Triclabendazole resistance in Fasciola hepatica: First report in sheep from the Santa Cruz province, Argentinian Patagonia.

In the fall of 2022, decreased triclabendazole (TCBZ) efficacy against F. hepatica was suspected in a sheep farm located in the Santa Cruz province, Argentinian Patagonia. Since TCBZ-resistance in F. hepatica has never been reported in this province, this study aimed to confirm potential TCBZ-resistance in F. hepatica and to evaluate the efficacy of closantel (CLO) and nitroxinil (NTX), through faecal egg count reduction test (FECRT), and the efficacy of albendazole (ABZ) through the in vitro egg hatch test (EHT) in sheep. Sixty-eight (68) animals were selected from a herd of eighty (80) female Merino naturally infected with F. hepatica based on eggs per gram of F. hepatica (EPGFh) counts and assigned into four (4) groups (n = 17 per group): Group Control, animals did not receive anthelmintic treatment; Group TCBZ, animals were orally treated with TCBZ (12 mg/kg); Group CLO, animals were orally treated with CLO (10 mg/kg); and Group NTX, animals were subcutaneously treated with NTX (10 mg/kg). The fluke egg output was monitored on days 0 and 21 post-treatment. For the EHT, liver fluke eggs were isolated from faecal samples (approx. 50 g) collected from animals of the control group. TCBZ efficacy against liver fluke was 53.4%, confirming the presence of TCBZ-resistant isolates on the farm. CLO and NTX were highly effective (100%) for the treatment of F. hepatica on this farm. The EHT was carried out in two different laboratories, in which was observed an ABZ efficacy of 95.8 (Bariloche) and 96.5% (Tandil). These results indicate the ABZ susceptibility of this F. hepatica isolate and the inter-laboratory precision of the test.

Feeding on the Fruit Waste Orange Bagasse Modifies Immature Protein Content, Body Weight, Scent Bouquet Composition, and Copula Duration in Males of a Tephritid Frugivorous Fly.

Anastrepha ludens is a polyphagous frugivorous tephritid that infests citrus and mango. Here, we report the establishment of a laboratory colony of A. ludens reared on a larval medium that is a waste for the citrus industry, specifically, orange (Citrus × sinensis) fruit bagasse. After 24 generations of rearing on a nutritionally poor orange bagasse diet, pupae weighed 41.1% less than pupae from a colony reared on a nutritionally rich artificial diet. Larvae from the orange bagasse diet had 6.94% less protein content than larvae from the artificial diet, although their pupation rate was similar. Males from the orange bagasse diet produced a scent bouquet with 21 chemical compounds and were sexually competitive, but they had significantly shorter copulations when compared to males from the artificial diet and from the wild host, Casimiroa edulis, which had relatively simple scent bouquets. The chemical complexity in the odors of males from the orange bagasse diet might initially have attracted females to novel scent combinations, but, once in the copula, they may have been able to sense negative characteristics in males, leading them to terminate copulations soon after they began. We conclude that A. ludens can adjust morphological, life history, nutritional, and chemical traits when adapted to a larval environment consisting of fruit bagasse.

A matheuristic approach to the air-cargo recovery problem under demand disruption.

Air cargo transport is subject to unpredictable changes in expected demand, necessitating adjustments to itinerary planning to recover from such disruptions. We study a flight rescheduling problem to react to cargo demand disruptions in the short run. To increase flexibility, we consider two different cargo assignment policies. We propose a matheuristic approach to solve the problem that provides high-quality solutions in a short computational time, based on column generation in which each subproblem is solved using an ad-hoc heuristic. The approach is tested on demand disruption instances containing up to 75 air cargo orders with different penalty levels. The results show that the proposed method improves profit by 54% over the solution generated by a commercial MIP solver within a 1-h time limit, and by 15% over the solution with the routes fixed as in the original flight planning that only allows cargo to be re-routed. We also show that there exist incremental benefits in the range of 3-5% by allowing cargo for a given order to be transported by various aircraft.

Afforestation or intense pasturing improve the ecological and economic value of abandoned tropical farmlands.

Increasing demands for livelihood resources in tropical rural areas have led to progressive clearing of biodiverse natural forests. Restoration of abandoned farmlands could counter this process. However, as aims and modes of restoration differ in their ecological and socio-economic value, the assessment of achievable ecosystem functions and benefits requires holistic investigation. Here we combine the results from multidisciplinary research for a unique assessment based on a normalization of 23 ecological, economic and social indicators for four restoration options in the tropical Andes of Ecuador. A comparison of the outcomes among afforestation with native alder or exotic pine, pasture restoration with either low-input or intense management and the abandoned status quo shows that both variants of afforestation and intense pasture use improve the ecological value, but low-input pasture does not. Economic indicators favour either afforestation or intense pasturing. Both Mestizo and indigenous Saraguro settlers are more inclined to opt for afforestation.

Universalidad de los servicios de salud en México / Universal Coverage of Health Services in Mexico

Las reformas llevadas a cabo en años recientes al sistema de salud en México han reducido las inequidades en la atención a la salud de la población, pero han sido insuficientes para resolver todos los problemas del Sistema Nacional de Salud (SNS). Para que el derecho a la protección de la salud consagrado en la Constitución sea una realidad para todos los ciudadanos, México se encuentra ante la necesidad de garantizar el acceso universal y efectivo a los servicios de salud. En este trabajo se delinea una reforma de largo alcance para la consolidación de un sistema de salud, afín con estándares internacionales, que establezca las condiciones estructurales para reducir las desigualdades en cobertura. Esta reforma se plantea a partir de un "pluralismo estructurado" para evitar tanto el monopolio ejercido desde el sector público como la atomización en el sector privado, y no caer en los extremos de procedimientos autoritarios o ausencia de regulación. Esto implica sustituir la actual integración vertical con segregación de grupos sociales, por una organización horizontal con separación de funciones. Implica, asimismo, reformas de tipo jurídico y fiscal, fortalecimiento del SNS, reorganización de las instituciones de salud y formulación de los instrumentos normativos, técnicos y financieros que hagan operativo el esquema propuesto para hacer plenamente efectivo el derecho humano a la salud de los mexicanos.

The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

El peso de la enfermedad en adultos mayores, México 1994 / Burden of disease in the elderly, Mexico 1994

Ojetivo. Estimar los años de vida saludable perdidos en los adultos mayores en México durante 1994. Material y métodos. Se estimaron los años perdidos por muerte prematura y los años vividos con discapacidad para 108 enfermedades, ambos sexos, 32 estados de la República Mexicana divididos en área rural y urbana, en la población de 60 años y más, empleando la metodologia propuesta por Murray López pero adecuándola a las características locales. Los insumos utilizados son: estadísticas de mortalidad de 1994 (después de corregir el subregistro y la mala clasificación de la causas de muerte), estadísticas de incicidencia y prevalencia provenientes de estudios epidemiológicos locales, encuestas nacionales de salud y estimaciones propias. Los resultados obtenidos fueron sometidos a evaluaciones sobre la consistencias interna y externa. Resultados. Durante 1994 la población mexicana de 60 y más perdió 1.8 millones de años de vida saludable (AVISA), 59 por ciento por muerte prematura y 41 por ciento por discapacidad. La mayor parte del peso de la enfermedad lo constituyen enfermedades no transmisibles. Las principales necesidades de salud se dividen en dos grupos de enfermedades: a) las que tradicionalmente son de elevada frecuencia en esta edad, como son los problemas isquémicos de corazón, diabetes y enfermedades cerebrovasculares, y b) las enfermedades altamente discapacitantes como demencia, caídas y artritis reumatoide, entre otras. Conclusiones. El empleo de indicadores compuestos como los AVISA para evaluar necesidades de salud en los adultos mayores ayudan a los planificadores a incorporar dentro de las necesidades prioritarias enfermedades discapacitantes a la par de enfermedades de elevada letalidad, logrando con ello más equidad en la asignación de recursos a los distintos programas de atención curativa, prevención y rehabilitación

To estimate the disability adjusted life years lost (DALYs) in population over 60 years of age in Mexico during 1994. Material and methods. Years of life lost due to premature mortality (YLL) and years lived with disability (YLD) were estimated for 108 diseases, both sexes, and 32 states of the Mexican Republic divided in rural and urban areas in the population over 60 years of age, using the methodology originally proposed by Murray and López adapted to specific local characteristics. The inputs used were: mortality statistics for 1994 (after corrections of under-registration and miss classification), statistics on incidence and prevalence from local epidemiological studies, national health surveys and estimates by the authors. Results. During 1994 the Mexican population over 60 years of age lost 1.8 million DALYs, 59% of which were YLL while 41% were YLD. Most of the burden of disease is due to noncommunicable diseases. The principal health needs of the elderly in Mexico can be divided in two groups: a) those that traditionally are frequent in this age group, such as ischaemic heart disease, diabetes, stroke and b) disabling diseases such as dementia, falls and arthritis as the most important. Conclusions. The use of composite indicators such as DALYs to assess health needs in older adult can help decision-makers and planners to incorporate disabling and lethal diseases within the list of priority needs, thereby achieving greater equity in the assignment of resources to different health care, prevention and rehabilitation programs.

Salud y derechos humanos / Health and human rights

Compilación de trabajos realizados en torno a la salud y los derechos humanos, con el fin de hacer avanzar la causa de la salud en el desarrollo social. El documento se divide en: 1. La protección a la salud como derecho humano 2. Los derechos humanos como base doctrinaria para las políticas de salud 3. Aplicación de normas éticas de investigación médica en países en desarrollo 4. Problemas médicos emergentes y derechos humanos 5. SIDA y derechos humanos 6. Las organizaciones no gubernamentales frente al derecho a la salud 7. Salud y derechos humanos. La labor de la CDHDF en el ámbito de la salud 8. Grupos vulnerables

Carcinoma de celulas transicionales de vejiga superficial resección transuretral y quimioterapia intravesical / Transitional cell carcinoma of superficial bladder: transurethral resection and intravesical chemotherapy

Evaluación de los pacientes con Carcinoma de Células Transicionales de vejiga (CCTV) superficial, tratados con Resección transuretral (RTU) asociada o no a quimioterapia intravesical (QTIV). Diseño: Análisis retrospectivo de una serie de casos durante 10 años. Lugar: Servicios de urología y oncología médica en centro oncológico de referencia nacional. Pacientes: 21 pacientes portadores de CCTV superficial estadio O y A. Intervenciones: RTU a todos los pacientes. Administración intravesical de Adriamicina 50 mg., semanalmente por 4 semanas y mensualmente por 2 años a 10 pacientes. Mediciones: Evaluación de respuesta completa (RC) a los 2 y 5 años, porcentaje de sobrevida libre de enfermedad a los 5 años y promedio del período libre de enfermedad. Resultados: RC similar para las dos modalidades de tratamiento a los años: RTU 64 por ciento, RTU+QTIV 60 por ciento. Dif. EE 18 por ciento, 95 por ciento IC-45 por ciento a 37 por ciento, p:0,75; a los 5 años: 36 por ciento y 40 por ciento respectivamente. Dif EE 18 por ciento, 95 por ciento. IC-46 por ciento a 38 por ciento, p>0,5. Porcentaje de sobrevida global acumulada a los 5 años 29 por ciento para los dos grupos, X2=0,0061, p>0.95. Período libre de enfermedad X= 52 +/- 4,7 DE meses para RTU y 62 +/-1 DE meses para el grupo que recibió QTIV, t=6,849 p<0,0005. Conclusiones: La QTIV no modificó la respuesta ni la sobrevida libre de enfermedad a los 2 y 5 años, sin embargo prolongó significativamente el período librede esta

Síndrome de Dubin Johnson / Dubin-Johnson`s Syndrome

Se presentan 5 pacientes con Síndrome de Dubin-Johnson diagnósticados entre noviembre de 1975 y noviembre de 1985 en el Hospital San Juan de Dios. Se realizó análisis clínico de laboratorio, gabinete y estudios histológicos del hígado. Tres de los 5 casos eran de sexo femenino, siendo los tres primeros casos presentados, hermanos. La edad en el momento del diagnóstico osciló entre 17 y 26 años siendo el promedio 20 años. Todos los casos cursaron con hiperbilirrubinemia de predominio directo, que no pasó de 4 mg/dl. Cuatro de los 5 casos, mostraron aumento paradójico en la eliminación de la bromosulftaleína (BSP); así mismo en los cuatro que se realizó biopsia hepática, ésta reveló depósito de pigmento pardo oscuro en los hepatocitos, descrito como característico de la enfermedad. El cuadro clínico se caracterizó principalmente por ictericia y hepatomegalia leve.