Relationship between Climate Variables and Dengue Incidence in Argentina.

BACKGROUND: Climate change is an important driver of the increased spread of dengue from tropical and subtropical regions to temperate areas around the world. Climate variables such as temperature and precipitation influence the dengue vector's biology, physiology, abundance, and life cycle. Thus, an analysis is needed of changes in climate change and their possible relationships with dengue incidence and the growing occurrence of epidemics recorded in recent decades. OBJECTIVES: This study aimed to assess the increasing incidence of dengue driven by climate change at the southern limits of dengue virus transmission in South America. METHODS: We analyzed the evolution of climatological, epidemiological, and biological variables by comparing a period of time without the presence of dengue cases (1976-1997) to a more recent period of time in which dengue cases and important outbreaks occurred (1998-2020). In our analysis, we consider climate variables associated with temperature and precipitation, epidemiological variables such as the number of reported dengue cases and incidence of dengue, and biological variables such as the optimal temperature ranges for transmission of dengue vector. RESULTS: The presence of dengue cases and epidemic outbreaks are observed to be consistent with positive trends in temperature and anomalies from long-term means. Dengue cases do not seem to be associated with precipitation trends and anomalies. The number of days with optimal temperatures for dengue transmission increased from the period without dengue cases to the period with occurrences of dengue cases. The number of months with optimal transmission temperatures also increased between periods but to a lesser extent. CONCLUSIONS: The higher incidence of dengue virus and its expansion to different regions of Argentina seem to be associated with temperature increases in the country during the past two decades. The active surveillance of both the vector and associated arboviruses, together with continued meteorological data collection, will facilitate the assessment and prediction of future epidemics that use trends in the accelerated changes in climate. Such surveillance should go hand in hand with efforts to improve the understanding of the mechanisms driving the geographic expansion of dengue and other arboviruses beyond the current limits. https://doi.org/10.1289/EHP11616.

Chilaiditi syndrome in pediatric patients - Symptomatic hepatodiaphragmatic interposition of colon: A case report and review of literature.

BACKGROUND: Chilaiditi syndrome is a rare disorder characterized by the hepatodiaphragmatic interposition of the intestine. CASE SUMMARY: Here we report a case of a 12-year-old male who was admitted to the pediatric intensive care unit secondary to abdominal pain and severe respiratory distress. He was treated conservatively but the symptoms persisted requiring a surgical approach. While there have been several cases of Chilaiditi syndrome reported in adults, there is a scarcity of cases reported in the pediatric population. Our review of the literature found only 30 pediatric cases, including our reported case, with Chilaiditi syndrome, 19 (63%) of which were male. The median age of diagnosis was 4.5 years old with an interquartile range of 2.0-10.0 years. In our review, we found that the most common predisposing factors in children are aerophagia (12/30 cases) and constipation (13/30 cases). Ninety percent of the cases presented with complete intestinal interposition, in 100% of which, the colon was involved. Three of the 30 cases were associated with volvulus. CONCLUSION: In the pediatric population, conservative (21/30 cases) and surgical (8/30 cases) treatment approaches have produced satisfactory outcomes for all the patients, regardless of approach.

Dengue emergence in the temperate Argentinian province of Santa Fe, 2009-2020.

Dengue virus (DENV) transmission occurs primarily in tropical and subtropical climates, but within the last decade it has extended to temperate regions. Santa Fe, a temperate province in Argentina, has experienced an increase in dengue cases and virus circulation since 2009, with the recent 2020 outbreak being the largest in the province to date. The aim of this work is to describe spatio-temporal fluctuations of dengue cases from 2009 to 2020 in Santa Fe Province. The data presented in this work provide a detailed description of DENV transmission for Santa Fe Province by department. These data are useful to assist in investigating drivers of dengue emergence in Santa Fe Province and for developing a better understanding of the drivers and the impacts of ongoing dengue emergence in temperate regions across the world. This work provides data useful for future studies including those investigating socio-ecological, climatic, and environmental factors associated with DENV transmission, as well as those investigating other variables related to the biology and the ecology of vector-borne diseases.

Spatio-temporal analysis of leptospirosis incidence and its relationship with hydroclimatic indicators in northeastern Argentina.

Leptospirosis is considered the most globally widespread zoonotic illness; it has been classified as an emerging or reemerging infectious disease by the World Health Organization. Leptospirosis is a disease caused by a pathogenic spirochete of the genus Leptospira. The infection occurs by contacting with the urine of animal reservoirs or contaminated environments. Leptospirosis can be controlled by vaccines used mainly in animals, antibiotics given to exposed humans, and flood-affected people moved to a safe place. Northeastern Argentina accounts for the highest annual number of cases and deaths due to leptospirosis of the country. This interdisciplinary study aims to analyze the spatial and temporal distribution of leptospirosis, and assesses the hydroclimatic factors that give rise to the outbreaks in northeastern Argentina. The main goal is to detect the hydroclimatic indicators that can influence leptospirosis outbreaks occurrence in the northeastern Argentina. We perform a spatio-temporal analysis of the leptospirosis in the provinces of Santa Fe and Entre Ríos to distinguish the regions, years and seasons with the highest incidence of this disease. This study analyzes confirmed cases of leptospirosis between 2009 and 2018 years. Hydroclimatic indicators (monthly total precipitation, monthly river hydrometric level and Oceanic Niño Index) associated with outbreaks of leptospirosis vary in different spatial scales (provincial, departmental and cities). In the last outbreak of leptospirosis in 2015-2016 the number of cases was lower than expected. This could have been a consequence of increased prophylaxis in that flood event. Therefore, this is a variable that should be incorporated in future studies.

Analysis of the spatial distribution of scientific publications regarding vector-borne diseases related to climate variability in South America.

Most vector-borne diseases exhibit a distinct seasonal pattern, which clearly suggests that they are weather sensitive. Rainfall, temperature, and other climate variables affect in many ways both the vectors and the pathogens they transmit. Likewise, climate can be determinant in outbreaks incidence. A growing number of studies have provided evidence indicating the effects of climate variability on vector-borne diseases. However, oftentimes, the different diseases and regions are not uniformly represented, scarcity or lack of publications in some countries is common. The objectives of this work were to analyze the distribution and abundance of publications on vector-borne diseases associated with climate variability in South America, identify those works that conducted a geographic analysis and detect the countries where outbreaks occurred and the climate variables with which they were associated. A systematic review of the literature published on vector-borne diseases linked to climate variability in South America was conducted, identifying, evaluating and summarizing scientific papers. The distribution of the study areas and disease type in the publications were represented on maps. Dengue and leishmaniasis were the most studied and widely represented diseases in South America. The country with the largest number of published papers and presence of all disease types was Brazil. Outbreaks of disease were related to different climate variables. Most diseases from the publications under study occurred in equatorial and tropical climates. The disease represented by the largest number of different types of climates was dengue. The technique used in this work allowed us to determine the status of knowledge of the main diseases associated with climate variability in South America. This methodology could be improved in the future by incorporating other bibliographic sources as well as other diseases related to climate variability.

How far from water? terrestrial dispersal and nesting sites of the freshwater turtle Phrynops hilarii in the floodplain of the Paraná River (Argentina).

Terrestrial environments surrounding aquatic resources are important and intensively used by semi-aquatic species. In the present work, terrestrial dispersal and nesting sites of the freshwater turtle Phrynops hilarii were analyzed in the floodplain of the Paraná River, using field data and variables obtained from remote sensing. A total of 112 turtles and 44 nests were recorded during road sampling for one year (covered a total of 786 km in 30 surveys). Individuals were at a mean distance of 171.45 m from water, with a negative correlation between number of turtles and distance from water bodies. No significant differences in distance of turtles from water were observed among seasons. Phrynops hilarii nested at a mean distance of 136.51 m from water, showing a negative correlation between number of nests and distance from water bodies. Mean elevation of nests relative to maximum level of water body nearest each record was 1.13 m. The correlation between number of nests and elevation of the nearest water body was positive and significant. The landscape surrounding wetlands is important for P. hilarii to complete the life cycle, as nesting is done in this environment. Our results show that the habitat selected for nesting and terrestrial dispersal was proportionally different from that available in the entire study area, with a higher proportion of wetlands, grasslands and forests.

Transcervical intrapartum amnioinfusion for preterm premature rupture of the membranes.

OBJECTIVES: To investigate the effect of transcervical amnioinfusion on the management of labour and neonatal outcomes in preterm premature rupture of the membranes. STUDY DESIGN: This clinical trial included 86 patients with premature rupture of the membranes between weeks 27 and 35 of gestation. Patients were randomly assigned to receive amnioinfusion via a two-way catheter or to the control group. Clinical management was otherwise the same in both groups. RESULTS: Amnioinfusion decreased the frequency of variable decelerations in fetal heart rate (27.9% versus 53.5%, p<0.05) and the rate of obstetric interventions motivated by nonreassuring fetal status (13.6% versus 52.4%, p<0.05). At delivery, pH values were significantly higher in the treatment group than in the conventionally managed control group (median 7.29 versus 7.27). CONCLUSIONS: Intrapartum transcervical amnioinfusion for preterm premature rupture of the membranes reduced the number of interventions needed because of nonreassuring fetal status, and improved neonatal gasometric values without increasing maternal or fetal morbidity.