Therapeutic Choices in Patients with Ph-Positive Chronic Myelogenous Leukemia In Mexico in the Era of Tyrosine Kinase Inhibitors: Stem Cell Transplantation or Tyrosine Kinase Inhibitors? Fifteen Years Later.

Background: Chronic myelogenous leukemia is a neoplastic proliferation of the granulocytic series. In Mexico, chronic myelogenous leukemia accounts for approximately 10% of all leukemias. Tyrosine-kinase inhibitors are considered front-line therapy in high-income countries, whereas allogeneic hematopoietic stem cell transplantation is a recognized therapeutic approach, mainly in low- and middle-income countries. Objective: To analyze the overall survival of persons with chronic myelogenous leukemia who have received tyrosine-kinase inhibitors or allogeneic hematopoietic stem cell transplantation in a medical center, since 1994, and briefly discuss the current indications of these treatments in the tyrosine-kinase inhibitors era. Methods: We retrospectively analyzed all patients with a diagnosis of chronic myelogenous leukemia treated in a medical center between 1994 and 2023; subsets of individuals who received an allogeneic hematopoietic stem cell transplantation or tyrosine-kinase inhibitors therapy as first-line treatment were analyzed. Results: 60 persons with chronic myelogenous leukemia were treated with allogeneic hematopoietic stem cell transplantation or tyrosine-kinase inhibitors: 35 received an allogeneic hematopoietic stem cell transplantation, whereas 25 were given tyrosine-kinase inhibitors. All patients who underwent an allogeneic hematopoietic stem cell transplantation engrafted successfully, and the procedure was completed on an outpatient basis in most cases (29/35). The median survival in allogeneic hematopoietic stem cell transplantation was 78.3 months (CI 95%: 0-205.6) and in persons given tyrosine-kinase inhibitors the median was not reached. Conclusion: Tyrosine-kinase inhibitors were significantly superior to allogeneic hematopoietic stem cell transplantation in prolonging the overall survival of persons with chronic myelogenous leukemia in our single institution experience.

Arsenic and mercury exposure in different insect trophic guilds from mercury mining areas in Mexico.

The exposure to arsenic and mercury in various insect trophic guilds from two mercury mining sites in Mexico was assessed. The two study sites were La Laja (LL) and La Soledad (LS) mines. Additionally, a reference site (LSR) was evaluated for LS. The terrestrial ecosystem was studied at LL, whereas both the terrestrial ecosystem and a stream called El Cedral (EC) were assessed at LS. The study sites are situated in the Biosphere Reserve Sierra Gorda (BRSG). Mercury vapor concentrations were measured with a portable analyzer, and concentrations of arsenic and mercury in environmental and biological samples were determined through atomic absorption spectrophotometry. Both pollutants were detected in all terrestrial ecosystem components (soil, air, leaves, flowers, and insects) from the two mines. The insect trophic guilds exposed included pollinivores, rhizophages, predators, coprophages, and necrophages. In LS, insects accumulated arsenic at levels 29 to 80 times higher than those found in specimens from LSR, and 10 to 46 times higher than those from LL. Similarly, mercury exposure in LS was 13 to 62 times higher than LSR, and 15 to 54 times higher than in LL. The analysis of insect exposure routes indicated potential exposure through air, soil, leaves, flowers, animal prey, carrion, and excrement. Water and sediment from EC exhibited high levels of arsenic and mercury compared to reference values, and predatory aquatic insects were exposed to both pollutants. In conclusion, insects from mercury mining sites in the BRSG are at risk.

Therapeutic Choices in Patients with Ph-Positive Chronic Myelogenous Leukemia In Mexico in the Era of Tyrosine Kinase Inhibitors: Stem Cell Transplantation or Tyrosine Kinase Inhibitors? Fifteen Years Later

ABSTRACT Background: Chronic myelogenous leukemia is a neoplastic proliferation of the granulocytic series. In Mexico, chronic myelogenous leukemia accounts for approximately 10% of all leukemias. Tyrosine-kinase inhibitors are considered front-line therapy in high-income countries, whereas allogeneic hematopoietic stem cell transplantation is a recognized therapeutic approach, mainly in low- and middle-income countries. Objective: To analyze the overall survival of persons with chronic myelogenous leukemia who have received tyrosine-kinase inhibitors or allogeneic hematopoietic stem cell transplantation in a medical center, since 1994, and briefly discuss the current indications of these treatments in the tyrosine-kinase inhibitors era. Methods: We retrospectively analyzed all patients with a diagnosis of chronic myelogenous leukemia treated in a medical center between 1994 and 2023; subsets of individuals who received an allogeneic hematopoietic stem cell transplantation or tyrosine-kinase inhibitors therapy as first-line treatment were analyzed. Results: 60 persons with chronic myelogenous leukemia were treated with allogeneic hematopoietic stem cell transplantation or tyrosine-kinase inhibitors: 35 received an allogeneic hematopoietic stem cell transplantation, whereas 25 were given tyrosine-kinase inhibitors. All patients who underwent an allogeneic hematopoietic stem cell transplantation engrafted successfully, and the procedure was completed on an outpatient basis in most cases (29/35). The median survival in allogeneic hematopoietic stem cell transplantation was 78.3 months (CI 95%: 0-205.6) and in persons given tyrosine-kinase inhibitors the median was not reached. Conclusion: Tyrosine-kinase inhibitors were significantly superior to allogeneic hematopoietic stem cell transplantation in prolonging the overall survival of persons with chronic myelogenous leukemia in our single institution experience. (Rev Invest Clin. 2024;76(2):91-6)

Prevalence and Consequences of a Delayed Diagnosis in Multiple Myeloma: A Single Institution Experience.

BACKGROUND: Multiple myeloma (MM) is a disease with unspecific initial symptoms which may lead into a delay in the diagnosis, seemingly increasing the risk of complications and in turn reducing the overall survival (OS). OBJECTIVE: To analyze the consequences of a delayed diagnosis of MM in both the OS and the progression-free survival (PFS) of the patients in a single center in México. METHODS: The study included patients with MM who were diagnosed at Clínica Ruiz, Puebla, México, between 1983 and 2022. According to the time elapsed between the onset of symptoms to the establishment of the definite diagnosis of MM, 4 groups were constructed: 1) Less than 3 months, 2) 3-6 months, 3) 6-12 months, and 4) More than 12 months. RESULTS: About 136 patients had a complete clinical record and at least a 3-month follow up period. A delay in the diagnosis of MM (more than 3 months from the onset of symptoms) was recorded in 92/136 persons (68%). The median follow-up for the whole group was 24.7 months, median OS was 131.4 months, whereas median PFS was 85.4 months. There was a significant trend for being in earlier stages of the disease and being diagnosed within 3 months from the onset of symptoms (P = .049). Both OS and PFS were similar in the patients diagnosed before or after 3 months from the symptoms onset (P = .772). The 6-12 months group was the group with the better median both OS (197.4 months) and DFS (197.4) from the diagnosis. The median OS for the other groups were similar among them. CONCLUSION: A delay in the diagnosis of MM is very frequent in México (68% of cases); despite the fact that there was a significant trend for being in earlier stages of the disease and being diagnosed within 3 months from the onset of symptoms, we did not find a relationship between a delay on the diagnosis of the disease and a higher risk of complications and/or poor prognosis. Possible explanations to these findings are discussed.

Neutrophil to lymphocyte ratio and systemic immune-inflammatory index as markers of response to autologous hematopoietic stem cell transplantation in persons with multiple sclerosis.

INTRODUCTION: Biomarkers that help to evaluate the immune system and could be useful in multiple sclerosis (MS) are the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII). The objective of this work is to evaluate the significance of the SII index, PLR, and NLR before and after transplantation in individuals with MS who underwent autologous hematopoietic stem cell transplant (aHSCT) at a single institution. METHODS: Patients with MS who received an aHSCT between 2017 and 2022 were included in the study. NLR, PLR, and SII index were calculated prior to the transplant and 100 days after, and evaluation of the expanded disability status scale (EDSS) was done before the transplant and 12 months after. The cohort was divided into two groups: aHSCT responders (R) and nonresponders (NR). RESULTS: Fifty-eight individuals were examined: 37 patients in the responders group R group and 21 in NR group. There was no statistically significant difference in the SII, NLR, and PLR prior to the transplant, however at 100 days post-HSCT, NLR in the R group was 1.8 versus 3.1 in the NR group (p = 0.003), PLR was 194 versus 295, respectively (p = 0.024), meanwhile SII index was 489.5 versus 729.3 (p < 0.001). CONCLUSION: High NLR and SII index values after the aHSCT were associated with a worsening in the EDSS score. However, since this is the first ever study that compared NLR and SII index with the aHSCT response in persons with MS, further studies must be performed to corroborate this information.

Second Autologous Hematopoietic Stem Cell Transplantation in Multiple Sclerosis: A Single-Center Prospective Experience.

Immunosuppressive therapy is useful in persons with multiple sclerosis (MS), and autologous hematopoietic stem cell transplantation (aHSCT) is the most effective immunosuppressive treatment in this setting. Information on the usefulness of a second aHSCT in patients with MS is scarce. In a group of 1225 individuals with MS prospectively managed with aHSCT, we analyzed the salient features of 4 patients who received 2 consecutive transplants. After a moderate initial response to the first aHSCT, the patients were transplanted again after deterioration of their neurologic status; the second transplant was well tolerated and, in all instances, was completed on an outpatient basis and with no associated undesired toxicity. The autograft protocol is registered in ClinicalTrials.gov, identifier NCT02674217. After the second graft, the expanded disability status scale score stabilized in 2 patients; in 1, the post-transplant period was too short to assess the response, and in another, the development of associated Parkinson's disease precluded the assessment of the outcome. In conclusion, a second aHSCT in persons with MS is feasible, safe, and may lead to a positive response in some cases.

The consequences of delayed diagnosis and treatment in persons with multiple sclerosis given autologous hematopoietic stem cell transplantation.

OBJECTIVES: We have analyzed the association of delayed both diagnosis and treatment of persons with MS with the long-term results of patients given autologous hematopoietic stem cell transplantation (aHSCT). METHODS: Patients with MS referred to the HSCT-Mexico program were included in the study; in 103, detailed pre- and post-transplant evolution could be recorded. Two groups of patients were analyzed according to the time of evolution between the onset of symptoms and the definite diagnosis of MS: more than 8 months (delayed diagnosis, DD), or less than 8 months (non-delayed diagnosis, NDD). The progression of MS was assessed by changes in the expanded disability status scale (EDSS). RESULTS: The time elapsed between the onset of symptoms and the correct diagnosis was lower for the NDD group (1.55 vs. 35.87 months, p<0.05). Both groups of patients showed a similar EDSS score at diagnosis (1.5 vs. 1.5); however, the EDSS at the time of the transplant was higher in the DD group (4.5 vs. 3.0, p=0.3) and the response of the EDSS score to the transplant was significantly better for the NDD group, the last EDSS scores being 2.5 vs. 4.25 (p=0.03). Both groups of patients responded to aHSCT by diminishing the EDSS, but the response was significantly better in the NDD group. CONCLUSIONS: These data indicate that both the pre-transplant progression of the disease and the response to aHSCT were significantly worse in the DD group. An early diagnosis and an early aHSCT intervention are critical for a good prognosis, in terms of lowering and stabilizing the motor disability in MS patients given autografts.

In persons with CIDP, auto-HSCT can be conducted fully on an outpatient basis and induces significant clinical responses: A prospective study in a single center.

BACKGROUND: Chronic inflammatory demyelinating polyneuropathy (CIDP) is one of the world's most common treatable neuropathy which usually responds to immunosuppressive treatment. Autologous hematopoietic stem cell transplantation (aHSCT) is an intense way of inducing immunosuppression. OBJECTIVE: We analyze the evolution of CIDP patients treated with aHSCT in our center. METHODS: Between 2018 and 2023, persons with CIDP were prospectively autografted employing the "Mexican method" to conduct grafts on an outpatient basis, employing cyclophosphamide 200 mg/Kg and rituximab 1000 mg. The protocol is registered in ClinicalTrials.gov identifier NCT02674217. RESULTS: In our center 21 autologous transplant cases were completed in 2018-2023. Seven patients provided data to assess the efficacy of the procedure. Positive responses (stabilization and/or improvement) were observed in all seven patients: Five reported improvements in the Inflammatory Neuropathy Cause and Treatment (INCAT) score and one reported stabilization. In the Inflammatory Rasch-Built Overall Disability Scale (I-RODS) score. Median INCAT score was 5 (range 1-9), whereas median I-RODS score was 24 (range 11-29). Five patients (71%) reported improvement in the INCAT score, one reported stabilization and one informed worsening; concerning the I-RODS score 5 (71%) informed improvement, whereas two reported stabilization. CONCLUSION: aHSCT conducted fully in an outpatient basis, employing the conditioning regimen of the "Mexican method" appears to be a feasible therapeutic option for persons with CIDP. Additional studies are needed to confirm these observations.

Preservation of Fresh-Cut 'Maradol' Papaya with Polymeric Nanocapsules of Lemon Essential Oil or Curcumin.

Papaya is one of the most consumed fruits in the world; however, tissue damage caused by cuts quickly leads to its decay. Therefore, this study aimed to prepare and characterize lemon oil and curcumin nanocapsules to evaluate their capacity for preserving fresh-cut papaya. Lemon essential oil and curcumin nanocapsules were prepared using ethyl cellulose (EC) and poly-(ε-caprolactone) (PCL) by the emulsification-diffusion method coupled with ultrasound. The particles had sizes smaller than 120 nm, with polydispersity indices below 0.25 and zeta potentials exceeding -12 mV, as confirmed by scanning electron microscopy. The nanoparticles remained stable for 27 days, with sedimentation being the instability mechanism observed. These nanoparticles were employed to coat fresh-cut papaya, which was stored for 17 days. The results demonstrated their remarkable efficacy in reducing the respiration rate. Furthermore, nanocapsules maintained the pH and acidity levels of the papayas for an extended period. The lemon oil/EC nanocapsule treatment retained the color better. Additionally, all systems exhibited the ability to minimize texture loss associated with reduced pectin methylesterase activity. Finally, the nanocapsules showed a notable reduction in polyphenol oxidase activity correlating with preserving total phenolic compounds in the fruit. Therefore, the lemon oil and curcumin nanoparticles formed using EC and PCL demonstrated their effectiveness in preserving fresh-cut 'Maradol' papaya.

Therapy of childhood acute lymphoblastic leukemia in resource-poor geospaces.

The therapy of children with acute lymphoblastic leukemia (ALL) in limited resource geospaces is challenging and must balance safety, efficacy, availability, and affordability. We modified the control arm of the St. Jude Total XI protocol for outpatient delivery including once-weekly daunorubicin and vincristine in initial therapy, postponing intrathecal chemotherapy until day 22, prophylactic oral antibiotics/antimycotics, use of generic drugs, and no central nervous system (CNS) radiation. Data were interrogated from 104 consecutive children ≤12 years (median, 6 years [interquartile range (IQR), 3, 9 years]. All therapies were given in an outpatient setting in 72 children. Median follow-up is 56 months (IQR 20, 126 months). A total of 88 children achieved a hematological complete remission. Median event-free survival (EFS) is 87 months [95% confidence interval (CI), 39, 60], 7.6 years in low-risk children (3.4, 8 years) whereas 2.5 years (1, 10 years) in high-risk children. The 5-year cumulative incidence of relapse (CIR) is 28% (18, 35%), 26% (14, 37%) in low-risk children and 35% (14, 52%) in high-risk children. Median survival for all subjects is not reached but must exceed 5 years. A total of 36 children relapsed at a median of 12 months (5, 23 months). Outcomes were comparable to those reported in the control arm of the Total Therapy XI study, but inferior to current treatment protocols in high-income countries. The average cost of the first 2 years of therapy was $28,500 USD compared with an average cost of approximately $150,000 USD in the US, an 80% saving. In conclusion, using an outpatient-based modification of the St. Jude Total XI protocol, we obtained good results with relatively few hospitalizations or adverse events and at a substantial saving. This model can be applied in other resource-poor geospaces.

MicroRNAs as a possible biomarker in the treatment of multiple sclerosis.

Multiple sclerosis (MS) is a demyelinating, autoimmune and inflammatory disease that affects the central nervous system (CNS) and is one of the leading causes of disability in young adults worldwide. There are different drugs for the treatment of MS that aim to modify the natural course of the disease and thus slow its progression. This group of drugs is known as disease modifying therapy (DMT). To evaluate the effectiveness of these drugs, mainly clinical and MRI parameters are used. In recent years, different studies have emerged that propose the use of biomarkers to improve the evaluation of the effectiveness of DMT and to provide individualized therapy. MicroRNAs (miRNAs) are part of these biomarkers that have been proposed both for their wide availability in different tissues and body fluids and for their possible involvement in different biological processes. In this review we briefly discuss the mechanisms of action of drugs available for the treatment of MS, as well as recent findings on the expression levels of different miRNAs in MS patients under treatment with DMT.

SARS-CoV-2 vaccination patterns in a private hematology and internal medicine outpatient clinic.

OBJECTIVE: Determine the proportion of vaccinated patients in a private hematology and internal medicine outpatient clinic and potential factors in adherence in at-risk patients (due to onco-hematological diseases). MATERIALS AND METHODS: This is a cross-sectional study of outpatients from a private clinic. We applied a non-validated instrument to all patients attending the outpatient clinic from May to October 2021. According to the primary diagnosis, we classified patients into onco-hematological and non-onco-hematological patients. Since national authorities exclusively executed and planned the rollout of vaccines, the order and eligibility defined by authorities of vaccination was considered when conducting the analysis and patients were classified according to the their corresponding group. RESULTS: 397 participants were accrued, 269 (68%) had an onco-hematological condition. In the whole group, 73 (18.3%) had a history of infection. Vaccination history was present in 286 persons (72%); 82% had two doses. In the subset of 269 persons with an onco-hematological condition, 191 (71%) were vaccinated, whereas 95 participants with non-hematological conditions (73%) had received the vaccine. Vaccination status was associated with age (OR 1.07, 95%CI: 1.03,1.10, p<0.0001) and body mass index (OR 1.11, 95%CI: 1.04,1.17, p<0.0001). CONCLUSIONS: According to our study, vaccination adherence at our center is significantly different from the nationwide proportion of vaccines.

First report of Athelia rolfsii (= Sclerotium rolfsii) causing southern blight on Pachyrhizus erosus in Mexico.

Pachyrhizus erosus, commonly named jicama, is native to Mexico and is cultivated for its tuberous roots which are edible. In November 2021, field sampling was carried out in municipality of Huaquechula (18.748640N, 98.550817W, 1,580 m above sea level), state of Puebla, México. The disease had an incidence between 20 and 30% in approximately 10 ha. Infected plants showed wilting, yellowing foliage, rotting with white mycelium, abundant sclerotia were observed in the roots and tuber. Tuber splits transversely over time. Twenty plants with symptoms of disease were carried out to isolate the fungus. The sclerotia found in the tubers were disinfected with 3% NaOCl, rinsed twice with sterile distilled water, and excess moisture was removed and, transferred on Potato Dextrose Agar (PDA) culture medium and incubated at 28°C. Mycelial fragments from symptomatic tubers, were plated directly to PDA. Twenty representative isolates were obtained by hyphal-tip method, one for each diseased plant sampled (10 isolates from sclerotia and the other 10 from fragments of mycelium). After 10 days, colonies showed fast-growing, dense, cottony-white aerial mycelium, forming globoid to irregular sclerotia, measuring 1.0-1.7 mm in diameter (mean = 1.42 mm; n=100). The number of sclerotia produced per Petri dish ranged from 54 to 542 (mean = 274, n = 50). These sclerotia were initially white and gradually turned brown. Microscopic examination showed septate hyphae with some cells having clamp connections. Based on morphological characteristics, the fungal isolates were identified as Athelia rolfsii (Curzi) CC Tu & Kimbr (Syn: Sclerotium rolfsii Sacc) (Mordue 1974). For molecular identification, a representative isolate (Sr.1), the ITS region was amplified (650 bp) using primers ITS1/ITS4 (White et al. 1990). The obtained sequence (GenBank: ON206899) was subjected to BLAST analysis, where it had 100% identity with A. rolfsii isolates (GenBank: MG836252 and MH517363). Phylogenetic analysis with the neighbor-joining method in MEGAX, grouped the Sr.1 isolate into a common clade with different A. rolfsii isolates. Pathogenicity was confirmed by inoculating 20 tubers detached from healthy P. erosus variety "Criolla de Morelos", into which a portion of mycelium from the Sr.1 isolate was inserted with a sterile wooden stick at one point per tuber. In five tubers, only a sterile wooden stick was inserted as negative controls. The tubers were placed under laboratory conditions with relative humidity close to 100% and a temperature of 28°C. Symptoms like those observed in the field were observed after five days. Control tubers showed no symptoms. Additional pathogenicity tests were performed on 50 plants of 100-day-old P. erosus of the variety "Criolla de Morelos", grown in pots with sterile soil. Ten sclerotia of 10 days old were deposited at the base of the stem, 10 mm below the soil surface; as control treatment only, sterile distilled water was deposited on 20 plants. The plants were placed in a greenhouse (Center for Technological Innovation in Protected Agriculture of the Popular Autonomous University of the State of Puebla), at 28 ± 1°C and 90% of temperature and relative humidity, respectively. After 15 days, all inoculated plants showed symptoms similar to those observed in the field. Control plants showed no symptoms. A. rolfsii was re-isolated from inoculated tubers and stem, fulfilling Koch's postulates. Previously, A. rolfsii was reported in Mexico, causing southern blight on sesame (Hernández-Morales et al. 2018). To our knowledge, this is the first report of Athelia rolfsii causing southern blight on P. erosus in Mexico (Farr and Rossman 2022). This research is important to design management strategies and prevent its spread to other P. erosus-producing areas.

Development and Characterization of pH-Dependent Cellulose Acetate Phthalate Nanofibers by Electrospinning Technique.

The aim of this work was to obtain pH-dependent nanofibers with an electrospinning technique as a novel controlled release system for the treatment of periodontal disease (PD). Cellulose acetate phthalate (CAP) was selected as a pH-sensitive and antimicrobial polymer. The NF was optimized according to polymeric dispersion variables, polymer, and drug concentration, and characterized considering morphology, diameter, entrapment efficiency (EE), process efficiency (PE), thermal properties, and release profiles. Two solvent mixtures were tested, and CHX-CAP-NF prepared with acetone/ethanol at 12% w/v of the polymer showed a diameter size of 934 nm, a uniform morphology with 42% of EE, and 55% of PE. Meanwhile, CHX-CAP-NF prepared with acetone/methanol at 11% w/v of polymer had a diameter of 257 nm, discontinuous nanofiber morphology with 32% of EE, and 40% of PE. EE and PE were dependent on the polymer concentration and the drug used in the formulation. Studies of differential scanning calorimetry (DSC) showed that the drug was dispersed in the NF matrix. The release profiles of CHX from CHX-CAP-NF followed Fickian diffusion dependent on time (t0.43-0.45), suggesting a diffusion-erosion process and a matrix behavior. The NF developed could be employed as a novel drug delivery system in PD.

Diagnósticos microbiológicos en un hospital gineco-obstétrico pediátrico: Un reporte de centro único / Microbiological diagnoses in a pediatric gyneco-obstetric hospital. A single center report

Introducción: La identificación de los microorganismos patógenos es un elemento clave la toma de decisiones clínicas y de formulación de estrategias para la prevención y control de los procesos infecciosos que aquejan a la población pediátrica. El objetivo del presente estudio fue realizar un perfil epidemiológico microbiológico en un hospital pediátrico de Quito-Ecuador. Métodos: Se trata de un estudio observacional retrospectivo de informes microbiológicos de niños atendidos en el Hospital Gineco-Obstétrico Pediátrico Luz Elena Arismendi de Quito entre enero y diciembre del año 2020. Resultados: Ingresaron al estudio 102 reportes de cultivos positivos de la población pediátrica. Enterococcus faecalis 16/102 casos (15.69%), Staphylococcus aureus 16/102 casos (15.69%), Escherichia coli 14/102 casos (13.72%), Klebsiella pneumonia 13/102 casos (12.75%), Staphylococcus epidermidis 13/102 casos (12.75%) explicaron la mayor prevalencia del grupo. Los meses de mayores reportes microbiólógicos fueron Junio y Noviembre. Fueron 51 hemocultivos positivos, 14 por Enterococcus faecalis, 10 por Staphylococcus aureus 10 casos, Diversas morfmorfologías coagulasa 9 casos. A nivel de líquido cefalorraquídeo fueron 11 reportes positivos con una prevalencia de Staphylococcus epidermidis en 7 casi y Staphylococcus aures en 4 casos. A nivel de urocultivos 12 casos fueron positivos, Escherichia coli 4 casos, Klebsiella oxytoca 3 casos y Klebsiella pneumoniae 3 casos. Conclusión: El presente reporte tiene similitudes con reportes latinoamericanos en prevalencia de Staphylococcus y Escherichia coli. Se requiere continuidad en ente reporte. No existieron casos multiresistentes

Introduction: The identification of pathogenic microorganisms is a key element in making clinical decisions and formulating strategies for the prevention and control of infectious processes that affect the pediatric population. The objective of the present study was to carry out a microbiological epidemiological profile in a pediatric hospital in Quito-Ecuador. Methods: This is a retrospective observational study of microbiological reports of children treated at the Luz Elena Arismendi Pediatric Gyneco-Obstetric Hospital in Quito between January and December 2020. Results: A total of 102 reports of positive cultures from the pediatric population were included in the study. Enterococcus faecalis 16/102 cases (15.69%), Staphylococcus aureus 16/102 cases (15.69%), Escherichia coli 14/102 cases (13.72%), Klebsiella pneumonia 13/102 cases (12.75%), and Staphylococcus epidermidis 13/102 cases (12.75%) explained the higher prevalence of the group. The months with the highest microbiological reports were June and November. There were 51 positive blood cultures, 14 for Enterococcus faecalis, 10 for Staphylococcus aureus, 10 cases, and 9 cases of various coagulase morphologies. At the level of cerebrospinal fluid, there were 11 positive reports with a prevalence of Staphylococcus epidermidis in almost 7 cases and Staphylococcus aureus in 4 cases. At the level of urine cultures, 12 cases were positive: Escherichia coli, 4 cases; Klebsiella oxytoca, 3 cases; and Klebsiella pneumoniae, 3 cases. Conclusion: This report has similarities with Latin American reports in the prevalence of Staphylococcus and Escherichia coli. Continuity is required in the entire report. There were no multi-resistant cases.

Raman Spectroscopy and Machine-Learning for Early Detection of Bacterial Canker of Tomato: The Asymptomatic Disease Condition.

Bacterial canker of tomato is caused by Clavibacter michiganensis subsp. michiganensis (Cmm). The disease is highly destructive, because it produces latent asymptomatic infections that favor contagion rates. The present research aims consisted on the implementation of Raman spectroscopy (RS) and machine-learning spectral analysis as a method for the early disease detection. Raman spectra were obtained from infected asymptomatic tomato plants (BCTo) and healthy controls (HTo) with 785 nm excitation laser micro-Raman spectrometer. Spectral data were normalized and processed by principal component analysis (PCA), then the classifiers algorithms multilayer perceptron (PCA + MLP) and linear discriminant analysis (PCA + LDA) were implemented. Bacterial isolation and identification (16S rRNA gene sequencing) were realized of each plant studied. The Raman spectra obtained from tomato leaf samples of HTo and BCTo exhibited peaks associated to cellular components, and the most prominent vibrational bands were assigned to carbohydrates, carotenoids, chlorophyll, and phenolic compounds. Biochemical changes were also detectable in the Raman spectral patterns. Raman bands associated with triterpenoids and flavonoids compounds can be considered as indicators of Cmm infection during the asymptomatic stage. RS is an efficient, fast and reliable technology to differentiate the tomato health condition (BCTo or HTo). The analytical method showed high performance values of sensitivity, specificity and accuracy, among others.

Geographic Object-Based Analysis of Airborne Multispectral Images for Health Assessment of Capsicum annuum L. Crops.

Vegetation health assessment by using airborne multispectral images throughout crop production cycles, among other precision agriculture technologies, is an important tool for modern agriculture practices. However, to really take advantage of crop fields imagery, specialized analysis techniques are needed. In this paper we present a geographic object-based image analysis (GEOBIA) approach to examine a set of very high resolution (VHR) multispectral images obtained by the use of small unmanned aerial vehicles (UAVs), to evaluate plant health states and to generate cropland maps for Capsicum annuum L. The scheme described here integrates machine learning methods with semi-automated training and validation, which allowed us to develop an algorithmic sequence for the evaluation of plant health conditions at individual sowing point clusters over an entire parcel. The features selected at the classification stages are based on phenotypic traits of plants with different health levels. Determination of areas without data dependencies for the algorithms employed allowed us to execute some of the calculations as parallel processes. Comparison with the standard normalized difference vegetation index (NDVI) and biological analyses were also performed. The classification obtained showed a precision level of about 95 % in discerning between vegetation and non-vegetation objects, and clustering efficiency ranging from 79 % to 89 % for the evaluation of different vegetation health categories, which makes our approach suitable for being incorporated at C. annuum crop's production systems, as well as to other similar crops. This methodology can be reproduced and adjusted as an on-the-go solution to get a georeferenced plant health estimation.

The Avocado Sunblotch Viroid: An Invisible Foe of Avocado.

This review collects information about the history of avocado and the economically important disease, avocado sunblotch, caused by the avocado sunblotch viroid (ASBVd). Sunblotch symptoms are variable, but the most common in fruits are irregular sunken areas of white, yellow, or reddish color. On severely affected fruits, the sunken areas may become necrotic. ASBVd (type species Avocado sunblotch viroid, family Avsunviroidae) replicates and accumulates in the chloroplast, and it is the smallest plant pathogen. This pathogen is a circular single-stranded RNA of 246-251 nucleotides. ASBVd has a restricted host range and only few plant species of the family Lauraceae have been confirmed experimentally as additional hosts. The most reliable method to detect ASBVd in the field is to identify symptomatic fruits, complemented in the laboratory with reliable and sensitive molecular techniques to identify infected but asymptomatic trees. This pathogen is widely distributed in most avocado-producing areas and causes significant reductions in yield and fruit quality. Infected asymptomatic trees play an important role in the epidemiology of this disease, and avocado nurseries need to be certified to ensure they provide pathogen-free avocado material. Although there is no cure for infected trees, sanitation practices may have a significant impact on avoiding the spread of this pathogen.