Life history data of four populations of Triatoma mexicana (Hemiptera: Reduviidae) from Central Mexico.

Triatomine bugs are vectors for the Trypanosoma cruzi Chagas parasites, the etiological agent for Chagas disease. This study evaluated 6 epidemiologically significant behaviors (development time, number of blood meals required for molting to the next instar, mortality rate, aggressiveness, feeding duration, and defecation delay) across 4 populations of Triatoma mexicana Herrich-Schaeffer (Heteroptera: Reduviidae), a major T. cruzi vector in Central Mexico. We collected triatomines from areas characterized by high (HP), medium (MP), medium-high (MHP), and low (LP) prevalence of human T. cruzi infection. The MHP population had the shortest development time, <290 days. Both the HP and MP populations required the most blood meals to molt to the next instar, with a median of 13. Mortality rates varied across all populations, ranging from 44% to 52%. All of the tested populations showed aggressive behavior during feeding. All populations shared similar feeding durations, with most exceeding 13 min and increasing with each instar. Quick defecation, during feeding, immediately after or less than 1 min after feeding, was observed in most nymphs (78%-90%) from the MP and MHP populations and adults (74%-92%) from HP, MP, and MHP populations. Though most parameters suggest a low potential for T. mexicana to transmit T. cruzi, unique feeding and defecation behaviors in 3 populations (excluding the LP group) could elevate their epidemiological importance. These population-specific differences may contribute to the varying prevalence rates of T. cruzi infection in areas where T. mexicana is found.

Concepciones de usuarios sobre nuevas vías de administración de profilaxis pre-exposición para el VIH / Users' expectations of the new pre-exposure prophylaxis for the HIV modalities

Resumen Este artículo tiene como objetivo discutir las concepciones de los Hombres Gay, Hombres Bisexuales y una Mujer Transgénero que usan o quieren usar profilaxis previa a la exposición por el virus de la inmunodeficiencia humana oral (PrEP) sobre nuevas vías de administración. Fueron entrevistados 17 usuarios del BCN Checkpoint. Las entrevistas fueron grabadas en audio, sometidas a análisis categorial temático teniendo en cuenta la perspectiva praxeográfica. Todos están adaptados al uso de la PrEP diaria y a demanda. En relación con las nuevas vías de administración (PrEP inyección intramuscular cada dos meses; pastilla mensual; inyección subcutánea cada seis meses) todos son muy receptivos a esas posibilidades, pero les falta información sobre las especificidades de cada una de ellas y una evaluación específica de sus necesidades. Tanto la satisfacción con el uso de PrEP oral, como las expectativas sobre las nuevas vías de administración son positivas. Sin embargo, lo más importante para los/a entrevistados/a es la garantía de que tendrán seguimiento para continuar cuidando de la salud afectivo-sexual, lo que no depende del tipo de vía de administración.

Abstract This article aims to discuss the expectations of Homosexual Men, Bisexual Men and a Transgender Woman, who use or want to use an oral pre-exposure prophylaxis (PrEP) for the human immunodeficiency virus (HIV) about PrEP modalities. Sixteen PrEP users, who are followed up in the BCN Checkpoint, were interviewed,. The interviews were audio-recorded, subjected to thematic categorical analysis within the theoretical framework from the praxiographic perspective. They are all adapted to the use of daily oral and event-based PrEP. In relation to the new PrEP modalities (monthly pill; intramuscular injection every two months; subcutaneous injection every six months), they are all very receptive to these possibilities, but they lack information on the specificities of each and specific assessment of their needs. Comments about the use of oral PrEP are positive, and expectations regarding the new PrEP modalities are visibly high. However, the most important thing for the interviewees is the guarantee that they will have follow-up appointments to continue taking care of their affective-sexual health, which is not dependent on the type of PrEP modalities.

Users' expectations of the new pre-exposure prophylaxis for the HIV modalities. / Concepciones de usuarios sobre nuevas vías de administración de profilaxis pre-exposición para el VIH.

This article aims to discuss the expectations of Homosexual Men, Bisexual Men and a Transgender Woman, who use or want to use an oral pre-exposure prophylaxis (PrEP) for the human immunodeficiency virus (HIV) about PrEP modalities. Sixteen PrEP users, who are followed up in the BCN Checkpoint, were interviewed,. The interviews were audio-recorded, subjected to thematic categorical analysis within the theoretical framework from the praxiographic perspective. They are all adapted to the use of daily oral and event-based PrEP. In relation to the new PrEP modalities (monthly pill; intramuscular injection every two months; subcutaneous injection every six months), they are all very receptive to these possibilities, but they lack information on the specificities of each and specific assessment of their needs. Comments about the use of oral PrEP are positive, and expectations regarding the new PrEP modalities are visibly high. However, the most important thing for the interviewees is the guarantee that they will have follow-up appointments to continue taking care of their affective-sexual health, which is not dependent on the type of PrEP modalities.

Este artículo tiene como objetivo discutir las concepciones de los Hombres Gay, Hombres Bisexuales y una Mujer Transgénero que usan o quieren usar profilaxis previa a la exposición por el virus de la inmunodeficiencia humana oral (PrEP) sobre nuevas vías de administración. Fueron entrevistados 17 usuarios del BCN Checkpoint. Las entrevistas fueron grabadas en audio, sometidas a análisis categorial temático teniendo en cuenta la perspectiva praxeográfica. Todos están adaptados al uso de la PrEP diaria y a demanda. En relación con las nuevas vías de administración (PrEP inyección intramuscular cada dos meses; pastilla mensual; inyección subcutánea cada seis meses) todos son muy receptivos a esas posibilidades, pero les falta información sobre las especificidades de cada una de ellas y una evaluación específica de sus necesidades. Tanto la satisfacción con el uso de PrEP oral, como las expectativas sobre las nuevas vías de administración son positivas. Sin embargo, lo más importante para los/a entrevistados/a es la garantía de que tendrán seguimiento para continuar cuidando de la salud afectivo-sexual, lo que no depende del tipo de vía de administración.

Role of Prolonged Intubation in Vocal Fold Motion Impairment in Critically Ill Patients.

OBJECTIVE: COVID-19 upsurge in orotracheal intubation (OTI) has opened a new opportunity for studying associated complications. Vocal fold motion impairment (VFMI) is a known complication of OTI. The present study sought to determine the impact of OTI and prolonged OTI on the risk of developing VFMI; to identify both risk and protective factors associated with it. STUDY DESIGN: Retrospective cohort study. SETTING: Multicenter. METHODS: Medical charts were reviewed for all patients that received invasive mechanical ventilation with a subsequent flexible laryngoscopic assessment between March 2020 and March 2022. The main outcomes were the presence of VFMI, including immobility (VFI) and hypomobility (VFH). RESULTS: A total of 155 patients were included, 119 (76.8%) COVID-19 and 36 (23.2%) non-COVID-19 patients; overall 82 (52.9%) were diagnosed with VFMI. Eighty (52.3%) patients underwent a tracheostomy. The median (IQR) intubation duration was 18 (11-24.25) days, while the median (IQR) time to tracheostomy was 22 (16-29). In the adjusted model, we observed there was a 68% increased risk for VFMI from day 21 of intubation (RR: 1.68; 95% CI 1.07-2.65; P = 0.025). CONCLUSIONS: VFMI is a frequent complication in severely ill patients that undergo intubation. A prolonged OTI was associated with an increased risk of VFMI, highlighting the importance of timely tracheostomy. Further research is needed to confirm these findings in other subsets of critically ill patients.

Photoprotective effect of topical treatment with Lopezia racemosa extract against deleterious UVB irradiation effects in the skin of hairless mice.

Lopezia racemosa is known as a "mosquito flower or perlilla." It is commonly found in corn crops. In traditional Mexican medicine, this plant is used to treat stomach cancer and urinary tract infections. Likewise, compounds and extracts isolated from plants have shown cytotoxic and anti-inflammatory effects. The objective of this study was to evaluate the photochemoprotective effect of topical treatment with the methanolic extract of L. racemosa (MELR) as a photochemoprotective agent against the harmful effects of UV irradiation (UVR) on a bacterial model and hairless mice. The MELR components were separated and analyzed via HPLC-UV-ESI-MS. Antioxidant activity was evaluated by the ability of MERL to scavenge DPPH and ABTS free radicals and by its FRAP capacity. The toxicity of MELR was evaluated in keratinocyte cultures. The photoprotective capacity of MELR was assessed through challenge experiments using models with bacteria and hairless CD1 et/et mice; cytokines related to the damage caused by UVR were also measured. In the methanolic extract of L. racemosa, five metabolites were detected and identified: two isomers of quercetin 6-C glycoside, orientin, quercetin 3-(6″-acetylglycoside) and quercetin 3-(6″-galloylglycoside) 7-(2,3-dihydroxytetrahydro-2H-pyran-4-yl acetate). MELR exhibited DPPH and ABTS radical scavenging properties, in addition to Fe ion reducing activity. MELR showed a photoprotective effect against UVB radiation-induced death in Escherichia coli bacteria. At the histological level, topical treatment of CD-1 et/et mice with MERL reduced the damage caused by UVR. Quantification of interleukins in the blood of mice revealed that the expression of IL-12 was greater in the control group treated with ultraviolet radiation than in the group protected with MELR. The methanolic extract of L. racemosa has photochemoprotective properties.

Rescue and rehabilitation of maned wolf (Chrysocyon brachyurus) in Paraguay: Case description.

The maned wolf, Chrysocyon brachyurus, is the largest South American canid, with a natural distribution that stretches across Peru, Bolivia, Brazil, Argentina, Paraguay and Uruguay. The present study reports the case of a rescued specimen of maned wolf that underwent a rehabilitation process in Paraguay, starting in October 2020 with its rescue, and finalising in May 2021 with the reintroduction. Herein, we document findings regarding the general management, biometrics, feeding and environmental enrichment; chemical immobilisation and monitoring; haematology, blood biochemistry and specific serology-relevant pathogens; skin examination and bone marrow cytology; orthopaedic, ophthalmological and dental evaluation; abdominal and cardiac ultrasonography; radiology and copro-parasitology. Main findings include the feeding habits of the individual and enrichment opportunities. The animal weighed 7 kg on arrival, with an estimated age of 5 months, and 18 kg on reintroduction, with an estimated age of 1 year. The animal tested negative to serologic tests for Brucella canis, Dirofilaria, canine distemper, Toxoplasmosis and canine parvovirus. Leptospira testing showed antibodies against L. grippotyphosa on both samplings, L. wolffi and L. ictero on the first sampling, and L. pomona on the second sampling. Abdominal organs were examined and measured through ultrasound evaluation and kidneys showed no alterations. Echocardiography showed preserved mitral, tricuspid and aortic valve flows, but turbulent pulmonary valve flow. Copro-parasitology reported the presence of Lagochilascaris sp. and Balantidium sp. All the information gathered aided in diagnosing the health status of the individual, and the response to environmental enrichment helped assess the behaviour, which led to the suggestion of reintroducing the animal. These data constitute the first published health check of a maned wolf in Paraguay, which can contribute to the species' conservation in the country. The protocol presented in this study can serve as a basis for developing an action plan for the maned wolf in Paraguay.

The Role of Carbohydrate Intake on the Gut Microbiome: A Weight of Evidence Systematic Review.

(1) Background: Carbohydrates are the most important source of nutritional energy for the human body. Carbohydrate digestion, metabolism, and their role in the gut microbiota modulation are the focus of multiple studies. The objective of this weight of evidence systematic review is to investigate the potential relationship between ingested carbohydrates and the gut microbiota composition at different taxonomic levels. (2) Methods: Weight of evidence and information value techniques were used to evaluate the relationship between dietary carbohydrates and the relative abundance of different bacterial taxa in the gut microbiota. (3) Results: The obtained results show that the types of carbohydrates that have a high information value are: soluble fiber with Bacteroides increase, insoluble fiber with Bacteroides and Actinobacteria increase, and Firmicutes decrease. Oligosaccharides with Lactobacillus increase and Enterococcus decrease. Gelatinized starches with Prevotella increase. Starches and resistant starches with Blautia decrease and Firmicutes increase. (4) Conclusions: This work provides, for the first time, an integrative review of the subject by using statistical techniques that have not been previously employed in microbiota reviews.

Biological aspects of crosses between populations of Triatoma mexicana (Hemiptera: Reduviidae: Triatominae).

We examined the degree of reproductive isolation in four populations of Triatoma mexicana Herrich-Schaeffer from Mexico along with fertility and the segregation of morphological characteristics in two generations of offspring from crosses between these populations. The percentage of couples with (fertile) offspring was high among all sets of crosses between cohorts from Peñamiller, Meztitlán, and Orizabita. It was low in crosses involving a cohort from Tierra Blanca, mainly in crosses with Meztitlán. Among sets of crosses involving Tierra Blanca specimens, whole first-generation (F1) individuals were morphologically similar to the specimens from other locations. All F1 individuals of crosses involving Peñamiller looked like Peñamiller. However, in crosses between F1 and F1 progeny of parental crosses, alleles for size, overall color, length of head, ante and post ocular distance, and humeral angle apparently had Mendelian dominant/recessive relationships. The cohorts from Peñamiller and Meztitlán seemed to be dominant with respect to Orizabita and Tierra Blanca. Results indicated that cohorts from Peñamiller, Meztitlán, and Orizabita were not reproductively isolated. In contrast, Tierra Blanca was reproductively isolated from the other three populations of T. mexicana and is apparently undergoing an early divergence process of speciation for allopatry.

New patch-based strategy for COVID-19 automatic identification using chest x-ray images.

Purpose: The development of a robust model for automatic identification of COVID-19 based on chest x-rays has been a widely addressed topic over the last couple of years; however, the scarcity of good quality images sets, and their limited size, have proven to be an important obstacle to obtain reliable models. In fact, models proposed so far have suffered from over-fitting erroneous features instead of learning lung features, a phenomenon known as shortcut learning. In this research, a new image classification methodology is proposed that attempts to mitigate this problem. Methods: To this end, annotation by expert radiologists of a set of images was performed. The lung region was then segmented and a new classification strategy based on a patch partitioning that improves the resolution of the convolution neural network is proposed. In addition, a set of native images, used as an external evaluation set, is released. Results: The best results were obtained for the 6-patch splitting variant with 0.887 accuracy, 0.85 recall and 0.848 F1score on the external validation set. Conclusion: The results show that the proposed new strategy maintains similar values between internal and external validation, which gives our model generalization power, making it available for use in hospital settings. Supplementary Information: The online version contains supplementary material available at 10.1007/s12553-022-00704-4.

Acute Vocal Fold Hemorrhage: Retrospective Analysis in a Voice Unit.

OBJECTIVES: To describe our experience in diagnosis, evaluation, management and evolution of adult patients diagnosed with vocal fold hemorrhage (VFH) in the Voice Unit at Universidad Católica Clinical Hospital Santiago, Chile. STUDY DESIGN: Retrospective chart review. METHODS: Adult patients diagnosed with VFH between 2012 and 2020 were included. Demographic data, medical and vocal history, vocal symptoms and questionnaires, laryngeal videostroboscopy, treatment, and follow-up controls were reviewed. RESULTS: A total of 34 patients were included, 52.9% (18) patients were female and 47.1% (16) male. Mean age was 42 years (22-76 years) and 47.1% were professional voice users. Principal voice symptoms were dysphonia (32/34), vocal fatigue (21/34) and throat clearing (17/34). Twenty-six (76.5%) patients had VFH and a concomitant lesion in the same vocal fold (VF), being a hemorrhagic polyp the most prevalent associated lesion (61.8%). All patients were managed initially with voice rest, showing improvement at first follow up visit according to VRQOL-STD (mean difference -32.43, P = 0.009) and VHI-10 (mean difference 11.22, P = 0.036), and laryngeal videostroboscopic resolution in 66.7% (8/12) at a mean 12.5 (range 6-30) days. CONCLUSIONS: VFH is an infrequent phonotraumatic condition. More studies are needed to advance in knowledge of this pathology as there is contradictory evidence in the literature regarding predisposing factors, evolution and prognosis of this condition.

Clinical and sociodemographic characterization of pregnant women hospitalized with COVID-19.

INTRODUCTION: In pregnant women, a higher risk for developing viral respiratory infections is identified. OBJECTIVE: To analyze sociodemographic characteristics, evolution, clinical manifestations, and complications of pregnant women hospitalized with COVID-19. METHODS: Study conducted at 11 public hospitals; sociodemographic variables, comorbidities, signs and symptoms, laboratory and imaging findings, pregnancy characteristics, treatment and pregnancy outcome were included for analysis. RESULTS: Age ranged between 15 and 40 years; 85.1% were at third trimester of pregnancy, 11.9% at second and 3% at first; 27% had any comorbidity such as obesity, hypertension or asthma; 89.5% had fever, 73.1% cough, 44.8% dyspnea, 43.3% headache and 35.8% myalgia. Diagnoses were mild disease (55.2%), mild pneumonia (26.9%), severe pneumonia (10.4%), severe pneumonia with acute respiratory distress syndrome (4.5%), and severe pneumonia with septic shock (3%); 76.2% had noninvasive oxygen support, and 9%, mechanical ventilation. Pregnancy was interrupted in 53.8%; 95.5% were discharged due to improvement of their condition and 4.5% died. CONCLUSIONS: Age range and symptoms are consistent with those previously reported. Evidence was found of an increase in cesarean section without a clear indication in women with COVID-19.

INTRODUCCIÓN: En las mujeres embarazadas se identifica mayor riesgo de desarrollar infecciones respiratorias virales. OBJETIVO: Analizar características sociodemográficas, evolución, manifestaciones clínicas y complicaciones en mujeres embarazadas con COVID-19 que fueron hospitalizadas. MÉTODOS: Estudio en 11 hospitales públicos; se incluyeron variables sociodemográficas, comorbilidades, síntomas y signos, hallazgos de laboratorio y gabinete, características del embarazo, tratamiento y desenlace de la gestación. RESULTADOS: La edad osciló entre 15 y 40 años; 85.1 % cursaba el tercer trimestre del embarazo, 11.9 % el segundo y 3 % el primero; 27 % presentó alguna comorbilidad como obesidad, hipertensión o asma; 89.5 % presentó fiebre, 73.1 % tos, 44.8 % disnea, 43.3 % cefalea y 35.8 % mialgias. Los diagnósticos fueron enfermedad leve (55.2 %), neumonía leve (26.9 %), neumonía severa (10.4 %), neumonía severa con síndrome de distrés respiratorio agudo (4.5 %) y neumonía severa con choque séptico (3 %); 76.2 % recibió soporte de oxígeno no invasivo y 9 %, ventilación mecánica. Se interrumpió el embarazo en 53.8 %; 95.5 % egresó por mejoría y 4.5 % falleció. CONCLUSIONES: El rango de edad y los síntomas coinciden con los señalados en la literatura especializada. En mujeres con COVID-19 se evidenció el incremento de la operación cesárea sin una indicación clara.

Inteligencia artificial explicable, una perspectiva al problema de la clasificación automática de COVID-19 mediante radiografías de tórax

RESUMEN Esta investigación pretende dilucidar, a partir del análisis de técnicas de inteligencia artificial explicables, la robustez y el nivel de generalización de los métodos de visión por computadora propuestos para identificar COVID-19 utilizando imágenes de radiografías de tórax. Asimismo, alertar a los investigadores y revisores sobre el problema del aprendizaje por atajos. En este estudio se siguen recomendaciones para identificar si los modelos de clasificación automática de COVID-19 se ven afectados por el aprendizaje por atajos. Para ello, se revisaron los artículos que utilizan métodos de inteligencia artificial explicable en dicha tarea. Se evidenció que al utilizar la imagen de radiografía de tórax completa o el cuadro delimitador de los pulmones, las regiones de la imagen que más contribuyen a la clasificación aparecen fuera de la región pulmonar, algo que no tiene sentido. Los resultados indican que, hasta ahora, los modelos existentes presentan el problema de aprendizaje por atajos, lo cual los hace inapropiados para ser usados en entornos clínicos.

ABSTRACT This research aims to elucidate, from the analysis of explainable artificial intelligence techniques, the robustness and level of generalization of the proposed computer vision methods to identify COVID-19 using chest X-ray images. Also, alert researchers and reviewers about the problem of learning by shortcuts. In this study, recommendations are followed to identify if the automatic classification models of COVID-19 are affected by shortcut learning. To do this, articles that use explainable artificial intelligence methods were reviewed. It was shown that when using the full chest X-ray image or the bounding box of the lungs, the regions of the image that contribute the most to the classification appear outside the lung region, something that does not make sense. The results indicate that, so far, the existing models present the problem of learning by shortcuts, which makes them inappropriate to be used in clinical settings.

Caracterización clínica y sociodemográfica de mujeres embarazadas con COVID-19 hospitalizadas / Clinical and sociodemographic characterization of pregnant women hospitalized with COVID-19

Resumen Introducción: En las mujeres embarazadas se identifica mayor riesgo de desarrollar infecciones respiratorias virales. Objetivo: Analizar características sociodemográficas, evolución, manifestaciones clínicas y complicaciones en mujeres embarazadas con COVID-19 que fueron hospitalizadas. Métodos: Estudio en 11 hospitales públicos; se incluyeron variables sociodemográficas, comorbilidades, síntomas y signos, hallazgos de laboratorio y gabinete, características del embarazo, tratamiento y desenlace de la gestación. Resultados: La edad osciló entre 15 y 40 años; 85.1 % cursaba el tercer trimestre del embarazo, 11.9 % el segundo y 3 % el primero; 27 % presentó alguna comorbilidad como obesidad, hipertensión o asma; 89.5 % presentó fiebre, 73.1 % tos, 44.8 % disnea, 43.3 % cefalea y 35.8 % mialgias. Los diagnósticos fueron enfermedad leve (55.2 %), neumonía leve (26.9 %), neumonía severa (10.4 %), neumonía severa con síndrome de distrés respiratorio agudo (4.5 %) y neumonía severa con choque séptico (3 %); 76.2 % recibió soporte de oxígeno no invasivo y 9 %, ventilación mecánica. Se interrumpió el embarazo en 53.8 %; 95.5 % egresó por mejoría y 4.5 % falleció. Conclusiones: El rango de edad y los síntomas coinciden con los señalados en la literatura especializada. En mujeres con COVID-19 se evidenció el incremento de la operación cesárea sin una indicación clara.

Abstract Introduction: In pregnant women, a higher risk for developing viral respiratory infections is identified. Objective: To analyze sociodemographic characteristics, evolution, clinical manifestations, and complications of pregnant women hospitalized with COVID-19. Methods: Study conducted at 11 public hospitals; sociodemographic variables, comorbidities, signs and symptoms, laboratory and imaging findings, pregnancy characteristics, treatment and pregnancy outcome were included for analysis. Results: Age ranged between 15 and 40 years; 85.1% were at third trimester of pregnancy, 11.9% at second and 3% at first; 27% had any comorbidity such as obesity, hypertension or asthma; 89.5% had fever, 73.1% cough, 44.8% dyspnea, 43.3% headache and 35.8% myalgia. Diagnoses were mild disease (55.2%), mild pneumonia (26.9%), severe pneumonia (10.4%), severe pneumonia with acute respiratory distress syndrome (4.5%), and severe pneumonia with septic shock (3%); 76.2% had noninvasive oxygen support, and 9%, mechanical ventilation. Pregnancy was interrupted in 53.8%; 95.5% were discharged due to improvement of their condition and 4.5% died. Conclusions: Age range and symptoms are consistent with those previously reported. Evidence was found of an increase in cesarean section without a clear indication in women with COVID-19.

Current limitations to identify covid-19 using artificial intelligence with chest x-ray imaging (part ii). The shortcut learning problem.

Since the outbreak of the COVID-19 pandemic, computer vision researchers have been working on automatic identification of this disease using radiological images. The results achieved by automatic classification methods far exceed those of human specialists, with sensitivity as high as 100% being reported. However, prestigious radiology societies have stated that the use of this type of imaging alone is not recommended as a diagnostic method. According to some experts the patterns presented in these images are unspecific and subtle, overlapping with other viral pneumonias. This report seeks to evaluate the analysis the robustness and generalizability of different approaches using artificial intelligence, deep learning and computer vision to identify COVID-19 using chest X-rays images. We also seek to alert researchers and reviewers to the issue of "shortcut learning". Recommendations are presented to identify whether COVID-19 automatic classification models are being affected by shortcut learning. Firstly, papers using explainable artificial intelligence methods are reviewed. The results of applying external validation sets are evaluated to determine the generalizability of these methods. Finally, studies that apply traditional computer vision methods to perform the same task are considered. It is evident that using the whole chest X-Ray image or the bounding box of the lungs, the image regions that contribute most to the classification appear outside of the lung region, something that is not likely possible. In addition, although the investigations that evaluated their models on data sets external to the training set, the effectiveness of these models decreased significantly, it may provide a more realistic representation as how the model will perform in the clinic. The results indicate that, so far, the existing models often involve shortcut learning, which makes their use less appropriate in the clinical setting.

Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones.

OBJECTIVE: To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones. METHODS: A retrospective, longitudinal, descriptive, and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018. The adherence to drug treatment was measured 6 months after its initiation, and the numerical values of the metabolic studies were compared. Wilcoxon tests were performed to compare the difference before and after treatment. RESULTS: Ninety patients were evaluated, with 73.3% of adherence. The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs. There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients (p=0.031 vs. p=0.528). CONCLUSIONS: Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation; the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.

Similarities and differences in the arrangement of the atrioventricular conduction axis in the canine compared to the human heart.

BACKGROUND: Subtle differences exist between dog and human, despite use of the dog as a model for cardiac surgical and electrophysiological research. OBJECTIVE: The purpose of this study was to investigate the differences in the atrioventricular conduction axis and adjacent structures between dogs and humans. METHODS: We prepared 33 human and 5 canine hearts for serial histologic sections of the atrioventricular conduction axis, making correlations with gross anatomic findings. We additionally examined and photographed 15 intact normal human hearts obtained from infants undergoing autopsy. Furthermore, we interrogated a computed tomographic dataset from a human adolescent and from 2 autopsied canine hearts, both with normal cardiac anatomy. RESULTS: All canine hearts lacked an inferoseptal recess, with the noncoronary leaflet of the aortic valve and the right fibrous trigone having direct attachments to the septal surface of the left ventricular outflow tract. This correlated with an extensive nonbranching component of the ventricular conduction axis, which skirted half of the noncoronary aortic sinus. This anatomic arrangement was observed in 2 of 15 of autopsied infant hearts. In the human hearts with an inferoseptal recess, the relatively shorter nonbranching bundle is embedded within the fibrous tissue forming its right wall. CONCLUSION: We found a major difference between canine and the majority of human hearts, namely, the presence or absence of an inferoseptal recess. When this recess is absent, as in the canine heart and in some human hearts, a greater proportion of the atrioventricular conduction axis is found within the circumference of the subaortic outflow tract.

Leishmania spp Epitopes in Humans Naturally Resistant to the Disease: Working Toward a Synthetic Vaccine.

Vaccines are one of the most effective strategies to fight infectious diseases. Reverse vaccinology strategies provide tools to perform in silico screening and a rational selection of potential candidates on a large scale before reaching in vitro and in vivo evaluations. Leishmania infection in humans produces clinical symptoms in some individuals, while another part of the population is naturally resistant (asymptomatic course) to the disease, and therefore their immune response controls parasite replication. By the identification of epitopes directly in humans, especially in those resistant to the disease, the probabilities of designing an effective vaccine are higher. The aim of this work was the identification of Leishmania epitopes in resistant humans. To achieve that, 11 peptide sequences (from Leishmania antigenic proteins) were selected using epitope prediction tools, and then, peripheral blood mononuclear cells (PBMCs) were isolated from human volunteers who were previously divided into four clinical groups: susceptible, resistant, exposed and not exposed to the parasite. The induction of inflammatory cytokines and lymphoproliferation was assessed using monocyte-derived dendritic cells (moDCs) as antigen-presenting cells (APCs). The response was evaluated after exposing volunteers' cells to each peptide. As a result, we learned that STI41 and STI46 peptides induced IL-8 and IL-12 in moDCs and lymphoproliferation and low levels of IL-10 in lymphocytes differentially in resistant volunteers, similar behavior to that observed in those individuals to L. panamensis lysate antigens. We conclude that, in silico analysis allowed for the identification of natural Leishmania epitopes in humans, and also STI41 and STI46 peptides could be epitopes that lead to a cellular immune response directed at parasite control.

Inactivation of Herpes Simplex Virus by Photosensitizing Anthraquinones Isolated from Heterophyllaea pustulata.

Heterophyllaea pustulata is a phototoxic plant from Argentina. Aerial parts extracts, high in photosensitizing anthraquinones, have shown in vitro antiviral activity. The purpose of this study was to study the antiherpetic activity of the main purified anthraquinones, even evaluating their competence as photodynamic sensitizers to photo-stimulate the antiviral effect. In vitro antiviral activity against Herpes Simplex virus type I and the photo-inactivation of viral particle were studied by the Neutral Red uptake test and observation of the cytopathic effect. Rubiadin 1-methyl ether and 5,5'-bisoranjidiol produced a significant effect (≥ 80% inhibition) with minimal damage to host cells (subtoxic concentration). Anthraquinones with poor antiherpetic activity at its maximum noncytotoxic concentration showed an important photo-stimulated effect, such is the case of soranjidiol and 5,5'-bisoranjidiol (28.0 ± 6.3 vs. 81.8 ± 2.1% and 15.5 ± 0.3 vs. 89.8 ± 1.7%, respectively). The study also proved the decrease of viral particles, necessary to reduce infection. Therefore, photosensitizing anthraquinones from natural resources could be proposed to develop new treatments for localized viral lesions with antimicrobial photodynamic therapy.