Efecto de los microplásticos de poliestireno sobre el citoesqueleto de células humanas / Effect of Polystyrene Microplastics on the Cytoskeleton of Human Cells

Resumen El plástico se ha vuelto muy popular en los últimos años gracias a su durabilidad y propiedades. A pesar de sus múltiples ventajas, la humanidad ha desarrollado cierta dependencia hacia este material, lo que ha propiciado un incremento en su uso y, a su vez, en la generación de desechos ante el escaso hábito de reúso. Uno de los polímeros plásticos más usados es el poliestireno (PS), ya que este se usa en una amplia gama de aplicaciones gracias a su bajo costo y fácil producción. Sin embargo, pasado el tiempo de vida útil de este plástico, es considerado como desecho. El PS al estar expuesto a condiciones atmosféricas como la radiación UV, se fragmenta dando como resultado la creación de microplásticos (MP), mismos que son pequeñas partículas que no sobrepasan los 5 mm, lo que representa una amenaza al medio ambiente pues, al degradarse, las propiedades decaen, se genera un cambio dimensional y, además, pueden ser fácilmente transportadas no solo al medio ambiente, sino también a los organismos. Este artículo de revisión se enfoca en evidenciar las principales rutas que siguen los MP al interaccionar con los seres humanos y los efectos potenciales de los PS-MP en el citoesqueleto, así como en resaltar la necesidad de más estudios al respecto.

Abstract Plastic has become very popular in recent years due to its durability and properties. Despite its many advantages, humanity has developed a certain dependence on this material, which represents an increase in its use and in turn, in waste. One of the most widely used plastic polymers is the polystyrene (PS), as is used in a wide range of applications due to its low cost and easy production, although after the useful life of the plastic, it is considered as waste. When plastic is exposure to atmospheric conditions such as UV radiation, it degrades and fragments giving rise to microplastics (MPs), which are defined as small particles that do not exceed 5 mm, representing a threat to the environment because when they degrade the properties decay, a dimensional change is generated and they can also be easily transported not only to the environment but also to organisms. This review article focuses on highlighting the main pathways that MPs follow when interacting with humans and the potential effects of PS-MPs on the cytoskeleton, as well as highlighting the need for more studies in this regard.

Lobectomy in patients with differentiated thyroid cancer: experience of a Chilean tertiary center.

PURPOSE: Thyroid lobectomy (TL) is an appropriate treatment for up to 4 cm intrathyroidal differentiated thyroid cancer (DTC). There is scarce data regarding TL outside first-world centers. Our aim is to report a cohort of patients with DTC treated with TL in Chile. METHODS: We included DTC patients treated with TL, followed for at least 6 months, characterized their clinicopathological features and classified their risk of recurrence and response to treatment. RESULTS: Eighty-two patients followed for a median of 2.3 years (0.5-7.0). Seventy-three (89%) patients had papillary, 8 (9.8%) follicular and 1 (1.2%) high-grade DTC. The risk of recurrence was low in 56 (68.3%) and intermediate in 26 (31.7%). Eight (9.8%) patients required early completion thyroidectomy and radioiodine. At last follow-up, 52 (70.3%) had excellent, 19 (25.7%) had indeterminate, and 1 (1.4%) had structural incomplete response. CONCLUSION: In a developing country, TL is an adequate option for appropriately selected DTC patients.

Pertussis in Mexico from 2000 to 2019: A real-world study of incidence, vaccination coverage, and vaccine effectiveness.

BACKGROUND: The national immunization program in Mexico includes a 3-dose primary series of pertussis vaccine and a toddler booster dose. In Mexico, whole-cell pertussis vaccines (wP) were switched in 2007 to acellular pertussis vaccines (aP). METHODS: This retrospective study using Mexican National Databases of Health and population surveillance (2000-2019) assessed the incidence of pertussis, infant pertussis vaccination coverage, and vaccine effectiveness (VE) against clinically-diagnosed and/or laboratory-confirmed pertussis in children aged 6.5-18.5 or 24.5 months for the primary series, and children aged 18.5 or 24.5-48.5 months for the toddler booster. RESULTS: The incidence of pertussis sharply increased in 2012 and was highest in 2012, 2015, and 2016 (0.84-0.94/100,000 person-years). Coverage was highest for the first dose in the primary series, decreasing for each subsequent dose. The VE against notified pertussis was 96.4% (95% CI: 94.7, 97.6) for the first three doses of wP vaccine (2000-2007) and 95.7% (95% CI: 95.1, 96.2) for the first three doses of aP vaccine (2008-2019). CONCLUSIONS: Our findings suggested high levels of vaccine effectiveness overall were achieved for the aP and wP vaccines in Mexico between 2000 and 2019.

Mathematical modeling of Dengue virus serotypes propagation in Mexico.

The Dengue virus (DENV) constitutes a major vector borne virus disease worldwide. Prediction of the DENV spread dynamics, prevalence and infection rates are crucial elements to guide the public health services effort towards meaningful actions. The existence of four DENV serotypes further complicates the virus proliferation forecast. The different serotypes have varying clinical impacts, and the symptomatology of the infection is dependent on the infection history of the patient. Therefore, changes in the prevalent DENV serotype found in one location have a profound impact on the regional public health. The prediction of the spread and intensity of infection of the individual DENV serotypes in specific locations would allow the authorities to plan local pesticide spray to control the vector as well as the purchase of specific antibody therapy. Here we used a mathematical model to predict serotype-specific DENV prevalence and overall case burden in Mexico.

Heavy metals in the sediments of urban sinkholes in Cancun, Quintana Roo.

Soils in urban areas can accumulate heavy metals as a result of anthropogenic inputs. This research focuses on a young coastal tourist city that has been urbanized over the last 52 years and shows accelerated demographic growth and urban development. Deposition of heavy metals in soils is caused by human economic activities, which has significant implications for the environment. We evaluated heavy metal concentrations in urban sinkholes, which are sites for the natural accumulation of water and sediments. These locations also receive rainfall runoff or have been used as unregulated dumps. By performing a multistage extraction to address availability and risk, we found that Zn, Fe and Al were the predominant metals; Cu, Pb and Ni were only detected in some sinkholes. The contamination factor was high for Zn and moderate for Pb. The geoaccumulation index showed that Zn is the most abundant and available metal in urban sinkholes and the metal with the highest potential ecological risk. Between 12 and 50% of the total concentration of all metals was extracted from the organic matter phase. Correlations were found between the degree of urbanization of the city and the degree of pollution, and the trends were stronger in older sections of the city. Zn is the most prevalent element and has high concentrations. The metal concentrations in the sediments can be used as warning signs for their potential risk to environmental and human health, and these results can be compared with those of other tourist cities in karstic environments around the world.

Exposición a radiación ionizante en médicos residentes de ortopedia en un hospital de referencia.

OBJECTIVE: To describe and analyze the exposure to ionizing radiation of orthopedic residents. METHOD: A prospective study was carried out to evaluate the degree of exposure to ionizing radiation with a bandage dosimeter placed under the lead apron for medical residents for 10 months. An online survey measured the degree of knowledge about radiation safety. RESULTS: 54 resident physicians participated. 55.6% report having knowledge of the existence of radiological protection equipment and 40.7% report that they had previous training in its use. 77.8% use the leaded apron and 31.5% use thyroid protection. 81.5% were positioned less than 1 meter from the source of the X-ray production of the arc in C. The total mean radiation exposure was 2.9 ± 2.17 mSv (95% confidence interval: 1.25-14.28; p = 0.424). CONCLUSIONS: Orthopedic residents present radiation doses below the International Commission on Radiological Protection recommended limit. However, there is a lack of knowledge of radiation protection and as well as a lack of interest and ignorance of the adverse effects of radiation.

OBJETIVO: Describir y analizar la exposición a radiación ionizante de los residentes de ortopedia. MÉTODO: Se realizó un estudio prospectivo para evaluar el grado de exposición a radiación ionizante con un dosímetro de placa colocado debajo del mandil plomado a médicos residentes, por 10 meses. Mediante una encuesta en línea se midió el grado de conocimientos sobre seguridad radiológica. RESULTADOS: Participaron 54 médicos residentes. El 55.6% refiere tener conocimiento de la existencia de equipo de protección radiológica y el 40.7% refiere que tuvo entrenamiento previo en su uso. El 77.8% utiliza el mandil plomado y el 31.5% la protección tiroidea. El 81.5% se posicionó a menos de 1 metro de la fuente de producción de rayos X del arco en C. La exposición a la radiación media total fue de 2.9 ± 2.17 mSv (intervalo de confianza del 95%: 1.25-14.28; p = 0.424). CONCLUSIONES: Los médicos residentes de ortopedia presentan dosis de radiación menores que el límite recomendado por la International Commission on Radiological Protection. Sin embargo, existe una falta de conocimientos sobre protección radiológica, así como falta de interés e ignorancia de los efectos adversos de la radiación.

No Más Fracturas - Implementación de la primera Unidad de Coordinación de Fracturas en Chile: experiencia al año de funcionamiento / Implementation of a fracture liaison service. Experience with 177 patients

BACKGROUND: Every year about 9 million fragility fractures (FF) occur worldwide and 80% of these are underdiagnosed or undertreated. Aiming to close the gap of diagnosis and treatment of osteoporosis, Fracture Liaison Services (FLS) were developed. AIM: To describe the implementation of the first FLS in Chile, its inclusion criteria, patient enrolment, treatment adherence and referrals during the first year. MATERIAL AND METHODS: A FLS was implemented at a health care network composed by two hospitals. The International Osteoporosis Foundation (IOF) guidelines were applied with a nurse practitioner as the coordinator. From May 2020 to April 2021 all patients diagnosed with a FF in the emergency rooms were invited to participate. Patients with pathological fractures and active cancer were excluded. Demographical data, fracture location, previous fractures, treatment and adherence, and mortality were recorded. RESULTS: From 443 patients with a diagnosis of FF, 177 patients (40%) accepted to participate. Their mean age was 74 ± 13 years and 84% (149) were female. Forty eight percent (84) had a lower extremity FF. Hip fractures were the most common (67). Ninety-five patients reported previous FF and 11,2% (20) had received anti-osteoporotic treatment. At four months of follow-up, 62% (50) had received vitamin D and calcium supplementation and 20% (16) of those patients with an indication of anti-osteoporotic drugs, had received them. CONCLUSIONS: The implementation of the FLS was successful with a 40% enrolment of patients, receiving certification by the IOF.

Stochastic epidemiological model: Simulations of the SARS-CoV-2 spreading in Mexico.

In this paper we model the spreading of the SARS-CoV-2 in Mexico by introducing a new stochastic approximation constructed from first principles, where the number of new infected individuals caused by a single infectious individual per unit time (a day), is a random variable of a time-dependent Poisson distribution. The model, structured on the basis of a Latent-Infectious-(Recovered or Deceased) (LI(RD)) compartmental approximation together with a modulation of the mean number of new infections (the Poisson parameters), provides a good tool to study theoretical and real scenarios.

Distribution and ecological risk of metals in an urban natural protected area in the Riviera Maya, Mexico.

Urbanization can negatively impact natural protected areas near or surrounded by cities, and such impacts include untreated wastewater discharge, leachates from dumpsters, e-waste, and road dust. In this research, we show that not only large cities with industry are prone to be polluted, but also young touristic cities with high population increase rate can suffer from urban contamination. We evaluated metal pollution in a natural protected area within a 50-year-old city without conventional industry that was likely contaminated by the urban sprawl around the protected area. We tested water, zooplankton, sediment and plant samples for metallic elements to evaluate their bioaccumulation in zooplankton, enrichment factors and geoaccumulation index values in sediments, and translocation factors in plants. Finally, we evaluated the ecological risk due to metal contamination. Metals at levels above our detection limit (20 µg/L) were not found in the water and zooplankton samples. The sediments and plants in the storm drain section of the protected area had a greater concentration of metals and wastewater indicators (coliforms) than those in the rest of the lagoon. Moreover, signs of Al, Cu, Ni, Zn, Cr, Pb, and Ti contamination were found in the plant tissues. We estimated that the ecological risk of this natural protected area surrounded by the city of Cancun (Mexico) ranged from mild to strong, with Zn being the metal of most concern. The results highlight that young touristic cities around the world will endure contamination from urban sources; signs or early warnings of contamination must be identified to prevent and resolve such issues.

Burden of disease and associated complications of hepatitis a in children and adults in Mexico: A retrospective database study.

BACKGROUND: Hepatitis A virus (HAV) infection is a leading cause of viral hepatitis in children, yet the HAV vaccine is not included in the national immunization program (NIP) in Mexico. This study addresses an identified evidence gap of the burden of hepatitis A disease, complications, and associated costs in Mexico by analyzing surveillance and healthcare data. Data review included disease morbidity (incidence and hospitalization), mortality, and healthcare resource utilization costs. METHODS: In this observational, retrospective database study, we conducted a systematic screening, extraction, and analysis of outcome data from the national surveillance system in Mexico from January 2000 to December 2019. RESULTS: During the analysis period (2000-2019), the average incidence rate/year of HAV cases was 14.7 (5.4-21.5) per 100,000 inhabitants. Children 1-9 years of age (YoA) had the highest average incidence rate/year with 47.8 (14.7-74.5). The average hospitalization rate/year due to HAV infection was 5.8% (2.9-9.6%). Although the highest burden of HAV continued to be in children (1-9 YoA), an increase in incidence and hospitalizations (with complications) in older age groups (≥ 10-64 YoA) was observed. The annual average fatality rate was estimated to be 0.44% (0.26-0.83%) of which 28.8% of deaths were concentrated in adults ≥ 65 YoA. The total direct costs of medical attention due to HAV and related complications were estimated at $382 million Mexican pesos. CONCLUSION: The overall results suggest an uptrend in HAV infections in adolescents/adults compared to children in Mexico. Therefore, as the overall incidence risk of HAV infection decreases, the mean age of infection increases. This consequently increases the risk of severity and complications in older age groups, thus increasing the demand for healthcare resources. Our findings provide evidence for including the inactivated HAV vaccine in the Mexican NIP.

[Implementation of a fracture liaison service. Experience with 177 patients]. / No Más Fracturas - Implementación de la primera Unidad de Coordinación de Fracturas en Chile: experiencia al año de funcionamiento.

BACKGROUND: Every year about 9 million fragility fractures (FF) occur worldwide and 80% of these are underdiagnosed or undertreated. Aiming to close the gap of diagnosis and treatment of osteoporosis, Fracture Liaison Services (FLS) were developed. AIM: To describe the implementation of the first FLS in Chile, its inclusion criteria, patient enrolment, treatment adherence and referrals during the first year. MATERIAL AND METHODS: A FLS was implemented at a health care network composed by two hospitals. The International Osteoporosis Foundation (IOF) guidelines were applied with a nurse practitioner as the coordinator. From May 2020 to April 2021 all patients diagnosed with a FF in the emergency rooms were invited to participate. Patients with pathological fractures and active cancer were excluded. Demographical data, fracture location, previous fractures, treatment and adherence, and mortality were recorded. RESULTS: From 443 patients with a diagnosis of FF, 177 patients (40%) accepted to participate. Their mean age was 74 ± 13 years and 84% (149) were female. Forty eight percent (84) had a lower extremity FF. Hip fractures were the most common (67). Ninety-five patients reported previous FF and 11,2% (20) had received anti-osteoporotic treatment. At four months of follow-up, 62% (50) had received vitamin D and calcium supplementation and 20% (16) of those patients with an indication of anti-osteoporotic drugs, had received them. CONCLUSIONS: The implementation of the FLS was successful with a 40% enrolment of patients, receiving certification by the IOF.

Sarcoid-like granulomatous myositis-associated hypercalcemia. An infrequent case to consider.

PTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13.4 mg/dl) following a trip to the Caribbean. The evaluation showed a suppressed PTH, 25-hydroxy vitamin D of 7.5 ng/ml, 18F-FDG PET/CT showed markedly increased uptake in intercostal, back, shoulder, buttock and thigh muscles and a deltoid biopsy confirmed extensive granulomatous myositis. He was prescribed glucocorticoids which resulted in normalized plasma calcium levels and complete recovery from tetraparesis. Sarcoid-like granulomatous myositis should be incorporated into the differential diagnosis of PTH-independent hypercalcemia, especially in the absence of clinical features of sarcoidosis and with special emphasis on the use of 18F-FDG PET/CT to ensure a correct approach.

La hipercalcemia PTH-independiente asociada a enfermedades granulomatosas está bien documentada y la sarcoidosis es la enfermedad más característica, a pesar de que existen otras. Describimos un caso de miositis granulomatosa simil-sarcoidea. Un hombre de 87 años consultó por tetraparesia e hipercalcemia (calcio corregido por albúmina 13.4 mg/dl) luego de un viaje al Caribe. La evaluación mostró una PTH suprimida, 25-hidroxivitamina D 7.5 ng/ml, 18F-FDG PET/CT mostró marcado aumento de captación a nivel de musculatura intercostal, dorsal, deltoidea, glúteos y muslos. Una biopsia deltoidea confirmó una miositis granulomatosa extensa. Se prescribieron glucocorticoides, resultando en normalización del calcio plasmático y completa recuperación de la tetraparesia. La miositis granulomatosa simil-sarcoidea debe ser incorporada dentro del diagnóstico diferencial de la hipercalcemia PTH-independiente, especialmente en ausencia de hallazgos clínicos de sarcoidosis y con especial énfasis en el uso de 18F-FDG PET/CT para su correcta aproximación.

Sarcoid-like granulomatous myositis-associated hypercalcemia. An infrequent case to consider / Hipercalcemia asociada a miositis granulomatosa sarcoidea simil- sarcoidea. Un caso infrecuente a considerar

Abstract PTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13.4 mg/dl) following a trip to the Caribbean. The evaluation showed a suppressed PTH, 25-hydroxy vitamin D of 7.5 ng/ml, 18F-FDG PET/CT showed markedly increased uptake in intercostal, back, shoulder, but tock and thigh muscles and a deltoid biopsy confirmed extensive granulomatous myositis. He was prescribed glucocorticoids which resulted in normalized plasma calcium levels and complete recovery from tetraparesis. Sarcoid-like granulomatous myositis should be incorporated into the differential diagnosis of PTH-independent hypercalcemia, especially in the absence of clinical features of sarcoidosis and with special emphasis on the use of 18F-FDG PET/CT to ensure a correct approach.

Resumen La hipercalcemia PTH-independiente asociada a enfermedades granulomatosas está bien documentada y la sarcoidosis es la enfermedad más característica, a pesar de que existen otras. Des cribimos un caso de miositis granulomatosa simil-sarcoidea. Un hombre de 87 años consultó por tetraparesia e hipercalcemia (calcio corregido por albúmina 13.4 mg/dl) luego de un viaje al Caribe. La evaluación mostró una PTH suprimida, 25-hidroxivitamina D 7.5 ng/ml, 18F-FDG PET/CT mostró marcado aumento de captación a nivel de musculatura intercostal, dorsal, deltoidea, glúteos y muslos. Una biopsia deltoidea confirmó una miositis granulomatosa extensa. Se prescribieron glucocorticoides, resultando en normalización del calcio plasmático y completa recuperación de la tetraparesia. La miositis granulomatosa simil-sarcoidea debe ser incorporada den tro del diagnóstico diferencial de la hipercalcemia PTH-independiente, especialmente en ausencia de hallazgos clínicos de sarcoidosis y con especial énfasis en el uso de 18F-FDG PET/CT para su correcta aproximación.

Pertussis infant morbidity and mortality trends after universal maternal immunisation in Mexico: An ecological database study with time-series analysis.

INTRODUCTION: Pertussis is a highly contagious infectious disease caused by Bordetella pertussis and a leading cause of infant mortality in Mexico. The Tetanus-diphtheria-acellular pertussis (Tdap) vaccine was recommended in the Mexican Immunisation Programme for pregnant women in 2013. We describe pertussis morbidity and mortality trends in infants ≤2 and ≤12 months of age), before and after maternal Tdap immunisation implementation in Mexico. METHODS: An ecological retrospective database study was performed in the Mexican National and Workers Social Security Institutes (IMSS; ISSSTE). Data were collected on confirmed pertussis ambulatory cases, hospitalisations, and deaths, plus vaccination coverage (Tdap; Diphtheria-tetanus-acellular pertussis [DTPa]) and population estimates. Descriptive and regression time-trend analyses were performed for pertussis morbidity and mortality in infants between pre- (2010-2012) and post- (2014-2018) maternal Tdap immunisation periods. RESULTS: Around 1 million infants a year are covered in IMSS/ISSSTE databases. Average full primary infant DTPa vaccine coverage was 71.4%-72.7% nationally. Since 2013, annual maternal Tdap vaccine coverage ranged from 70%-93%. Between 2010-2018, 2,024 pertussis cases, 2,518 hospitalisations and 71 deaths were reported in infants. Among infants 0-2 months old (maternal immunisation target group), there was a significant decrease, post-maternal vaccination, in pertussis incidence (49.9%, p < 0.000), hospitalisation (70.0%, p < 0.000) and mortality (82.4%, p = 0.003). In infants 0-12 months old, pertussis hospitalisations (28.9%, p = 0.000) and mortality (36.2%, p = 0.059) decreased, but incidence increased (61.8%, p = 0.000). CONCLUSION: After maternal immunisation was implemented, there was a decreasing trend in incidence, hospitalisation and death due to pertussis in infants 0-2 months old. Increases in incidence reported in 0-12-month-olds are likely due to major changes in diagnosis and reporting introduced during the study period as well as limited vaccination and health coverage in some states. These findings confirm the important contribution of the Tdap maternal immunisation programme in reducing pertussis disease burden, particularly severe disease, among infants in Mexico.

A multi-approach assessment of land use effects on groundwater quality in a karstic aquifer.

Groundwater represents almost half of the drinking water worldwide and more than one third of water used for irrigation. Agro-industrial activities affect water resources in several manners; one of the most important is leaching of agrochemical residues. This research identifies the major contributors of changes in groundwater quality comparing two contrasting land uses in a karstic area of the Yucatan peninsula as case study. Using a multiple approach, we assess the impact of land use with physicochemical data, multivariate analyses, hydrogeochemistry and nitrate isotopic composition. We confirmed that agricultural land use has a greater impact on groundwater quality, observed in higher concentration of nitrates, ammonium, potassium and electrical conductivity. Seasonality has an influence on phosphates and the chemical composition of the groundwater, increasing the concentration of dissolved substances in the rainy season. There was a clear effect of manure application in the agricultural zone and the nitrate isotopic composition of groundwater points toward recharge in certain areas. We consider that seasonality and land use effects are intertwined and sometimes difficult to separate, likely because of land use intensity and hydrogeochemical process at a local scale. Finally, we observed poor groundwater quality in the agricultural area during the wet season; thus, it is desirable to maintain non-agricultural areas that provide groundwater of appropriate quality.

Dinámica de aparición de criaderos de Aedes aegypti (Diptera: Culicidae) en la provincia La Habana, 2013-2017 / Dynamics of the appearance of breeding sites of Aedes aegypti (Diptera: Culicidae) in the province of Havana, 2013-1017

Introducción: El Programa Nacional de Control de Aedes aegypti realiza actividades de rutina para controlar la trasmisión de arbovirosis en el país, pero siempre quedan poblaciones residuales del vector, que demandan de una vigilancia entomológica sostenible. Objetivo: Determinar la presencia de estadios inmaduros de Ae. aegypti en la provincia La Habana en el periodo 2013-2017. Métodos: Se realizó un análisis del número de criaderos larvales, detectados por los trabajadores del Programa Nacional de Control de Ae. aegypti, en La provincia La Habana entre 2013-2017. La frecuencia de los muestreos fue mensual y se siguió la metodología de encuestas del programa. Resultados: Al analizar el número de criaderos larvales por meses de los 15 municipios de provincia La Habana, se observó un incremento de estos en el periodo de junio a octubre en todos los años y un pico entre los meses de enero a marzo en los años 2014, 2016 y 2017. La incidencia de Ae. aegypti resultó homogénea al comparar las medias por año, excepto para el año 2015 en el cual se observó una disminución significativa en el número de criaderos en comparación solo con el año 2017. Conclusiones: A pesar del esfuerzo que realizan los trabajadores del programa, no se ha logrado una disminución significativa de criaderos de Ae. aegypti, lo que evidencia la necesidad de fortalecer los sistemas de vigilancia y mantener la sostenibilidad de las acciones para controlar de forma efectiva la trasmisión de arbovirosis en la provincia La Habana(AU)

Introduction: The National Aedes aegypti Control Program carries out routine activities to control the transmission of arbovirus infections in the country. However, there still exist residual populations of the vector which require sustainable entomological surveillance. Objective: Determine the presence of immature stage Ae. aegypti in the province of Havana in the period 2013-2017. Methods: An analysis was conducted of the number of larval breeding sites detected by workers from the National Ae. aegypti Control Program in the province of Havana in the period 2013-2017. Sampling was performed on a monthly basis following the surveying methodology of the Program. Results: Analysis of the data on larval breeding sites per month in the 15 municipalities of the province of Havana revealed an increase in their number in the June-October period of every year, and a peak between the months of January and March in the years 2014, 2016 and 2017. Comparison of mean values per year found that incidence of Ae. aegypti was homogeneous, except for the year 2015, when a significant decrease was observed in the number of breeding sites only with respect to the year 2017. Conclusions: Despite the effort made by workers from the Program, a significant reduction has not been achieved in the number of Ae. aegypti breeding sites, which is evidence of the need to strengthen the surveillance systems and maintain the sustainability of the actions performed to effectively control the transmission of arbovirus infections in the Havana province(AU)

Vaccine coverage and compliance in Mexico with the two-dose and three-dose rotavirus vaccines.

Worldwide, rotavirus infection has been a leading cause of severe diarrhea morbidity and mortality. Two rotavirus vaccines have been used in the National Immunization Program (NIP) in Mexico; two-dose Rotarix from 2006 to 2011 and three-dose RotaTeq since 2011. This study assessed coverage (receiving at least one dose or full dose series) in eligible infants, compliance (% completing dose series and % completing series on schedule) in eligible infants vaccinated with Rotarix (2010) versus RotaTeq (2012), using Mexican Social Security Institute data nationwide and by regions. In 2010, 80.7% received at least one dose of Rotarix, 75.6% received both doses and 57.0% received both doses on schedule. In 2012, 85.7% received at least one dose of RotaTeq, 61.0% received all three doses and 43.2% received all three doses on schedule. More eligible infants received all doses with Rotarix versus RotaTeq (p < 0.001). Among infants vaccinated with Rotarix versus RotaTeq, 93.7% versus 71.1% completed full series (p < 0.001), and 75.5% versus 70.9% completed full series on schedule (p = 0.105), respectively. The full series coverage and compliance decreased in all regions with RotaTeq compared with Rotarix. In conclusion, rotavirus vaccination has successfully reduced morbidity and mortality in children under 5 years in Mexico. This study found significant differences in full series coverage and compliance among infants and a higher proportion of completed scheduled at an earlier age in Mexico when comparing a two-dose vaccine in 2010 with a three-dose vaccine in 2012. Such differences might need to be taken into consideration to maximize NIP benefits, including early protection of the rotavirus vaccination program.

Vitamin D and Bone Mineral Density in HIV Newly Diagnosed Therapy-Naive Patients Without Any Secondary Causes of Osteoporosis.

Bone loss and vitamin D deficiency are common in HIV patients. However, bone health status in newly diagnosed HIV patients has not been thoroughly described. Our aim was to assess the bone mineral density (BMD), bone resorption and vitamin D status in newly diagnosed HIV patients. A prospective observational study in HIV newly diagnosed therapy-naive persons. Patients with secondary causes of osteoporosis were excluded. Bone densitometry (DXA), a bone resorption marker (CTx), 25-hydroxyvitamin D (25OHD), CD4 count and HIV viral load (VL) were done in 70 patients. Vitamin D results were compared with a group of healthy volunteers. All patients were men, mean age 31 years (19-50). Low BMD (Z score ≤ 2.0) was found in 13%, all of them in lumbar spine, and in only one patient also in femoral neck. Bone resorption was high in 16%. One out of four participants had low BMD or high bone resorption. Vitamin D deficiency (25OHD < 20 ng/mL) was found in 66%. Mean 25OHD in patients was significantly lower than in healthy volunteers (p = 0.04). No associations were found between BMD, CTx, 25OHD and VL or CD4 count. We hypothesize that HIV infection negatively affects bone health based on the results we found among newly diagnosed, therapy-naive, HIV-infected patients, without any known secondary causes of osteoporosis. Low BMD or high bone resorption, are significantly prevalent in these patients. HIV-infected patients had a higher prevalence of vitamin D deficiency than controls, which was not correlated with CD4 count or VL.