Características clínicas y sociodemográficas de pacientes con epilepsia en un hospital pediátrico en Honduras / Clinical and sociodemographic characteristics of patients with epilepsy in a pediatric hospital in Honduras

Antecedentes: La epilepsia es una patología frecuente en pediatría; representa el mayor número de referencias al Servicio de Neurología. En Honduras son pocas las publicaciones recientes del tema. Objetivo: Describir las características clínicas y sociodemográficas de pacientes con epilepsia en un centro nacional de referencia pediátrica. Métodos: Estudio descriptivo retrospectivo. Se utilizaron expedientes clínicos de pacientes atendidos en Consulta Externa de Neuropediatría Hospital María, Especialidades Pediátricas (HMEP), Tegucigalpa, Honduras, durante mayo 2015-marzo 2019. Para el análisis de datos se utilizó estadística descriptiva. Resultados: De los 334 pacientes, el sexo masculino fue el más afectado 55.7% (186), procedentes de zona urbana 69.5% (232); la mediana de edad fue 7 años. En 26.3% (88) de los casos, el padre estuvo ausente y el 81.1% (271) de los pacientes eran hijos de madre desempleada. Como etiología se encontró que el 54.4% (182) fue desconocida. El 26.3% (88) tuvo antecedente familiar de epilepsia y el 50.6% (174/344) de los pacientes tuvieron eventualidad perinatal, de estos 24.7% (43/174) presentó asfixia neonatal. El 32.7% (108/330) se encontraban en estado de malnutrición. Las crisis focales fueron más frecuentes y el factor precipitante de crisis más común fue abandono de tratamiento. El 36.6% (126) tenía algún tipo de discapacidad, siendo la cognitiva la más sobresaliente. Discusión: Es necesario reforzar estrategias de salud pública dirigidas a la prevención prenatal, natal y posnatal de la epilepsia, brindar apoyo a las familias monoparentales y asegurar acceso continuo a servicios de salud...(AU)

Risk assessment of RNAi-based pesticides to non-target organisms: Evaluating the effects of sequence similarity in the parasitoid wasp Telenomus podisi.

RNA interference (RNAi)-based pesticides are promising novel pest management products that might reduce environmental impacts compared to other pesticides. Their sequence-guided mode of action facilitates a high species-selectivity, preventing harm on non-target organisms. However, there is currently no consensus on the minimum needed sequence similarity for efficient RNAi in insects and studies have shown that adverse effects in non-targets cannot always be ruled out a priori. This study investigates the effects of exposing the parasitoid wasp Telenomus podisi to double-stranded RNA (dsRNA) which is lethal to its host, the Neotropical brown stink bug Euschistus heros. Feeding T. podisi with wasp-specific dsRNA targeting the vATPase A and actin-2 genes led to 76.4 ± 9.9% and 76.7 ± 8.8% mortality respectively, demonstrating that dietary RNAi is functional in T. podisi. When feeding T. podisi with E. heros-specific dsRNA targeting the same genes, no lethal or sublethal effects were observed. To link sequence similarity to potential gene silencing effects in the parasitoids, the expression of genes showing the highest degree of similarity (17-21 nucleotide matches) with these two target genes was monitored and was found unaffected by the E. heros-specific dsRNA. Our study confirms that RNAi was in this case highly specific and that for E. heros, RNAi-based pesticides can be used complementary to biological control in an integrated pest management context.

Echocardiographic 60-day mortality markers in patients hospitalized in intensive care for COVID-19.

BACKGROUND: Coronavirus disease COVID-19 produces a predominantly pulmonary affection, being cardiac involvement an important component of the multiorganic dysfunction. At the moment there are few reports about the behavior of echocardiographic images in the patients who have the severe forms of the disease. OBJECTIVE: Identify the echocardiographic prognostic markers for death within 60 days in patients hospitalized in intensive care. METHODS: A single-center prospective cohort was made with patients hospitalized in intensive care for COVID-19 confirmed via polymerase chain reaction who got an echocardiogram between May and October 2020. A Cox multivariate model was plotted reporting the HR and confidence intervals with their respective p values for clinical and echocardiographic variables. RESULTS: Out of the 326 patients included, 153 patients got an echocardiogram performed on average 6.8 days after admission. The average age was 60.7, 47 patients (30.7%) were females and 67 (44.7%) registered positive troponin. 91 patients (59.5%) died. The univariate analysis identified TAPSE, LVEF, pulmonary artery systolic pressure, acute cor pulmonale, right ventricle diastolic dysfunction, and right ventricular dilatation as variables associated with mortality. The multivariate model identified that the acute cor pulmonale with HR= 4.05 (CI 95% 1.09 - 15.02, p 0.037), the right ventricular dilatation with HR= 3.33 (CI 95% 1.29 - 8.61, p 0.013), and LVEF with HR= 0.94 (CI 95% 0.89 - 0.99, p 0.020) were associated with mortality within 60 days. CONCLUSIONS: In patients hospitalized in the intensive care unit for COVID-19, the LVEF, acute cor pulmonale and right ventricular dilatation are prognostic echocardiographic markers associated with death within 60 days.

Imidacloprid-mediated alterations on the salivary glands of the Neotropical brown stink bug, Euschistus heros.

The management of the Neotropical brown stinkbug Euschistus heros (Hemiptera: Pentatomidae) in soybean fields has been heavily dependent on the application of neonicotinoid insecticides. Neonicotinoids act primarily by impairing the function of the nicotinic acetylcholine receptors of the nervous system. These compounds also target specific organs (e.g., salivary glands), which may potentiate their insecticidal efficacy. Here, we evaluated whether the exposure to the neonicotinoid imidacloprid would cause cytomorphological changes in the salivary glands of E. heros. First, we determined the lethal concentrations (LCs) of imidacloprid through contact and ingestion. Subsequently, the cytomorphology of the salivary glands were evaluated in insect groups that survived exposure to the LC5 (3.75 mg a.i./L), LC50 (112.5 mg a.i./L), or LC75 (375.0 mg a.i./L, equivalent to the recommended field rate) doses. Imidacloprid induced apoptosis and necrosis in the salivary gland cells according to the insecticide concentration and salivary gland region. All concentrations increased apoptosis and injured cells (e.g., vacuolization, chromatin condensation, swelling of organelles, and plasma membrane rupture) in the principal and accessory salivary glands. Individuals that survived exposure to the highest concentrations (i.e., LC5 and LC50) were more affected, and exhibited several necrotic cells on their main principal salivary glands. Collectively, our results indicate that imidacloprid exerts toxic effects on the non-target organs, such as the salivary glands, which increases the efficacy of this compound in the management of stink bug infestations.

Liposome encapsulation and EDTA formulation of dsRNA targeting essential genes increase oral RNAi-caused mortality in the Neotropical stink bug Euschistus heros.

BACKGROUND: The Neotropical stink bug Euschistus heros is a major pest in soybean fields. Development of highly species-specific pesticides based on RNA interference (RNAi) could provide a new sustainable and environmentally friendly control strategy. RESULTS: Here, the potential of RNAi as a pest control tool against E. heros was assessed. First, target gene selection using a microinjection approach was performed. Seven of the 15 candidate genes tested exhibited > 95% mortality after hemolymph injection of 27.5 ng dsRNA. Subsequently, dsRNA was administered orally using different formulations: naked dsRNA, liposome-encapsulated-dsRNA and dsRNA formulated with EDTA. Liposome-encapsulated dsRNA targeting vATPase A and muscle actin led to significant mortality after 14 days (45% and 42%, respectively), whereas EDTA-formulated dsRNA did so for only one of the target genes. Ex vivo analysis of the dsRNA stability in collected saliva indicated a strong dsRNA-degrading capacity by E. heros saliva, which could explain the need for dsRNA formulations. CONCLUSION: The results demonstrate that continuous ingestion of dsRNA with EDTA or liposome-encapsulated dsRNA can prevent dsRNA from being degraded enzymatically and suggest great potential for using these formulations in dsRNA delivery to use RNAi as a functional genomics tool or for pest management of stink bugs. © 2018 Society of Chemical Industry.

Ultrastructural analysis of salivary glands in a phytophagous stink bug revealed the presence of unexpected muscles.

The exceptional abilities of stink bugs (Hemiptera: Pentatomidae) to colonize a diverse group of plants have been attributed to the feeding behaviors and the functions of the salivary complex of these insects. Here, we describe the ultrastructure of the salivary glands of the Neotropical brown stink bug, Euschistus heros, which is a major component of the pentatomid pest complex on soybeans, Glycine max, in the neotropics. Our results revealed a salivary gland complex consisting of two lobes (i.e., anterior and posterior), with a constriction between them (i.e., the hilum), in which the salivary and accessory gland ducts are inserted. The principal gland epithelium has a single layer of cells lining an enlarged lumen filled with saliva, and these cells are cuboidal, rich in rough endoplasmic reticulum and secretory vesicles, with well-developed nuclei, all of which are typical features of protein-secreting cells. We report, for the first time in insects, the presence of a layer of muscle cells surrounding the columnar hilum epithelium. The accessory salivary gland cells are cuboidal with nuclei containing condensed chromatin and cytoplasm rich in vacuoles and rough endoplasmic reticulum, indicating the potential involvement of these glands in water transport/secretion. The lumen content of each lobe of the principal gland suggests that the lobes produce different compounds. Thus, our results suggest that the E. heros salivary complex might have unconventional mechanisms to mix/release saliva, which might help explain the polyphagous abilities of these insects.