Understanding systemic land use dynamics in conflict-affected territories: The cases of Cesar and Caquetá, Colombia.

In the Colombian context, disputes over natural resources, mainly over land, and poor governance are intertwined with armed conflict. Although efforts to address this situation, including the 2016 peace agreement signed between Colombian government and the Revolutionary Armed Forces of Colombia (FARC, by Spanish acronym) are underway, these disputes continue, affecting land use dynamics. Understanding the complexity and trends in land use conflicts, as well as the specific regional characteristics underlying differing land use changes across regions, is critical. This article aims to systematically understand land use dynamics in two contrasting and conflict-affected territories in Colombia, Caquetá and Cesar, thus identifying entry points to address land-use conflicts at the regional level. To address the complexity of each regional case, we apply a methodology based on system thinking to capture the interconnections between socio-economic and environmental system components and their land use dynamics. Results depicted through causal loop diagrams not just show the cascade of environmental, social, and economic failures resulting from land use changes in these two conflict-affected territories but also suggest that land tenure systems innovations and the promotion of sustainable land use interventions at the regional level can reverse the consequences of the land use changes. Thus, future actions addressing land use conflicts must be context-dependent, tackling the root and structural causes.

Azathioprine Biotransformation in Young Patients with Inflammatory Bowel Disease: Contribution of Glutathione-S Transferase M1 and A1 Variants.

The contribution of candidate genetic variants involved in azathioprine biotransformation on azathioprine efficacy and pharmacokinetics in 111 young patients with inflammatory bowel disease was evaluated. Azathioprine doses, metabolites thioguanine-nucleotides (TGN) and methylmercaptopurine-nucleotides (MMPN) and clinical effects were assessed after at least 3 months of therapy. Clinical efficacy was defined as disease activity score below 10. Candidate genetic variants (TPMT rs1142345, rs1800460, rs1800462, GSTA1 rs3957357, GSTM1, and GSTT1 deletion) were determined by polymerase chain reaction (PCR) assays and pyrosequencing. Statistical analysis was performed using linear mixed effects models for the association between the candidate variants and the pharmacological variables (azathioprine doses and metabolites). Azathioprine metabolites were measured in 257 samples (median 2 per patient, inter-quartile range IQR 1-3). Clinical efficacy at the first evaluation available resulted better in ulcerative colitis than in Crohn's disease patients (88.0% versus 52.5% responders, p = 0.0003, linear mixed effect model, LME). TGN concentration and the ratio TGN/dose at the first evaluation were significantly higher in responder. TPMT rs1142345 variant (4.8% of patients) was associated with increased TGN (LME p = 0.0042), TGN/dose ratio (LME p < 0.0001), decreased azathioprine dose (LME p = 0.0087), and MMPN (LME p = 0.0011). GSTM1 deletion (58.1% of patients) was associated with a 18.5% decrease in TGN/dose ratio and 30% decrease in clinical efficacy. GSTA1 variant (12.8% of patients) showed a trend (p = 0.049, LME) for an association with decreased clinical efficacy; however, no significant effect on azathioprine pharmacokinetics could be detected. In conclusion, GSTs variants are associated with azathioprine efficacy and pharmacokinetics.

SIADH versus adrenal insufficiency: a life-threatening misdiagnosis.

BACKGROUND: Primary adrenal insufficiency (PAI) in children is an uncommon but severe condition which can be either inherited or acquired. It consists in clinical manifestation of defective production or ineffective action of endogenous glucocorticoids; deficiency in mineralocorticoids and adrenal androgens may coexist. Diagnosis of PAI in children and young people can be challenging; while adrenal crisis (acute decompensation) is a life-threatening condition, with patient presenting with characteristic features of hypoglycemia, hypotension, collapse and coma, chronic adrenal insufficiency may present with vague and non-specific symptoms, making the diagnosis more difficult.1 Gastroenteritis and Syndrome of Inappropriate Secretion of Antidiuretic hormone (SIADH) are the most frequent reported misdiagnosis in patients with adrenal insufficiency (AI). While intravenous fluid replacement in the suspect of a gastroenteritis would be beneficial, a SIADH misdiagnosis can be harmful since the treatment of this condition is based primarily on fluid restriction. CASE PRESENTATION: We report the case of a child admitted to the emergency department whose condition was ultimately diagnosed as autoimmune adrenal insufficiency after few hours of inappropriate fluid restriction following a SIADH misdiagnosis. CONCLUSIONS: AI is a rare condition in children and the diagnosis can be challenging. A missed diagnosis of AI or an inadequate treatment may cause severe complications, especially if a SIADH is erroneously diagnosed. Emergency physicians and pediatricians should be familiar with this diagnosis to enhance early recognition of this potentially life-threatening condition.

Implementación de dos metodologías diagnósticas para la determinación del virus de influenza porcina / Improvement of two diagnostics methods for detection of influenza swine virus

La influenza porcina, es una enfermedad respiratoria aguda viral altamente contagiosa, de morbilidad elevada y capaz de provocar complicaciones letales. Tiene gran importancia en la industria pecuaria debido a las cuantiosas pérdidas económicas que ocasiona su alta morbilidad. Por esta razón, en este trabajo se implementaron las pruebas de cultivo celular y RT-PCR para las proteínas M, H y N para la determinación del virus de influenza porcina. En este trabajo, se procesaron y analizaron 82 muestras de hisopos nasales, 12 lavados broncoalveolares y 12 tejidos pulmonares, dando resultados negativos para la detección del virus de influenza. Al comparar la RT-PCR de la proteína M con la de cultivo celular como "Gold Standard" se obtuvo una sensibilidad y especificidad del 100% e índice Kappa de 1, indicando una concordancia muy buena entre las dos pruebas.

The swine influenza virus, is an acute disease that affects the respiratory tract of the pig, It is highly contagious and have a raised morbility ratio also could turn into a fatal end. This disease has a very important roll into the pig production farms since it is a cause of loses of funds. For that reason, this work implemented the cell culture technique and RT-PCR for M, H and N proteins segments for the fast and accurate diagnosis of this virus. On this work, were tested 82 nasal swabs, 12 broncoalveolars washes, and 12 lung tissues, given negative results for the swine influenza virus. During the compilation of RT-PCR for M protein segment with the cell culture as a gold standard, it attained a sensibility and specificity of 100% and Kappa index of 1 indicating a good concordance between the two probes.