mechanisms underlying clinical benefit from anti-HER2 therapies.

Regional scale-up of an Emergency Triage Assessment and Treatment (ETAT) training programme from a referral hospital to primary care health centres in Guatemala.

OBJECTIVE: Emergency Triage Assessment and Treatment (ETAT) was developed by the WHO to teach paediatric assessment, triage and initial management to healthcare workers (HCWs) in resource-limited hospital-based settings. This study sought to evaluate the extension of ETAT training from a regional hospital to paediatric HCWs at local primary care health centres (PHCs) in Guatemala. METHODS: Prior to providing a 16 h ETAT training module, immediately after, and at 3, 6 and 12 months, we used written pre-tests and post-tests and five-point Likert surveys to evaluate, respectively, clinical knowledge and provider confidence in providing acute care paediatrics; hands-on clinical skills were tested at 3, 6 and 12 months. RESULTS: Fifty-two HCWs (14 general physicians, 38 nurses) from four regional PHCs participated; 65%, 60% and 46% completed 3-month, 6-month and 12-month follow-ups, respectively. Test scores show significant acquisition of clinical knowledge initially, which was retained over time when tested at 3, 6 and 12 months (46 vs 70, p<0.001). Hands-on clinical skills scores demonstrated retention at 3, 6 and 12 months. Although participants were more confident about acute care paediatrics immediately after training (66 vs 104, p<0.001), this decreased with time, though not to pre-intervention levels. CONCLUSIONS: ETAT trainings were successfully extended to PHCs in a resource-limited setting with significant knowledge acquisition and retention over time and improved HCW confidence with acute care paediatrics. This process could serve as a successful model for in-country and international scale-up of ETAT.

In vitro evaluation of marginal and internal adaptation of class II CAD/CAM ceramic restorations with different resinous bases and interface treatments.

OBJECTIVES: This in vitro study evaluated the influence of different composite bases and surface treatments on marginal and internal adaptation of class II CEREC CAD/CAM ceramic inlays, before and after simulated occlusal loading. METHODS: Thirty-two IPS Empress CAD class II inlays (MO or OD) (n = 8/group) were placed on third molars, with margins 1 mm below the cementum-enamel junction (CEJ), following different cavity treatments. These treatments were non-liner (control group), a flowable composite liner (Premise flow) sandblasted or treated with soft air abrasion and a restorative composite liner (Premise) sandblasted. The restorations were then luted with Premise. All specimens were submitted to 1,000,000 cycles with a 100-N eccentric load. The tooth restoration margins were analysed semi-quantitatively by SEM pre- and post-loading. The internal adaptation was also evaluated after test completion. RESULTS: The percentage of satisfactory marginal adaptation varied from 75 to 87 % pre-loading and 62 to 72 % post-loading in occlusal enamel, from 71 to 83 % pre-loading and 52 to 63 % post-loading in proximal enamel, and from 68 to 88 % pre-loading and 43 to 66 % post-loading in cervical dentin. There were no significant differences among groups. The percentages of satisfactory tooth-composite internal adaptation varied from 81 to 98 % in occlusal dentin, from 63 to 90 % in axial dentin, and from 71 to 84 % in cervical dentin without any statistical difference. CONCLUSIONS: The results of the present study support the use of flowable or restorative composites as a liner underneath ceramic CAD/CAM inlays, producing marginal and internal adaptation which is not different from restorations placed directly on dentin. Soft air abrasion proved not to be different from sandblasting for treating cavities before cementation. CLINICAL RELEVANCE: The results of this in vitro test validate the increasing use of a flowable base/liner underneath CAD/CAM ceramic inlays to optimise tissue conservation and clinical procedures; in this case, soft air abrasion is recommended as a pre-cementation step.

Nasopharyngeal carriage of Streptococcus pneumoniae in Latin America and the Caribbean: A systematic review and meta-analysis.

BACKGROUND: Streptococcus pneumoniae is a leading cause of morbidity and mortality globally, causing bacteremic pneumonia, meningitis, sepsis, and other invasive pneumococcal diseases. Evidence supports nasopharyngeal pneumococcal carriage as a reservoir for transmission and precursor of pneumococcal disease. OBJECTIVES: To estimate the pneumococcal nasopharyngeal burden in all age groups in Latin America and the Caribbean (LAC) before, during, and after the introduction of pneumococcal vaccine conjugate (PVC). METHODS: Systematic literature review of international, regional, and country-published and unpublished data, together with reports including data from serotype distribution in nasopharyngeal carriage in children and adults from LAC countries following Cochrane methods. The protocol was registered in PROSPERO database (ID: CRD42023392097). RESULTS: We included 54 studies with data on nasopharyngeal pneumococcal carriage and serotypes from 31,803 patients. In children under five years old, carriage was found in 41% and in adults over 65, it was 26%. During the study period, children under five showed a colonization proportion of 34% with PCV10 serotypes and 45% with PCV13 serotypes. When we analyze the carriage prevalence of PCV serotypes in all age groups between 1995 and 2019, serotypes included in PCV10 and those included in PCV13, both showed a decreasing trend along analysis by lustrum. CONCLUSION: The data presented in this study highlights the need to establish national surveillance programs to monitor pneumococcal nasopharyngeal carriage to monitor serotype prevalence and replacement before and after including new pneumococcal vaccines in the region. In addition, to analyze differences in the prevalence of serotypes between countries, emphasize the importance of approaches to local realities to reduce IPD effectively.

Antimicrobial resistance of Streptococcus pneumoniae from invasive pneumococcal diseases in Latin American countries: a systematic review and meta-analysis.

Background: Invasive pneumococcal disease has declined since pneumococcal conjugate vaccine introduction in Latin America and the Caribbean (LAC). However, serotype distribution and antimicrobial resistance patterns have changed. Methods: We conducted a systematic review to evaluate the frequency of antimicrobial resistance of Streptococcus pneumoniae from invasive disease in LAC. Articles published between 1 January 2000, and 27 December 2022, with no language restriction, were searched in major databases and gray literature. Pairs of reviewers independently selected extracted data and assessed the risk of bias in the studies. The quality of antimicrobial resistance (AMR) studies was evaluated according to WHO recommendations (PROSPERO CRD42023392097). Results: From 8,600 records identified, 103 studies were included, with 49,660 positive samples of S. pneumoniae for AMR analysis processed. Most studies were from Brazil (29.1%) and Argentina (18.4%), were cross-sectional (57.3%), reported data on AMR from IPD cases (52.4%), and were classified as moderate risk of bias (50.5%). Resistance to penicillin was 21.7% (95%IC 18.7-25.0, I2: 95.9), and for ceftriaxone/cefotaxime it was 4.7% (95%IC 3.2-6.9, I2: 96.1). The highest resistance for both penicillin and ceftriaxone/cefotaxime was in the age group of 0 to 5 years (32.1% [95%IC 28.2-36.4, I2: 87.7], and 9.7% [95%IC 5.9-15.6, I2: 96.9] respectively). The most frequent serotypes associated with resistance were 14 for penicillin and 19A for ceftriaxone/cefotaxime. Conclusion: Approximately one-quarter of invasive pneumococcal disease isolates in Latin America and the Caribbean displayed penicillin resistance, with higher rates in young children. Ongoing surveillance is essential to monitor serotype evolution and antimicrobial resistance patterns following pneumococcal conjugate vaccine introduction.

Salud auditiva y exposición a ruido ambiental en población de 18 a 64 años de Bogotá, Colombia, entre el 2014 y el 2018.

Introducción. La salud auditiva es un tema de interés en salud pública que afecta la calidad de vida y que puede afectarse por la exposición continua al ruido, un factor de riesgo que genera síntomas auditivos y extraauditivos. OBJETIVO: Identificar el estado de salud auditiva de adultos que viven en Bogotá, y su asociación con factores de exposición a ruido ambiental, individuales y otológicos. Materiales y métodos. Se realizó un estudio transversal mediante el análisis de una base de datos con 10.311 registros, obtenidos entre los años 2014 y 2018, producto de una encuesta estructurada de percepción de ruido y tamizaje auditivo. Se hizo un análisis descriptivo bivariado y una regresión logística binaria. RESULTADOS: El 35,4 % de los participantes presentó disminución auditiva. En el componente de percepción: 13,0 % refirió no escuchar bien, 28,8 % informó síntomas extraauditivos, 53,3 % tenía antecedentes otológicos, y 69,0 % manifestó molestia por ruido extramural. En la regresión logística, las variables más asociadas con disminución auditiva fueron: de las ambientales, vivir en zonas de mayor ruido (OR = 1,50) (IC95%: 1,34-1,69); de las individuales, ser hombre (OR = 1,85) (IC95%: 1,64-2,09) y la edad (por cada año de vida, el riesgo de disminución auditiva aumentó 6 %); y de las otológicas, tener antecedente de síntomas otológicos (OR = 1,86) (IC95%: 1,66-2,08). CONCLUSIONES: La disminución auditiva es multicausal en la población evaluada. Los factores que aumentan su prevalencia son incremento de la edad, ser hombre, tabaquismo, medicamentos ototóxicos, vivir en zonas de mayor exposición a ruido y presentar síntomas extraauditivos.