Physicochemical treatments for the reduction of aflatoxins and Aspergillus niger in corn grains (Zea mays).

BACKGROUND: Corn grains are commonly contaminated with mycotoxins and fungi. The purpose of this study was to evaluate the reduction of aflatoxins B1 , B2 , G1 , and G2 and the inhibition of Aspergillus niger in corn grains using ultrasound, ultraviolet (UV) radiation, electrolyzed water, and sodium bicarbonate. The determination of aflatoxins was performed by high-performance liquid chromatography with fluorescence detection and postcolumn derivatization, and analysis of A. niger was performed by evaluating mycelial growth in potato dextrose agar. The best treatment for reducing aflatoxins and inhibiting mycelial growth was evaluated in corn contaminated with A. niger. RESULTS: The results show a significant reduction in aflatoxins in the following order: sodium bicarbonate > ultrasound > UV > electrolyzed water for aflatoxins B1 , B2 , and G2 . For aflatoxin G1 , the order of reduction was sodium bicarbonate > ultrasound > electrolyzed water > UV, with maximum values between 70.50% and 87.03% reached with sodium bicarbonate; for the other treatments, the reduction was between 51.51% and 65.44%. Regarding the fungus, the order of inhibition in the control of mycelial growth was sodium bicarbonate > ultrasound > electrolyzed water > UV in corn grains, and inhibition of mycelial growth was obtained at a sodium bicarbonate concentration of 3.0 g L-1 . CONCLUSION: Sodium bicarbonate, electrolyzed water, ultrasound, and UV radiation inhibited the growth of A. niger on potato dextrose agar and reduced the contents of aflatoxins B1 , B2 , G1 , and G2 in vitro. Sodium bicarbonate showed an ability to inhibit mycelial growth in corn grains. © 2020 Society of Chemical Industry.

Toxicity induced by multiple high doses of vitamin B12 during pernicious anemia treatment: a case report.

Context: The clinical consequences of excess vitamin B12 induced by multiple oral doses of cyanocobalamin are not well-known.Case details: A young woman was treated with multiple daily doses of 1 mg of cyanocobalamin for severe pernicious anemia. After a total dose of 12 mg, she developed acne, palpitations, anxiety, akathisia, facial ruddiness, headache, and insomnia. She improved two weeks after stopping the drug. There were no sequelae nor complications.Discussion: Although these symptoms of cobalamin toxicity were unexpected and unusual, the case reminds us that the administration of any drug is not entirely safe.

Imagen corporal (IC) y estrategias de afrontamiento (EA): Análisis de las características médico quirúrgicas en mujeres con diagnóstico de cáncer de mama / Body image (BI) and coping strategies (CS): Analysis of medical and surgical characteristics in women diagnosed with breast cancer

Resumen A partir de un diseño No-experimental transversal, se buscó identificar la posible relación entre la IC y las EA, y sus diferencias según variables médico quirúrgicas (intervención quirúrgica, tiempo de diagnóstico y estadio del cáncer). Participaron treinta y siete mujeres diagnosticadas con cáncer de mama de todos los estadios. Se usó el Cuestionario de Afrontamiento al Estrés para Pacientes Oncológicos (CAEPO), la Escala de Imagen Corporal (BIS) y un cuestionario Ad-hoc. No se encontró relación entre la IC y las EA, y éstas no varían según la intervención quirúrgica (mastectomía radical y cirugía conservadora), el tiempo de diagnóstico en años (menos de 1, entre 1 y 3, entre 3 y 5, y más de 5), o el estadio (0 o in situ, I, II, III y IV); sin embargo, las pacientes que no recibieron intervención quirúrgica evidenciaron mayor deterioro de su IC que aquellas que sí lo hicieron.

Abstract From a non-experimental transverse design, we sought to identify the possible relationship between BI and CS, and their differences according to surgical-medical variables (surgical intervention, time of diagnosis and stage of cancer). Thirty-seven women diagnosed with breast cancer from all stages participated. The Stress Coping Questionnaire for Oncological Patients (CAEPO), the Body Image Scale (BIS) and an Ad-hoc questionnaire were used. No relationship was found between BI and CS, and these did not vary according to the surgical procedure (radical mastectomy and conservative surgery), the time of diagnosis in years (less than 1, between 1 and 3, between 3 and 5, and more of 5), or the stage (0 or in situ, I, II, III and IV); however, the patients who did not receive surgical intervention showed greater deterioration of their BI than those who did.

Effect of the type and number of washes in the efficacy of long lasting insecticidal nets for Aedes aegypti control in Girardot, Colombia.

INTRODUCTION: The use of long lasting insecticidal materials has shown promising results in the control of Aedes aegypti. OBJECTIVE: To evaluate the efficacy of long-lasting insecticidal nets (PermaNet®) for Aedes aegypti control after three washing treatments in the city of Girardot, Colombia. MATERIALS AND METHODS: Standard bioassays were conducted with the nets following the World Health Organization protocols using wild A. aegypti after three washing treatments: (1) Detergent powder, (2) detergent powder and bleach, and (3) bar soap, until completing 20 washes. RESULTS: The type and number of wash treatments had a significant effect on net efficacy. Greater effects in the insecticide bioavailability were seen for the bar soap treatment. After six washes, mortality decreased by 50% (25/50), vs 66% (33/50) for the detergent powder and 84% (42/50) for the detergent powder and bleach treatments. Regarding the number of washes, the bar soap treatment reduced the efficacy to 68% after only three washes. CONCLUSION: The effectiveness of long-lasting insecticidal nets (PermaNet 2.0) for A. aegypti control varied in relation to the treatment and number of washes. The bar soap treatment resulted in the greatest reduction of mortality. Further studies on insecticidal reductions are needed under local conditions.

Efecto del tipo y del número de lavados en la eficacia de mosquiteros tratados con deltametrina de larga duración para el control de Aedes aegypti en Girardot, Colombia / Effect of the type and number of washes in the efficacy of long lasting insecticidal nets for Aedes aegypti control in Girardot, Colombia

Resumen Introducción. El uso de mosquiteros tratados con insecticida en fórmulas de larga duración ha demostrado resultados prometedores en el control de Aedes aegypti. Objetivo. Evaluar la eficacia de mosquiteros impregnados con deltametrina en una fórmula de larga duración para el control de A. aegypti en Girardot, Colombia, después de tres lavados. Materiales y métodos. Se hicieron bioensayos de eficacia de los mosquiteros contra A. aegypti silvestres después de utilizar los siguientes tres productos de lavado, siguiendo la metodología de la Organización Mundial de la Salud: detergente en polvo, detergente en polvo y blanqueador, y jabón de barra, todos utilizados hasta en 20 lavados. Resultados. El tipo de producto de lavado y el número de lavados afectaron significativamente la eficacia de los mosquiteros impregnados con deltametrina. El lavado con jabón de barra presentó el mayor efecto, pues en tan solo seis lavados la mortalidad bajó a 50 % (25/50), en contraste con 66 % (33/50 de mortalidad después del lavado con detergente en polvo y de 84 % (42/50) después del lavado con detergente y blanqueador. En cuanto al número de lavados, el jabón en barra también causó una mayor reducción de la eficacia: a 68 % con solo tres lavados. Conclusión. La eficacia de los mosquiteros impregnados con deltametrina de larga duración en el control de A. aegypti varió con el tipo de producto de lavado y el número de lavados, siendo el jabón en barra el que redujo su eficacia en mayor medida. Se requieren nuevos estudios para establecer la disminución en la concentración del insecticida entre lavados.

Abstract Introduction: The use of long lasting insecticidal materials has shown promising results in the control of Aedes aegypti. Objective: To evaluate the efficacy of long-lasting insecticidal nets (PermaNet®) for Aedes aegypti control after three washing treatments in the city of Girardot, Colombia. Materials and methods: Standard bioassays were conducted with the nets following the World Health Organization protocols using wild A. aegypti after three washing treatments: (1) Detergent powder, (2)detergent powder and bleach, and (3) bar soap, until completing 20 washes. Results: The type and number of wash treatments had a significant effect on net efficacy. Greater effects in the insecticide bioavailability were seen for the bar soap treatment. After six washes, mortality decreased by 50% (25/50), vs 66% (33/50) for the detergent powder and 84% (42/50) for the detergent powder and bleach treatments. Regarding the number of washes, the bar soap treatment reduced the efficacy to 68% after only three washes. Conclusion: The effectiveness of long-lasting insecticidal nets (PermaNet 2.0) for A. aegypti control varied in relation to the treatment and number of washes. The bar soap treatment resulted in the greatest reduction of mortality. Further studies on insecticidal reductions are needed under local conditions.

One-day workshop-based training improves physical activity prescription knowledge in Latin American physicians: a pre-test post-test study.

BACKGROUND: The physical inactivity pandemic and related non-communicable diseases have made it imperative for medical doctors (MDs) to effectively provide lifestyle counseling as part of prevention and treatment plans for patients. A one-day certification workshop was designed to improve MDs PA prescription knowledge, as part of the Exercise is Medicine® (EIM®) global health initiative. The objective was to determine knowledge gain of MDs participating in a standardized, one-day PA prescription workshop performed throughout Latin America (LA). METHODS: A 20-question multiple-choice test on PA topics, based on international guidelines, was completed before and after the workshop. Pre and post-test analyses, without a control group, were performed on 1044 MDs after the 8-h workshop that was delivered 41 times across 12 LA countries, from January 2014 to January 2015. Knowledge improvement was determined using the class-average normalized gain and individual relative gain. T-tests with 95% confidence interval levels were conducted to analyze differences between MD specialties. RESULTS: Test scores improved on average from 67 to 82% after the workshop (p <0.001). The average total individual relative gain was 29% [CI: 26 to 32%]. Relative gain by country ranged from 9.3% [CI: 2 to 16%; Nicaragua] to 73% [CI: 47 to 98%; Dominican Republic]. The mean of the 41 workshops' class-average normalized gain was 46% [CI: 42 to 51%]. The largest groups of participants were general practitioners (GPs) (33%; n = 348), internal medicine (19%; n = 194), and family medicine (9%n = 92) specialists. Relative gain for GPs was not different than for all grouped primary care specialties (30% vs. 27%, p =0.48). The knowledge gain was higher for the workshop modules on screening/risk stratification and prescription (43% [CI: 39-48%] and 38% [CI: 34-42%], than for the module on PA benefits and risks (26% [CI: 23-28%]). CONCLUSION: This one-day workshop had a positive impact on the knowledge gain of MD's on the topic of PA prescription. Although all groups of specialties increased knowledge, GPs and family medicine MDs benefited the most. This short course is an effective continuing education strategy for teaching PA assessment, counseling and prescription to MDs in Latin America, a topic rarely included in the training of MD's in the region and the world. Further follow-up is needed to ascertain impact on PA counseling practices.

Innovative dengue vector control interventions in Latin America: what do they cost?

BACKGROUND: Five studies were conducted in Fortaleza (Brazil), Girardot (Colombia), Machala (Ecuador), Acapulco (Mexico), and Salto (Uruguay) to assess dengue vector control interventions tailored to the context. The studies involved the community explicitly in the implementation, and focused on the most productive breeding places for Aedes aegypti. This article reports the cost analysis of these interventions. METHODS: We conducted the costing from the perspective of the vector control program. We collected data on quantities and unit costs of the resources used to deliver the interventions. Comparable information was requested for the routine activities. Cost items were classified, analyzed descriptively, and aggregated to calculate total costs, costs per house reached, and incremental costs. RESULTS: Cost per house of the interventions were $18.89 (Fortaleza), $21.86 (Girardot), $30.61 (Machala), $39.47 (Acapulco), and $6.98 (Salto). Intervention components that focused mainly on changes to the established vector control programs seem affordable; cost savings were identified in Salto (-21%) and the clean patio component in Machala (-12%). An incremental cost of 10% was estimated in Fortaleza. On the other hand, there were also completely new components that would require sizeable financial efforts (installing insecticide-treated nets in Girardot and Acapulco costs $16.97 and $24.96 per house, respectively). CONCLUSIONS: The interventions are promising, seem affordable and may improve the cost profile of the established vector control programs. The costs of the new components could be considerable, and should be assessed in relation to the benefits in reduced dengue burden.

Perfil de resistencia a antibióticos en bacterias que presentan la enzima NDM-1 y sus mecanismos asociados: una revisión sistemática / A profile of resistance in bacteria and the mechanisms associated due to the presence of the enzyme NDM-1: a systematic review

En 2008 se reportó la enzima NDM-1 que genera resistencia a carbapenémicos. Para determinar el perfil de resistencia que presentan las bacterias frente a esta enzima se adelantó una revisión sistemática. La búsqueda de artículos se realizó en diferentes bases de datos y para su selección se consideraron criterios de inclusión y exclusión obteniendo un total de 154 artículos. Se identificaron 617 casos, presentados en trece géneros bacterianos, que codifican para los cuatro mecanismos de resistencia, principalmente a betalactámicos y aminoglucósidos. Cuando se presenta la enzima, la posibilidad que haya genes asociados para la producción de resistencias es alta, generando así que se presenten mecanismos que evitan la acción del antibiótico haciendo difícil implementar un tratamiento efectivo.

In 2008 the NDM-1 enzyme was first reported, the enzyme responsible for the resistance to carbapenems. We conducted a systematic review to determine the resistance profile due to the presence of this enzyme in bacteria. We searched academic articles in principal databases resulting in the selection of 154 articles given our inclusion and exclusion criteria. 617 cases and 13 bacterial genera were reported in our sample. We find 4 resistance mechanisms which are principally resistant to beta-lactams and aminoglycosides. Hence, we have that the presence of the NDM-1 increases the likelihood of having genes that improves the bacteria's resistance dramatically. The presence of the NDM-1 induces mechanisms which impacts the effectiveness of antibiotics and appropriate treatments are difficult to find.

Understanding Water Storage Practices of Urban Residents of an Endemic Dengue Area in Colombia: Perceptions, Rationale and Socio-Demographic Characteristics.

INTRODUCTION: The main preventive measure against dengue virus transmission is often based on actions to control Ae. Aegypti reproduction by targeting water containers of clean and stagnant water. Household water storage has received special attention in prevention strategies but the evidence about the rationale of this human practice is limited. The objective was to identify and describe water storage practices among residents of an urban area in Colombia (Girardot) and its association with reported perceptions, rationales and socio-demographic characteristics with a mixed methods approach. METHODS: Knowledge, attitudes and practices and entomological surveys from 1,721 households and 26 semi-structured interviews were conducted among residents of Girardot and technicians of the local vector borne disease program. A multivariate analysis was performed to identify associations between a water storage practice and socio-demographic characteristics, and knowledge, attitudes and practices about dengue and immature forms of the vector, which were then triangulated with qualitative information. RESULTS: Water storage is a cultural practice in Girardot. There are two main reasons for storage: The scarcity concern based on a long history of shortages of water in the region and the perception of high prices in water rates, contrary to what was reported by the local water company. The practice of water storage was associated with being a housewife (Inverse OR: 2.6, 95% CI 1.5 -4.3). The use of stored water depends on the type of container used, while water stored in alberca (Intra household cement basins) is mainly used for domestic cleaning chores, water in plastic containers is used for cooking. CONCLUSIONS: It is essential to understand social practices that can increase or reduce the number of breeding sites of Ae. Aegypti. Identification of individuals who store water and the rationale of such storage allow a better understanding of the social dynamics that lead to water accumulation.

Effectiveness and feasibility of long-lasting insecticide-treated curtains and water container covers for dengue vector control in Colombia: a cluster randomised trial.

BACKGROUND: Long-lasting insecticide-treated net (LLIN) window and door curtains alone or in combination with LLIN water container covers were analysed regarding effectiveness in reducing dengue vector density, and feasibility of the intervention. METHODS: A cluster randomised trial was conducted in an urban area of Colombia comparing 10 randomly selected control and 10 intervention clusters. In control clusters, routine vector control activities were performed. The intervention delivered first, LLIN curtains (from July to August 2013) and secondly, water container covers (from October to March 2014). Cross-sectional entomological surveys were carried out at baseline (February 2013 to June 2013), 9 weeks after the first intervention (August to October 2013), and 4-6 weeks after the second intervention (March to April 2014). RESULTS: Curtains were installed in 922 households and water container covers in 303 households. The Breteau index (BI) fell from 14 to 6 in the intervention group and from 8 to 5 in the control group. The additional intervention with LLIN covers for water containers showed a significant reduction in pupae per person index (PPI) (p=0.01). In the intervention group, the PPI index showed a clear decline of 71% compared with 25% in the control group. Costs were high but options for cost savings were identified. CONCLUSIONS: Short term impact evaluation indicates that the intervention package can reduce dengue vector density but sustained effect will depend on multiple factors.

A propósito de un caso de psicosis temprana: un nuevo paradigma en salud mental / About a case of early psychosis: a new paradigm in mental health

La intervención precoz en las fases tempranas de las psicosis ha adquirido una creciente relevancia en los últimos años debido a sus potenciales implicaciones sobre la clínica y la evolución de la enfermedad. Es conocido que tras un primer episodio psicótico hay un "periodo crítico" que se extiende a los cinco años siguientes, siendo esta una fase de alta vulnerabilidad. El abordaje integral e intensivo durante este periodo tiene como finalidad optimizar el proceso de recuperación ayudando al paciente y a su familia a reconstruir sus vidas y evitar recadas. A continuación exponemos la gestión de un caso en un reciente programa de "intervención precoz en psicosis" implementado en nuestra unidad de rehabilitación(AU)

Early intervention in the early phases of psychosis has become increasingly relevant in recent years because of their potential clinical implications for the evolution of the disease. It is known that after a first psychotic episode is a "critical period" that extends to five years, this being a period of high vulnerability. Comprehensive and intensive approach during this period aims at optimizing the recovery process by helping the patient and his family rebuild their lives and prevent relapse. Below are the management of a case in a recent program of "early intervention in psychosis" implemented in our rehabilitation unit(AU)