Excess Child Mortality Associated With Colombia's Armed Conflict, 1998-2019.

Importance: Armed conflicts are directly and indirectly associated with morbidity and mortality due to destruction of health infrastructure and diversion of resources, forced displacement, environmental damage, and erosion of social and economic security. Colombia's conflict began in the 1940s and has been uniquely long-lasting and geographically dynamic. Objective: To estimate the proportion of infant and child mortality associated with armed conflict exposure from 1998 to 2019 in Colombia. Design, Setting, and Participants: This ecological cohort study includes data from all 1122 municipalities in Colombia from 1998 to 2019. Statistical analysis was conducted from February 2022 to June 2023. Exposure: Armed conflict exposure was measured dichotomously by the occurrence of conflict-related events in each municipality-year, enumerated and reported by the Colombian National Center for Historic Memory. Main Outcomes and Measures: Deaths among children younger than 5 years and deaths among infants younger than 1 year, offset by the number of births in that municipality-year, enumerated by Colombia's national vital statistics. Results: The analytical sample included 24 157 municipality-years and 223 101 conflict events covering the period from 1998 to 2019. Overall, the presence of armed conflict in a municipality was associated with a 52% increased risk of death for children younger than 5 years of age (relative risk, 1.52 [95% CI, 1.34-1.72]), with similar results for 1- and 5-year lagged analyses. Armed conflict was associated with a 61% increased risk in infant (aged <1 year) death (relative risk, 1.61 [95% CI, 1.43-1.82]). On the absolute scale, this translates to a risk difference of 3.7 excess child deaths per 1000 births (95% CI, 2.7-4.7 per 1000 births) and 3.0 excess infant deaths per 1000 births (95% CI, 2.3-3.6 per 1000 births) per year, beyond what would be expected in the absence of armed conflict. Across the 22-year study period, the population attributable risk was 31.7% (95% CI, 23.5%-39.1%) for child deaths and 35.3% (95% CI, 27.8%-42.0%) for infant deaths. Conclusions and Relevance: This ecological cohort study of Colombia's spatiotemporally dynamic armed conflict suggests that municipal exposure to armed conflict was associated with excess child and infant deaths. With a record number of children living near active conflict zones in 2020, policy makers and health professionals should understand the magnitude of and manner in which armed conflicts directly and indirectly undermine child health.

Functional response and mutual interference in the parasitoid Coptera haywardi (Oglobin) (Hymenoptera: Diapriidae) attacking Anastrepha ludens (Loew) (Diptera: Tephritidae) pupae.

Functional response and mutual interference are important attributes of natural enemies that should be analysed in species with the potential to be used as biological control agents in order to increase the predictive power of the possible benefits and/or consequences of their release in the field. Our main objective was to determine the functional response and mutual interference of Coptera haywardi (Oglobin), a pupal parasitoid of economically important fruit flies (Diptera: Tephritidae). The functional response of C. haywardi on A. ludens pupae corresponded to a type II model, with an attack rate of 0.0134 host pupa/h and a handling time of 1.843 h, which reveals a meticulous selection process of pupal hosts. The effect of mutual interference among foraging females was negatively correlated with increased parasitoid density in the experimental arena, showing a gradual decline in attack rate per individual female. The increase in the number of foraging females also had an impact on the number of oviposition scars per pupa and the number of immature parasitoids per dissected pupa, but not on the percentage of adult emergence or the sex ratio. Our results suggest that C. haywardi could act as a complementary parasitoid in the control of fruit fly pupae, since the random distribution of these pupae in the soil would decrease the possibility of aggregation and mutual interference between foraging females.

Interference of tritrophic (grape × medfly × parasitoid) interactions by mineral and biomaterial films.

Fruit fly infestation is one of the main obstacles to the exportation of fresh agricultural produce. Films of mineral particles and biomaterials have the potential to protect fruits against tephritid fruit fly infestation. The present study evaluated the effects of particle films on the tritrophic interactions of grape (Vitis vinifera L.), the fruit fly Ceratitis capitata (Wiedemann) and the parasitoid Diachasmimorpha longicaudata (Ashmead) under semi-field conditions. Grapes were biometrically characterised (i.e. colour, firmness, mass, length and diameter), treated with mineral particles, biomaterials or distilled water (control), and then used in oviposition and parasitism bioassays. In the oviposition bioassay, the treated grapes were exposed to 50 C. capitata pairs in field cages, and after 48 h, the punctures and eggs on each fruit were counted. In the parasitism bioassay, treated grapes were artificially infested with third-instar C. capitata larvae (two per fruit), exposed (2 h) to 50 D. longicaudata pairs in field cages to determine parasitism index, larval and pupal viabilities and number of flies and parasitoids emerged. Treatment with the mineral film affected fruit colour and reduced C. capitata oviposition but failed to significantly affect the parasitism capacity of D. longicaudata. The ability of the parasitoid to locate and parasitise C. capitata larvae in kaolin-coated fruits suggests that kaolin films could be used in conjunction with biological agents to control fruit flies.

Effect of the Sterile Insect Technique and Augmentative Parasitoid Releases in a Fruit Fly Suppression Program in Mango-Producing Areas of Southeast Mexico.

The Sterile Insect Technique (SIT), by means of sterile male releases of Anastrepha ludens (Loew), coupled with Augmentative Biological Control (ABC), by releasing the parasitoid Diachasmimorpha longicaudata (Ashmead), was evaluated in a commercial mango production area for one year. The obtained results were compared with mean fruit fly population values from two previous years without the combined use of both techniques. The treatments were: SIT + ABC, SIT, ABC, and Control, and each treatment was established in blocks of 5000 Ha separated by distances of 5-10 km. The evaluations were carried out through fruit sampling to assess percent parasitism and trapping of adult flies to obtain Flies per Trap per Day (FTD) values. The mean percentage of parasitism increased from 0.59% in the control treatment to 19.38% in the block with ABC. The FTD values decreased from ~0.129 and ~0.012 in the control block to 0.0021 in the block with SIT and ABC, representing a 98% suppression. The difference between the two periods in the control block was not significant. We conclude that the integration of both techniques resulted in an additive suppression of the pest population, supporting the use of both control techniques in an area-wide pest management context.

Additive Effect of Releasing Sterile Insects Plus Biocontrol Agents against Fruit Fly Pests (Diptera: Tephritidae) under Confined Conditions.

Pest control models integrating the use of the sterile insect technique (SIT) and augmentative biological control (ABC) have postulated that it is possible to obtain a synergistic effect from the joint use of these technologies. This synergistic effect is attributed to the simultaneous attack on two different biological stages of the pest (immature and adult flies), which would produce higher suppression on the pest populations. Here we evaluated the effect of the joint application of sterile males of A. ludens of the genetic sexing strain Tap-7 along with two parasitoid species at the field cage level. The parasitoids D. longicaudata and C. haywardi were used separately to determine their effect on the suppression of the fly populations. Our results showed that egg hatching percentage was different between treatments, with the highest percentage in the control treatment and a gradual reduction in the treatments with only parasitoids or only sterile males. The greatest induction of sterility (i.e., the lowest egg hatching percentage) occurred with the joint use of ABC and SIT, demonstrating that the earlier parasitism caused by each parasitoid species was important reaching high levels of sterility. Gross fertility rate decreased up to 15 and 6 times when sterile flies were combined with D. longicaudata and C. haywardi, respectively. The higher parasitism by D. longicaudata was determinant in the decrease of this parameter and had a stronger effect when combined with the SIT. We conclude that the joint use of ABC and SIT on the A. ludens population had a direct additive effect, but a synergistic effect was observed in the parameters of population dynamics throughout the periodic releases of both types of insects. This effect can be of crucial importance in the suppression or eradication of fruit fly populations, with the added advantage of the low ecological impact that characterizes both techniques.

Bacterial Diversity Associated with Anastrepha obliqua Males Change Under Mass-Rearing Conditions and with Irradiation.

Recent advances in understanding the symbiotic interactions between bacteria and fruit flies have shown that they are relevant for mass rearing and the sterile insect technique (SIT). SIT involves mass production and release of sterile insects that would copulate with their wild conspecifics and thus decrease the population growth rate. The irradiation process used to sterilize mass-reared flies can modify the diversity and structure of the midgut bacterial communities, which could affect sterile male survival, flight capacity, and sexual competitiveness. Our aim was to compare bacterial communities in the midgut of wild and mass-reared Anastrepha obliqua (Macquart) males irradiated at 0, 60, and 80 Gy. After adult's emergence, their midguts were dissected, DNA was extracted, and high-throughput sequencing of the V3-V4 region of the 16S rDNA gene was performed. A total of 11 phyla, 17 classes, 47 families, and 52 genera of bacteria were identified. The most representative phylum was Proteobacteria and the predominant family was Enterobacteriaceae. We found that wild males had a different intestinal bacterial community from mass-reared males. In addition, irradiation at 60 and 80 Gy caused changes in the diversity and structure of the midgut microbiota of these sterile males, suggesting that mass rearing and irradiation cause artificial selection of the bacterial communities in the gut of A. obliqua males.

Superparasitism and fitness parameters in three native wasp parasitoids (Braconidae: Opiinae) of the Mexican fruit fly, Anastrepha ludens (Diptera: Tephritidae).

Knowledge on reproductive strategies and host use in insect parasitoids is fundamental for biological control purposes. Superparasitism and multiparasitism, oviposition in a previously parasitized host by a female of the same or different species, respectively, may impact pest management decisions. Our objective was to determine the occurrence of superparasitism and multiparasitism in three species of native larval-pupal solitary endoparasitoids that attack Anastrepha Shiner species (Diptera: Tephritidae) in the Neotropical region, and the possible effect on offspring fitness parameters. Doryctobracon crawfordi (Viereck), Utetes anastrephae (Viereck), and Opius hirtus (Fischer) occur in sympatry in Mexico, and are currently under consideration for use as biocontrol agents. Experiments were conducted under laboratory conditions with females acting alone (self-superparasitism), females in groups of the same species (conspecific superparasitism), and females in mixed groups (multiparasitism). Our results showed that self-superparasitism is an uncommon strategy in the three native species and is rare under conditions of intraspecific competition. In the case of multiparasitism, a higher number of immature stages of U. anastrephae was observed, compared to those of D. crawfordi and O. hirtus. However, it is not clear yet if this was due to some adult female trait or to the competitive ability of the larvae. We conclude that most females of the native species studied appeared to avoid superparasitism, specifically when acting alone, suggesting a high discrimination ability, which is probably a result of a close relationship and evolutionary history with Anastrepha hosts.

Clinical outcome of patients with COVID-19 Pneumonia treated with corticosteroids and colchicine in Colombia.

BACKGROUND: To date, there is no specific antiviral therapy for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (Covid-19). Since there is no specific therapy against SARS-CoV2, current efforts aim to prevent contagion through public health measures and develop a protective vaccine. While waiting for the latter, it is necessary to evaluate the drugs that at least, in initial studies, suggested some degree of utility in the management of Covid-19 or its complications. The main objective of the study was to describe the clinical manifestations and outcomes of patients with severe Covid-19 Pneumonia treated with corticosteroids and colchicine. MATERIALS AND METHODS: A cross sectional study of 301 adult patients with Covid-19 Pneumonia confirmed by Real-Time Polymerase Chain Reaction for SARS-CoV2 (RT-PCR SARS-CoV2), Berlin protocol, who required hospitalization in three hospitals in Antioquia, Colombia. Patients were treated according to the institutional protocol (from March 20, 2020 to June 30, 2020) with corticosteroid if the patient required supplemental oxygen. From July 1, 2020, the management protocol changed with the addition of colchicine to all patients admitted to the institutions. The treatment was supervised and monitored by the same specialist in Infectology of the institutions. We describe the clinical manifestations and outcomes of the patients who received these treatments. The information of the patients was analyzed according to the outcome of interest (alive/dead) with univariate, bivariate, and multivariate measures to adjust the variables that presented statistical association. RESULTS: All patients had pneumonia documented by chest computed tomography with ground glass images and presented an alveolar pressure/inspired oxygen fraction (PaFi) less than 300. Three hundred one patients were included, 240 (79.7%) received corticosteroids, within these 145 (48.2%) received colchicine also, and the remaining 61 (20.3%) patients did not receive corticosterioids or colchicine. Mortality in the group that received colchicine was lower compared to the group that did not receive it (9.6 vs 14.6%, p-value = 0.179). CONCLUSIONS: Treatment with corticosteroids and colchicine for managing patients with severe Covid-19 Pneumonia was associated with low mortality at the hospital level. Randomized, placebo-controlled studies are required to evaluate the effect of corticosteroids and colchicine on complications or death from Covid-19.

Effect of GF-120 (Spinosad) Aerial Sprays on Colonies of the Stingless Bee Scaptotrigona mexicana (Hymenoptera: Apidae) and the Honey Bee (Hymenoptera: Apidae).

Despite their relevant contribution to the conservation of tropical ecosystems and crop productivity through pollination, the stingless bees (Apidae: Meliponini) can be considered a group of neglected species in the assessment of pesticides upon nontarget organisms. In this article, we evaluated the effect of aerial sprays of the spinosad-based fruit fly toxic bait GF-120 upon colonies of the stingless bee Scaptotrigona mexicana Guérin (Hymenoptera: Apidae), an economically important and abundant species in some landscapes of Mexico, located in mango orchards. Colonies of the honey bee Apis mellifera L. (Hymenoptera: Apidae) were used for comparison. Eight colonies (four of A. mellifera and four of S. mexicana) were moved into each of two mango orchards, one was used as a control, with no insecticide application, and other received five weekly aerial sprays of GF-120. Foraging activity and strength of colonies of both species were measured nine times over the fruiting season, previous, during and after insecticide application. We did not find a significant difference in foraging activity and strength between exposed and control colonies of A. mellifera during the observation period. However, colonies of S. mexicana seemed to be affected by the exposure, as revealed by a reduction in colony strength. However, 1 yr later, with no insecticide applications, the colonies of both species were evaluated and found to be in good conditions. Our results showed that weekly aerial sprays of GF-120 are unlikely to generate acute poisoning in both species, even if in acute toxicity tests this product has been found to be highly active.

Synthesis of exo-Imidazolidin-2-one Dienes, Their Isomerization, and Selectivity in Diels-Alder Cycloadditions.

An efficient and alternative synthesis of exo-imidazolidin-2-one dienes is described. A condensation reaction was carried out with bis-imino derivatives, diacetyl, and triphosgene, affording symmetrically N, N-disubstituted dienes. The use of alkyl methyl α-diketones led to the formation of nonsymmetrical dienes, which underwent isomerization to provide more stable inner-outer-ring dienes under Lewis acid conditions. Evaluation was made of the reactivity as well as regio- and stereoselectivity of these dienes in Diels-Alder reactions. They proved to be highly reactive and selective. DFT calculations of the transition states accounted for their behavior.

Iniciativa para fortalecer la atención materna e infantil en un grupo de municipios en Colombia / Initiative to strengthen maternal and child health care in a group of municipalities in Colombia / Iniciativa para robustecer a atenção materna e infantile em um grupo de municípios na Colômbia

Resumen Objetivo: Presentar los resultados de una iniciativa conjunta para mejorar la calidad de la atención en salud materna e infantil en 36 municipios colombianos. Metodología: Se incluyen los principales resultados de una iniciativa en salud pública implementada entre 2012 y 2015 en 36 municipios. Su enfoque fue sistémico e incluyó cuatro componentes: 1) Elaboración y seguimiento de planes de mejoramiento continuo de la calidad de los servicios de salud materno-infantil basados en necesidades locales, involucrando actores clave municipales/departamentales, 2) evaluación indirecta de la calidad de los servicios con revisión de historias clínicas, 3) capacitación, asistencia técnica y acompañamiento, y 4) retroalimentación periódica de resultados a las instituciones del sistema de salud. Resultados: Esta iniciativa estimuló el mejoramiento de la calidad de atención en salud del binomio madre-hijo en los municipios participantes y posiblemente incidió en la reducción de la razón de mortalidad materna en varios territorios. Se documentan aciertos y problemas en la gestión de los servicios de salud de las instituciones participantes. Discusión: A pesar de las diferencias territoriales y múltiples factores internos y externos que inciden en la calidad de los servicios, el enfoque propuesto puede implementarse en territorios con contextos diversos. Los cambios, positivos en la mayoría de territorios, evidenciaron que el éxito y la sostenibilidad de las acciones son posibles, aún en entornos complejos, pero se requiere aplicar juiciosamente la metodología propuesta y creatividad para formular soluciones locales.

Abstract Objective: To present the results of a joint initiative to improve the quality of maternal and child health care in 36 Colombian townships. Methodology: The main results of a public health initiative implemented between 2012 and 2015 in 36 municipalities are included. Its approach was systemic and included four components: 1) Elaboration and monitoring of health care quality improvement plans for maternal and child health services based on local needs, involving municipal / departmental key actors; 2) periodic review of medical records to indirectly evaluate the quality of services; 3) continuous training, technical assistance and support, and 4) periodic feedback of results to the health system institutions. Results: This initiative stimulated the improvement of mother and child health care quality in the participating municipalities, and possibly affected the reduction of the maternal mortality rate in various territories. Successes and problems in the management of the health services of the participating institutions' healthcare service management. Discussion: Despite the territorial differences and multiple internal and external factors affecting quality of health care services the proposed approach can be implemented in territories with different contexts. Positive changes in most territories showed that success and sustainability of actions are possible, even in complex environments, but it is necessary to apply the proposed methodology the judiciously and to have creativity to formulate local solutions.

Resumo Objetivo: Presentar os resultados duma iniciativa conjunta pra melhorar a qualidade da atenção em saúde materna e infantil em 36 municípios colombianos. Metodologia: Se incluem os principais resultados duma iniciativa em saúde pública implementada entre 2012 e 2015 nesses 36 municípios. O Seu foco foi sistémico e incluiu quatro componentes: 1) Elaboração e tamisado de planos de melhoramento continuo da qualidade dos serviços de saúde materno infantil baseados nas necessidades locais, envolvendo atores chave municipais/ departamentais, 2) avaliação indireta da qualidade dos serviços com revisão de historias clínicas, 3) capacitação, assistência técnica e acompanhamento, e 4) retroalimentação periódica de resultados ás instituições do sistema de saúde. Resultados: Esta iniciativa estimulou o melhoramento da qualidade de atenção em saúde do binômio mãe e filho nestes municípios participantes e possivelmente incidiu na redução da razão de mortalidade materna em vários territórios. Se documentam sucessos e também tropeços no gerir dos serviços de saúde das instituições envolvidas. Discussão: Embora as diferencias territoriais e múltiplos fatores internos ou externos que incidem na qualidade dos serviços, o enfoque proposto pode implementar-se em territórios com contextos diversos. Os câmbios, positivos na maioria de territórios, evidenciaram que o êxito e a sustentabilidade das ações são possíveis, ainda em entornos complexos, porem se requere aplicar com bom juízo a metodologia proposta e criatividade para formular soluciones locais.

Guía colombiana de práctica clínica para el tratamiento de la diabetes mellitus tipo 2: falla al tratamiento inicial / Colombian Clinical Practice Guideline for Treatment of Type 2 Diabetes Mellitus: First Line Treatment Failure

Introducción: Existen diferentes opciones de manejo para pacientes con diabetes mellitus tipo 2 (DMT2) que ya iniciaron tratamiento farmacológico con metformina y no han alcanzado metas de control glucémico. Resulta prioritario definir pautas para escoger la mejor opción en estos pacientes, así como en aquellos que no han tenido un control óptimo con la combinación de dos medicamentos. Objetivo: Definir cuál es antidiabético de elección, entre sulfonilureas, tiazolidinedionas, inhibidores de DPP-4, agonista del receptor de GLP-1 o insulina basal, como segunda y tercera líneas de manejo en pacientes con DMT2. Métodos: Se elaboró la guía de práctica clínica, siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social colombiano. Se revisó la evidencia disponible de forma sistemática y se formularon las recomendaciones utilizando la metodología GRADE. Conclusiones: En pacientes con DMT2 y falla terapéutica al manejo con metformina como monoterapia (HbA1C > 7 %) se recomienda como primera opción adicionar un inhibidor DPP-4, como segunda opción adicionar inhibidor SGLT2 o sulfonilureas con bajo riesgo de hipoglucemia y como tercera opción agregar insulina basal a los pacientes que con la combinación de dos fármacos fallen en alcanzar su meta de HbA1C. Si la falla terapéutica se asocia con un IMC persistentemente ≥ 30, se sugiere la adición de un agonista de GLP-1 por el potencial beneficio sobre la reducción de peso.

Introduction: There are different options to treat type 2 diabetes (DMT2) patients who began treatment with metformin and have not reached therapeutic golds. It is imperative to define rules to choose the best option, in these patients, as in those who have not achieved an optimal control under combined therapy. Aim: To define the best option between sulfonylureas, thiazolidinediones, DPP4 inhibitors, GLP-1 agonist or basal insulin, as second or third line treatment, in patients with DMT2 who have not reached therapeutic golds with metformin or combined therapy. Methods: A clinical practice guide has been developed following the broad outline of the methodological guide from the Colombian Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Conclusions: In patients with DMT2 who did not reach their therapeutic goal with metformin as a monotherapy (Hb1Ac <7%), addition of a second oral antidiabetic medication is recommended. it is recommended as a first step to add a DPP-4 inhibitor. It is suggested to add a SGLT2 inhibitor or a sulfonylurea having low risk of hypoglycemia as acceptable options. It is suggested to add basal insulin as a third antidiabetic medication if the combination of two pharmacological treatments does not enable the patient to reach and maintain the HbA1c goal. It is suggested to add a GLP-1 agonist if therapeutic failure appears in patients who remain obese (BMI ≥30 kg/m²), considering its potential to reduce weight.

Guía de práctica clínica para el tratamiento de la diabetes mellitus tipo 2: manejo inicial / Clinical Practice Guideline for Treatment of Type 2 Diabetes Mellitus: Initial Treatment

Introducción: En la actualidad es ampliamente aceptada la metformina como manejo farmacológico inicial para el tratamiento de la diabetes mellitus tipo 2 (DMT2). Resulta, sin embargo, controversial si en algunos tipos de pacientes puede iniciarse tratamiento únicamente con cambios intensivos de estilo de vida o si existen grupos en quienes debería iniciarse desde el inicio terapia farmacológica combinada. Objetivo: Definir el impacto de estrategias de cambio intensivo en la dieta y de ejercicio, así como de la terapia farmacológica con metformina asociada a un segundo antidiabético oral como estrategias de manejo inicial en pacientes con DMT2 recién diagnosticada. Métodos: Se elaboró la guía de práctica clínica, siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social colombiano. Se revisó la evidencia disponible de forma sistemática y se formularon las recomendaciones utilizando la metodología GRADE. Conclusiones: En pacientes con DMT2 recién diagnosticada no se recomienda el manejo únicamente con cambios intensivos del estilo de vida; estos deben acompañar el manejo farmacológico con metformina, dando prelación a los componentes de la dieta mediterránea y al ejercicio aeróbico. En los pacientes con DMT2 recién diagnosticada y niveles de HbA1C > 8 % se recomienda utilizar terapia combinada desde el inicio con metformina y otro antidiabético oral, siendo de primera elección los inhibidores de DPP-4.

Introduction: Today, metformin is widely accepted as standard initial pharmacologic treatment for diabetes mellitus type 2 (DMT2). However, it is controversial if in some groups of patients, the treatment can be initiated only with life style changes, or if there are groups who should begin with combined therapy since the beginning. Aim: To define the effect of intensive strategies for change of diet or exercise, and the effect of combined therapy with metformin and a second oral antidiabetic, as initial treatment in patients with newly DMT2. Methods: A clinical practice guide has been developed following the broad outline of the methodological guide from the Colombian Ministry of Health and Social Welfare. with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Conclusions: In patients with recently diagnosed DMT2, initial treatment with lifestyle changes only is not recommended. However, it is recommended that lifestyles changes must begin simultaneously with metformin, including the components of a Mediterranean diet and aerobic exercise. In patients with recently diagnosed DMT2 and HbA1c levels >8%, it is recommended to administer a combined therapy from the beginning with metformin and another oral antidiabetic medication. The DPP4 inhibitor is recommended.

Natural Parasitism in Fruit Fly (Diptera: Tephritidae) Populations in Disturbed Areas Adjacent to Commercial Mango Orchards in Chiapas and Veracruz, Mexico.

To determine the natural parasitism in fruit fly populations in disturbed areas adjacent to commercial mango orchards in the states of Chiapas and Veracruz, Mexico, we recorded over one year the fruit fly-host associations, fly infestation, and parasitism rates in backyard orchards and patches of native vegetation. We also investigated the relationship between fruit size, level of larval infestation, and percent of parasitism, and attempted to determine the presence of superparasitism. The most recurrent species in trap catches was Anastrepha obliqua (Macquart), followed by Anastrepha ludens (Loew), in both study zones. The fruit infestation rates were higher in Chiapas than in Veracruz, with A. obliqua again being the most conspicuous species emerging from collected fruits. The diversity of parasitoids species attacking fruit fly larvae was greater in Chiapas, with a predominance of Doryctobracon areolatus (Szépligeti) in both sites, although the exotic Diachasmimorpha longicaudata (Ashmead) was well established in Chiapas. Fruit size was positively correlated with the number of larvae per fruit, but this relationship was not observed in the level of parasitism. The number of oviposition scars was not related to the number of immature parasitoids inside the pupa of D. areolatus emerging from plum fruits. Mass releases of Di. longicaudata seem not to affect the presence or prevalence of the native species. Our findings open new research scenarios on the role and impact of native parasitoid species attacking Anastrepha flies that can contribute to the development of sound strategies for using these species in projects for augmentative biological control.

Long-term attraction and toxic effects of tephritid insecticide-bait mixtures by applying Torricelli's barometer principle in a trapping device.

BACKGROUND: The field activity of the mixtures of liquid baits and insecticides used in the control of tephritid pests is normally short, both when they are sprayed or when used in trapping or in attract-and-kill devices. A new lure-and-kill device based on Torricelli's barometer principle was tested as a long-lasting dispenser for two liquid hydrolysed protein baits mixed with insecticide, GF-120 and Captor 300 + malathion, against Anastrepha ludens (Loew) flies of laboratory origin. The dispensers were kept under field conditions for 42 days. Laboratory bioassays for insecticide properties and field cage studies for attraction capacity were carried out on a weekly basis after 22 and 42 days of weathering respectively. RESULTS: Our results demonstrated that both mixtures of insecticides and phagostimulant baits killed up to 80% of the tested flies when they were 42 days old. The attraction capacity of both weathering-exposed mixtures was even higher than fresh insecticidal-bait mixtures after the same period. CONCLUSION: The device is efficient when used with the liquid baits currently employed in the control of tephritid flies. It also offers a high potential for combining visual stimuli, such as shape and colour, and for improving trapping and bait station designs. Incorporating this new device in trapping and attract-and-kill methods could help to reduce the frequency of servicing of the traps and bait stations and lower their costs. © 2015 Society of Chemical Industry.

[Rhabdomyolysis in a Bipolar Adolescent. Analysis of Associated Factors]. / Rabdomiolisis en adolescente bipolar. Análisis de los factores asociados.

OBJECTIVE: To describe a case of rhabdomyolysis associated with the use of quetiapine and lamotrigine in an adolescent treated for bipolar disorder. METHOD: Description of the clinical case, analysis of the associated factors and a non-systematic review of the relevant literature. RESULTS: An 18 year old male, with bipolar disorder and treated pharmacologically with quetiapine and lamotrigine, after two weeks of physical activity presents with rhabdomyolysis. Quetiapine and exercise have been associated with rhabdomyolysis. The mediator mechanism of this association has not been found, although it has been established that there is neuromuscular dysfunction and an increase in sarcomere permeability. CONCLUSIONS: This clinical case allowed the complex interaction between antipsychotic agents and increased physical activity to be observed in a psychiatric adolescent patient, as well as the appearance of a potentially lethal medical complication.

Alternativas terapéuticas al manejo farmacológico con estatinas en adultos con dislipidemia. Revisión sistemática de la literatura y recomendaciones generales / Therapeutic alternatives to pharmacological management with statin drugs in adults with dyslipidemia. Systematic literature review and general recommendations

Objetivo: Evaluar el impacto sobre la incidencia y recurrencia de eventos cardiovasculares y cerebrovasculares (prevención primaria y secundaria), los niveles de las fracciones lipídicas y la incidencia de efectos secundarios en personas con hipercolesterolemia intolerantes al tratamiento con las estatinas. Métodos: Se elaboró una guía de práctica clínica siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social para recolectar de forma sistemática la evidencia científica y formular las recomendaciones utilizando la metodología GRADE. Población Población adulta, con diagnóstico de dislipidemia, o en riesgo de desarrollarla, intolerantes al manejo con las estatinas. Recomendaciones: Se formulan recomendaciones a favor del uso de diferentes medicamentos (los fibratos, la niacina, los ácidos omega 3, las resinas secuestradoras de ácidos biliares, el ezetimibe), según su efectividad hipolipemiante y reducción de eventos cardiovasculares, como propuesta adaptada al contexto social colombiano.

Objective To evaluate the impact on the incidence and recurrence of cardiovascular and cerebrovascular events (primary and secondary prevention), the levels of lipid fractions and the incidence of side effects in people with hypercholesterolemia intolerant to statin therapy. Methods: A clinical practice guideline was developed following the guidelines of the methodological guidance of the Ministry of Health and Social Protection to systematically collect the evidence and make recommendations using the GRADE methodology. Population: Adult population, diagnosed with dyslipidemia or at risk of developing, intolerant to management with statin drugs. Recommendations: Recommendations for the use of different medications (fibrates, niacin, omega 3 acids, bile acid binding resins, ezetimibe) are formulated according to their lipid-lowering effectiveness and reduction of cardiovascular events, a proposal adapted to the Colombian social context.

Rabdomiolisis en adolescente bipolar. Análisis de los factores asociados / Rhabdomyolysis in a Bipolar Adolescent. Analysis of Associated Factors

Objetivo: Describir un caso de rabdomiolisis asociada a uso de quetiapina y lamotrigina en adolescente tratado por trastorno afectivo bipolar. Método: Descripción del caso clínico, análisis de los factores asociados y revisión no sistemática de la literatura relevante. Resultados: Varón de 18 arios de edad con trastorno afectivo bipolar, tratado farmacológicamente con quetiapina y lamotrigina, que tras 2 semanas de entrenamiento físico presentó rabdomiolisis. La quetiapina y el ejercicio se han asociado a rabdomiolisis. No se ha encontrado el mecanismo que media tal asociación, si bien se plantea disfunción neuromuscular e incremento en la permeabilidad sarcomérica. Conclusiones: Este caso clínico permite observar la interacción compleja de los psicofármacos y la actividad física en un paciente psiquiátrico adolescente, y la aparición de una complicación médica potencialmente letal.

Objective: To describe a case of rhabdomyolysis associated with the use of quetiapine and lamotrigine in an adolescent treated for bipolar disorder. Method: Description of the clinical case, analysis of the associated factors and a nonsystematic review of the relevant literature. Results: An 18 year old male, with bipolar disorder and treated pharmacologically with quetiapine and lamotrigine, after two weeks of physical activity presents with rhabdomyolysis. Quetiapine and exercise have been associated with rhabdomyolysis. The mediator mechanism of this association has not been found, although it has been established that there is neuromuscular dysfunction and an increase in sarcomere permeability. Conclusions: This clinical case allowed the complex interaction between antipsychotic agents and increased physical activity to be observed in a psychiatric adolescent patient, as well as the appearance of a potentially lethal medical complication.

Palladium-catalyzed synthesis of natural and unnatural 2-, 5-, and 7-oxygenated carbazole alkaloids from N-arylcyclohexane enaminones.

A palladium-catalyzed synthesis of the carbazole framework is described, including the preparation of 2-, 5-, and 7-oxygenated natural and unnatural carbazole alkaloids. A series of N-arylcyclohexane enaminones, generated by condensation of cyclohexane-1,3-dione with diverse anilines, were aromatized by a Pd(0)-catalyzed thermal treatment to afford the corresponding diarylamines. The latter were submitted to a Pd(II)-catalyzed cyclization and methylation processes to provide the desired carbazoles, including clausine V. Following an inverse strategy, a new and short total synthesis of glycoborine is also reported.

Hot-water phytosanitary treatment against Ceratitis capitata (Diptera: Tephritidae) in 'Ataulfo' mangoes.

We determined the thermal death rate constants and mortality curves for the eggs and different instars of Ceratitis capitata (Mediterranean fruit fly) (Wiedemann) submerged in isolation in water at 44, 46, and 48 degrees C and submerged within fruits of Mangifera indica (mango) (L.) in water at 43.1, 44.1, 45.1, and 46.1 degrees C. The first instar was the most tolerant to this treatment, with estimated times for achieving 99.9968% mortality of 103.28, 92.73, and 92.49 min at temperatures of 43.1, 44.1, and 45.1 degrees C, respectively. The results of the study indicate that 'Ataulfo' mangoes weighing < 329 +/- 2.11 g and at risk immature Mediterranean fruit fly infestation should be immersed for 95 min at 46.1-47 degrees C to ensure that the fruit pulp remains at this temperature for 10 min. An efficacy test was conducted that involved treating 730 mangoes, with an average weight of 326 +/- 2.11 g (mean +/- SE) and infested with 84 +/- 1.15 first instars. In this test, none of the 61,720 larvae treated survived. The confirmatory test was performed using commercial equipment in which 1,112 infested mango fruit weighing an average of 329 +/- 2.11 g were treated. Each fruit was previously infested with an average of 59 +/- 0.61 first instars (= 65,825 total larvae) of which none survived. The data collected on mango quality indicate that hot water immersion for 95 min at 46.1-47 degrees C can produce a more uniform fruit-color and positively modify the pH (producing more palatable fruits), but can also produce a loss of firmness and weight (5%). Taking all factors into consideration, we conclude that this treatment is sufficient to meet quarantine restrictions against C. capitata while maintaining market quality at least for 15 d.