Blood Type Associated with the Risk of COVID-19 Infection in Pregnant Women.

COVID-19 forced us to investigate risk factors to provide the best medical attention, especially in vulnerable groups, such as pregnant patients. Studies in other populations have analyzed blood groups in relation to infection, complications, and death. The present study aimed to analyze the association of blood groups with the risk of infection and complications in pregnant women and newborns from the Mexican-Mestizo population. We studied 1906 individuals. Quantitative variables were analyzed through the Student's t-test. Categorical variables were analyzed through Pearson's chi-square test, and logistic regression was used to analyze the association between categorical variables and outcomes. No significant association was observed between blood groups and infection risk. Individuals with the AB blood type are at higher risk for developing severe disease, although blood groups do not seem to be involved in the risk of SARS-CoV-2 infection. However, the AB blood group could be considered a risk factor for developing severe COVID-19 in the Mexican population.

Can mask mandates boost nature-based tourism? The role of escapism and travel anxiety.

Tourism in a post-pandemic era will likely be oriented toward nature because contact with nature has restorative health benefits. The purpose of this study was to analyze the antecedents of tourists' intentions to visit nature-based resorts during a pandemic. A nationally representative sample of the Spanish population (n = 500) was recruited by an online commercial panel to test and empirically validate the proposed conceptual framework. The findings confirmed a direct relationship between negative perceptions of wearing face masks during the COVID-19 pandemic and tourists' intentions to visit nature-based resorts. The relationship between the perceived negative effects of wearing face masks and the intention to visit nature-based resorts was positively mediated by the need for escapism. This impact was less pronounced for anxious travelers, as shown by results corroborating the moderating effect of travel anxiety. The findings of this study contribute to research on tourism crises and provide future insights into the recovery of the industry during COVID-19.

Social media sites users' choice between utilitarian and informational reinforcers assessed using temporal discounting.

Objective: This study provides a first approach to the use of the Multiple-Choice Procedure in social media networks use, as well as empirical evidence for the application of the Behavioral Perspective Model to digital consumption behavior in young users in conjunction with a methodology based on behavioral economics. Participants/methods: The participants were part of a large university in Bogotá, Colombia, and they received an academic credit once they completed the online questionnaire. A total of 311 participants completed the experiment. Of the participants, 49% were men with a mean age of 20.6 years (SD = 3.10, Range = 15-30); 51% were women with a mean age of 20.2 years (SD = 2.84, Range = 15-29). Results: Among the total participants, 40% reported that they used social networks between 1 and 2 h a day, 38% between 2 and 3 h, 16% for 4 h or more, and the remaining 9% used them for 1 h or less per day. The factorial analysis of variance (ANOVA) allowed us to identify a statistically significant effect of the delay of the alternative reinforcer, that is, the average crossover points were higher when the monetary reinforcer was delayed 1 week, compared to the immediate delivery of the monetary reinforcer. There was no statistically significant effect of the interaction between the magnitude of the reinforcer and the delay time of the alternative reinforcer. Conclusions: This study supports the relative reinforcing value of an informational reinforcement consequence such as social media use, which is sensitive to both the magnitude of reinforcement and the delay in delivery as individual factors. The findings on reinforcer magnitude and delay effects are consistent with previous research that have applied behavioral economics to the study of non-substance-related addictions.

Influencer Worship and Self-Connection with the Promoted Brands on Social Media: Why Benign Envy and Trait Competitiveness Matter.

The objective of this study was to investigate the relationship between influencer worship and consumers' self-connection with the brands promoted by the influencer in social media contexts. Data from 698 active social media users who follow influencers were collected to test the conceptual framework. The findings support the positive link between influencer worship and consumers' self-connection with the brands promoted by the influencer on social media and suggest that this relationship is mediated by the activation of benign envy. The results also confirm the positive moderating effect of trait competitiveness on this relationship. Specifically, the effect is stronger for individuals with a higher level of competitive orientation. The findings contribute to the understanding of the relationship between influencers and their followers through computer-mediated environments. Theoretical contributions and managerial implications are presented.

Predicting COVID-19 Vaccination Intention: The Roles of Institutional Trust, Perceived Vaccine Safety, and Interdependent Self-Construal.

The purpose of this study is to explore the process through which institutional trust influences individuals' vaccination intentions for a coronavirus vaccine. We collected data from a national representative sample of the Spanish population (N = 500) from an online research panel to test the proposed conceptual model. Results revealed a positive association of institutional trust with coronavirus vaccination intentions. This effect was mediated by perceived vaccine safety and positive attitude toward the vaccine. Furthermore, findings corroborate the moderating effect of interdependent self-construal on the indirect relationship between institutional trust and vaccination intention, implying that this effect was stronger for individuals with higher levels of interdependent orientation. Findings have implications for the development of evidence-based health communication strategies for encouraging COVID-19 vaccination.

Association between 25-OH Vitamin D Deficiency and COVID-19 Severity in Pregnant Women.

Evidence from studies in the general population suggests an association between vitamin D insufficiency/deficiency and COVID-19 susceptibility and disease severity. The present study was performed on 165 third-trimester pregnant women at the time of delivery. Seventy-nine women tested negative for SARS-CoV-2. From 86 women testing positive, 32 were asymptomatic, 44 presented a mild form of the disease, and 10 experienced severe symptoms. Serum 25-OH vitamin D levels were measured on blood samples collected on admission. Low vitamin D levels were detected in symptomatic but not asymptomatic COVID-19 patients compared to healthy women (p = 0.0227). In addition, 20 (45.4%) pregnant women in the mild COVID-19 group and 6 (60%) in the severe group were vitamin D deficient (p = 0.030). On the other hand, lasso regression analysis showed that 25-OH vitamin D deficiency is an independent predictor of severe COVID-19 with an odds ratio (OR) of 5.81 (95% CI: 1.108-30.541; p = 0.037). These results show the relationship between vitamin D deficiency in pregnant women and the severity of COVID-19 infection and support the recommendation to supplement with vitamin D to avoid worse COVID-19 outcomes during pregnancy.

The effect of threat and fear of COVID-19 on booking intentions of full board hotels: The roles of perceived coping efficacy and present-hedonism orientation.

This study proposes a novel theoretical model on the negative effect of the perceived cognitive threat and fear of COVID-19 on full board hotel booking intentions, which includes the moderating effects of perceived coping efficacy and present-hedonism orientation. The model was tested with a representative online sample (N = 400) of the Spanish population older than 35 years. The results confirmed negative effects of threat and fear of COVID-19 on hotel booking intentions, as well as a negative moderating effect of perceived coping efficacy on the influence of fear of COVID-19. However, coping efficacy did not moderate the effect of perceived cognitive threat on hotel booking intentions. The present-hedonism orientation positively affected full board hotel booking intentions, but did not, however, reduce the negative effect of threat or fear on those intentions. The findings provide new insights for hospitality managers that can contribute to accelerate the recovery of the hospitality industry.

Melatonin Improves Levels of Zn and Cu in the Muscle of Diabetic Obese Rats.

Melatonin improves metabolic alterations associated with obesity and its diabetes (diabesity). We intend to determine whether this improvement is exerted by changing Zn and/or Cu tissue levels in liver, muscle, pancreas, and brain, and in internal (perirenal, perigonadal, and omentum) and subcutaneous lumbar white adipose tissues (IWAT and SWAT, respectively). Male Zücker diabetic fatty (ZDF) rats and lean littermates (ZL) were orally supplemented either with melatonin (10 mg/kg body weight/day) or vehicle for 6 weeks. Zn and Cu concentrations were not significantly influenced by diabesity in the analyzed tissues (p > 0.05), with the exception of Zn in liver. In skeletal muscle Zn and Cu, and in perirenal WAT, only Zn levels increased significantly with melatonin supplementation in ZDF rats (p < 0.05). This cytoplasmic Zn enhancement would be probably associated with the upregulation of several Zn influx membrane transporters (Zips) and could explain the amelioration in the glycaemia and insulinaemia by upregulating the Akt and downregulating the inhibitor PTP1B, in obese and diabetic conditions. Enhanced Zn and Cu levels in muscle cells could be related to the reported antioxidant melatonin activity exerted by increasing the Zn, Cu-SOD, and extracellular Cu-SOD activity. In conclusion, melatonin, by increasing the muscle levels of Zn and Cu, joined with our previously reported findings improves glycaemia, insulinaemia, and oxidative stress in this diabesity animal model.

COVID-19 Infection in Pregnancy: PCR Cycle Thresholds, Placental Pathology, and Perinatal Outcomes.

(1) This study aimed to evaluate characteristics, perinatal outcomes, and placental pathology of pregnant women with or without SARS-CoV-2 infection in the context of maternal PCR cycle threshold (CT) values. (2) This was a retrospective case-control study in a third-level health center in Mexico City with universal screening by RT-qPCR. The association of COVID-19 manifestations, preeclampsia, and preterm birth with maternal variables and CT values were assessed by logistic regression models and decision trees. (3) Accordingly, 828 and 298 women had a negative and positive test, respectively. Of those positive, only 2.6% of them presented mild to moderate symptoms. Clinical characteristics between both groups of women were similar. No associations between CT values were found for maternal features, such as pre-gestational BMI, age, and symptomatology. A significantly higher percentage of placental fibrinoid was seen with women with low CTs (<25; p < 0.01). Regarding perinatal outcomes, preeclampsia was found to be significantly associated with symptomatology but not with risk factors or CT values (p < 0.01, aOR = 14.72). Moreover, 88.9% of women diagnosed with COVID-19 at <35 gestational weeks and symptomatic developed preeclampsia. (4) The data support strong guidance for pregnancies with SARS-CoV-2 infection, in particular preeclampsia and placental pathology, which need further investigation.

Prevalence, clinical features, and outcomes of SARS-CoV-2 infection in pregnant women with or without mild/moderate symptoms: Results from universal screening in a tertiary care center in Mexico City, Mexico.

The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 [2-18] days vs. 2 [2-3] days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.

Prevalence of Depression, Anxiety, and Perceived Stress in Postpartum Mexican Women during the COVID-19 Lockdown.

The COVID-19 lockdown represents a new challenge for mental health researchers and clinical practitioners. This cross-sectional study aimed to investigate the prevalence of depression, anxiety, and perceived stress in postpartum Mexican women. The study included 293, 4-12-week postpartum women over the age of 18. The Edinburgh Postpartum Depression Scale (EPDS), Trait-State Trait Anxiety Inventory (T-STAI), and Ten Perceived Stress Scale (PSS-10), which are all questionnaires validated for the Mexican population, were applied using a web-based online survey. Prevalence and 95% confidence intervals (CIs) were calculated. The mean ± standard deviation (SD) of the maternal age was 29.9 ± 6.3 years; the EPDS score: 11 ± 6, T-STAI score: 41.7 ± 12.3, and PSS-10 score: 17.1 ± 7. The prevalence (95% CI) of the postpartum depression symptoms was 39.2% (34-45%), trait anxiety symptoms were found among 46.1% (32-43%) of the participants, and moderate and high perceived stress were in 58% (52-64) and 10.9% (7.8-15) of the participants, respectively. The prevalence of depressive symptoms, generalized anxiety, and perceived stress was higher among postpartum Mexican women during the COVID-19 outbreak than before the lockdown. Our findings highlight the importance of monitoring perinatal mental health during pandemics and the need to design effective psychologic interventions for these patients.

The impact of the COVID-19 pandemic on subjective mental well-being: The interplay of perceived threat, future anxiety and resilience.

The COVID-19 pandemic has potentially a serious impact on many people's mental well-being. This study analyses the influence of the perceived threat of COVID-19 on subjective mental well-being with an online survey (n = 711). Findings confirmed the hypothesized model that provides a process explanation for this effect through the mediating influence of the activation of future anxiety. In addition, results confirmed that this influence via future anxiety is moderated by resilience, a personality trait that enables individuals to cope better with stressful or traumatic events. Individuals with higher levels of resilience compared to those with lower levels registered a lower impact of perceived Covid threat on future anxiety and, in turn, on subjective well-being. This study contributes theoretically to a better understanding of the factors that determine the impact of traumatic events such as a pandemic on people's mental health. The implications of this study indicate interventions that may be carried out to minimize the pandemic's negative psychological consequences.

Isolation of Viable Adipocytes and Stromal Vascular Fraction from Human Visceral Adipose Tissue Suitable for RNA Analysis and Macrophage Phenotyping.

Visceral adipose tissue (VAT) is an active metabolic organ composed mainly of mature adipocytes and stromal vascular fraction (SVF) cells, which release different bioactive molecules that control metabolic, hormonal, and immune processes; currently, it is unclear how these processes are regulated within the adipose tissue. Therefore, the development of methods evaluating the contribution of each cell population to the pathophysiology of adipose tissue is crucial. This protocol describes the isolation steps and provides the necessary troubleshooting guidelines for efficient isolation of viable mature adipocytes and SVF from human VAT biopsies in a single process, using a collagenase enzymatic digestion technique. Moreover, the protocol is also optimized to identify macrophage subsets and perform mature adipocyte RNA isolation for gene expression studies, which allows performing studies dissecting the interaction between these cell populations. Briefly, VAT biopsies are washed, minced mechanically, and digested to generate a single-cell suspension. After centrifugation, mature adipocytes are isolated by flotation from the SVF pellet. The RNA extraction protocol ensures a high yield of total RNA (including miRNAs) from adipocytes for downstream expression assays. Simultaneously, SVF cells are used to characterize macrophage subsets (pro- and anti-inflammatory phenotype) through flow cytometry analysis.

Vitamin D Deficiency in Mexican Pregnant Women: Is Supplementation with ≤400 IU/day Enough?

Controversy remains surrounding vitamin D routine supplementation in healthy pregnancy, and the doses are unclear. The aim of this study was to describe maternal vitamin D status throughout pregnancy in a group of Mexican women and evaluate the effect of frequently prescribed doses of vitamin D3 on longitudinal 25-OH-D concentrations, adjusting for obesity, season, and other factors. We conducted a cohort study (Instituto Nacional de Perinatología-INPer) (2017-2020)) of healthy pregnant women without complications. Pregestational overweight/obesity (body mass index ≥ 25), vitamin D3 supplementation (prescribed by physician; 0-250, 250-400, and >400 IU/day), and serum 25-OH-D concentrations (ELISA) were evaluated in each trimester of pregnancy. Vitamin D deficiency or insufficiency was computed (<20 and <30 ng/mL, respectively). We studied 141 adult women; 58.5% had pregestational obesity or overweight. In the first trimester, 45.8% of the women were supplemented with vitamin D3; 51.4% had vitamin D insufficiency and 37.3%, deficiency. In the third trimester, 75.4% of the women were supplemented, and 20% of them still had deficiency. The final general mixed linear model showed that 25-OH-D significantly increased throughout pregnancy (p < 0.001); the highest increase was observed in the third trimester in women with doses >400 IU/day of vitamin D3 (+4 ng/mL, 95% CI: 1.72-8.11 ng/mL). In winter/autumn, 25-OH-D concentrations were also lower (p ≤ 0.05). In this group of pregnant Mexican women, the prevalence of vitamin D deficiency and insufficiency was high. A higher increase in 25-OH-D concentrations during pregnancy was observed when the women were supplemented with >400 IU/day. Common supplementation doses of 250-400 IU/day were insufficient for achieving an adequate maternal vitamin D status.

Expression of Membrane Progesterone Receptors in Eutopic and Ectopic Endometrium of Women with Endometriosis.

Endometriosis is one of the most frequent gynecological diseases in reproductive age women, but its etiology is not completely understood. Endometriosis is characterized by progesterone resistance, which has been explained in part by a decrease in the expression of the intracellular progesterone receptor in the ectopic endometrium. Progesterone action is also mediated by nongenomic mechanisms via membrane progesterone receptors (mPRs) that belong to the class II members of the progesterone and adipoQ receptor (PAQR) family. The aim of the present study was to evaluate the expression at mRNA and protein levels of mPR members in the eutopic and ectopic endometrium of women with endometriosis. Total RNA and total protein were isolated from control endometrium (17 samples), eutopic endometrium (17 samples), and ectopic endometrium (9 samples). The expression of PAQR7 (mPRα), PAQR8 (mPRß), and PAQR6 (mPRδ) at mRNA and protein levels was evaluated by RT-qPCR and Western blot, whereas PAQR5 (mPRγ) gene expression was evaluated by RT-qPCR. Statistical analysis between comparable groups was performed using one-way ANOVA followed by Tukey's multiple comparisons test with a confidence interval of 95 %. The analysis of gene expression showed that PAQR7 and PAQR5 expression was lower in both eutopic and ectopic endometrium as compared to the endometrium of women without endometriosis, whereas the expression of PAQR8 and PAQR6 was only reduced in eutopic endometrium. Furthermore, mPRα and mPRß protein content was decreased in the ectopic endometrium of women with endometriosis. Our results demonstrate a decrease in the expression and protein content of mPRs in eutopic and ectopic endometrium of patients with endometriosis, which could contribute to the progesterone resistance observed in patients with this disease.

Parameters of Oxidative Stress in Reproductive and Postmenopausal Mexican Women.

In the reproductive phase, women experience cyclic changes in the ovaries and uterus, and hormones regulate these changes. Menopause is the permanent loss of menstruation after 12 months of amenorrhea. Menopause is also linked to a decrease in estrogen production, causing an imbalance in oxidative stress. We aimed to compare the three stages of lipid peroxidation, protein oxidative damage, and total antioxidant capacity (TAC) between reproductive-aged women (RAW) and postmenopausal women (PMW) in Mexico. We carried out a cross-sectional study with 84 women from Mexico City, including 40 RAW and 44 PMW. To determine the oxidative stress of the participants, several markers of lipid damage were measured: dienes conjugates (DC), lipohydroperoxides (LHP), and malondialdehyde (MDA); exposure to protein carbonyl is indicative of oxidative modified proteins, and TAC is indicative of the antioxidant defense system. Biomarkers of oxidative stress were significantly lower in RAW vs. PMW. DC were 1.31 ± 0.65 vs. 1.7 ± 0.51 pmol DC/mg dry weight (p = 0.0032); LHP were 4.95 ± 2.20 vs. 11.30 ± 4.24 pmol LHP/mg dry weight (p < 0.0001); malondialdehyde was 20.37 ± 8.20 vs. 26.10 ± 8.71 pmol MDA/mg dry weight (p = 0.0030); exposure of protein carbonyl was 3954 ± 884 vs. 4552 ± 1445 pmol PC/mg protein (p = 0.042); and TAC was 7244 ± 1512 vs. 8099 ± 1931 pmol Trolox equivalent/mg protein (p = 0.027). PMW display significantly higher oxidative stress markers compared to RAW; likewise, PMW show a higher TAC.

Cáncer de vagina: reporte de un caso / Vaginal cancer: A case report

Vaginal cancer has a low incidence in the female population. We present the case of a 77-year-old woman who was admitted to the hospital due to postmenopausal vaginal bleeding and initial diagnosis of cancer of the uterine cervix. Vaginal biopsy was performed from an ulcerated exophytic 3 x 2 cm lesion in the superior third of the posterior vaginal wall. Pathology reported a poorly differentiated squamous cell carcinoma of the vagina. The surgical specimen showed an infiltrating, nonkeratinizing, moderately differentiated squamous cell carcinoma of the vagina. We present a case where similarity of symptomatology with cancer of the cervix may have led to a wrong diagnosis or management, due to the anatomical proximity of both tissues.

El cáncer de vagina tiene una baja incidencia en la población femenina. Una mujer de 77 años acudió al hospital con antecedentes de sangrado vaginal posmenopáusico y diagnóstico inicial de cáncer de cérvix. Se le realizó biopsia vaginal por lesión ulcerada exofítica de 3 x 2 cm en el tercio superior de la pared vaginal posterior, cuyo resultado patológico fue cáncer escamoso pobremente diferenciado de la vagina. La patología de la pieza operatoria mostró carcinoma de células escamosas, infiltrante, no queratinizante, medianamente diferenciado de vagina. Presentamos el caso, en el que pudo haber confusión en el diagnóstico y/o manejo por la similitud de la sintomatología con el cáncer de cuello uterino, debido a la localización anatómica y la proximidad de ambos tejidos.

Implementación de herramienta tecnológica (TIC) para la vigilancia de factores ambientales y posibles afecciones relacionadas a la exposición por uso de plaguicidas agrícolas en Paraguay / Implementation of a technological tool (TIC) for the monitoring of environmental factors and possible conditions related to exposure due to the use of agricultural pesticides in Paraguay

Introducción: Paraguay, con alto desarrollo de agricultura extensiva, es potencialmente vulnerable a situaciones relacionadas con manejo inadecuado, falta de prevención y riesgos para la salud individual, comunitaria y ambiental, por incumplimiento de buenas prácticas en la selección, manipulación y gestión de plaguicidas. Objetivo: Diseñar e implementar un método de vigilancia con carga de datos del sistema público para detectar, jerarquizar y mapear eventos relacionados al manejo inadecuado de plaguicidas; establecer posibles asociaciones con causas de morbilidad y mortalidad; y seguimiento para evaluar riesgos relativos. Métodos: Con la creación del Sistema de Información Georreferenciado de Evaluación de Casos de afecciones a la Salud (SIGEC), método web que recolecta información del monitoreo comunitario de manejo y posibles efectos de plaguicidas en pequeños productores y empresas agrícolas, y de parcelas de plantaciones en el territorio nacional, se realizó un estudio de vigilancia epidemiológica sobre condiciones de vida, variables ambientales y riesgo de exposición a plaguicidas. Resultados: Al relacionar datos del egreso hospitalario de enfermedades trazadoras (EH) 2011 - 2015, en mapas por Departamentos, Regiones del Estudio Piloto y por Distritos, se observó una concentración de las mismas en 3 a 4 regiones relacionadas al uso de plaguicidas, repitiéndose dicha situación en patologías con concentraciones altas (color rojo) o intermedias (color amarillo), con posible asociación casual o causal. Los demás distritos de estas regiones observadas que se encuentran coloreadas de verde, no implica ausencia de casos registrados, sino que se encuentran en el tercio inferior del total registrado (tabla a la izquierda de los mapas). La poligonización valora el grado de exposición de personas en riesgo y brinda georreferenciamiento de las variables del Monitoreo Comunitario, además permite seguimiento mediante gráficos de puntos, útiles para los tomadores de decisiones en salud. Las herramientas propuestas son amigables y similares a las del Censo Comunitario realizado por estadígrafos regionales en las USF. Conclusiones: La vigilancia epidemiológica basada en el SIGEC complementa la visión parcial de los actuales sistemas de seguimiento del MSP y BS mediante la información en gráficos georreferenciados, visualiza datos del problema de salud planteado, en un territorio específico, utiliza variables ambientales y laborales con posible relación a exposición de plaguicidas, en formato de lectura fácil, convirtiéndola en herramienta útil para el posterior seguimiento a través de investigaciones con diseño pertinente, utilizando modelos estadísticos apropiados, para la posterior aplicación de políticas públicas. Palabras-clave: Exposición a plaguicidas; vigilancia del ambiente del trabajo; monitoreo epidemiológico; programas informáticos

Introduction: Paraguay, with high development of extensive agriculture, is potentially vulnerable to situations related to inadequate management, lack of prevention and risks to individual, community and environmental health, due to non-compliance with good practices in the selection, handling and management of pesticides. Objective: Design and implement a surveillance method with data loading of the public system to detect, prioritize and map events related to the inadequate handling of pesticides; establish possible associations with causes of morbidity and mortality; and monitoring to assess relative risks. Methods: With the creation of the Georeferenced Information System for the Evaluation of Cases of Health Conditions (SIGEC), a web method that collects information on community monitoring of management and possible effects of pesticides on small producers and agricultural companies, and on plantation plots In the national territory, an epidemiological surveillance study was conducted on life conditions, environmental variables and risk of exposure to pesticides. Results: When relating hospital discharge data of tracer diseases (EH) 2011 - 2015, in maps by Departments, Regions of the Pilot Study and by Districts, a concentration of them was observed in 3 to 4 regions related to the use of pesticides, repeating this situation in pathologies with high concentrations (red color) or intermediate (yellow color), with possible causal or casual association. The other districts of these observed regions that are colored green, does not imply absence of registered cases, but they are in the lower third of the total registered (table on the left of the maps). Poligonization assesses the degree of exposure of people at risk and provides georeferencing of the Community Monitoring variables, and also allows monitoring through point charts, useful for health decision-makers. The proposed tools are friendly and similar to those of the Community Census conducted by regional statisticians at the USF. Conclusions: The epidemiological surveillance based on the SIGEC complements the partial vision of the current monitoring systems of the MSP and BS through the information in georeferenced graphs, visualizes data of the health problem raised, in a specific territory, uses environmental and labor variables with possible relation to exposure of pesticides, in easy reading format, making it a useful tool for subsequent monitoring through relevant design investigations, using appropriate statistical models, for the subsequent application of public policies. Key words: Exposure to pesticides; monitoring of the work environment; epidemiological monitoring; Software

Monitoreo comunitario para la vigilancia de exposición al uso de plaguicidas en Paraguay, Año 2018 / Community monitoring for the surveillance of exposure to the use of pesticides in Paraguay 2018

Dentro del Proyecto CONACYT "Construyendo estándares socioambientales y de salud pública con el sector primario para incremento de la competitividad en los mercados PIN15-1103. CONACYT/ALTER VIDA" se aplicó un Cuestionario de Monitoreo Comunitario para la exposición y posibles impactos a la salud por el uso de plaguicidas; el objetivo de este artículo es validar el cuestionario de monitoreo comunitario y presentar los datos del trabajo de campo. El diseño del estudio fue observacional y descriptivo, se tomaron dos comunidades dedicadas a la producción agrícola, una en Caaguazú y otra en San Pedro. El muestro fue no probabilístico por bola de nieve comprendiendo a aquellos expuestos a plaguicidas en ambos distritos seleccionados, con una distancia máxima 1 kilómetro a los cultivos o plantaciones. Las variables analizadas incluyeron datos de filiación, uso y exposición de los agroquímicos, uso de equipos de protección individual, gestión de los residuos de plaguicidas, capacitación, salud. También se aplicó el alfa de Cronbach para estudiar la confiabilidad del instrumento. Todos los análisis fueron hechos con SPSS 25. Como conclusión, se ha detectado que la gestión en el uso de los agroquímicos en la población analizada debe ser reforzada en varios ejes, desde la capacitación, gestión en el uso, la disposición final, entre otras. El instrumento tiene buena consistencia y fiabilidad interna. Palabras clave: exposición ocupacional a agroquímicos, impactos a la salud, Paraguay.

Within the CONACYT Project "Building socio-environmental and public health standards with the primary sector to increase competitiveness in the markets PIN15-1103.CONACYT/ALTER VIDA" a Community Monitoring Questionnaire was applied for the exhibition and possible impacts on health for the use of pesticides, the objective of this article is to validate the community monitoring questionnaire and present the data of the field work. The design of the study was observational and descriptive, taking two communities dedicated to agricultural production, one in Caaguazú and the other in San Pedro. The sampling was not probabilistic by snowball comprising those exposed to pesticides in both selected districts, with a maximum distance of 1 kilometre to crops or plantations. The variables analyzed include filiation's data, use and exposure of agrochemicals, use of personal protection equipment, and management of pesticide residues, training, and health. Cronbach's alpha was also applied to study the reliability of the instrument. All analyzes were done with SPSS 25. In conclusion, it has been detected that the management in the use of agrochemicals in the analyzed population must be reinforced in several areas, from training, management in use, final disposal, among others. The instrument has good internal consistency. Key words: occupational exposure to agrochemicals; health impacts; Paraguay

Macrophage Populations in Visceral Adipose Tissue from Pregnant Women: Potential Role of Obesity in Maternal Inflammation.

Obesity is associated with inflammatory changes and accumulation and phenotype polarization of adipose tissue macrophages (ATMs). Obese pregnant women have alterations in adipose tissue composition, but a detailed description of macrophage population is not available. In this study, we characterized macrophage populations in visceral adipose tissue (VAT) from pregnant women with normal, overweight, and obese pregestational weight. Immunophenotyping of macrophages from VAT biopsies was performed by flow cytometry using CD45 and CD14 as markers of hematopoietic and monocyte linage, respectively, while HLA-DR, CD11c, CD163, and CD206 were used as pro- and anti-inflammatory markers. Adipocyte number and size were evaluated by light microscopy. The results show that pregnant women that were overweight and obese during the pregestational period had adipocyte hypertrophy. Two different macrophage populations in VAT were identified: recruited macrophages (CD45⁺CD14⁺), and a novel population lacking CD45, which was considered to be a resident macrophages subset (CD45−CD14⁺). The number of resident HLA−DRlow/− macrophages showed a negative correlation with body mass index (BMI). Both resident and recruited macrophages from obese women expressed higher CD206 levels. CD11c expression was higher in resident HLA-DR⁺ macrophages from obese women. A strong correlation between CD206 and CD11c markers and BMI was observed. Our findings show that being overweight and obese in the pregestational period is associated with adipocyte hypertrophy and specific ATMs populations in VAT.