Identification of biomarkers for disease severity in nasopharyngeal secretions of infants with upper or lower respiratory tract viral infections.

Lower respiratory tract infections (LRTIs) produced by viruses are the most frequent cause of morbidity and mortality in children younger than 5 years of age. The immune response triggered by viral infection can induce a strong inflammation in the airways and cytokines could be considered as biomarkers for disease severity as these molecules modulate the inflammatory response that defines the outcome of patients. Aiming to predict the severity of disease during respiratory tract infections, we conducted a 1-year follow-up observational study in infants who presented upper or lower respiratory tract infections caused by seasonal respiratory viruses. At the time of enrollment, nasopharyngeal swabs (NPS) were obtained from infants to measure mRNA expression and protein levels of IL-3, IL-8, IL-33, and thymic stromal lymphopoietin. While all cytokines significantly increased their protein levels in infants with upper and lower respiratory tract infections as compared to control infants, IL-33 and IL-8 showed a significant increase in respiratory syncytial virus (RSV)-infected patients with LRTI as compared to patients with upper respiratory tract infection. We also found higher viral loads of RSV-positive samples with a greater IL-8 response at the beginning of the symptoms. Data obtained in this study suggest that both IL-8 and IL-33 could be used as biomarkers for clinical severity for infants suffering from LRTIs caused by the RSV.

Assessment of Mutations Associated With Genomic Variants of SARS-CoV-2: RT-qPCR as a Rapid and Affordable Tool to Monitoring Known Circulating Variants in Chile, 2021.

Since the first report of SARS-CoV-2 infection in humans, the virus has mutated to develop new viral variants with higher infection rates and more resistance to neutralization by antibodies elicited after natural SARS-CoV-2 infection or by vaccines. Therefore, rapid identification of viral variants circulating in the population is crucial for epidemiological assessment and efforts to contain the resurgence of the pandemic. Between January and November 2021, we performed a large variant RT-qPCR-based screening of mutations in the spike protein of 1851 SARS-CoV-2-positive samples derived from outpatients from the UC-Christus Health Network in Chile. In a portion of samples (n = 636), we validated our RT-qPCR-pipeline by WGS, obtaining a 99.2% concordance. Our results indicate that from January to March 2021 there was a dominance of non-identifiable variants by the RT-qPCR-based screening; however, throughout WGS we were able to identify the Lambda (C.37) variant of interest (VOI). From March to July, we observed the rapid emergence of mutations associated with the Gamma variant (P.1), which was quickly replaced by the appearance of a combination of samples harboring mutations associated with the Delta variant (B.1.617.2), which predominated until the end of the study. Our results highlight the applicability of cost-effective RT-qPCR-based screening of mutations associated with known variants of concern (VOC), VOI and variants under monitoring (VUM) of SARS-CoV-2, being a rapid and reliable tool that complements WGS-based surveillance.

Detección del SARS-CoV-2 mediante RT-qPCR utilizando saliva en pacientes ambulatorios con estudio de COVID-19

Resumen Introducción: La pandemia de COVID-19 ha afectado a millones de personas en todo el mundo. La identificación de sujetos infectados ha sido importante para el control. Objetivo: Evaluar el rendimiento de una reacción de polimerasa en cadena (RPC) cuantitativa en tiempo real (en inglés: RT-qPCR) para SARS-CoV-2, utilizando saliva como matriz en comparación con un hisopado nasofaríngeo (HNF). Metodología: Se reclutaron adultos en atención ambulatoria, la mayoría sintomáticos. Fueron estudiadas 530 muestras pareadas de saliva e HNF con RT-qPCR. Resultados: Fueron positivas 59 muestras de HNF y 54 de saliva. La sensibilidad con saliva fue 91%, especificidad 100%, el valor predictor positivo (VPP) 100%, valor predictor negativo (VPN) 98%. El índice Kappa fue de 0,95 y LR-0,08. En promedio, el umbral de ciclo (en inglés cycle threshold-CT) de la saliva fue 3,99 puntos más alto que los de HNF (p < 0,0001) mostrando que la carga viral (CV) es menor en saliva. La carga viral en ambas disminuyó con el tiempo después del inicio de los síntomas. El muestreo de saliva fue preferido por los sujetos en lugar de HNF. Conclusión: Este estudio demuestra que la RPC para SARS-CoV-2 utilizando saliva, es adecuada para el diagnóstico de COVID-19 en adultos ambulatorios, especialmente en la etapa temprana de los síntomas.

Abstract Background: The COVID-19 pandemic has affected millions of people around the world. Part of control strategies is testing a large proportion of the population to identify and isolate the infected subjects. Aim: To evaluate the SARS-CoV-2 detection by the performance of a reverse transcription and quantitative polymerase chain reaction (RT-qPCR) against SARS-CoV-2, using saliva as a matrix compared to a nasopharyngeal swab (NPS) to simplify obtaining a diagnostic sample. Methods: Adults in outpatient care were recruited, 95% of them symptomatic. We studied 530 paired saliva and NPS samples by SARS-CoV-2 RT-qPCR. Results: Fifty-nine individuals tested positive in NPS and 54 in saliva samples. Sensitivity for saliva sample was 91%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 98%. The Kappa index was 0.95 and LR-0.08. On average, the cycle threshold (CT) of saliva was 3.99 points higher than those of NPS (p < 0.0001) showing that viral load (VL) is lower in saliva than in NPS. Viral load in both decreased over the time after onset of symptoms. Saliva sampling was preferred by subjects instead of NPS. Conclusion: This study demonstrates that SARS-CoV-2 RT-qPCR using saliva, even with lower VL, is suitable for the diagnosis of COVID-19 in outpatient adults, especially at early stage of symptoms.

Escala de autoeficacia general: reevaluación de su evidencia de confiabilidad y validez en Chile

Background: Self-efficacy is a psychological variable closely related to healthy behaviors. One of the most widely used instruments to measure this variable is the general self-efficacy scale (GSES). In Chile, the only psychometric study of this scale has important analytical limitations. Aim: To assess reliability and validity of GSES in a large Chilean sample. Material and Methods: The GSES and a self-esteem scale were applied to 2995 participants aged 11 to 76 years (60% women). Results: The scale showed optimal levels of homogeneity and internal consistency. The exploratory factor analysis and the parallel analysis suggested a one-dimensional internal structure. However, this model showed a mediocre fit in the confirmatory factor analysis due to the residual correlation between a pair of items with high semantic similarity. A one-dimensional model specifying this residual correlation attained an acceptable fit in a new confirmatory factor analysis. The new model reached strict invariance according to sex, and partial strict invariance according to age. The latent factor of the GSES showed a positive association with the latent factor of a self-esteem scale. Conclusions: The GSES is an adequate scale to measure general self-efficacy in the Chilean population and allows unbiased comparisons based on sex or age.

[The general self-efficacy scale (GSES): Reevaluation of its reliability and validity evidence in Chile]. / Escala de autoeficacia general: reevaluación de su evidencia de confiabilidad y validez en Chile.

BACKGROUND: Self-efficacy is a psychological variable closely related to healthy behaviors. One of the most widely used instruments to measure this variable is the general self-efficacy scale (GSES). In Chile, the only psychometric study of this scale has important analytical limitations. AIM: To assess reliability and validity of GSES in a large Chilean sample. MATERIAL AND METHODS: The GSES and a self-esteem scale were applied to 2995 participants aged 11 to 76 years (60% women). RESULTS: The scale showed optimal levels of homogeneity and internal consistency. The exploratory factor analysis and the parallel analysis suggested a one-dimensional internal structure. However, this model showed a mediocre fit in the confirmatory factor analysis due to the residual correlation between a pair of items with high semantic similarity. A one-dimensional model specifying this residual correlation attained an acceptable fit in a new confirmatory factor analysis. The new model reached strict invariance according to sex, and partial strict invariance according to age. The latent factor of the GSES showed a positive association with the latent factor of a self-esteem scale. CONCLUSIONS: The GSES is an adequate scale to measure general self-efficacy in the Chilean population and allows unbiased comparisons based on sex or age.

Correction to: Genome and transcriptome of the natural isopropanol producer Clostridium beijerinckii DSM6423.

Following the publication of this article [1], the authors noticed that Figs. 2, 3 and 4 were in the incorrect order and thus had incorrect captions.

Genome and transcriptome of the natural isopropanol producer Clostridium beijerinckii DSM6423.

BACKGROUND: There is a worldwide interest for sustainable and environmentally-friendly ways to produce fuels and chemicals from renewable resources. Among them, the production of acetone, butanol and ethanol (ABE) or Isopropanol, Butanol and Ethanol (IBE) by anaerobic fermentation has already a long industrial history. Isopropanol has recently received a specific interest and the best studied natural isopropanol producer is C. beijerinckii DSM 6423 (NRRL B-593). This strain metabolizes sugars into a mix of IBE with only low concentrations of ethanol produced (< 1 g/L). However, despite its relative ancient discovery, few genomic details have been described for this strain. Research efforts including omics and genetic engineering approaches are therefore needed to enable the use of C. beijerinckii as a microbial cell factory for production of isopropanol. RESULTS: The complete genome sequence and a first transcriptome analysis of C. beijerinckii DSM 6423 are described in this manuscript. The combination of MiSeq and de novo PacBio sequencing revealed a 6.38 Mbp chromosome containing 6254 genomic objects. Three Mobile Genetic Elements (MGE) were also detected: a linear double stranded DNA bacteriophage (ϕ6423) and two plasmids (pNF1 and pNF2) highlighting the genomic complexity of this strain. A first RNA-seq transcriptomic study was then performed on 3 independent glucose fermentations. Clustering analysis allowed us to detect some key gene clusters involved in the main life cycle steps (acidogenesis, solvantogenesis and sporulation) and differentially regulated among the fermentation. These putative clusters included some putative metabolic operons comparable to those found in other reference strains such as C. beijerinckii NCIMB 8052 or C. acetobutylicum ATCC 824. Interestingly, only one gene was encoding for an alcohol dehydrogenase converting acetone into isopropanol, suggesting a single genomic event occurred on this strain to produce isopropanol. CONCLUSIONS: We present the full genome sequence of Clostridium beijerinckii DSM 6423, providing a complete genetic background of this strain. This offer a great opportunity for the development of dedicated genetic tools currently lacking for this strain. Moreover, a first RNA-seq analysis allow us to better understand the global metabolism of this natural isopropanol producer, opening the door to future targeted engineering approaches.

Effects of palatal augmentation prosthesis in oropharyngeal dysphagia in Chilean patients with tongue cancer: Cases report

ABSTRACT: Therapy of malignant neoplasms of the tongue or oropharynx may cause dysphagia. Dysphagia in patients has negative significant social and psychological consequences. The six cases reports describe the effect of palatal augmentation prosthesis (PAP) on the management of dysphagia in patients with oral-pharyngeal cancer and as consequence of its treatment. The study also assesses PAP's effects on the quality of life of such patients.

Description of internet addiction among Chilean medical students: a cross-sectional study.

OBJECTIVE: Internet addiction (IA) has been described as an emerging behavior related to the development of new technologies, with scarce studies on the subject and none involving medical students. The Internet Addiction Test (IAT) is a screening instrument used to detect IA worldwide, which was published in 1998 and inspired by the DSM-IV criteria for pathologic gambling. The objective of this study aims to measure the prevalence of IA in Chilean medical students and its possible association with demographic variables and depressive symptoms. METHODS: First- to fifth-year undergraduate medical students at a medical school in Santiago de Chile answered a self-administered survey that included demographic data, the IAT scale, and the Goldberg's General Health Questionnaire (GHQ-12) to screen for IA and depressive symptoms, respectively. RESULTS: Three hundred eighty-four students participated, achieving a response rate of 69.8 %, of which 11.5 % were classified as problematic users according to the IAT. The authors found a statistical association between positive results on the IAT and positive scores on the GHQ-12, as well as with the male gender. CONCLUSION: In this first study of IA in medical students, the authors found a rate of incidence similar to what has been published in the literature focusing on college students. Additionally, there was a positive association between emotional symptoms and other abuse behaviors.

Neurobiologic basis of craving for carbohydrates.

OBJECTIVES: There is a relationship between emotional disorders, obesity, and craving for carbohydrates. This relationship complicates the success of treatments aimed at combatting obesity, which is considered to be the epidemic of the twenty-first century. We conducted a review of the neurobiologic basis for carbohydrate craving, with the hope that this understanding will enable the design of more efficient therapeutic strategies. METHOD: We conducted a non-systematic literature search in PubMed using MeSH. RESULTS: Research on the basis of carbohydrate craving is varied, but may be grouped into five main areas: the serotonergic system, palatability and hedonic response, the motivational system, stress response systems, and gene-environment interaction. CONCLUSIONS: The models that integrate motivational systems with palatability and hedonic response studies are the ones that we believe can best explain both craving for carbohydrates and related addictive phenomena. Research has contributed to a greater understanding of the neurobiologic basis of carbohydrate craving. The latter, in turn, contributes to an understanding of the implications, challenges, and possible therapies that might be put in place to cope with this phenomenon.

Viral RNA mutations are region specific and increased by ribavirin in a full-length hepatitis C virus replication system.

High rates of genetic variation ensure the survival of RNA viruses. Although this variation is thought to result from error-prone replication, RNA viruses must also maintain highly conserved genomic segments. A balance between conserved and variable viral elements is especially important in order for viruses to avoid "error catastrophe." Ribavirin has been shown to induce error catastrophe in other RNA viruses. We therefore used a novel hepatitis C virus (HCV) replication system to determine relative mutation frequencies in variable and conserved regions of the HCV genome, and we further evaluated these frequencies in response to ribavirin. We sequenced the 5' untranslated region (5' UTR) and the core, E2 HVR-1, NS5A, and NS5B regions of replicating HCV RNA isolated from cells transfected with a T7 polymerase-driven full-length HCV cDNA plasmid containing a cis-acting hepatitis delta virus ribozyme to control 3' cleavage. We found quasispecies in the E2 HVR-1 and NS5B regions of untreated replicating viral RNAs but not in conserved 5' UTR, core, or NS5A regions, demonstrating that important cis elements regulate mutation rates within specific viral segments. Neither T7-driven replication nor sequencing artifacts produced these nucleotide substitutions in control experiments. Ribavirin broadly increased error generation, especially in otherwise invariant regions, indicating that it acts as an HCV RNA mutagen in vivo. Similar results were obtained in hepatocyte-derived cell lines. These results demonstrate the potential utility of our system for the study of intrinsic factors regulating genetic variation in HCV. Our results further suggest that ribavirin acts clinically by promoting nonviable HCV RNA mutation rates. Finally, the latter result suggests that our replication model may be useful for identifying agents capable of driving replicating virus into error catastrophe.

Niveles de mercurio en cabello de individuos expuestos ocupacionalmente en el área odontológica / Mercury levels in the hair of occupationally exposed individuals in the dental area

En este estudio se establecieron los niveles de mercurio (Hg) en cabello de individuos profesionalmente expuestos en el área odontológica y se contrastaron con las concentraciones mercuriales de un grupo control no expuesto ocupacionalmente al Hg. Las muestras de cabello fueron recolectadas de 15 individuos expuestos y 15 no expuestos, residentes de la ciudad de Maracaibo y zonas circunvencians. Los individuos fueron interrogados a través de una encuesta en relación a datos personales, dirección de habitación, ocupación, alimentación, hábitos, salud, tratamiento médicos, número de restauraciones de amalgama, tratamientos cosméticos en el cabello, etc. Se tomaron 2 cm de cabello distal en la zona occipital del cuero cabelludo de cada individuos, las cuales se almacenaron en bolsas plásticas de cierre hermético a 4§C. Previo al análisis espectrométrico, las muestras se levaron y se desmineralizaron usando microondas. La determinacion exacta, precisa y libre de interferencias de Hg se realizó empleando la espectrometría de absorción atómica por vapor frío. La concentración media de Hg (+- 1 DE obtenida para el grupo expuesto (E) fue 2,07 +- 2,23 (ca. intervalo experimental: 0,13 - 7,91 mg Hg/g) y para el grupo control (C) fue 2,65 +- 2,06 (ca. intervalo experimental): 0,75 - 6,75 mg Hg/g). No se observaron diferencias estadísticamente significativas (p>0,05) entre los niveles de mercurio para los grupos E y C; por lo tanto, el vapor de Hg absorbido en la clínica dental no influyó en el nivel de Hg en cabello del grupo expuesto, debido posiblemente al uso de sistemas de aire acondicionado y buena ventilación que presentaron las clínicas. Los resultados obtenidos en este estudio revelaron que el manejo y uso apropiado de la amalgama dental no altera el nivel de mercurio presente en el cabello del personal que labora en la clínica dental

Amikacin nephrotoxicity: incidence, clinical course and risk factors: a prospective study in a teaching hospital

Con el fin de conocer la incidencia, curso clínico y factores predisponentes de la toxicidad renal por amikacina, se siguieron durante cinco meses, todos los enfermos hospitalizados que recibieron este aminoglucósido por vía endovenosa. Se escluyeron a los enfermos con: insuficiencia renal aguda, insuficiencia renal crónica en fase sustitutiva; a los que recibieron ciclosporina y/o que desarrollaron durante el seguimiento síndrome hepatorrenal o estado de choque. En todos los casos se obtuvo creatinina sérica al ingreso y posteriormente cada 72 horas y niveles de amikacina en sangre cada 7 días. Se estudiaron 249 pacientes, 123 hombres y 126 mujeres, con edad media ñ DE de 47 ñ 8.5 años, creatinina sérica de 1.08 ñ 0.48 mg/dl y depuración calculada de creatinina de 99 ñ 45 ml/min. Siete pacientes recibieron amikacina como único antibiótico, 194 asociado a otro y 48 como parte de triple esquema

El hogar sustituto como sistema de recuperación integral en lactantes desnutridos y graves (Programa COFADE) / The forster home as an integral recovery system for undernourished and severely undernourshed infants (COFADE PROGRAM)

En el Servicio de Salud Metropolitano Sur Oriente se lleva a cabo un proyecto intersectorial de salud con los municipios, destinado a recuperar desnutridos primarios avanzados a través de un sistema de colocaciones familiares: lactantes cuyo tratamiento ambulatorio no ha sido extioso se envían a hogares sustitutos cuidadosamente seleccionados y capacitados donde permanecen alrededor de 4 meses para tratamiento nutricional y psicomotor. Los padres participan activamente en el trabajo con el niño, desarrollándose paralelamente labor educacional y social con el hogar de origen por equipo multiprofesional. Este programa es financiado y ejecutado por el Servicio de Salud y seis Municipalidades