Eco-Metabolomics Applied to the Chemical Ecology of Poison Frogs (Dendrobatoidea).

Amphibians are one of the most remarkable sources of unique natural products. Biogenic amines, peptides, bufodienolides, alkaloids, and volatile organic compounds have been characterized in different species. The superfamily Dendrobatoidea represents one of the most enigmatic cases of study in chemical ecology because their skin secretome is composed by a complex mixture (i.e. cocktail) of highly lethal and noxious unique alkaloid structures. While chemical defences from dendrobatoids (families Dendrobatidae and Aromobatidae) have been investigated employing ecological, behavioral, phylogenetic and evolutionary perspectives, studies about the analytical techniques needed to perform the chemical characterization have been neglected for many years. Therefore, our aim is to summarize the current methods applied for the characterization of chemical profiles in dendrobatoids and to illustrate innovative Eco-metabolomics strategies that could be translated to this study model. This approach could be extended to natural products other than alkaloids and implemented for the chemical analysis of different species of dendrobatoids employing both low- and high-resolution mass spectrometers. Here, we overview important biological features to be considered, procedures that could be applied to perform the chemical characterization, steps and tools to perform an Eco-metabolomic analysis, and a final discussion about future perspectives.

Why Do These Yeasts Smell So Good? Volatile Organic Compounds (VOCs) Produced by Malassezia Species in the Exponential and Stationary Growth Phases.

Malassezia synthesizes and releases volatile organic compounds (VOCs), small molecules that allow them to carry out interaction processes. These lipid-dependent yeasts belong to the human skin mycobiota and are related to dermatological diseases. However, knowledge about VOC production and its function is lacking. This study aimed to determine the volatile profiles of Malassezia globosa, Malassezia restricta, and Malassezia sympodialis in the exponential and stationary growth phases. The compounds were separated and characterized in each growth phase through headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC-MS). We found a total of 54 compounds, 40 annotated. Most of the compounds identified belong to alcohols and polyols, fatty alcohols, alkanes, and unsaturated aliphatic hydrocarbons. Unsupervised and supervised statistical multivariate analyses demonstrated that the volatile profiles of Malassezia differed between species and growth phases, with M. globosa being the species with the highest quantity of VOCs. Some Malassezia volatiles, such as butan-1-ol, 2-methylbutan-1-ol, 3-methylbutan-1-ol, and 2-methylpropan-1-ol, associated with biological interactions were also detected. All three species show at least one unique compound, suggesting a unique metabolism. The ecological functions of the compounds detected in each species and growth phase remain to be studied. They could interact with other microorganisms or be an important clue in understanding the pathogenic role of these yeasts.

Una propuesta desde el centro de Cuba sobre la cuarentena turística en la nueva normalidad / A proposal from the center of Cuba on the tourist quarantine in the New Normality Phase

RESUMEN Una vez emitidas las alertas tempranas sobre la COVID-19, Cuba comenzó a revisar todos los protocolos de actuación en frontera y las tareas del Control Sanitario Internacional que estarían contenidas en el Plan para el control y la prevención del nuevo coronavirus; se reforzaron las tres líneas de vigilancia epidemiológica, el plan con nuevas medidas y los protocolos de actuación. Se establecieron los Protocolos de Control Sanitario Internacional en la atención primaria de salud y en las instalaciones turísticas. Implementar la cuarentena con características turísticas para los viajeros que arriben a Cuba, en Fase Epidémica, de Recuperación o en Fase de Nueva Normalidad, en hoteles o instalaciones destinadas al turismo de salud, es una propuesta organizativa que fortalece el Programa Nacional de Control Sanitario Internacional para la prevención del SARS-COV-2. Estas acciones contribuirán a controlar la pandemia, evitar los rebrotes, y mantener el turismo con ingresos a la economía nacional.

ABSTRACT Once the early warnings on COVID-19 were issued, Cuba began to review all action protocols at the border and International Sanitary Control tasks that would be contained in the Plan for the control and prevention of the new coronavirus; three lines of epidemiological surveillance, the plan with new measures and the action protocols were reinforced. International Health Control Protocols were established in primary health care and in tourist facilities. Implementing the quarantine with tourist characteristics for travelers arriving in Cuba, in the Epidemic, Recovery or New Normality Phase, in hotels or facilities for health tourism, is an organizational proposal that strengthens the National Program for International Sanitary Control to prevent SARS-COV-2. These actions will help to control the pandemic, prevent outbreaks, and maintain tourism with incomes to the national economy.

First characterization of toxic alkaloids and volatile organic compounds (VOCs) in the cryptic dendrobatid Silverstoneia punctiventris.

BACKGROUND: Poison frogs are known for the outstanding diversity of alkaloid-based chemical defences with promising therapeutic applications. However, current knowledge about chemical defences in Dendrobatoidea superfamily has two sources of bias. First, cryptic, brown-colored species have been neglected in comparison to those conspicuously colored, and second, there has been little interest in characterizing metabolites other than alkaloids mediating defensive functions. In an effort to contribute to fill the gap of knowledge about cryptic species and broadening the spectrum of compounds analyzed we have applied head-space solid phase microextraction coupled to gas chromatography and mass spectrometry (HS-SPME/GC-MS) for extracting amphibian alkaloids and volatile organic compounds (VOCs) from Silverstoneia punctiventris. RESULTS: Using the skin from 8 specimens in 4 biological replicates we have found 33 different compounds. Twenty of them were classified as VOCs into 15 chemical classes including alkanes, alcohols, carbonyl compounds, methylpyridines, benzothiazoles, N-alkylpyrrolidines, pyrazines, and sesquiterpenoids, some of which were previously reported as repellents, defence compounds or defence pheromones in other organisms, and as sex pheromones in a treefrog. Interestingly, six of the remaining compounds were identified as alkaloids previously reported in other toxic/unpalatable dendrobatid frogs. CONCLUSIONS: This is the first report of alkaloids and VOCs found in the Silverstoneia genus, which has been assumed for decades as non-chemically defended. This study establishes HS-SPME/GC-MS as a new application for a simultaneous approach to amphibian alkaloids and VOCs in poison frogs while opens up new research questions to assess the co-occurrence of both type of compounds and to investigate the evolutionary significance of a defence gradient that includes olfactory avoidance, unpalatability, and toxicity in dendrobatids. In addition, our results show that amphibian alkaloids could have a dual function (olfactory at distance, taste by contact) never explored before neither in Silverstonaeia nor in any other dendrobatid species.

Learning about microbial language: possible interactions mediated by microbial volatile organic compounds (VOCs) and relevance to understanding Malassezia spp. metabolism.

BACKGROUND: Microorganisms synthesize and release a large diversity of small molecules like volatile compounds, which allow them to relate and interact with their environment. Volatile organic compounds (VOCs) are carbon-based compounds with low molecular weight and generally, high vapor pressure; because of their nature, they spread easily in the environment. Little is known about the role of VOCs in the interaction processes, and less is known about VOCs produced by Malassezia, a genus of yeasts that belongs to the human skin mycobiota. These yeasts have been associated with several dermatological diseases and currently, they are considered as emerging opportunistic yeasts. Research about secondary metabolites of these yeasts is limited. The pathogenic role and the molecular mechanisms involved in the infection processes of this genus are yet to be clarified. VOCs produced by Malassezia yeasts could play an important function in their metabolism; in addition, they might be involved in either beneficial or pathogenic host-interaction processes. Since these yeasts present differences in their nutritional requirements, like lipids to grow, it is possible that these variations of growth requirements also define differences in the volatile organic compounds produced in Malassezia species. AIM OF REVIEW: We present a mini review about VOCs produced by microorganisms and Malassezia species, and hypothesize about their role in its metabolism, which would reveal clues about host-pathogen interaction. KEY SCIENTIFIC CONCEPTS OF REVIEW: Since living organisms inhabit a similar environment, the interaction processes occur naturally; as a result, a signal and a response from participants of these processes become important in understanding several biological behaviors. The efforts to elucidate how living organisms interact has been studied from several perspectives. An important issue is that VOCs released by the microbiota plays a key role in the setup of relationships between living micro and macro organisms. The challenge is to determine what is the role of these VOCs produced by human microbiota in commensal/pathogenic scenarios, and how these allow understanding the species metabolism. Malassezia is part of the human mycobiota, and it is implicated in commensal and pathogenic processes. It is possible that their VOCs are involved in these behavioral changes, but the knowledge about this remains overlocked. For this reason, VOCs produced by microorganisms and Malassezia spp. and their role in several biological processes are the main topic in this review.

Experiencia del cuidador familiar ante la muerte del niño con cáncer / Relative caregiver experience facing the death of a child with cancer / Experiência do cuidador familiar ante a morte da criança com câncer

Resumen: En este estudio se trazó como objetivo la descripción de la experiencia del cuidador familiar ante la muerte del niño con cáncer. Para ello, se utilizó como método un estudio cualitativo con enfoque fenomenológico descriptivo bajo la perspectiva de Colaizzi, en el que se incluyeron 18 participantes que cumplieron con los criterios de inclusión de ser padre o madre de un niño con cáncer que haya fallecido en un periodo de 5 meses a 5 años. Se realizaron entrevistas a profundidad hasta lograr saturación teórica. Como resultados, se obtuvieron seis temas que describen la experiencia del cuidador: idealización del niño fallecido, batalla perpetua, vínculo inquebrantable, pérdida de sentido, levantarse y seguir, y lucha espiritual; estos representan la percepción y vivencia de los cuidadores en el duelo. Como conclusiones se consideró que las expresiones de dolor, incertidumbre y vacío son sentimientos y sensaciones descritas por los cuidadores, que hacen parte del proceso de duelo, pero también describen su paso hacia la aceptación y trascendencia, en la que dan importancia al ser espiritual del niño como una forma de creer que sigue junto a ellos.

Abstract: The objective of this study is to describe the relative caregiver's experience when facing the death of a child with cancer. With this purpose, the Colaizzi's descriptive phenomenological method was used in a qualitative study including 18 participants meeting the inclusion criteria of being parent to a child with cancer who died in a period from 5 months to 5 years. In-depth interviews were performed until reaching theoretical saturation. As a result, 6 topics describing the caregivers experience were found: idealization of the sick child, perpetual battle, unbreakable bond, loss of sense, get up and move on, and spiritual struggle; representing the perception and experience of caregivers in mourning. It was concluded that expressions of pain, uncertainty and emptiness are feelings and sensations described by the caregivers, which are part of the mourning process, but also describe their movement to acceptance and transcendence, where they give importance to the spiritual being of the child as the way to believe cheats still next to them.

Resumo: O objetivo deste estudo é descrever a experiência do cuidador familiar ante a morte da criança com câncer. Para isso, foi utilizado como método o estudo qualitativo com abordagem fenomenológica descritiva sob a perspectiva de Colaizzi, no qual foram incluídos 18 participantes que cumpriram com os critérios de inclusão: ser pai ou mãe de criança com câncer que tivessem falecido em um período de 5 meses a 5 anos. Foram realizadas entrevistas a profundidade até conseguir saturação teórica. Como resultados, foram obtidos seis temas que descrevem a experiência do cuidador: idealização da criança falecida, batalha perpétua, vínculo inquebrantável, perda de sentido, seguir adiante e luta espiritual; estes representam a percepção e vivência dos cuidadores no luto. Como conclusões, foi considerado que as expressões de dor, a incerteza e o vazio são sentimentos e sensações que os cuidadores descrevem como parte do processo de luto, mas também como passagem à aceitação e à transcendência, na qual dão importância ao ser espiritual da criança como forma de acreditar que continua junto deles.

Cierre de la comunicación interauricular por cateterismo intervencionista con dispositivo Amplatzer en pediatría / Atrial Septal defect closure by interventional catheterization with Amplatzer device in Pediatrics

Introducción: El cateterismo intervencionista corrige las cardiopatías complejas, donde el dispositivo Amplatzer es el más usado y está disponible en Cuba. Objetivo: Evaluar el cateterismo intervencionista con Amplatzer, en el cierre de la comunicación interauricular ostium secundum. Métodos: Estudio de evaluación, longitudinal y prospectivo en 92 pacientes. El cierre de la comunicación por cateterismo con Amplatzer, se realizó en el Cardiocentro Pediátrico William Soler (2010-2016). Se utilizaron variables demográficas, ecocardiográficas (transtorácicas y transesofágicas) antes, durante y al año del cateterismo. Se observaron las complicaciones. La evaluación clínica y ecocardiográfica se realizó al año poscateterismo. Los pacientes a quienes se les realizó el proceder en el 2016, se evaluaron a los 6 meses. Resultados: Se encontraron diferencias significativas en el sexo (p<0,05): femenino 64,1 por ciento con homogeneidad para la edad (p= 0,244): media 9,8 años ( 5 desviaciones estándar. Precateterismo: 28,3 por ciento eran desnutridos y 17,4 por ciento delgados; poscateterismo la desnutrición mejoró significativamente (p= 0,000): desnutridos 9,8 por ciento y delgados 8,7 por ciento. El diámetro medio del defecto por ecocardiografía transcateterismo fue significativo (p= 0,000). Transcateterismo: 98,9 por ciento con cierre de defecto, 16,3 por ciento con insuficiencia tricúspidea y 4,3 por ciento con insuficiencia mitral. Poscateterismo: 98,9 por ciento con Amplatzer bien colocado. Hubo complicaciones inmediatas en 8,7 por ciento (arritmias, derrame pericárdico y embolización). Al año se detectó cortocircuito residual pequeño (n= 1) e insuficiencias valvulares auriculoventriculares (n= 3). La evolución fue satisfactoria (n= 91). Conclusiones: La evolución del cierre de la comunicación interauricular ostium secundum con dispositivo Amplatzer es satisfactoria, con mejoras de la desnutrición(AU)

Introduction: The interventional catheterization corrects complex heart diseases, and the Amplatzer device is the most widely used and is available in Cuba. Objective: To assess the interventional catheterization with Amplatzer device in the ostium secundum atrial septal closure. Methods: Longitudinal and prospective evaluation study in 92 patients. The closure of the communication by Amplatzer catheterization was performed in the William Soler Pediatric Cardiocenter of (2010-2016). Demographic and echocardiographic (transthoracic and transesophageal) variables were used before, during, and at the year of the catheterization. Complications were observed. Clinical and echocardiographic assessment was made a year after catheterism. The patients who underwent the procedure in 2016 were evaluated at 6 months. Results: Significant differences were found in the sex (p< 0.05): Female 64.1 t percent with homogeneity of the age (p= 0.244): average 9.8 years ( 5 standard deviations. Pre-catheterism: 28.3 percent were malnourished and 17.4 percent thin; post-catheterism: malnutrition improved significantly (p= 0.000): 9.8 percent malnourished and 8.7 percent thin. The average diameter of the defect by transcatheter echocardiography was significant (p= 0.000). Transcatheter: 98.9 percent : with default closure, 16.3 percent with tricuspid insufficiency and 4.3 percent with mitral regurgitation. Post-catheterism: 98.9 percent with Amplatzer device correctly positioned. There were immediate complications in 8.7 percent (arrhythmia, pericardial effusion, and embolization). A year after, small residual short circuit was detected (n= 1), and atrioventricular valve regurgitation (n= 3). The evolution was satisfactory (n= 91). Conclusions: The evolution of ostium secundum atrial septal defect´s closure with Amplatzer device is satisfactory and improves malnutrition(AU)

Impact of Transcatheter Device Closure of Atrial Septal Defect on Atrial Arrhythmias Propensity in Young Adults.

Atrial septal defect (ASD) is a condition that requires early intervention because of the consequences over the right-side heart. Chronic atrial stretching promotes atrial conduction delay and the imbalance of the conduction homogeneity, which lead to the propensity to atrial arrhythmias (AA). We aim to evaluate the impact of transcatheter closure of ASD on atrial vulnerability markers leading to late AA in young adults. We conducted a prospective, longitudinal study in one hundred patients (mean age 25.2 ± 5.4 years) who underwent transcatheter closure of ASD at Cardiocentro Pediátrico William Soler. P-wave maximum (Pmax) and P-wave dispersion (Pd) were analyzed from 12-lead electrocardiogram. Left-side and right-side intraatrial and interatrial electromechanical delay (EMD) were measured with tissue Doppler imaging. Both electrocardiographic and echocardiographic analyses were performed during the study period. Compared to baseline, there was a significant reduction in P max (p ≤ 0.001) and Pd (p ≤ 0.001) after 3 months of procedure. All atrial electromechanical coupling parameters significantly reduced at 6 months of ASD closure and tend to remain at lower values till the last evaluation. Over 9.2 ± 1.6 years of follow-up, 15 subjects (15%) developed AA, of which intraatrial reentrant tachycardia (66.6%) became the main rhythm disturbance. Intra-right atrial EMD ≥ 16 ms (HR 4.08, 95% CI 1.15-14.56; p = 0.03) and Pd 45 ms (HR 1.66, 95% CI 1.06-2.59; p = 0.02) were identified as predictors of late AA. Transcatheter device closure of ASD in young adults promotes a significant reduction of electrocardiographic and echocardiographic markers of AA vulnerability, which persist during the long-term follow-up. Nevertheless, Pd and interatrial EMD were identified as independent risk factors of AA.

Yeast Smell Like What They Eat: Analysis of Volatile Organic Compounds of Malassezia furfur in Growth Media Supplemented with Different Lipids.

Malassezia furfur is part of the human skin microbiota. Its volatile organic compounds (VOCs) possibly contribute to the characteristic odour in humans, as well as to microbiota interaction. The aim of this study was to investigate how the lipid composition of the liquid medium influences the production of VOCs. Growth was performed in four media: (1) mDixon, (2) oleic acid (OA), (3) oleic acid + palmitic acid (OA+PA), and (4) palmitic acid (PA). The profiles of the VOCs were characterized by HS-SPME/GC-MS in the exponential and stationary phases. A total number of 61 VOCs was found in M. furfur, among which alkanes, alcohols, ketones, and furanic compounds were the most abundant. Some compounds previously reported for Malassezia (γ-dodecalactone, 3-methylbutan-1-ol, and hexan-1-ol) were also found. Through our experiments, using univariate and multivariate unsupervised (Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA)) and supervised (Projection to Latent Structures Discriminant Analysis (PLS-DA)) statistical techniques, we have proven that each tested growth medium stimulates the production of a different volatiles profile in M. furfur. Carbon dioxide, hexan-1-ol, pentyl acetate, isomer5 of methyldecane, dimethyl sulphide, undec-5-ene, isomer2 of methylundecane, isomer1 of methyldecane, and 2-methyltetrahydrofuran were established as differentiating compounds among treatments by all the techniques. The significance of our findings deserves future research to investigate if certain volatile profiles could be related to the beneficial or pathogenic role of this yeast.

Behavioral responses of Rhodnius prolixus to volatile organic compounds released in vitro by bacteria isolated from human facial skin.

BACKGROUND: Previous studies have demonstrated the role of volatile organic compounds (VOCs) produced by skin microbiota in the attraction of mosquitoes to humans. Recently, behavioral experiments confirmed the importance of VOCs released by skin microbiota in the attraction of Rhodnius prolixus (Hemiptera: Triatominae), a vector of Chagas disease. METHODS/FINDINGS: In this study, we screened for VOCs released in vitro by bacteria isolated from human facial skin that were able to elicit behavioral responses in R. prolixus. The VOCs released in vitro by eight bacterial species during two growth phases were tested with adult Rhodnius prolixus insects using a dual-choice "T"-shaped olfactometer. In addition, the VOCs released by the bacteria were analyzed with headspace solid-phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC-MS). The VOCs produced by Staphylococcus capitis 11C, Staphylococcus warneri and Staphylococcus epidermidis 1 were attractive to R. prolixus, while the VOCs released by Citrobacter koseri 6P, Brevibacterium epidermidis and Micrococcus luteus 23 were non-attractive. CONCLUSIONS: The results shown here indicate that VOCs released by bacteria isolated from human facial skin have a potential for biotechnological uses as a strategy to prevent the vectorial transmission of Chagas disease mediated by Rhodnius prolixus.

Experiences of patient-family caregiver dyads in palliative care during hospital-to-home transition process.

BACKGROUND: there are many people with advanced cancer who are cared for in the community, though little is known about patients' and family members' lived experiences during discharge from hospital to home. OBJECTIVES: to describe the experiences of the patient-family caregiver dyad during the transition from hospital to home at a National Cancer Institute in Colombia. METHODS: a descriptive phenomenological approach was taken for this study. RESULTS: Forty-one nominal codes emerged, comprising seven themes that describe the experience of the individual in palliative care and their family caregiver during the transition from hospital to home care. CONCLUSIONS: the patient-family caregiver dyad have to deal with symptoms while being confronted with the prognosis and progression of the disease at home. The economic costs in acquiring supplies needed for proper care provision are considerable. In addition there are administrative fees from consultations and accessing the health services. Emotional and spiritual support for the dyad is required.

Conspicuousness, color resemblance, and toxicity in geographically diverging mimicry: The pan-Amazonian frog Allobates femoralis.

Predation risk is allegedly reduced in Batesian and Müllerian mimics, because their coloration resembles the conspicuous coloration of unpalatable prey. The efficacy of mimicry is thought to be affected by variation in the unpalatability of prey, the conspicuousness of the signals, and the visual system of predators that see them. Many frog species exhibit small colorful patches contrasting against an otherwise dark body. By measuring toxicity and color reflectance in a geographically variable frog species and the syntopic toxic species, we tested whether unpalatability was correlated with between-species color resemblance and whether resemblance was highest for the most conspicuous components of coloration pattern. Heterospecific resemblance in colorful patches was highest between species at the same locality, but unrelated to concomitant variation in toxicity. Surprisingly, resemblance was lower for the conspicuous femoral patches compared to the inconspicuous dorsum. By building visual models, we further tested whether resemblance was affected by the visual system of model predators. As predicted, mimic-model resemblance was higher under the visual system of simulated predators compared to no visual system at all. Our results indicate that femoral patches are aposematic signals and support a role of mimicry in driving phenotypic divergence or mimetic radiation between localities.

Prospective, comprehensive, and effective viral monitoring in Cuban children undergoing solid organ transplantation.

PURPOSE: In Cuba, viral monitoring in the post-transplant period was not routinely performed. The aim of this research is to identify the most frequent viruses that affect transplanted Cuban children, by implementing a viral follow-up during the post-transplant period. METHODS: The study population included all Cuban pediatric patients who underwent solid organ transplantation (SOT) between November 2009 and December 2012. A total of 34 transplanted pediatric patients of kidney (n = 11) and liver (n = 23) were prospectively monitored during a 34-week period for viral DNAemia and DNAuria by simultaneous detection of cytomegalovirus (CMV), Epstein-Barr virus, herpes simplex virus type 1 and 2, varicella zoster virus, human herpesvirus 6, human adenovirus, and polyomaviruses (BKV and JCV) using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: Viral genome of at least one virus was detected in 21 of 34 recipients, 18 patients excreted virus in urine while 12 presented DNAemia. CMV (41.2%) and BKV (35.3%) were the most frequent viruses detected during the follow-up. CMV was the virus mainly associated with clinical symptoms and DNAemia. Its excretion in urine (with cut off value of 219 copies/mL) was associated with detection in plasma (p < 0.001); furthermore, CMV viruria was predictive of CMV viremia (OR:8.4, CI:2.4-29.1, p = 0.001). There was no association between high viral load and clinical complications, due to the prompt initiation of preemptive ganciclovir. CONCLUSION: This comprehensive viral monitoring program effectively prevents the development of critical viral disease, thus urge the implementation of qRT-PCR as routine for viral monitoring of transplanted Cuban organ recipients.

Morbilidad por accidentes en menores de cinco años / Morbidity Caused by Accidents in Children under Five Years

Fundamento: los accidentes o lesiones no intencionales representan un problema de salud mundial y constituyen una de las primeras causas de morbilidad en la edad pediátrica. Objetivo: describir la morbilidad por accidentes en niños menores de cinco años del área de salud V de Cienfuegos. Métodos: estudio descriptivo realizado en Policlínico Área V, Cienfuegos, encaminado al análisis de la morbilidad por accidentes (ocurridos en el periodo junio-noviembre de 2008) en niños de cero a cinco años, pertenecientes a los consultorios 3, 4, 23 y 25 de dicha área de salud. Se trabajó con las variables demográficas, tipo de accidente, causas, lugar de ocurrencia, presencia de adultos en el momento de ocurrido, solicitud asistencia médica, y factores de riesgo. Resultados: sufrieron accidentes el 40,2 % de la población estudiada y la frecuencia de accidentes alcanzó un 48,2 %. Se mostraron más afectados los niños de dos, tres y menores de un año, así como el sexo masculino. Las caídas, las quemaduras y la aspiración de cuerpos extraños, resultaron los accidentes más frecuentes, y en su mayoría ocurrieron en el hogar. Conclusiones: el estudio mostró una alta prevalencia de accidentes en la población estudiada, lo que evidencia que lamentablemente los adultos no están haciendo todo lo posible por disminuir la ocurrencia de accidentes. Se requiere ser más activos en la vigilancia del niño y en la eliminación de posibles factores detonantes del accidente.

Background: Accidents or unintentional injuries are a global health problem. In addition, they are considered as one of the leading causes of morbidity in children. Objective: To describe the morbidity caused by accidents in children under the age of five years in the V Health Area in Cienfuegos. Methods: A descriptive study was conducted in Area V Polyclinic, Cienfuegos, aimed at analyzing the morbidity caused by accidents (from June to November 2008) in children from zero to five years who belonged to consultations 3, 4, 23 and 25 of that health area. The demographic variables, type of accident, cause, place of occurrence, adult presence at the time of the accident, request for medical assistance, as well as risk factors were analyzed. Results: 40.2% of the population studied had accidents and the accident frequency rate reached 48.2%. Children aged two, three and less than one year were the most affected as well as males. Falls, burns and foreign body aspiration were the most frequent accidents, occurring mostly at home. Conclusions: Unfortunately adults are not doing everything possible to reduce the occurrence of accidents. They need to be more active in the child vigilance and the elimination of potential triggering factors of the accident.

Assessment of infection with polyomaviruses BKV, JCV and SV40 in different groups of Cuban individuals.

We investigated the frequency of BKV, JCV and SV40 reactivation in three groups of Cuban patients by multiplex nested PCR assay of 40 paraffin-embedded colorectal neoplasm tissues, 113 urine samples, and 125 plasma samples from 27 transplant recipients, and cerebrospinal fluid (CSF) from 67 HIV-1-infected individuals with central nervous system (CNS) disorders. None of these polyomaviruses were detected in colorectal neoplasms. JCV DNA was detected in 2 of 67 patients (2.9%) with CNS disorders, but neither BKV nor SV40 was identified. BKV was found in urine from 38.5% and 28.6% of adult and pediatric transplant recipients, respectively. In adult renal transplant recipients, excretion of BKV in urine was significantly associated with episodes of acute rejection (p=0.012) and with excretion of HCMV in urine (p= 0.008). In Cuba, the polyomaviruses studied here could not be related to colorectal neoplasms, and JCV was rarely detected in CSFs of HIV-1-infected individuals, whilst BKV reactivation was found to occur frequently in organ transplant recipients.

Staphylococcus aureus resistente a la meticilina: detección de portadores entre niños hospitalizados y niños sanos de la comunidad

Se realizó un estudio descriptivo puntual para la búsqueda de portadores nasales de cepas de Staphylococcus aureus resistentes a la meticilina (SARM), entre niños sanos atendidos en círculos infantiles y entre niños hospitalizados expuestos a uno de los factores de riesgo o más que predisponen para la colonización por este tipo de cepas; durante el período comprendido entre octubre de 2000 a febrero de 2001, en el municipio Marianao. Para el aislamiento primario de las cepas SARM se utilizó el medio oxacilina-manitol-sal-agar (OMSA) y a todas las cepas identificadas como S. aureus se les determinó la sensibilidad a drogas antimicrobianas por el método de Kirby-Bauer. Para identificar la resistencia a la oxacilina en las cepas recuperadas en OMSA se aplicaron los métodos: oxacillin salt-agar screening-plate y la determinación de la concentración mínima inhibitoria (CMI) en agar y en caldo. Se investigó la presencia del gen mecA mediante la reacción en cadena de la polimerasa en aquellas cepas que presentaron una CMI ³ 4 µg/mL de oxacilina. De los niños sanos, 0,35 % y de los hospitalizados, 2 % constituyeron portadores nasales de cepas SARM. Las cepas aisladas en ambos grupos de estudio mostraron índices altos de resistencia para la penicilina, tetraciclina y eritromicina por el método de Kirby-Bauer. Se identificó el gen mecA en una cepa SARM aislada de un portador nasal hospitalizado y se definió que su comportamiento se correspondía con el descrito para una cepa homorresistente para la oxacilina.

A descriptive punctual study was conducted to search for nasal carriers of Staphylococcus aureus strains resistant to methycilin (SARM) among sound children attended in nurseries and hospitalized children exposed to one or more risk factors predisposing to the colonization by this type of strains from October, 2000, to February, 2001, in Marianao municipality. For the primary isolation of the SARM strains, it was used the oxacillin-manitol-salt-agar (OMSA) and the sensitivity to antimicrobial drugs was determined in all strains identified as S. Aereus by using the Kirby-Bauer method. In order to identify the resistance to oxacillin in the strains recovered from OMSA, the oxacillin salt-agar screening -plate method and the determination of inhibitory minimum concentration (IMC) in agar and broth were applied. The presence of the mecA gene was nvestigated by polymerase chain reaction in those strains with an IMC ³ 4 mg/mL of oxacillin. Of the sound children, 0.35 % and of the hospitalized, 2 %, were nasal carriers of SARM strains. The strains isolated in both study groups showed high indexes of resistance to penicillin, tetracycline and erythromycin by the Kirby-Bauer method. The mecA gene was identified in a SARM strain isolated from a hospitalized nasal carrier and it was defined that its behaviour agreed with the one described for a strain homoresistant to oxacillin.

[Methicillin-resistant Staphylococcus aureus. Detection of carriers among hospitalized children and healthy children from the community]. / Staphylococcus aureus resistente a la meticilina: detección de portadores entre niños hospitalizados y niños sanos de la comunidad.

A descriptive punctual study was conducted to search for nasal carriers of Staphylococcus aureus strains resistant to methycilin (SARM) among sound children attended in nurseries and hospitalized children exposed to one or more risk factors predisposing to the colonization by this type of strains from October, 2000, to February, 2001, in Marianao municipality. For the primary isolation of the SARM strains, it was used the oxacillin-manitol-salt-agar (OMSA) and the sensitivity to antimicrobial drugs was determined in all strains identified as S. aureus by using the Kirby-Bauer method. In order to identify the resistance to oxacillin in the strains recovered from OMSA, the oxacillin salt-agar screening-plate method and the determination of inhibitory minimum concentration (IMC) in agar and broth were applied. The presence of the mecA gene was nvestigated by polymerase chain reaction in those strains with an IMC > or = 4 mg/mL of oxacillin. Of the sound children. 0.35 % and of the hospitalized, 2 %, were nasal carriers of SARM strains. The strains isolated in both study groups showed high indexes of resistance to penicillin, tetracycline and erythromycin by the Kirby-Bauer method. The mecA gene was identified in a SARM strain isolated from a hospitalized nasal carrier and it was defined that its behaviour agreed with the one described for a strain homoresistant to oxacillin.

Prevalencia de hepatitis A en niños de 2 a 14 años y en población laboral de 18 a 49 años en Montevideo, Uruguay / Prevalence of Hepatitis A in 2 to 14 year-old children and in working population aged 18 to 49 years in Montevideo, Uruguay

La hepatitis por virus A es un problema de salud pública mundial. Es la más frecuente de las hepatitis virales tanto en países desarrollados como en desarrollo y aumenta su incidencia con el aumento de la edad de la población. La aparición de vacunas que previenen la enfermedad hace necesario conocer sus características epidemiológicas con vistas a establecer sus indicaciones. En Montevideo no se disponía de datos representativos de prevalencia en niños y adultos. Esta investigación se realizó con el objetivo de determinar la prevalencia de la infección por el virus de la hepatitis A (HAV) en niños de 2 a 14 años y en población laboral entre 18 y 49 años en diferentes franjas de edad, en Montevideo; la prevalencia en manipuladores de alimentos; la relación de la adquisición de la infección con la edad y con las condiciones sanitarias. Se calculó el tamaño de la muestra en 896 niños, para luego dividirlas en las franjas establecidas según la misma proporción que la población de Montevideo. Se estimó una prevalencia de infección de 30 por ciento de acuerdo con los datos disponibles, con un error permitido de 3 por ciento y un coeficiente de confianza de 95 por ciento. La mitad de los niños procedía del sector público (Centro Hospitalario Pereira Rossell, Grupo 1), y la otra mitad del sector privado (Centros de Asistencia con sistema prepago, Grupo 2). El tamaño de la muestra para los adultos fue de 1.067, estimando una prevalencia de 50 por ciento de acuerdo con los datos disponibles, con un error permitido de 3 por ciento y un intervalo de confianza de 95 por ciento. Para el caso de los niños se obtuvo una muestra de sangre cuando concurrían a extracción por motivos ajenos al estudio, incluso al azar y previa firma del consentimiento informado por el responsable del niño. Se excluyeron los niños con alteraciones conocidas de la inmunidad. Se recabaron datos de interés epidemiológico sobre la enfermedad: domicilio, condición sanitaria, antecedentes personales y familiares de hepatitis. Las personas adultas incluidas al azar en el estudio fueron aquellas que aceptaron participar y firmaron el consentimiento por escrito al concurrir al Centro Clínico Medilab por motivos ajenos al estudio: para la realización del examen de Carné de Salud Básico necesario en toda persona en actividad laboral. Se obtuvo una muestra de sangre de 5 ml. y se completó una ficha predeterminada, similar a la de los niños...(AU)