Climate change increases threat to plant diversity in tropical forests of Central America and southern Mexico.

Global biodiversity is negatively affected by anthropogenic climate change. As species distributions shift due to increasing temperatures and precipitation fluctuations, many species face the risk of extinction. In this study, we explore the expected trend for plant species distributions in Central America and southern Mexico under two alternative Representative Concentration Pathways (RCPs) portraying moderate (RCP4.5) and severe (RCP8.5) increases in greenhouse gas emissions, combined with two species dispersal assumptions (limited and unlimited), for the 2061-2080 climate forecast. Using an ensemble approach employing three techniques to generate species distribution models, we classified 1924 plant species from the region's (sub)tropical forests according to IUCN Red List categories. To infer the spatial and taxonomic distribution of species' vulnerability under each scenario, we calculated the proportion of species in a threat category (Vulnerable, Endangered, Critically Endangered) at a pixel resolution of 30 arc seconds and by family. Our results show a high proportion (58-67%) of threatened species among the four experimental scenarios, with the highest proportion under RCP8.5 and limited dispersal. Threatened species were concentrated in montane areas and avoided lowland areas where conditions are likely to be increasingly inhospitable. Annual precipitation and diurnal temperature range were the main drivers of species' relative vulnerability. Our approach identifies strategic montane areas and taxa of conservation concern that merit urgent inclusion in management plans to improve climatic resilience in the Mesoamerican biodiversity hotspot. Such information is necessary to develop policies that prioritize vulnerable elements and mitigate threats to biodiversity under climate change.

Genetic analysis of the pX region of bovine leukemia virus genotype 1 in Holstein Friesian cattle with different stages of infection.

The pX genetic region of bovine leukemia virus (BLV) includes four genes with overlapping reading frames that code for the Tax, Rex, R3, and G4 proteins. These proteins are involved in the regulation of transcriptional and post-transcriptional viral expression, as well as having oncogenic potential. Our goal was to investigate the pathogenicity of the pX region of BLV genotype 1 in terms of lymphocytosis, lymphomas, and proviral DNA load. We screened 724 serological samples from mixed-age Holstein Friesian cattle from six states in Mexico. Peripheral blood leukocytes (PBLs) were isolated from whole blood with anticoagulant, and genomic DNA was extracted from the PBLs using a commercial kit. Then, a set of primers that hybridize in conserved regions of the BLV pX region were used, which allowed for PCR standardization to detect proviral DNA in infected cells. Positive amplicons were sequenced using the Sanger method, resulting in 1156-nucleotide-long final sequences that included the four pX region genes. The experimental group consisted of 30 animals. Twelve of these had lymphocytosis, six had lymphoma, and 12 were apparently healthy cattle without any signs of lymphocytosis or lymphoma. The presence of lymphoma was detected in six bovine tumor tissues using histopathology, and the presence of BLV was detected by in situ hybridization. Phylogenetic analysis demonstrated that the 30 sequences were associated with genotype 1, and the genetic distance between the sequences ranged from 0.2% to 2.09%. We identified two sequences in the G4 gene: one with a three-nucleotide deletion resulting in the loss of a leucine (AGU_7488L, in a cow with lymphocytosis), and one with a nine-nucleotide deletion resulting in the loss of leucine, proline, and leucine (AGU_18A, in a cow without lymphocytosis). Analysis of the PX region indicated that positive selection had occurred in the G4, rex, and R3 genes, and we found no difference in proviral DNA load between the studied groups. We were unable to establish an association between variations in the pX region and the development of lymphocytosis, lymphoma, asymptomatic status, or proviral DNA load in BLV-infected cattle.

Panorama de la investigación en fonoaudiología: tendencias en Colombia / Overview of research in speech therapy: trends in Colombia

El objetivo de este artículo es analizar el panorama investigativo disciplinar desde la producción académica nacional, para identificar poblaciones, áreas, enfoques de investigación, de esta manera reconocer necesidades y retos para la investigación formativa de la fonoaudiología en Colombia. Se analizó información proveniente de proyectos de investigación de pregrado y posgrado de 13 programas de formación en Fonoaudiología del país, entre 2010 y 2019, reportados por las instituciones de educación superior. Se recolectó información de informes y documentos de investigación (N=638). En primer lugar, se observa un incremento en la producción investigativa entre 2010 (4,9%) y 2019 (18,3%). El 85% de la investigación se identificó en pregrado y el 15% en postgrado. El enfoque predominante fue cualitativo (55,3%), el que, junto con el alcance descriptivo (77,8%) que representan la mayoría de productos de investigación. El escenario relacionado con el ámbito de salud clínico asistencial lidera la investigación (52,9%). Las áreas predominantes en este escenario investigativo son Lenguaje (29,1%) y Audición (27,4%) en poblaciones de adultos (56,7%) e infantil (28,52%). Se concluye que la producción investigativa desde la academia, específicamente desde los programas de formación de fonoaudiólogos en Colombia, evidencian la necesidad de fomentar la investigación de tipo experimental y analítica, con poblaciones de neonatos y lactantes, en áreas relacionadas con la función oralfaríngea y en escenarios inéditos. Además, es necesario incluir el uso de tecnologías y nuevos enfoques de intervención para aportar al abordaje basado en la evidencia. Futuras investigaciones deben permitir comparar la investigación antes y después de la pandemia, dada la virtualización y la inclusión de la fonoaudiología en escenarios como las unidades de cuidado crítico y cuidado paliativo.

The objective of this article is to analyze the disciplinary research landscape from the national academic production, to identify populations, areas, research approaches, in this way identify needs and challenges for formative research of speech therapy in Colombia. Information from undergraduate and graduate research projects of 13 training programs in Speech Therapy in the country, between 2010 and 2019, reported by higher education institutions, was analyzed. Information was collected from reports and research papers (N=638). First, there was an increase in research production between 2010 (4.9%) and 2019 (18.3%). 85% of the researchwas identified in undergraduate and 15% in postgraduate. The predominant approach was qualitative (55.3%), which, together with the descriptive scope (77.8%) that represent the majority of research products. The scenario related to the field of clinical health care leads the research (52.9%). The predominant areas in this research scenario are Language (29.1%) and Hearing (27.4%)in adult (56.7%) and child (28.52%) populations. It is concluded that the research production from the academy, specifically from the trainingprograms of speech therapists in Colombia, evidences the need to promote experimental and analytical research, with populations of neonates and infants, in areas related to oral function and in unprecedented scenarios. Besides, it is necessary to include the use oftechnologies and new intervention approaches to contribute to the evidence-based approach. Future research should allow comparison of research before and after the pandemic, given the virtualization and the inclusion of speech therapy in settings such as critical careand palliative care units.

Participación e inclusión social en adultos con afasia: análisis bibliométrico / Participation and Social Inclusion in Adults with Aphasia: Bibliometric Analysis / Participação e inclusão social em adultos com afasia: análise bibliométrica

Objetivo: Identificar el alcance y estado de la investigación relacionada con la participación e inclusión social de personas adultas con afasia, a partir del análisis de la literatura publicada. Materiales y métodos: Estudio descriptivo-analítico sobre las publicaciones registradas en Medline/PubMed, EBSCO y EMBASE del año 2005 a 2013, se seleccionaron 97 documentos relacionados con la temática, clasificados en ocho variables comunes para su estudio, fueron analizados en función de la distribución de artículos por núcleo temático, año de publicación y base de datos. Resultados: El núcleo temático con mayor representación fue el de inclusión, participación, accesibilidad y derechos de las personas con afasia, sus familias y entornos, documentos cuya producción se incrementa entre 2010 y 2011. Los documentos relacionados con prácticas profesionales inclusivas para personas con afasia representaron el segundo núcleo temático con mayor representatividad. Conclusiones: La literatura reconoce a la familia y sus entornos cercanos como elementos fundamentales para garantizar participación y autonomía de las personas con afasia. La Clasificación Internacional de la Funcionalidad, la Discapacidad y la Salud (CIF) debe convertirse en la bitácora de los profesionales de la rehabilitación para orientar acciones terapéuticas, cuyo objetivo sea la inclusión y participación de las personas con afasia en diferentes contextos y, principalmente, promuevan el regreso exitoso a su vida productiva y cotidiana. Esta oportunidad de rehabilitación hacia la independencia y autonomía promueve la autoestima, identidad y las oportunidades de inclusión.

Objective: To identify the scope and status of related research with the participation and social inclusion of adults with aphasia connected with the published literature. Materials and Methods: Descriptive analytic study on publications registered in Medline/PubMed, EBSCO and EMBASE from 2005 to 2013, 97 related documents were selected and classified into, eight common variables for its study and were analyzed according to the article distribution by thematic core, year of publication and database. Results: The most represented core theme was inclusion, participation, access and rights of persons with aphasia and their families and environments; production of these documents is increased between 2010 and 2011. Documents related to inclusive internshIPS for people with aphasia represented the second more representative thematic focus. Conclusions: Literature recognizes that elements related to family and their immediate environments are essential to ensure participation and independence of people with aphasia. The International Classification of Functioning, Disability and Health (ICF) should become the rehabilitation log for professionals to guide therapeutic actions, aimed at the inclusion and participation of people with aphasia in different contexts, and mainly to promote a successful return to a productive daily life. This rehabilitation opportunity toward independence and autonomy promotes self-esteem, identity and inclusion opportunities.

Objetivo: Identificar o alcance e estado da pesquisa relacionada com a participação e inclusão social de pessoas adultas com afasia, a partir da análise da literatura publicada. Materiais e métodos: estudo descritivo-analítico sobre as publicações registradas em Medline/PubMed, EBSCO e embase do ano 2005 a 2013, se selecionaram 97 documentos relacionados com a temática, classificados em oito variáveis comuns para seu estudo; foram analisados em função da distribuição de artigos por núcleo temático, ano de publicação e base de dados. Resultados: o núcleo temático com maior representação foi o relativo a inclusão, participação, acessibilidade e direitos de pessoas com afasia, suas famílias e entornos, documentos cuja produção incrementa entre 2010 e 2011. Os documentos relacionados com práticas profissionais inclusivas para pessoas com afasia representaram o segundo núcleo temático com maior representatividade. Conclusões: a literatura reconhece à família e seus entornos próximos como elementos fundamentais para garantir participação e autonomia das pessoas com afasia. A Classificação Internacional da Funcionalidade, a Deficiência e a Saúde (CIF) deve se converter na guia dos profissionais da reabilitação para orientar ações terapêuticas, cujo objetivo seja a inclusão e participação das pessoas com afasia em diferentes contextos e, principalmente, promovam o regresso bem-sucedido a sua vida produtiva e cotidiana. Esta oportunidade de reabilitação à independência e autonomia promove a autoestima, identidade e as oportunidades de inclusão.

Diacerhein attenuates the inflammatory response and improves survival in a model of severe sepsis.

INTRODUCTION: Hyperglycemia and insulin resistance have been associated with a worse outcome in sepsis. Although tight glycemic control through insulin therapy has been shown to reduce morbidity and mortality rates, the effect of intensive insulin therapy in patients with severe sepsis is controversial because of the increased risk of serious adverse events related to hypoglycemia. Recently, knowledge about diacerhein, an anthraquinone drug with powerful antiinflammatory properties, revealed that this drug improves insulin sensitivity, mediated by the reversal of chronic subclinical inflammation. The aim of the present study was to evaluate whether the antiinflammatory effects of diacerhein after onset of sepsis-induced glycemic alterations is beneficial and whether the survival rate is prolonged in this situation. METHODS: Diffuse sepsis was induced by cecal ligation and puncture surgery (CLP) in male Wistar rats. Blood glucose and inflammatory cytokine levels were assessed 24 hours after CLP. The effect of diacerhein on survival of septic animals was investigated in parallel with insulin signaling and its modulators in liver, muscle, and adipose tissue. RESULTS: Here we demonstrated that diacerhein treatment improves survival during peritoneal-induced sepsis and inhibits sepsis-induced insulin resistance by improving insulin signaling via increased insulin-receptor substrate-1-associated phosphatidylinositol 3-kinase activity and Akt phosphorylation. Diacerhein also decreases the activation of endoplasmic reticulum stress signaling that involves upregulation of proinflammatory pathways, such as the I kappa B kinase and c-Jun NH2-terminal kinase, which blunts insulin-induced insulin signaling in liver, muscle, and adipose tissue. Additionally, our data show that this drug promoted downregulation of proinflammatory signaling cascades that culminate in transcription of immunomodulatory factors such interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α. CONCLUSIONS: This study demonstrated that diacerhein treatment increases survival and attenuates the inflammatory response with a significant effect on insulin sensitivity. On the basis of efficacy and safety profile, diacerhein represents a novel antiinflammatory therapy for management of insulin resistance in sepsis and a potential approach for future clinical trials.

Atorvastatin improves survival in septic rats: effect on tissue inflammatory pathway and on insulin signaling.

The aim of the present study was to investigate whether the survival-improving effect of atorvastatin in sepsis is accompanied by a reduction in tissue activation of inflammatory pathways and, in parallel, an improvement in tissue insulin signaling in rats. Diffuse sepsis was induced by cecal ligation and puncture surgery (CLP) in male Wistar rats. Serum glucose and inflammatory cytokines levels were assessed 24 h after CLP. The effect of atorvastatin on survival of septic animals was investigated in parallel with insulin signaling and its modulators in liver, muscle and adipose tissue. Atorvastatin improves survival in septic rats and this improvement is accompanied by a marked improvement in insulin sensitivity, characterized by an increase in glucose disappearance rate during the insulin tolerance test. Sepsis induced an increase in the expression/activation of TLR4 and its downstream signaling JNK and IKK/NF-κB activation, and blunted insulin-induced insulin signaling in liver, muscle and adipose tissue; atorvastatin reversed all these alterations in parallel with a decrease in circulating levels of TNF-α and IL-6. In summary, this study demonstrates that atorvastatin treatment increased survival, with a significant effect upon insulin sensitivity, improving insulin signaling in peripheral tissues of rats during peritoneal-induced sepsis. The effect of atorvastatin on the suppression of the TLR-dependent inflammatory pathway may play a central role in regulation of insulin signaling and survival in sepsis insult.

Análisis crítico de la eficacia/seguridad de la conversión de la terapia inmunosupresora a sirolimus en pacientes con transplante renal / Critical analysis of the efficacy/safety of the conversion of immunosuppressive therapy to sirolimus in renal transplant patients

El transplante renal se ha convertido en el tratamiento de elección para los pacientes con enfermedad renal terminal y, por tanto, dependientes de hemodiálisis. Esta opción va necesariamente acompañada por una intervención inmunosupresora que consiste de una combinación de agentes, entre los que cabe destacar los inhibidores de calcineurina, ciclosporina y tacrolimus, la azatioprina, el micofenolato mofetilo y los corticosteroides. Más recientemente, los anticuerpos monocionales, baciliximab y daclizumab, así como los m-tor, sirolimus y everolimus se han adicionado a las posibilidades terapéuticas, en procura siempre de evitar el rechazo agudo y crónico del órgano transplantado y, con ello, prolongar sobrevida del injerto y del paciente, así como mejorar su calidad de vida y mantener la homeostasis inmunológica. El seguimiento de los pacientes cn transplante renal ha puesto de manifiesto que en algunos casos se genera una nefropatía crónica del injerto, fenómeno multifactorial que lleva a la disfunción crónica, y entre los posibles condicionantes modificables destaca el uso prolongado de los inhibidores de calcineurina; por eso, en la actualidad se está planteando la conversión inmunosupresora, de los inhibidores de calcineurina a los m-tor, especialmente al sirolimus. Este trabajo se presenta una revisión sistemática...

Morbi-mortalidad antes y después de la implementación del Seguro de Vejez en la CNS Hospital Obrero No. 2 / s

Existe un incremento en el número de pacientes hospitalizados de 762 a 887 pacientes después del inicio del seguro de vejez, no mostrando una variabilidad significativa en relación al sexo, en relación a la edad las hospitalizaciones son más frecuentes en mayores de 70 años. Los meses del año en los que se registran mayor número de internaciones son: julio y agosto que coincide con las estaciones de invierno y otoño por los cambios bruscos de temperatura a los que el anciano es particularmente labil, hay un ligero decremento en el mes de diciembre. La morbilidad prevalente guarda relación con lo reflejado en la bibliografía estudiada, siendo las enfermedades más frecuentes aquellas que comprometen al sistema cardiovascular (insuficiencia cardiaca congestiva, infarto de miocardio, hipertensión arterial), que desencadenan enfermedades neurológicas como el ACV. En segundo lugar, se encuentran enfermedades del sistema respiratorio (Neumonía, Asma, EPOC y TBC). En tercer lugar enfermedades digestivas y metabólicas como la diabetes y HDA. Llama la atención el número elevado de ancianos con desnutrición y anemia, ambas enfermedades carenciales que podrían ser prevenidas con una acción continua de atención primaria de salud, a pesar de no ser una prestación contemplada del seguro de vejez

Kinetic effects of trimethoprim-sulfamethoxazole in children with biliary atresia: a new dosing regimen

Pharmacokinetics for combination trimethoprim/sulfamethoxazole (TMP/SMX) was studied in only four patients with biliary atresia (BA): three girls, 6.2, 8.0 and 8.2 years of age and one boy 8.4 years of age, as this is an uncommon obstructive anomaly of the extrahepatic biliary system and has been described as having a poor prognosis. These four patients are the survivors of 27 initial children who were operated on previously. They have been receiving 2.3 ñ 0.5 mg/kg TMP, and 11.5 ñ2.6 mg/kg SMX every 12 h since 2 weeks after surgical treatment for biliary atresia performed at 2 - 2.5 months of age. The patients have suffered some episodes of cholangitis during their short lives, most of them after interrupting temporally the chemotherapy. Nevertheless, they have a achieved a favorable quality of life. TMP/SMX disposition was well characterized by a one compartment open pharmacokinetic model. Wide interpatient variability was observed for all pharmacokinetic parameters with coefficients of variation for t½ el, ClT, and Vd of 33.2, 49.6, and 26.3 per cent, respectively, for SMX and 108.9, 52.1, and 71.0 per cent, respectively, for TMP. A marked difference in the pharmacokinetics of TMP and SMX was observed, for example; (ClT: mean ñ SD; 90.3 ñ 47.0 ml/kg/g for TMP and 13.7 ñ 6.8 ml/kg/h for SMX), (t½ el with 7.93 ñ 8.64 h for TMP and 10.51 ñ 3.49 h for SMX). In order to develop dosage schedules that would reliably achieve peak serum concentrations of TMP/SMX in the therapeutic range, we found that established dose leads to high fluctuations at steady state between Cmax, ss and Cmin, ss, without maintaining therapeutic levels. Recommended maintenance dose varied from 8 to 30 mg/kg for SMX with a mean of 21.9 ñ 10.89 mg/kg/12 h, and from 0.8 to 4.5 mg/kg/12 h with a mean of 3.2 ñ 1.7 mg/kg/12 h. The present study illustrattes the need for pharmacokinetic studies for the individualization of drug dosing in patients with BA