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1.
Artículo en Inglés | MEDLINE | ID: mdl-38763938

RESUMEN

The protection of Earth's stratospheric ozone (O3) is an ongoing process under the auspices of the universally ratified Montreal Protocol and its Amendments and adjustments. A critical part of this process is the assessment of the environmental issues related to changes in O3. The United Nations Environment Programme's Environmental Effects Assessment Panel provides annual scientific evaluations of some of the key issues arising in the recent collective knowledge base. This current update includes a comprehensive assessment of the incidence rates of skin cancer, cataract and other skin and eye diseases observed worldwide; the effects of UV radiation on tropospheric oxidants, and air and water quality; trends in breakdown products of fluorinated chemicals and recent information of their toxicity; and recent technological innovations of building materials for greater resistance to UV radiation. These issues span a wide range of topics, including both harmful and beneficial effects of exposure to UV radiation, and complex interactions with climate change. While the Montreal Protocol has succeeded in preventing large reductions in stratospheric O3, future changes may occur due to a number of natural and anthropogenic factors. Thus, frequent assessments of potential environmental impacts are essential to ensure that policies remain based on the best available scientific knowledge.

3.
Int J Tuberc Lung Dis ; 27(9): 682-687, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37608477

RESUMEN

BACKGROUND: Depression is common among persons with TB and is associated with poor clinical outcomes. However, little is known about the relationship between latent TB infection (LTBI) and depression. We assessed the association between LTBI and depressive symptoms among household contacts (HHCs) of patients receiving TB treatment.METHODS: We enrolled 1,009 HHCs of 307 patients receiving TB treatment in Lima, Peru, during 2016-2018. At enrollment, HHC LTBI status was assessed using the interferon-gamma release assay (IGRA). Depressive symptoms were assessed at baseline and 12 months later using the Patient Health Questionnaire-9 (PHQ-9) with a cut-off of 5. We used logistic regression to estimate the odds ratio (OR) for PHQ-9 5, comparing HHCs with and without baseline LTBI.RESULTS: Among 921 HHCs, 374 (41.0%) had LTBI at baseline, and 69 (12.4%) of 567 HHCs had PHQ-9 5. Compared to HHCs without LTBI at enrollment, those with LTBI had almost two times the odds of PHQ-9 5 at follow-up after controlling for potential confounders (adjusted OR 1.93, 95% CI 1.09-3.39); this association was driven by greater severities of depressive symptoms.CONCLUSION: HHCs with LTBI had increased odds of depressive symptoms 1 year later. This population may benefit from mental health screening and interventions integrated into TB programs.


Asunto(s)
Tuberculosis Latente , Tuberculosis , Humanos , Depresión/diagnóstico , Depresión/epidemiología , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/epidemiología , Ensayos de Liberación de Interferón gamma , Oportunidad Relativa
4.
Int J Tuberc Lung Dis ; 27(7): 557-563, 2023 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-37353876

RESUMEN

BACKGROUND: Although culture remains the standard for TB diagnosis, 15-20% of patients diagnosed and treated for TB are culture-negative. We explored clinical characteristics, risk factors and treatment outcomes for culture-negative TB in a Peruvian cohort.METHODS: We recruited 4,500 index TB patients and 10,160 household contacts in Lima, Peru, and enrolled 692 secondary patients diagnosed with TB during follow-up of household contacts. We analyzed smear and culture status, sociodemographic factors, clinical characteristics and TB treatment outcomes to compare culture-negative and positive patients.RESULTS: Of the 4,880 adult patients, 915 (18.8%) were culture-negative. Culture-negative patients were less likely to report symptoms of TB disease and disease of longer duration. A multivariate analysis showed no statistically significant difference in loss to follow-up, treatment failure or recurrence between the culture-negative and -positive groups but a higher rate of death among culture-negative patients with an adjusted OR of 1.65 (95% CI 1.05-2.60). In a multivariate analysis of determinants of culture negativity, older age, substance use and being a secondary case were associated with culture status.CONCLUSIONS: More recognition and awareness of culture-negative TB is key for early and correct diagnosis to reduce transmission and improve treatment outcomes.


Asunto(s)
Tuberculosis Pulmonar , Adulto , Humanos , Tuberculosis Pulmonar/diagnóstico , Factores de Riesgo , Resultado del Tratamiento , Perú/epidemiología , Insuficiencia del Tratamiento
5.
Sci Total Environ ; 835: 155502, 2022 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-35490807

RESUMEN

Endocrine disruptors like thiocyanate are some of the principal causes of chronic disorders worldwide. Prenatal and postnatal exposure to thiocyanate can interfere with normal neurological development in both fetuses and newborns. Currently, little information regarding thiocyanate levels and potential sources of exposure is available. In this study, we evaluated thiocyanate uptake and accumulation in chard and spinach grown under greenhouse conditions. Both chard and spinach are commonly used to produce baby foods. Three thiocyanate concentrations were compared: Control, T1 (30 ng mL-1), and T2 (70 ng mL-1). Thiocyanate accumulation depended on the concentration and exposure time. Chard was found to accumulate more thiocyanate than spinach, with leaf accumulation > stem accumulation (p < 0.0194) and maximum concentrations of 76 ng g-1 (control), 112 ng g-1, (T1), and 134 ng g-1 (T2). The estimated daily intake (EDI) of thiocyanate for chard and spinach (fresh) exceeded the subchronic reference dose of 200 ng-1 kg-1 day-1 and the chronic reference dose of 600 ng-1 kg-1 day-1. In addition, the EDI of thiocyanate for spinach in baby food exceeded twice the chronic reference dose in the vulnerable newborn-1 year age group. However, all EDIs were lower than the lowest observed adverse effect level (LOAEL) of 1.9 × 105 ng kg-1 day-1. Further studies are needed that increase our knowledge of thiocyanate levels and potential environmental sources to reduce opportunities for exposure, especially in vulnerable groups.


Asunto(s)
Beta vulgaris , Suelo , Humanos , Recién Nacido , Spinacia oleracea , Tiocianatos , Agua
6.
Public Health Action ; 12(1): 7-9, 2022 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-35317538

RESUMEN

We describe the experience of integrating COVID-19 screening and testing into a mobile TB screening unit in Lima, Peru. All attendees received chest radiographs, which were analysed using CAD4TB and CAD4COVID; Xpert MTB/RIF Ultra was used to test for TB, and antibody and polymerase chain reaction (PCR) for SARS-CoV-2. One Xpert-positive TB case was diagnosed per 168 people screened, one person with SARS-CoV-2 antibodies per 3 people screened, and one PCR-confirmed SARS-CoV-2 infection per 8 people screened. Integrated screening can help to avoid delays in the diagnosis of both TB and COVID-19.


Nous décrivons l'expérience de l'intégration du dépistage et du test COVID-19 dans une unité mobile de dépistage de la TB à Lima, au Pérou. Toutes les personnes présentes ont reçu des radiographies pulmonaires, qui ont été analysées à l'aide de CAD4TB et CAD4COVID ; Xpert® MTB/RIF Ultra a été utilisé pour le dépistage de la TB, et les anticorps et la réaction en chaîne par polymérase (PCR) pour le SARS-CoV-2. Un cas de TB Xpert-positif a été diagnostiqué pour 168 personnes dépistées, une personne présentant des anticorps du SARS-CoV-2 pour 3 personnes dépistées et une infection du SARS-CoV-2 confirmée par PCR pour 8 personnes dépistées. Le dépistage intégré peut contribuer à éviter les retards dans le diagnostic de la TB et du COVID-19.

7.
Environ Geochem Health ; 44(2): 527-535, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32740759

RESUMEN

Perchlorate (ClO4-) has been identified as a persistent environmental contaminant of concern. Perchlorate exposure is a potential health concern because it interferes with hormone production by thyroid gland. Food (fruits and vegetables) and drinking water are an important source of human exposure to perchlorate. However, little is known about the occurrence of perchlorate in Chile. The purpose of this study was to determine the occurrence of perchlorate in 145 samples (soil, drinking water, surface water, groundwater, fertilizers, fruits and vegetables) collected across Chile and estimate associated exposure to consumers. Our results show that perchlorate was detected in soil (median: 22.2 ng g-1), drinking water (median: 3.0 ng mL-1), fruits (median: 0.91 ng g-1 fresh weight [FW]), lettuce (median: 5.0 ng g-1 FW) and chard (median: 4.15 ng g-1 FW). Interestingly, perchlorate concentrations detected in drinking water from three regions (Serena, Copiapo and Illapel) exceeded the USEPA interim drinking water health advisory level of 15 ng mL-1. Median concentrations of perchlorate in non-nitrogenous fertilizers (3.1 mg kg-1) were higher than those in nitrogenous fertilizers (1.3 mg kg-1). Estimated daily intake (EDI) of perchlorate via drinking water was lower than the USEPA's reference dose (7000 ng kg-1 bw day-1). The EDI of perchlorate via vegetables (chard and lettuce) produced in northern Chile was three times higher than those produced in other regions. The results of this study provide information about perchlorate sources in Chile, which will be helpful in modifying current regulations.


Asunto(s)
Agua Potable , Contaminantes Químicos del Agua , Chile , Agua Potable/análisis , Fertilizantes/análisis , Frutas/química , Humanos , Percloratos , Suelo , Verduras , Contaminantes Químicos del Agua/análisis
8.
Food Chem ; 370: 131101, 2022 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-34537427

RESUMEN

Very little information is available with regards to the bioavailability of perchlorate in spinach or chard used in the production of baby foods commodities. In the present study, the uptake and accumulation of perchlorate were compared under two different treatments (T1: 1 and T2: 10 mg L-1 ClO4-). Our results indicate that spinach has a higher capacity to accumulate perchlorate than chard (p < 0.0185). Concentrations of perchlorate in leaves, stems and roots (leaves > stem > roots) all gradually increased (p < 0.0001) as vegetable growing and treatment (T2 > T1). No significant differences were found between the control and T1. The daily intake for perchlorate (control) is below the proposed international standard, however, it was exceeded in T1 and T2. The results suggested that perchlorate is actively accumulate in high concentrations in vegetables used in the production of baby food commodities and the exposure of perchlorate via the food consumption (baby foods) was evaluated as not safe.


Asunto(s)
Beta vulgaris , Percloratos , Contaminación de Alimentos/análisis , Inocuidad de los Alimentos , Alimentos Infantiles/análisis , Percloratos/análisis , Spinacia oleracea , Verduras
9.
Nat Commun ; 12(1): 6088, 2021 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-34667165

RESUMEN

Plant pathogens pose increasing threats to global food security, causing yield losses that exceed 30% in food-deficit regions. Xylella fastidiosa (Xf) represents the major transboundary plant pest and one of the world's most damaging pathogens in terms of socioeconomic impact. Spectral screening methods are critical to detect non-visual symptoms of early infection and prevent spread. However, the subtle pathogen-induced physiological alterations that are spectrally detectable are entangled with the dynamics of abiotic stresses. Here, using airborne spectroscopy and thermal scanning of areas covering more than one million trees of different species, infections and water stress levels, we reveal the existence of divergent pathogen- and host-specific spectral pathways that can disentangle biotic-induced symptoms. We demonstrate that uncoupling this biotic-abiotic spectral dynamics diminishes the uncertainty in the Xf detection to below 6% across different hosts. Assessing these deviating pathways against another harmful vascular pathogen that produces analogous symptoms, Verticillium dahliae, the divergent routes remained pathogen- and host-specific, revealing detection accuracies exceeding 92% across pathosystems. These urgently needed hyperspectral methods advance early detection of devastating pathogens to reduce the billions in crop losses worldwide.


Asunto(s)
Ascomicetos/fisiología , Olea/microbiología , Enfermedades de las Plantas/microbiología , Prunus dulcis/microbiología , Xylella/fisiología , Deshidratación , Especificidad del Huésped , Olea/química , Prunus dulcis/química , Análisis Espectral , Estrés Fisiológico
10.
Remote Sens Environ ; 260: 112420, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34219817

RESUMEN

The early detection of Xylella fastidiosa (Xf) infections is critical to the management of this dangerous plan pathogen across the world. Recent studies with remote sensing (RS) sensors at different scales have shown that Xf-infected olive trees have distinct spectral features in the visible and infrared regions (VNIR). However, further work is needed to integrate remote sensing in the management of plant disease epidemics. Here, we research how the spectral changes picked up by different sets of RS plant traits (i.e., pigments, structural or leaf protein content), can help capture the spatial dynamics of Xf spread. We coupled a spatial spread model with the probability of Xf-infection predicted by a RS-driven support vector machine (RS-SVM) model. Furthermore, we analyzed which RS plant traits contribute most to the output of the prediction models. For that, in almond orchards affected by Xf (n = 1426 trees), we conducted a field campaign simultaneously with an airborne campaign to collect high-resolution thermal images and hyperspectral images in the visible-near-infrared (VNIR, 400-850 nm) and short-wave infrared regions (SWIR, 950-1700 nm). The best performing RS-SVM model (OA = 75%; kappa = 0.50) included as predictors leaf protein content, nitrogen indices (NIs), fluorescence and a thermal indicator (Tc), alongside pigments and structural parameters. Leaf protein content together with NIs contributed 28% to the explanatory power of the model, followed by chlorophyll (22%), structural parameters (LAI and LIDFa), and chlorophyll indicators of photosynthetic efficiency. Coupling the RS model with an epidemic spread model increased the accuracy (OA = 80%; kappa = 0.48). In the almond trees where the presence of Xf was assayed by qPCR (n = 318 trees), the combined RS-spread model yielded an OA of 71% and kappa = 0.33, which is higher than the RS-only model and visual inspections (both OA = 64-65% and kappa = 0.26-31). Our work demonstrates how combining spatial epidemiological models and remote sensing can lead to highly accurate predictions of plant disease spatial distribution.

12.
Rev. cir. (Impr.) ; 73(1): 59-65, feb. 2021. graf, ilus, tab
Artículo en Español | LILACS | ID: biblio-1388789

RESUMEN

Resumen Introducción: El trauma representa un verdadero reto para los sistemas sanitarios por ser un gran problema de salud pública. En Chile se desconoce el manejo del paciente politraumatizado. Objetivo: Describir los resultados del primer registro de trauma (RT) en línea, en los pacientes que se atienden en el Hospital Dr. Sótero del Río durante los primeros dos años de la implementación. Materiales y Método: Se recoge información prospectiva en un registro en red, sobre pacientes víctimas de trauma, ingresados al Hospital Dr. Sótero del Río durante dos años. Estas variables involucran todo el proceso de atención clínica desde el ingreso al alta o fallecimiento. Resultados: En dos años, se registran 3.515 ingresos de pacientes víctima de trauma. Entre estos, el 81,3% son hombres. El 27% sufre trauma penetrante y 59% cerrado. Destacan más lesiones por arma de fuego que por arma blanca. El 18,4% de los pacientes ingresados tiene un el Injury Severity Score (ISS) mayor a 15 puntos. 34 pacientes ingresan en paro cardiorrespiratorio y 7,3 % lo hace hipotenso. Se realizan 1.856 tomografías y el 54,4% requiere cirugía de urgencia. Ingresan 692 traumas torácicos, 654 abdominales, 1.550 de extremidades, 687 lesiones en cráneo y 190 traumas cervicales. Se activa el protocolo de transfusión masiva en el 3,1% de los ingresos. El 8,3% utiliza la unidad de paciente crítico y la mortalidad es de 2,9%, teniendo como primera causa el trauma encéfalocraneano y segunda el shock hemorrágico. Conclusiones: Nuestro hospital tiene una gran incidencia de trauma. La implementación de un RT permite conocer la dimensión y evaluar el proceso asistencial en torno al paciente víctima de trauma. Es necesario dirigir recursos e implementar capacitación en los centros de alto volumen de trauma, además, de continuar con la extensión de la herramienta como estrategia de monitorización multicéntrica.


Introduction: Trauma represents a real challenge for health systems because is a major public health problem. In Chile, the management of polytrauma patients is unknown. Aim: Describe the results of the first online trauma registry; in patients treated at the Dr. Sótero del Río Hospital during the first two years of implementation. Materials and Method: Prospective information is collected in a network registry, about trauma victims, admitted to Dr. Sótero del Río Hospital for two years. These variables involve the entire clinical care process from admission to discharge or death. Results: 3.515 admissions of trauma victims are registered in two years. Among these, 81.3% are men. 27% suffered penetrating trauma and 59% closed. They emphasize larger injuries by firearm than by bladed weapon. 18.4% of admitted patients have ISS greater than 15 points. 34 patients enter cardio-respiratory arrest and 7.3% make it hypotensive. 1,856 CT scans are performed and 54.4% require emergency surgery. They admitted 692 thoracic trauma, 654 abdominal, 1550 limb, 687 skull injuries and 190 cervical trauma. The massive transfusion protocol is activated at 3.1% of the admissions. 8.3% use the critical patient unit and mortality is 2.9%, with cranial brain trauma as the first cause and hemorrhagic shock as a second cause. Conclusions: Our hospital has a high incidence of trauma. The RT implementation allows us to know the dimension and assess the care process about the trauma patient. It is necessary to direct resources and implement training in high-volume trauma centers, as well as continuing with the extension of the tool as a multi-center monitoring strategy.


Asunto(s)
Humanos , Heridas y Lesiones/epidemiología , Índices de Gravedad del Trauma , Sistema de Registros , Heridas y Lesiones/mortalidad , Heridas y Lesiones/prevención & control , Traumatología/estadística & datos numéricos
13.
Rev. chil. enferm. respir ; 36(4)dic. 2020.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1388125

RESUMEN

Resumen La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.


Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.

14.
Environ Pollut ; 264: 114682, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32380400

RESUMEN

Perchlorate occurs naturally in the environment in deposits of nitrate and can be formed in the atmosphere and precipitate into soil. However, little is known about the occurrence and levels of perchlorate in soils and fertilizers in Chile and its impacts on agricultural systems and food safety. In this study, concentrations of perchlorate were determined in 101 surface soils and 17 fertilizers [nitrogenous (n = 8), nitrogen-phosphorous-potassium (NPK; n = 3), phosphate (n = 2) and non-nitrogenous (n = 4)] collected across Chile from 2017 to 2018. Our results show that perchlorate was detected mainly in agricultural soils (mean: 0.32 ng g-1), grassland rotation sites (0.41 ngg-1) and urban locations (0.38 ng g-1). Interestingly, elevated concentrations of perchlorate (9.66 and 54.0 ng g-1) were found in agricultural soils. All fertilizers contained perchlorate: nitrogenous fertilizers (mean: 32.6 mg kg-1), NPK (mean: 12.6 mg kg-1), non-nitrogenous fertilizers (mean: 10.2 mg kg-1) and phosphates (mean: 11.5 mg kg-1). Only one type of nitrogenous fertilizer (KNO3: 95.3 mg kg-1) exceeded the international regulation limit (50 mg kg-1). For two agronomic practices, the content of perchlorate in lettuce increased as the fertilizer application rate increased, with fertigation promoting a more significant accumulation. However, the concentrations generally remained below regulatory values. Our results suggest that fertilizers constitute an important source of perchlorate in soils.


Asunto(s)
Lactuca , Suelo , Agricultura , Chile , Fertilizantes/análisis , Percloratos
15.
Sci Total Environ ; 719: 137411, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32145491

RESUMEN

The application of excessive fertilizer represents a primary source of entry for perchlorate into crop systems and thus has raised widespread concern regarding food safety. Several studies have reported the occurrence of perchlorate in vegetables. However, limited information is available on the fate of perchlorate in the soil-plant system. In this study, we performed field experiments to evaluate the effects of the application rate of Chilean nitrate fertilizer and the type of fertilization (manual or fertigation) on the uptake of perchlorate by plants grown in open fields. Interestingly, in the control, chard and spinach accumulated 21.3 and 25.9 µg kg-1, respectively. For both agronomic practices, the content of perchlorate in chard and spinach increased as the fertilizer application rate increased, with fertigation promoting more significant accumulations. Spinach accumulated almost two times more perchlorate than chard for all treatments; however, the concentrations generally remained below regulatory values. The intake of spinach and chard presented a low risk to human health for all age groups. These findings enhance our understanding of the environmental impact of the use of fertilizers in agriculture and food safety.


Asunto(s)
Beta vulgaris , Suelo , Spinacia oleracea , Agricultura , Chile , Fertilizantes , Percloratos , Medición de Riesgo
16.
Neumol. pediátr. (En línea) ; 15(4): 429-483, 2020. ilus, tab
Artículo en Español | LILACS | ID: biblio-1146394

RESUMEN

Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.


La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.


Asunto(s)
Humanos , Niño , Adulto , Prestación Integrada de Atención de Salud , Fibrosis Quística/diagnóstico , Fibrosis Quística/terapia , Chile , Estado Nutricional , Fibrosis Quística/rehabilitación , Consenso , Recursos en Salud
17.
Nat Plants ; 4(7): 432-439, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29942047

RESUMEN

Plant pathogens cause significant losses to agricultural yields and increasingly threaten food security1, ecosystem integrity and societies in general2-5. Xylella fastidiosa is one of the most dangerous plant bacteria worldwide, causing several diseases with profound impacts on agriculture and the environment6. Primarily occurring in the Americas, its recent discovery in Asia and Europe demonstrates that X. fastidiosa's geographic range has broadened considerably, positioning it as a reemerging global threat that has caused socioeconomic and cultural damage7,8. X. fastidiosa can infect more than 350 plant species worldwide9, and early detection is critical for its eradication8. In this article, we show that changes in plant functional traits retrieved from airborne imaging spectroscopy and thermography can reveal X. fastidiosa infection in olive trees before symptoms are visible. We obtained accuracies of disease detection, confirmed by quantitative polymerase chain reaction, exceeding 80% when high-resolution fluorescence quantified by three-dimensional simulations and thermal stress indicators were coupled with photosynthetic traits sensitive to rapid pigment dynamics and degradation. Moreover, we found that the visually asymptomatic trees originally scored as affected by spectral plant-trait alterations, developed X. fastidiosa symptoms at almost double the rate of the asymptomatic trees classified as not affected by remote sensing. We demonstrate that spectral plant-trait alterations caused by X. fastidiosa infection are detectable previsually at the landscape scale, a critical requirement to help eradicate some of the most devastating plant diseases worldwide.


Asunto(s)
Enfermedades de las Plantas/microbiología , Xylella , Fluorescencia , Imagenología Tridimensional , Olea/microbiología , Imágenes Satelitales , Análisis Espectral/métodos , Termografía
18.
Ecotoxicol Environ Saf ; 150: 320-326, 2018 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-29294441

RESUMEN

To evaluate the potential role of phenolic compounds in Al and Cd stress tolerance mechanisms, Vaccinium corymbosum cv. Legacy plantlets were exposed to different metal concentrations. The present study used an in vitro plant model to test the effects of the following treatments: 100µM Al; 100µMAl + 50µMCd; and 100µMAl + 100µMCd during periods of 7, 14, 21 and 30 days. The oxidative damage was determined by the accumulation of malondialdehyde (MDA) and hydrogen peroxide (H2O2). The antioxidant activity values were determined using 1,1-diphenyl-2-picrylhydrazine (DPPH) and the ferric reducing antioxidant power test (FRAP). Additionally, the phenolic compound concentrations were determined using HPLC-DAD. The exposure to Al and Cd increased the MDA and H2O2 contents differentially, while the antioxidant capacity values showed differences between DPPH and FRAP with the largest changes in FRAP relative to Cd. SOD had the highest activity in the first 7 days, leading to a significant increase in phenolic compounds observed after 14 days, and chlorogenic acid was the major compound identified. Our results revealed that phenolic compounds seem to play an important role in the response to ROS. Therefore, the mechanisms of tolerance to Al and Cd in V. corymbosum will be determined by the type of metal and time of exposure.


Asunto(s)
Aluminio/toxicidad , Antioxidantes/metabolismo , Arándanos Azules (Planta)/efectos de los fármacos , Cadmio/toxicidad , Estrés Oxidativo/efectos de los fármacos , Fenoles/metabolismo , Contaminantes del Suelo/toxicidad , Arándanos Azules (Planta)/enzimología , Arándanos Azules (Planta)/crecimiento & desarrollo , Modelos Teóricos , Oxidación-Reducción
19.
Hum Nat ; 29(1): 45-64, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29159722

RESUMEN

In this paper, the structure of a southeastern Spanish population was studied for the first time with respect to its inbreeding patterns and its relationship with demographic and geographic factors. Data on consanguineous marriages (up to second cousins) from 1900 to 1969 were taken from ecclesiastic dispensations. Our results confirm that the patterns and trends of inbreeding in the study area are consistent with those previously observed in most non-Cantabrian Spanish populations. The rate of consanguineous marriages was apparently stable between 1900 and 1935 and then sharply decreased since 1940, which coincides with industrialization in Spain. A marked departure from Hardy-Weinberg expectations (0.25) in the ratio of first cousin (M22) to second cousin (M33) marriages in the study population (0.88) was observed. The high levels of endogamy (>80%) and its significant steadiness throughout the twentieth century is noteworthy. Accordingly, our results show that exogamous marriages were not only poorly represented but also that this reduced mobility (<6 km) suggests that the choice of a mate was preferentially local. We found higher mobility in M22 with respect to M33 cousin mating. The relationships between population size and consanguinity rates and inbreeding fit power-law distributions. A significant positive correlation was observed between inbreeding and elevation. Many Spanish populations have experienced a prolonged and considerable isolation across generations, which has led to high proportions of historical and local endogamy that is associated, in general, with high [Formula: see text] values. Thus, assessing genomic inbreeding using runs of homozygosity (ROH) in current Spanish populations could be an additional pertinent strategy for obtaining a more refined perspective regarding the population history inferred from the extent and frequency of ROH regions.


Asunto(s)
Consanguinidad , Genética de Población , Homocigoto , Matrimonio/etnología , Humanos , España/etnología
20.
Int J Tuberc Lung Dis ; 21(8): 894-901, 2017 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-28786798

RESUMEN

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) regimens often contain pyrazinamide (PZA) even if susceptibility to the drug has not been confirmed. This gap is due to the limited availability and reliability of PZA susceptibility testing. OBJECTIVES: To estimate the prevalence of PZA resistance using the Wayne assay among TB patients in Lima, Peru, to describe characteristics associated with PZA resistance and to compare the performance of Wayne with that of BACTEC™ MGIT™ 960. METHODS: PZA susceptibility using the Wayne assay was tested in patients diagnosed with culture-positive pulmonary TB from September 2009 to August 2012. Factors associated with PZA resistance were evaluated. We compared the performance of the Wayne assay to that of MGIT 960 in a convenience sample. RESULTS: The prevalence of PZA resistance was 6.6% (95%CI 5.8-7.5) among 3277 patients, and 47.7% (95%CI 42.7-52.6) among a subset of 405 MDR-TB patients. In multivariable analysis, MDR-TB (OR 86.0, 95%CI 54.0-136.9) and Latin American-Mediterranean lineage (OR 3.40, 95%CI 2.33-4.96) were associated with PZA resistance. The Wayne assay was in agreement with MGIT 960 in 83.9% of samples (κ 0.66, 95%CI 0.56-0.76). CONCLUSION: PZA resistance was detected using the Wayne assay in nearly half of MDR-TB patients in Lima. This test can inform the selection and composition of regimens, especially those dependent on additional resistance.


Asunto(s)
Antituberculosos/administración & dosificación , Pirazinamida/administración & dosificación , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Pulmonar/tratamiento farmacológico , Adolescente , Adulto , Anciano , Estudios de Cohortes , Farmacorresistencia Bacteriana , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Análisis Multivariante , Perú , Prevalencia , Estudios Prospectivos , Reproducibilidad de los Resultados , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/microbiología , Adulto Joven
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