Large-scale releases and establishment of wMel Wolbachia in Aedes aegypti mosquitoes throughout the Cities of Bello, Medellín and Itagüí, Colombia.

BACKGROUND: The wMel strain of Wolbachia has been successfully introduced into Aedes aegypti mosquitoes and has been shown to reduce the transmission of dengue and other Aedes-borne viruses. Here we report the entomological results from phased, large-scale releases of Wolbachia infected Ae. aegypti mosquitoes throughout three contiguous cities located in the Aburrá Valley, Colombia. METHODOLOGY/PRINCIPAL FINDINGS: Local wMel Wolbachia-infected Ae. aegypti mosquitoes were generated and then released in an initial release pilot area in 2015-2016, which resulted in the establishment of Wolbachia in the local mosquito populations. Subsequent large-scale releases, mainly involving vehicle-based releases of adult mosquitoes along publicly accessible roads and streets, were undertaken across 29 comunas throughout Bello, Medellín and Itagüí Colombia between 2017-2022. In 9 comunas these were supplemented by egg releases that were undertaken by staff or community members. By the most recent monitoring, Wolbachia was found to be stable and established at consistent levels in local mosquito populations (>60% prevalence) in the majority (67%) of areas. CONCLUSION: These results, from the largest contiguous releases of wMel Wolbachia mosquitoes to date, highlight the operational feasibility of implementing the method in large urban settings. Based on results from previous studies, we expect that Wolbachia establishment will be sustained long term. Ongoing monitoring will confirm Wolbachia persistence in local mosquito populations and track its establishment in the remaining areas.

Terapia complementaria en diarrea aguda / Complementary therapy in acute diarrhea

El tratamiento complementario en la diarrea aguda está dirigido a disminuir el número de deposiciones y aumentar la consistencia de las mismas. Dentro de este grupo se incluyen los antidiarreicos, que comprenden a los absorbentes, cuyo mecanismo de acción es absorber toxinas, microorganismos e incrementar el volumen de las heces (no todos recomendados), los que afectan la motilidad (contraindicados en pediatría) y el antihipersecretor (bloquean el 2do. mensajero, sin afectar la motilidad). Otro grupo de medicamentos son los antieméticos, que se emplean bajo supervisión y una vez corregido el desequilibrio hidroelectrolítico. Los prebióticos no han demostrado efectividad, por lo que no se recomiendan; los probióticos, que incluyen una amplia variedad de microorganismos, con utilidad demostrada, cuya respuesta es dependiente de la cepa y la dosis. Por último, la vitamina A y el zinc, respaldados por OMS/UNICEF en la estrategia de prevención y tratamiento de la diarrea aguda.

Complementary treatment in acute diarrhea is directed to reduce number and increase consistency of stools. This group of drugs include absorbents, whose mechanism of action is the absorption of toxins, drugs that affect motility and are contraindicated in pediatrics , and antihipersecretory drugs which block the second messenger, without affecting motility. Other groups of drugs are those called antiemetic which are recommended under a supervision and after hydroelectrolitric imbalance is corrected. No utility has been demonstrated for prebiotics. Probiotics, including a great number of microorganisms, have shown species and dose dependent utility. Vitamin A and zinc are recommended by the WHO/UNICEF in prevention and treatment of acute diarrhea.

Adding pregabalin to a multimodal analgesic regimen does not reduce pain scores following cosmetic surgery: a randomized trial.

PURPOSE: Multimodal analgesia increases the chance of successful discharge and pain control after surgery, and pregabalin is being promoted as an effective analgesic, based on placebo-controlled studies. We investigated whether adding pregabalin improved pain control and reduced opioid requests when it was added to a multimodal analgesic regimen for cosmetic surgery. METHODS: One hundred and ten women who underwent same-day cosmetic surgery were randomized to receive oral pregabalin, 75 mg q12 h for five consecutive days starting the night before surgery, or identical placebos. Participants, outcomes assessors, and the statistician were blinded. The primary outcome was postoperative numerical movement-evoked pain scores at 2, 24, 48, 72, and 96 h after surgery. The secondary outcomes included pain scores at rest; incidence of moderate to severe pain; and analgesic and antiemetic requirements; as well as the incidence of nausea, vomiting, and somnolence. RESULTS: Based on 99 patients who completed the study, we found no difference between the groups in the primary outcome; 72 h after surgery, movement-evoked median pain scores were <4/10 in both groups. We found no differences in opioid requirements (p = 0.95) or anti-inflammatory requirements (p = 0.45), and no difference in opioid-related adverse events. CONCLUSION: Perioperative pregabalin 75 mg twice a day does not increase benefit when it is added to an already multimodal analgesic regimen for patients undergoing cosmetic surgery. Several factors could explain our findings, including the possibility of publication bias in the current literature.

Emponzoñamiento escorpiónico: clínica y laboratorio usando antivenina / Scorpionid poisoning: clinic and laboratory using antivenins

Se trata de demostrar el efecto estimulador de la Tytuystoxina sobre el Sistema Nervioso Autónomo: fase colinérgica y adrenérgica. Determinar cambios en Amilasas, Glicemia y Fórmulas Blanca en fase aguda. Relacionar las variables anteriores con el del suero antiescorpiónico. Se tomaron pacientes pediátricos de ambos sexos con Emponzoñamiento Escorpiónico en áreas adyacentes al Hospital Victorino Santaella Ruíz, incluyéndose todos con signos y síntomas colinérgicos y catecolinérgicos, con un período no mayor de ocho (8) horas antes del emponzoñamiento y su ingreso a la emergencia. Se excluyeron emponzoñamientos tratados con simpaticomiméticos o cardiopatía previa. Se determinaron Amilasas, Glicemias y Fórmula Blanca al ingreso y a las ocho (8) horas. Se administró suero antiescorpiónico elaborado en la Universidad Central de Venezuela (UCV) a pacientes con clínica moderada y grave. Se obtuvo desaparición de la sintomatología en las primeras ocho (8) horas post-emponzoñamiento en un 95 por ciento de los pacientes correlacionándose los signos y síntomas con las modificaciones en los parámetros de laboratorio: Hipoglicemia. Amilasemia y Leucocitosis en fase aguda