Seroprevalence of Trypanosoma cruzi among children from Veracruz, Mexico: Epidemiological baseline for a control model based on Chagas disease active transmission / Seroprevalencia de Trypanosoma cruzi en niños de Veracruz, México: línea epidemiológica de base para un modelo de control fundamentado de la transmisión activa de la enfermedad de Chagas.

Introduction. In 2021, the Secretaría de Salud de México and the Pan American Health Organization launched an initiative to interrupt intra-domiciliary vector transmission of Trypanosoma cruzi based on the prevalence of Chagas disease in children. The Mexican State of Veracruz was leading this initiative. Objective. To estimate the seroprevalence of T. cruzi infection among children under 15 years of age from rural areas of Veracruz, México. Materials and methods. We identified eight localities of high priority from the Municipality of Tempoal, Veracruz, for baseline serology. Blood samples were collected on filter paper from 817 individuals between June and August 2017, for screening with a third-generation enzyme immunoassay. Reactive cases were confirmed by indirect hemagglutination, enzyme-linked immunosorbent assay, and indirect immunofluorescence tests on peripheral blood serum samples. We calculated seroprevalence and 95% confidence intervals (CI). Results. We confirmed Chagas disease cases in children under 15 years of age with a seroprevalence of 1,9% (95 % CI = 1,12-3,16) in the localities of Citlaltepetl, Cornizuelo, Cruz de Palma and Rancho Nuevo. Conclusions. These results indicate recent transmission of T. cruzi in these communities and allow to establish an epidemiological baseline for the design and implementation of a model focused on geographical areas with active transmission to advance toward the elimination of intra-domiciliary vector transmission of this parasite in Mexico.

Introducción. En el 2021, la Secretaría de Salud de México y la Organización Panamericana de la Salud lanzaron una iniciativa para interrumpir la transmisión vectorial intradomiciliaria de Trypanosoma cruzi, fundamentada en la prevalencia de la enfermedad de Chagas en la población infantil. El estado mexicano de Veracruz fue el pionero de esta iniciativa. Objetivo. Estimar la seroprevalencia de infección por T. cruzi en menores de 15 años de localidades rurales de Veracruz, México. Materiales y métodos. Se identificaron ocho localidades prioritarias para la serología basal del municipio de Tempoal, Veracruz. Entre junio y agosto de 2017, se recolectaron muestras de sangre en papel filtro de 817 individuos para su tamizaje mediante un inmunoensayo enzimático de tercera generación. Los casos reactivos del tamizaje se confirmaron mediante pruebas de hemaglutinación indirecta, ensayo de inmunoabsorción ligado a enzimas e inmunofluorescencia indirecta en muestras de suero. Se calculó la seroprevalencia y su intervalo de confianza (IC) del 95 %. Resultados. En las localidades de Citlaltépetl, Cornizuelo, Cruz de Palma y Rancho Nuevo se confirmaron casos de la enfermedad de Chagas en menores de 15 años con una seroprevalencia de 1,9 % (IC 95 % = 1,12-3,16). Conclusiones. Los resultados indican que estas comunidades presentan transmisión reciente de T. cruzi y permiten establecer una línea epidemiológica de base para el diseño e implementación de un modelo dirigido a aquellas áreas geográficas con transmisión activa. Se espera que dicho modelo contribuya a la eliminación de la transmisión vectorial intradomiciliaria del tripanosomátido en México.

Observación de los efectos de la colchicina en el síndrome de insuficiencia respiratoria aguda por COVID-19 / Observation of the effects of colchicine in acute respiratory distress syndrome due to COVID-19

Resumen Introducción: El síndrome de dificultad respiratoria aguda por COVID-19 es un trastorno infeccioso viral de afección sistémica con predominio de síntomas respiratorios que en nuestro país se manifestó en un 16% la forma grave de la enfermedad, misma que requirió tratamiento en unidades de cuidados intensivos. Sin embargo, ante la sobre saturación de los servicios de salud en todos los niveles, se buscan opciones terapéuticas para frenar la progresión de la enfermedad y con ello evitar el requerimiento de estas unidades. Objetivo: Observar el efecto de la colchicina como terapia adyuvante al glucocorticoide, sobre los niveles de oxemia en pacientes con síndrome de dificultad respiratoria aguda por COVID-19 Material y métodos: Se revisaron expedientes clínicos del periodo de diciembre 2020 a marzo 2021 de donde se obtuvieron variables clínico-epidemiológicas de 408 pacientes para estadística descriptiva y analítica. Resultados: Se observó una mayor hospitalización de pacientes hombres en 65.9%, las comorbilidades más prevalentes fueron obesidad e hipertensión arterial los cuales aumentaban la probabilidad de enfermedad por COVID-19 con un OR de 1.7 y 2 veces respectivamente. El uso de colchicina como terapia adyuvante al glucocorticoide disminuyó la mortalidad en formas graves de la enfermedad (OR 0.17), aumentó la probabilidad de egreso por mejoría (OR 5.22) y disminuyó el requerimiento de traslados (OR 6.65). Por otra parte, se encontró que la ventilación en prono despierto es un factor protector en todos los grupos (OR 0.36).

Abstract Introduction: Acute respiratory distress syndrome by COVID-19 is a viral infectious disorder of systemic affection with a predominance of respiratory symptoms that in our country manifested itself in 16% of the severe form of the disease, which required treatment in care units. intensive. However, given the over-saturation of health services at all levels, therapeutic options are sought to slow the progression of the disease and thus avoid the need for these units. Objective: To observe the effect of colchicine as adjuvant therapy to glucocorticoid, on oxemia levels in patients with acute respiratory distress syndrome due to COVID-19. Material and methods: Clinical records from the period from December 2020 to March 2021 were reviewed, from which clinical-epidemiological variables of 408 patients were obtained for descriptive and analytical statistics. Results: A greater hospitalization of male patients was observed in 65.9%, the most prevalent comorbidities were obesity and arterial hypertension, which increased the probability of COVID-19 disease with an OR of 1.7 and 2 times, respectively. The use of colchicine as adjuvant therapy to the glucocorticoid decreased mortality in severe forms of the disease (OR 0.17), increased the probability of discharge due to improvement (OR 5.22) and decreased the need for transfers (OR 6.65). On the other hand, it was found that awake prone ventilation is a protective factor in all groups (OR 0.36).

T2-based magnetic resonance genitography in children with complex anorectal malformations: experience at a tertiary pediatric hospital in Latin America.

In children with anorectal malformations (ARMs), it is essential to have a diagnostic imaging method that helps with the evaluation of the internal anatomy. In patients with a persistent cloaca, an ARM variant, in which the measurement of the urethral channel and common channel determines surgical management, there are multiple options for imaging. Magnetic resonance imaging (MRI) is an excellent method for this purpose, from which accurate measurements of channel length can be obtained. Additionally, the use of volumetric/isotropic sequences allows multiplanar reformatting. We present our experience with pelvic MRI and intracavitary non-paramagnetic contrast (MR genitography). This method uses volumetric T2-weighted images and the instillation of saline solution as a contrast agent to distinguish the common channel, length of the urethra, anatomy of the vagina, and presence and location of the rectal fistula. We believe this technique to be particularly useful for those working in settings with limited MRI resources.

Seroprevalencia de Trypanosoma cruzi en niños de Veracruz, México: línea epidemiológica de base para un modelo de control fundamentado de la transmisión activa de la enfermedad de Chagas / Seroprevalence of Trypanosoma cruzi among children from Veracruz, Mexico: Epidemiological baseline for a control model based on Chagas disease active transmission

Resumen Introducción. En el 2021, la Secretaría de Salud de México y la Organización Panamericana de la Salud lanzaron una iniciativa para interrumpir la transmisión vectorial intradomiciliaria de Trypanosoma cruzi, fundamentada en la prevalencia de la enfermedad de Chagas en la población infantil. El estado mexicano de Veracruz fue el pionero de esta iniciativa. Objetivo. Estimar la seroprevalencia de infección por T. cruzi en menores de 15 años de localidades rurales de Veracruz, México. Materiales y métodos. Se identificaron ocho localidades prioritarias para la serología basal del municipio de Tempoal, Veracruz. Entre junio y agosto de 2017, se recolectaron muestras de sangre en papel filtro de 817 individuos para su tamizaje mediante un inmunoensayo enzimático de tercera generación. Los casos reactivos del tamizaje se confirmaron mediante pruebas de hemaglutinación indirecta, ensayo de inmunoabsorción ligado a enzimas e inmunofluorescencia indirecta en muestras de suero. Se calculó la seroprevalencia y su intervalo de confianza (IC) del 95 %. Resultados. En las localidades de Citlaltépetl, Cornizuelo, Cruz de Palma y Rancho Nuevo se confirmaron casos de la enfermedad de Chagas en menores de 15 años con una seroprevalencia de 1,9 % (IC 95 % = 1,12-3,16). Conclusiones. Los resultados indican que estas comunidades presentan transmisión reciente de T. cruzi y permiten establecer una línea epidemiológica de base para el diseño e implementación de un modelo dirigido a aquellas áreas geográficas con transmisión activa. Se espera que dicho modelo contribuya a la eliminación de la transmisión vectorial intradomiciliaria del tripanosomátido en México.

Abstract Introduction. In 2021, the Secretaría de Salud de México and the Pan American Health Organization launched an initiative to interrupt intra-domiciliary vector transmission of Trypanosoma cruzi based on the prevalence of Chagas disease in children. The Mexican State of Veracruz was leading this initiative. Objective. To estimate the seroprevalence of T. cruzi infection among children under 15 years of age from rural areas of Veracruz, México. Materials and methods. We identified eight localities of high priority from the Municipality of Tempoal, Veracruz, for baseline serology. Blood samples were collected on filter paper from 817 individuals between June and August 2017, for screening with a third-generation enzyme immunoassay. Reactive cases were confirmed by indirect hemagglutination, enzyme-linked immunosorbent assay, and indirect immunofluorescence tests on peripheral blood serum samples. We calculated seroprevalence and 95% confidence intervals (CI). Results. We confirmed Chagas disease cases in children under 15 years of age with a seroprevalence of 1,9% (95 % CI = 1,12-3,16) in the localities of Citlaltepetl, Cornizuelo, Cruz de Palma and Rancho Nuevo. Conclusions. These results indicate recent transmission of T. cruzi in these communities and allow to establish an epidemiological baseline for the design and implementation of a model focused on geographical areas with active transmission to advance toward the elimination of intra-domiciliary vector transmission of this parasite in Mexico.

HIV Pretreatment Drug Resistance Trends in Mexico City, 2017-2020.

In response to increasing pretreatment drug resistance (PDR), Mexico changed its national antiretroviral treatment (ART) policy, recommending and procuring second-generation integrase strand-transfer inhibitor (INSTI)-based regimens as preferred first-line options since 2019. We present a four-year observational study describing PDR trends across 2017-2020 at the largest HIV diagnosis and primary care center in Mexico City. A total of 6688 baseline protease-reverse transcriptase and 6709 integrase sequences were included. PDR to any drug class was 14.4% (95% CI, 13.6-15.3%). A significant increasing trend for efavirenz/nevirapine PDR was observed (10.3 to 13.6%, p = 0.02). No increase in PDR to second-generation INSTI was observed, remaining under 0.3% across the study period. PDR was strongly associated with prior exposure to ART (aOR: 2.9, 95% CI: 1.9-4.6, p < 0.0001). MSM had higher odds of PDR to efavirenz/nevirapine (aOR: 2.0, 95% CI: 1.0-3.7, p = 0.04), reflecting ongoing transmission of mutations such as K103NS and E138A. ART restarters showed higher representation of cisgender women and injectable drug users, higher age, and lower education level. PDR to dolutegravir/bictegravir remained low in Mexico City, although further surveillance is warranted given the short time of ART optimization. Our study identifies demographic characteristics of groups with higher risk of PDR and lost to follow-up, which may be useful to design differentiated interventions locally.

CARACTERIZACIÓN GENÉTICA DE LA POBLACIÓN DE Heliconius sara (Nymphalidae) EN LA ISLA GORGONA, COLOMBIA / Genetic characterization of the Heliconius sara (Nymphalidae) population in the Gorgona Island, Colombia

RESUMEN La estructura genética de poblaciones de mariposas con distribución en islas y sus pares continentales ha sido poco documentada para el neotrópico. Este estudio presenta la caracterización de una población de Heliconius sara con distribución en la Isla Gorgona, ubicada en la región del Pacífico Oriental Colombiano. Para esto se examinaron secuencias parciales de un marcador mitocondrial incluyendo información obtenida del GenBank. Se comparó la diversidad y estructura genética con sus conespecíficos continentales y también con congéneres, con los que comparte un ancestro común cercano en el clado Sapho-Sara. Para el análisis de diversidad y estructura genética se realizó un análisis de varianza molecular. Este análisis muestra que la distancia entre la población de la isla y sus pares en el continente es consistente con la variación intraespecífica observada en otras especies del género Heliconius. Para la reconstrucción de la genealogía y datación reciente en el Pleistoceno superior del grupo monofilético de secuencias de H. sara, se realizó un análisis de inferencia bayesiana, así como una de máxima verosimilitud. Del análisis demográfico se seleccionó un modelo histórico de flujo asimétrico desde la isla hacia el continente que sugiere baja resistencia de la discontinuidad geográfica a la dispersión de esta mariposa diurna desde la isla. Este es el primer estudio en examinar un posible evento de aislamiento de una población insular de mariposas en Colombia.

ABSTRACT The genetic structure of butterfly populations among islands and mainland has been poorly documented for the neotropics. This study shows a characterization of the Heliconius sara population with distribution on Gorgona Island in the Colombian Eastern Tropical Pacific region. We obtained partial sequences of a mitochondrial DNA, including information obtained from GenBank. The genetic diversity and structure were compared among the island population and their mainland conspecific, but also with congenerics, with those shared by a recent common ancestor within the Sapho/Sara clade. For the analysis of diversity and genetic structure, an analysis of molecular variance was performed. This analysis shows that the genetic distance between the island's population and that of the mainland is consistent with the intraspecific variation observed in other species of the Heliconious genus. For the reconstruction of the genealogy and the recent dating calibration in the upper Pleistocene of the monophyletic group of H. sara, a Bayesian inference was carried out as well as one of maximum likelihood. From the demographic analysis, an asymmetric gene flow model from the island to the mainland was selected. This model suggests low historical resistance of the geographic discontinuity to dispersal of this small and diurnal butterfly from the island. This is the first study to examine a possible event of local isolation of an island population of a butterfly in Colombia.

Modelado de estructuras-3D de mutaciones raras del receptor-1-melanocortina asociadas al melanismo en el mielero / Modelling of 3d-structures of the rare melanocortin-1-receptor mutations associated to melanism in the bananaquit

ABSTRACT Melanism in plumage color is often associated to the single nucleotide polymorphism of the melanocortin-1-receptor. Despite the striking association between the substitution of a Glutamic-acid by for a Lysine at position 92 on the MC1R protein and a completely black plumage, an in-depth understanding of the effect of missense mutations on the conformational change and behavior of the MC1R in the lipid bilayer caused by the absence of a crystal structure is lacking. We examine the structural basis for receptor activation using DNA sequences from the GenBank to perform in silico protein homology-based modeling. Our tridimensional model shows that the Alanine for a 179-Threonine substitution is a structural complement of the charge-reversing effect associated to the substitution of a Glutamic-acid by for a Lysine at position 92 on the MC1R. We proposed the possibility of gradual evolution in stability and electrostatic properties of the MC1R by the sequential accumulation of these two rare substitutions. These two rare substitutions further perturb physical-chemical properties that may be necessary folding requirements of the constitutively active MC1R forms without altering of ligand binding affinity. The computational coarse-grained molecular dynamics of the MC1R binding affinities to the melanocyte-stimulating hormone predicted the disparity in ligand binding among alleles. We speculate that the disparity in structural constraints and ligand binding among the alleles within heterozygous individuals may contribute as a mechanism to the plumage color variation in the Coereba flaveola.

RESUMEN El melanismo en el color del plumaje se asocia frecuentemente al polimorfismo del receptor melanocortina-1. La ausencia de una estructura cristalográfica de la asociación entre la sustitución del Glutamato por Lisina en la posición 92 de la proteína MC1R y el plumaje completamente negro, no ha permitido tener un mejor entendimiento del efecto de mutaciones no sinónimas en la conformación y en el comportamiento en la membrana del MC1R. Examinamos la estructura asociada a la activación del receptor usando secuencias de ADN obtenidas del GenBank, para un modelamiento in silico de formas homólogas de la proteína. El modelo tridimensional muestra que la sustitución de Alanina por la Treonina en la posición 179 es un complemento estructural al efecto de reversión de carga asociado a la sustitución del Glutamato por Lisina en la posición 92 del MC1R. Proponemos la posibilidad de evolución gradual de la estabilidad y de propiedades electrostáticas del MC1R por la acumulación de estas substituciones. Estas perturban las propiedades fisicoquímicas que podrían ser necesarias para el plegamiento de las formas constitutivamente activas del MC1R sin alterar la afinidad de empalme con el ligando. La modelación computacional de la dinámica molecular de la afinidad de empalme del MC1R a la hormona estimulante de meloncitos predice la disparidad de la unión con el ligando entre alelos. Consideramos que posiblemente la disparidad entre alelos en heterocigotos en cuanto a restricciones estructurales y la unión con el ligando podría contribuir a la variación en el color del plumaje en Coereba flaveola.

Avaliação da ocorrência e dos conhecimentos sobre disfunção temporomandibular em profissionais da Equipe de Saúde da Família do Grupo Hospitalar Conceição / Evaluation of occurrence and knowledge on temporomandibular dysfunction in professionals of the Family Health Teams of the Conceição Hospital Group

Objetivo: considerando-se o elevado número de pessoas com disfunção temporomandibular (DTM) e que a busca por tratamento tem aumentado nos últimos anos, o objetivo do presente estudo foi avaliar a prevalência de DTM entre os integrantes da Equipe de Saúde da Família (ESF) e o conhecimento dos profissionais em relação a essa condição. Métodos: os questionários foram aplicados em 87 profissionais da ESF do Grupo Hospitalar Conceição. No primeiro questionário, avaliou-se a prevalência de DTM, no segundo, foram coletados os dados sociodemográficos e, no terceiro e último, avaliou-se o conhecimento sobre a etiologia, o diagnóstico e o tratamento das DTMs. A análise dos dados foi realizada por meio dos testes Qui-Quadrado ou Teste T de Student para um p ≤ 0,05. Resultados: os resultados demonstraram que os profissionais incluídos, em sua maioria, apresentam DTM leve e que o percentual de acertos dos dentistas foi superior estatisticamente ao dos médicos apenas no item tratamento. Conclusão: é de suma importância que os profissionais das ESFs estejam preparados para atender a demanda de pacientes que apresentam sinais e sintomas compatíveis com DTM.(AU)

Objectives: considering the high number of people affected by TMD and the demand for treatment has increased in the last years, the objective of the present study was to assess the prevalence of TMD among the members of the Family Health Team (FHT) and professionals' knowledge regarding this condition. Methods: three questionnaires were applied to 87 professionals from the Family Health Teams of the Hospital Conceição Group. The first questionnaire evaluated the prevalence of TMD, the second one collected the sociodemographic data and, finally, the research questionnaire sought to evaluate the professionals knowledge about the etiology, diagnosis and treatment of TMD. The data analysis were performed by the Chi-square or Student's T-Test for a p ≤ 0.05. Results: the results demonstrated that the professionals included in the sample have most have slight TMD. Regarding the professional knowledge, the percentage of correct answers of the dentists was statistically superior to the one of the doctors only in treatment. Conclusion: it is of the utmost importance that FHT professionals are prepared to meet the demand of patients with signs and symptoms compatible with TMD.(AU)

Molecular identification of Haemosporidia in avian endemics of Gorgona Island within a context for the eastern tropical Pacific region.

Island bird populations and their obligate blood parasites are of interest for understanding the accumulation of biodiversity and the evolutionary relationship with their mainland congeners. We examined avian Haemosporidia cytochrome b gene among terrestrial birds on Gorgona Island National Park, Colombia. Three Haemoproteus haplotype groups found on Gorgona Island have a higher genetic similarity to Haemoproteus found in the eastern tropical Pacific than those documented in Africa, Asia, Europe and Oceania. Two of the haplotype groups on the island are generalists in terms of infecting multiple hosts and their wide geographical distribution within the eastern tropical Pacific region, a third Haemoproteus haplogroup appears endemic to Gorgona Island. The overall prevalence of haemosporidian parasites is 57,9% for birds on Gorgona island, which is higher than local reports of prevalence documented in other archipelagos or the mainland. The island population of Cyanerpes cyaneus gigas seems to be the most susceptible to Haemoproteus infection when compared to Thamnophilus atrinucha gorgonae and Coereba flaveola gorgonae. Our findings support an ubiquitous pattern of endemism among organisms including avian haemosporidian parasites on Gorgona Island and also highlight the potential exposure of island bird populations to avian malaria.

Caracterización genética de la hormiga Atta cephalotes (Hymenoptera: Formicidae) en Isla Gorgona, Colombia

La variación genética entre las poblaciones insulares y continentales de las hormigas cortadoras de hojas ha sido poco estudiada, a pesar de su importancia para comprender su capacidad de dispersión, estructura regional y distribución de una de las especies más abundantes en el Neotrópico. Objetivo: Analizar la variación genética de una población insular de Atta cephalotes en un contexto regional más amplio para América Central y del Sur. Métodos: Se secuenció el gen de la Citocromo oxidasa I de A. cephalotes para las poblaciones de la isla Gorgona y el continente para realizar un análisis de la varianza molecular, flujo de genes, así como para calcular el tiempo de divergencia de los haplogrupos que se encuentran en la isla. Se realizó una prueba de asignación de individuos para estimar la conectividad genética espacial y la distribución de esta hormiga en el Pacífico Oriental Tropical. Resultados: Un total de 33 muestras de la isla y el continente colombiano se compararon con 389 secuencias de A. cephalotes registradas en Genbank para América Central y Suramérica. Esta hormiga cortadora de hojas en la Isla Gorgona está estrechamente relacionada con el continente colombiano a pesar de que la separación entre la isla y el continente probablemente constituya una barrera para el flujo de genes. Es probable que dos de los haplogrupos más comunes en el continente llegaran a la isla recientemente. Por lo tanto, no se puede excluir la influencia antropogénica en el proceso de colonización de la isla por parte de esta hormiga cortadora de hojas. Un mapa de conectividad muestra que esta población tiene límites geográficos que se superponen en gran medida con una región biogeográfica dentro del Pacífico Oriental Tropical. Esta población trans-andina acumula el 23 % de la diversidad de herencia matrilínea de A. cephalotes. Conclusiones: Esta hormiga cortadora de hojas en la isla Gorgona y el Pacífico colombiano está estrechamente relacionada con la población centroamericana y toda esta región alberga un segmento significativo de la diversidad genética de A. cephalotes de Suramérica.

Introduction: The genetic variation between island and mainland populations of leaf-cutter ants have been poorly studied, despite its importance to understand their local dispersion, regional structure, and the distribution of one of the most abundant species in the neotropics. Objective: To analyze the genetic variation of an insular population of Atta cephalotes in a larger regional context in Central and South America. Methods: The Cytochrome Oxidase I gene of A. cephalotes was sequenced for the Gorgona Island and mainland populations in order to conduct an analysis of molecular variance, gene flow, and to calculate divergence time of haplogroups occurring in the island. An individual assignment test was conducted to estimate the spatial genetic connectivity and the distribution for this ant in the Eastern Tropical Pacific. Results: A total of 33 samples from the island and the Colombian mainland were compared to 389 Genebank accessions ofA. cephalotes from Central and South America. This leaf-cutter ant in the Gorgona Island is closely related to the Colombian mainland, despite that the separation between the island and the mainland likely constitute a barrier to gene flow. It is likely that two of the most common haplogroups on the continent arrived on the island recently. Therefore, the anthropogenic influence in the process of colonization of the island by this leaf-cutting ant cannot be excluded. A map of connectivity shows that this population has geographic limits that largely overlap with a biogeographic region within the Eastern Tropical Pacific. This trans-andean population accumulates 23 % of the maternally inherited diversity of theA. cephalotes. Conclusions: This leaf-cutter ant in the Gorgona Island and the Colombian Pacific is closely related to the Central American population and the whole region harbor a significant segment of A. cephalotes genetic diversity in South America.

Genetic variation of avian malaria in the tropical Andes: a relationship with the spatial distribution of hosts.

BACKGROUND: Avian haemosporidia are obligate blood parasites with an ample range of hosts worldwide. To understand how host communities may influence the diversity of parasites of the neotropics, the spatial genetic variation of avian Plasmodium, Haemoproteus, and Leucocytozoon was examined between areas of host endemism and along the elevational gradient in the tropical Andes. METHODS: A total of 1686 accessions of the cytochrome b gene of avian haemosporidia were selected from 43 publications, that further provides additional information on 14.2% of bird species in the Neotropics. Haplotype groups were identified using a similarity-based clustering of sequences using a cut-off level ≥ 99.3% of sequence identity. Phylogenetic-based analyses were implemented to examine the spatial genetic structure of avian haemosporidia among areas of host endemism and the elevation gradient in the tropical Andes. RESULTS: The areas of avian endemism, including the tropical Andes, can explain the differential distribution of the haemosporidia cytochrome b gene variation. In the tropical Andes region, the total number of avian haemosporidia haplotypes follows a unimodal pattern that peaks at mid-elevation between 2000 and 2500 m above sea level. Furthermore, the haplotype assemblages of obligate blood parasites tend to overlap towards mid-elevation, where avian host diversity tends to be maximized. CONCLUSIONS: Spatial analyses revealed that richness and turnover in haemosporidia suggest an association with montane host diversity, according to elevation in the tropical Andes. In addition, the spatial distribution of haemosporidia diversity is closely associated with patterns of host assemblages over large geographical scale in the tropical Andes and areas of avian endemism nearby.

Avaliação da efetividade de tratamentos conservadores para disfunções temporomandibulares miogênicas: revisão integrativa da literatura / Evaluation of the effectiveness of conservative treatments for miogenic temporomandibular dysfunctions: integrating review of the literature

Objetivo: revisão integrativa sobre os principais métodos de tratamento conservador para disfunção temporomandibular, sendo eles: placa oclusal, aconselhamento e farmacoterapia. Materiais e método: a busca foi feita nas bases de dados PubMed, SciELO, Lilacs e Google Acadêmico, utilizando os seguintes descritores: "counseling and temporomandibular joint"; "counseling and facial pain"; "counseling and temporomandibular joint dysfunction syndrome"; "counseling and temporomandibular joint and drug therapy"; e "counseling and drug therapy and facial pain". Resultados: no total, foram encontrados 314 estudos nesta pesquisa, porém, somente 8 foram incluídos no estudo. Esses comprovam a eficácia desses métodos de tratamento, fazendo com que o paciente obtenha diminuição da sintomatologia dolorosa, melhora das funções mastigatórias, além de proporcionar um alívio na tensão muscular, devido ao relaxamento das estruturas relacionadas. A placa oclusal tende a diminuir as forças oclusais aplicadas, redistribuindo a carga mastigatória sobre as superfícies oclusais. Alguns fármacos (anti-inflamatórios, antidepressivos e relaxantes musculares) são capazes de minimizar a sintomatologia dolorosa, proporcionando uma melhora na qualidade do sono e a redução de episódios de dor intensa. Por sua vez, o aconselhamento orienta os pacientes para que possam evitar atitudes que piorem sua doença, educando-os e conscientizando-os sobre seus hábitos parafuncionais, além de reduzir os fatores causadores de sintomatologia dolorosa. Conclusão: conseguimos observar que esses tratamentos apresentam índices de sucesso relevantes, quando se referem à diminuição dos sintomas, especialmente o aconselhamento, que ainda é uma terapia conservadora pouco explorada. Faz-se necessária a realização de mais estudos neste campo, para que sejam obtidos resultados cada vez mais concretos e conclusivos. (AU)

Objective: integrative review on the main methods of conservative treatment for Temporomandibular Dysfunction, being occlusal plaque, counseling and pharmacotherapy. Materials and method: the search was done in the databases PubMed, SciELO, Lilacs and Google Scholar using the descriptors: "counseling" and "temporomandibular joint", "counseling" and "facial pain", "counseling" and "temporomandibular joint dysfunction syndrome", "counseling" and "temporomandibular joint" and "drug therapy" and "counseling" and "drug therapy" and "facial pain". Results: in total were found 314 studies in this work, but only 8 were included. These tests prove the efficacy of these treatment methods, causing to the patient a decrease in painful symptoms, an increase in masticatory functions, and also providing a relief in muscle tension due to the relaxation of related structures. The occlusal plaque tends to decrease the forces applied in the occlusion, preventing the muscles from exerting excessive force. Some drugs (anti-inflammatories, antidepressants and muscle relaxants) are able to minimize the painful symptomatology, providing an improvement in the quality of sleep and reduction of episodes of intense pain. In turn, counseling guides patients to avoid attitudes that worsen their illness, educating them and making them aware of their parafunctional habits, as well as reducing the factors that cause painful symptoms. Conclusion: we could observe that these treatments present relevant success indexes when it refers to the decrease of the symptoms, especially the counseling, which is still a little explored conservative therapy. It is still necessary to carry out further studies in this field in order to obtain increasingly concrete and conclusive results. (AU)

Optical properties of anatase TiO2: synergy between transition metal doping and oxygen vacancies.

Charge carriers (electrons and holes) are generated on the TiO2 using UV radiation; this excitation energy can be reduced by modifying the material electronic structure, for example, by doping or creating oxygen vacancies. Here, the electronic structure of a transition metal-doped anatase, bulk and surface, and their interaction with oxygen vacancies are studied using density functional theory. The visible light response of metal-doped TiO2 (101) is also determined. Transition metals generate intra-band gap states, which reduce the excitation energy but may also act as charge recombination sites. Dopants Fe, Co, and Ni remarkably enhance the visible light response due to the states in the middle of the gap. However, Co and Ni create heavier charge carriers. Our results show that Pd and Pt-doped TiO2 generate states near the valence and conduction band with a "clean" band gap (without states in the middle of the gap). Moreover, Pt-doped TiO2 maintains the charge mobility because it presents a small charge carriers mass. Hence, Pt-doped TiO2 represents the best alternative to activate TiO2 under visible light. The optical response of transition metal-doped TiO2 follows the order 3d > 4d > 5d. The oxygen vacancies reduce the response of metal-doped TiO2 to visible light because the unpaired electrons generated occupy the empty states of metal-doping. Graphical Abstract Density of states of TiO2 (101) surface doped with transition metals and oxygen vacancies.

Aplicativos móveis para ensino e assistência odontológica: uma revisão integrativa / Mobile applications for dental education and assistance: an integrative review

Este estudo teve como objetivo identificar o estado da arte atual e as tendências de pesquisas que utilizam aplicativos móveis na Odontologia por meio de uma revisão integrativa. Realizaram-se buscas nas bases de dados SciELO, LILACS e PubMed, utilizando os termos "mobile application", "Dentistry" e "informatics", e no Google Acadêmico, para abarcar a literatura cinza, com os mesmos termos na língua portuguesa, sem período de tempo determinado. Os títulos e resumos de todos os artigos encontrados foram lidos por dois pesquisadores de forma independente. Foram incluídas pesquisas oriundas de dados primários e que estivessem relacionados apenas à saúde bucal, cujo meio de informação fosse smartphones, nas línguas inglesa, portuguesa e espanhola. Além disso, os artigos publicados em periódicos científicos foram analisados em relação aos itens atribuídos no checklist do STROBE Statement. Foram encontrados 911 estudos. Após a leitura de todos os títulos e resumos, foram excluídos 897, totalizando 14 estudos para leitura na íntegra. Nove artigos foram incluídos no estudo, classificados em estudos com foco profissional (6) e estudos com foco acadêmico (3). Os dados descritos nos estudos deixam claro a crescente adoção do uso dos aplicativos como recursos educacionais e assistenciais. A criação de aplicativos móveis direcionados à Odontologia é apropriada, tanto no ensino, como uma nova possibilidade de construir conhecimento, quanto para o uso profissional, já que é inegável a disseminação global do uso de dispositivos móveis (AU).

This study aimed to identify the current state of the art and trends of research using mobile applications in Dentistry through an integrative review. SciELO, LILACS and PubMed databases, using the terms "mobile application", "Dentistry" and "informatics", and in Google Scholar, to cover the gray literature, with the same terms in the Portuguese language, without time limitation were searched. The titles and abstracts of all articles found were read independently by two researchers. Studies based on primary data that were related only to oral health, whose medium of information was smartphones, in the English, Portuguese and Spanish languages were included. Also, articles published in scientific journals were analyzed in relation to the items assigned in the STROBE Statement checklist. There were 911 studies. After reading all the titles and abstracts, 897 were excluded, totaling 14 studies for reading in full. Nine articles were included in the study, classified in studies with a professional focus (6) and studies with an academic focus (3). The data described in the studies have shown the increasing adoption the applications use as educational and assistance resources. The creation of mobile applications directed to Dentistry is appropriate, both in teaching, as a new possibility to build knowledge, and for professional use, since the global dissemination of the use of mobile devices is undeniable (AU).

Factors influencing the missed nursing care in patients from a private hospital.

Objective: to determine the factors that influence the missed nursing care in hospitalized patients. Methods: descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman's correlation and simple linear regression were used. Approval for the study was obtained from the ethics committee. Results: the participants were 71 nurses from emergency, intensive care and inpatient services. The global missed care index corresponded to M=7.45 (SD=10.74); the highest missed care index was found in the dimension basic care interventions (M=13.02, SD=17.60). The main factor contributing to the care missed was human resources (M=56.13, SD=21.38). The factors related to the care missed were human resources (rs=0.408, p<0.001) and communication (rs=0.418, p<0.001). Conclusions: the nursing care missed is mainly due to the human resource factor; these study findings will permit the strengthening of nursing care continuity.

[Testicular torsion: A case report]. / Torsión testicular: reporte de un caso.

BACKGROUND: The acute scrotum is an emergency. Testicular torsion represents approximately 25% of the causes. The annual incidence of testicular torsion is approximately 1/4,000 persons under 25 years, with highest prevalence between 12 and 18 years old. It usually occurs without apparent cause, but it has been associated with anatomical, traumatic, and environmental factors, among others. CLINICAL CASE: A male 15 year-old male, with no history of importance, was seen in the Emergency Department, presenting with a sudden and continuous pain in the left testicle. It was accompanied by a pain that radiated to the abdomen and left inguinal area, with nausea and vomiting of more than 12h onset. Doppler ultrasound showed changes suggestive of testicular torsion. Surgery was performed that showed findings of a necrotic left testicle with rotation of the spermatic cord of 360°. A left orchiectomy was performed. CONCLUSIONS: Testicular torsion should always be considered one of the leading causes of acute scrotal pain. Delays in diagnosis should be avoided as this is directly related to the percentage of testicular salvage or loss.

Factors influencing the missed nursing care in patients from a private hospital / Fatores que influenciam o cuidado de enfermagem omitido em pacientes de um hospital particular / Factores que influyen en el cuidado de enfermería perdido en pacientes de un hospital privado

ABSTRACT Objective: to determine the factors that influence the missed nursing care in hospitalized patients. Methods: descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman's correlation and simple linear regression were used. Approval for the study was obtained from the ethics committee. Results: the participants were 71 nurses from emergency, intensive care and inpatient services. The global missed care index corresponded to M=7.45 (SD=10.74); the highest missed care index was found in the dimension basic care interventions (M=13.02, SD=17.60). The main factor contributing to the care missed was human resources (M=56.13, SD=21.38). The factors related to the care missed were human resources (rs=0.408, p<0.001) and communication (rs=0.418, p<0.001). Conclusions: the nursing care missed is mainly due to the human resource factor; these study findings will permit the strengthening of nursing care continuity.

RESUMO Objetivo: determinar os fatores que influenciam o cuidado de enfermagem omitido em pacientes hospitalizados. Método: estudo descritivo correlacional, desenvolvido em um hospital particular do México. Para identificar o cuidado omitido e fatores relacionados, utilizou-se o instrumento MISSCARE, que mede o cuidado omitido e os fatores associados. O cuidado omitido e os fatores foram agrupados em índices globais e por dimensões. Para fins de análise, foi utilizada estatística descritiva, correlação de Spearman e regressão linear simples. O estudo recebeu aprovação de comité de ética. Resultados: participaram 71 enfermeiras dos serviços de urgências, terapia intensiva e hospitalização. O índice global de cuidado omitido mostrou um coeficiente M=7,45 (DE=10,74); o índice com maior cuidado omitido correspondeu à dimensão de intervenções de cuidado básico (M=13,02, DE=17,60). O principal fator que contribuiu ao cuidado omitido foi o de recursos humanos (M=56,13, DE=21,38). Os fatores relacionados ao cuidado omitido foram os recursos humanos (rs=0,408, p<0,001) e comunicação (rs=0,418, p<0,001). Conclusões: o cuidado omitido de enfermagem atribui-se principalmente ao fator de recursos humanos; com base nos resultados deste estudo pode-se fortalecer a continuidade do cuidado de enfermagem.

RESUMEN Objetivo: determinar los factores que influyen en el cuidado de enfermería perdido en pacientes hospitalizados. Método: estudio descriptivo correlacional, se realizó en un hospital privado de México. Para identificar el cuidado perdido y factores relacionados se utilizó el instrumento MISSCARE que mide el cuidado perdido y los factores asociados. El cuidado perdido y los factores se agruparon en índices globales y por dimensiones. Para el análisis se utilizó estadística descriptiva, correlación de Spearman y regresión lineal simple. El estudio fue aprobado por el comité de ética. Resultados: participaron 71 enfermeras de los servicios de urgencias, terapia intensiva y hospitalización. El índice global de cuidado perdido mostró una M=7,45 (DE=10,74); el índice con mayor cuidado perdido correspondió a la dimensión de intervenciones de cuidado básico (M=13,02, DE=17,60). El principal factor que contribuyó en el cuidado perdido, fue el de recursos humanos (M=56,13, DE=21,38). Los factores relacionados con el cuidado perdido fueron los de recursos humanos (rs=0,408, p<0,001) y comunicación (rs=0,418, p<0,001). Conclusiones: el cuidado perdido de enfermería se atribuye principalmente al factor de recurso humano; los hallazgos de este estudio permitirán fortalecer la continuidad en el cuidado de enfermería.

Ensino em serviço na perspectiva da Clínica Ampliada: relato de experiência / Education-service at the Expanded Clinic perspective: an experience report

A Clínica Ampliada pode ser compreendida como a relação estabelecida entre os diferentes profissionais de saúde com os usuários no intuito de produzir saúde por meio do empoderamento dos sujeitos e criação de autonomia. Neste contexto, a formação profissional em Odontologia deve primar pelo desenvolvimento das habilidades técnicas aliadas a qualidades humanistas para atuação na perspectiva da Clínica Ampliada. Considerando a discussão do processo de formação do cirurgiãodentista integrado ao serviço de saúde pública e a perspectiva de atuação na Clínica Ampliada, este trabalho teve como objetivo relatar a experiência acadêmica do estágio supervisionado, realizado um uma unidade de saúde, no município de Porto Alegre/RS. No modelo de um relato de experiência descritivo, com metodologia relacionada ao processo reflexivo crítico do aluno, o estágio ocorreu num período de 30 dias, com carga horária de 15 horas semanais, em uma unidade de saúde pertencente ao Grupo Hospitalar Conceição. Incluiu atividades de acompanhamento ambulatorial e de promoção e prevenção de saúde, realizados na unidade de saúde e sua área de atuação. Da experiência vivida, foi possível observar que os profissionais da equipe de saúde tinham como proposta para o atendimento a resolutividade clínica e a perspectiva de um plano de tratamento conjunto, de acordo com a realidade social de cada usuário, baseando-se na comunicação horizontal entre comunidade e profissionais. Assim, compreender a saúde bucal dentro da perspectiva da Clínica Ampliada requer, cada vez mais, uma análise conjunta das questões biopsicossociais dos indivíduos (AU).

The expanded clinic can be understood as the relationship established between the different health professionals with the users in order to produce health through the empowerment of the subjects and creation of autonomy. In this context, professional training in dentistry should be based on the development of technical skills combined with humanistic qualities to act in the perspective of the Expanded Clinic. Considering the debate regarding the formation of dentists integrated into the public health service and considering the prospect of performance in the expanded clinic, the purpose of this study is to report the academic experience of a supervised internship, in a health unit, in Porto Alegre/RS. The internship took place over a thirty-day period, with a workload of 15 hours per week, at the one health unit of the Grupo Hospitalar Conceição, and it was structured on a descriptive experience report method, related to the student's critical reflective process. The internship included activities of outpatient follow-up and health promotion and prevention, performed at the health unit and its operating fields. From the experience it was possible to observe that the team's proposal for the service performance it the conclusion of the treatment and the perspective of a joint treatment plan, specific to the social reality of each patient, based on the horizontal communication between the community and the professionals. Finally, understanding oral health within the perspective of the extended clinic requires a joint analysis of the bio-psycho-social issues of the persons (AU).

[Acute pancreatitis in childhood by choledocal stone in a choledocal cyst. Case report]. / Pancreatitis en la infancia por litiasis coledociana en quiste de colédoco complicado. Reporte de caso.

Acute pancreatitis is a known complication of choledochal cysts. It is associated with changes in the biliopancreatic junction and with intra-cystic gallstones. We describe a case of pancreatitis and biliary obstruction caused by choledochal cyst type IVa complicated with obstruction by biliary stones in a 2 year old infant.