PPE59 antibodies in tuberculous patients and potential use for diagnosis when assayed with other rapid biomarkers

BACKGROUND PPE 59, which is absent from bacillus Calmette Guérin (BCG) strains, seems to induce a humoral immune response in patients with tuberculosis (TB). Additional studies are needed to better evaluate this protein in immune response to tuberculosis. OBJECTIVES To evaluate the response of antibodies to PPE59 in TB individuals, its combination with IgG response to other, previously tested mycobacterial antigens (Ag) and with sputum smear microbiology (SM) results. METHODS We have cloned and expressed the rv3429 gene that encodes PPE59, then IgG, IgM, and IgA against PPE59 antigens measured by enzyme-linked immunosorbent assay (ELISA) in 212 sera samples obtained from the following subject cohorts: TB residents from Italy (79) and in Brazil (52); and an all-Brazilian cohort of 55 patients with other respiratory disorders; 10 patients infected with non-tuberculous mycobacteria, and 16 asymptomatic subjects. Drawing on results from a previous study(17) of serum samples from Brazilian subjects tested for IgG by ELISA against mycobacterial antigens ESAT-6, 16kDa, MT10.3, MPT-64 and 38kDa, the results were analysed in combination with those of the PPE59 and SM tests. FINDINGS Keeping the specificity rate at 97%, the overall PPE59 IgA sensitivity was 42.7%, while IgG and IgM showed lower performance (p < 0.0001). Combining PPE59 IgA/16kDa IgG results increased sensitivity to 71%, and even higher rates when the results were combined with SM results (86.5%, p = 0.001), at 88.9% specificity. Positive IgA was associated with pulmonary image alterations of high TB probability (p < 0.05). MAIN CONCLUSIONS Tests with TB patients found a moderate frequency of positivity for PPE59 IgA. However, the higher level of sensitivity attained in combination with PPE59 IgA/16kDa IgG/SM results unheard of before, although imperfect, suggests that this may be a potential additional tool for rapid detection of TB in low-resource areas.

The Impacts of Plastic Waste from Personal Protective Equipment Used during the COVID-19 Pandemic.

The period from 2019 to 2022 has been defined by the COVID-19 pandemic, resulting in an unprecedented demand for and use of Personal Protective Equipment (PPE). However, the disposal of PPE without considering its environmental impact and proper waste management practices has become a growing concern. The increased demand for PPE during the pandemic and associated waste management practices have been analyzed. Additionally, the discussion around treating these residues and exploring more environmentally friendly alternatives, such as biodegradable or reusable PPE, is crucial. The extensive use of predominantly non-degradable plastics in PPE has led to their accumulation in landfills, with potential consequences for marine environments through the formation of microplastics. Therefore, this article seeks to establish a connection between these issues and the Sustainable Development Goals, emphasizing the importance of efficient management aligned with sustainable development objectives to address these emerging challenges and ensure a more sustainable future.

COVID-19 personal protective equipment (PPE) contamination in coastal areas of Granada, Spain.

The use of disposable personal protective equipment (PPE) as a control measure to avoid transmission against COVID-19 has generated a challenge to the waste management and enhances plastic pollution in the environment. The research aims to monitor the presence of PPE waste and other plastic debris, in a time interval where the use of face mask at specific places was still mandatory, on the coastal areas of Granada (Spain) which belongs to the Mediterranean Sea. Four beaches called La Rijana, La Charca, La Rábita and Calahonda were examined during different periods. The total amount of sampled waste was 17,558 plastic units. The abundance, characteristics and distribution of PPE and other plastic debris were determined. Results showed that the observed amount of total plastic debris were between 2.531·10-2 and 24.487·10-2 units per square meter, and up to 0.136·10-2 for PPE debris, where face masks represented the 92.22 % of the total PPE debris, being these results comparable to previous studies in other coastal areas in the world. On the other hand, total plastic debris densities were in the range from 2.457·10-2 to 92.219·10-2 g/m2 and densities were up to 0.732·10-2 for PPE debris. PPE debris supposed 0.79 % of the weight of total waste and the 0.51 % of total items. Concerning non-PPE plastic waste: cigarettes filters, food containers and styrofoam were the most abundant items (42.95, 10.19 and 16.37 % of total items, respectively). During vacation periods, total plastic debris amount increased 92.19 % compared to non-vacation periods. Regarding type of beaches, the presence of plastic debris was significantly higher on touristic/recreational than in fishing beaches. Data showed no significant differences between accessible and no-accessible beaches, but between periods with restrictive policy about mask face use and periods with non-restrictive policy data suggest significant differences between densities (g/m2) for PPE litter. The amount of PPEs debris is also correlated with the number of cigarettes filters (Person's r = 0.650), food containers (r = 0.782) and other debris (r = 0.63). Finally, although interesting results were provided in this study, further research is required to better understand the consequences of this type of pollution and to provide viable solutions to this problem.

Skin lesions resulting from use of personal protective equipment in the context of COVID-19: a cross-sectional study.

OBJECTIVE: During the SARS-CoV-2 (COVID-19) pandemic, to prevent the transmission of the virus, the use of personal protection products and equipment were recommended by international and national organisations. The need to use it more frequently and for a long time can damage the skin of health professionals. The aim of this study was to estimate the prevalence and factors associated with skin lesions in health professionals resulting from the use of personal protective equipment (PPE). METHOD: This was a cross-sectional exploratory study through an online questionnaire. The first part of the questionnaire collected socio-labour characterisation data and the second part related to exposure factors. The variables were analysed according to the prevalence and the odds ratio (OR), within a 95% confidence interval (CI). RESULTS: Of the 398 participants who met the inclusion criteria, 65.3% were self-diagnosed with skin lesions: 37.3% with pressure injury, 25.8% with contact/allergic dermatitis and 2.7% with acne. Regarding the use of PPE, of the 240 professionals who reported using an N95 mask, 80.4% developed injuries, 70.4% of which related to a work regime of >6 hours per day (OR: 2.08, 95% CI: 1.79-2.42). CONCLUSION: The results of this study showed a significant prevalence of skin lesions in health professionals. Among exposure factors, the N95 mask and goggles stand out. Longer or more frequent exposure time to personal protective products and equipment proved to be important factors to be considered.

Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados.

Background: The use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados. Methods: A cross-sectional web-based online survey was conducted during April to June 2021 which recorded demographic information, details of PPE use and adverse skin reactions including severity and duration of onset of symptoms. Results: Most of the respondents used PPE for consecutive days (77.9%), 1-6 h/day (59.2%), and more than a year (62.5%). Fewer than half of the participants (45.6%) experienced adverse skin reactions from the use of PPE. The reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks produced adverse effects predominantly in the ears (60%) and cheeks (56.4%). Binary logistic regression showed that female HCWs (OR = 5.720 95% CI: 1.631, 20.063), doctors (OR = 5.215 95% CI: 0.877, 31.002), and longer duration of PPE use (>1 year) (OR = 2.902 95% CI: 0.958, 8.787) caused a significantly higher prevalence of adverse skin reactions. Conclusion: The PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged use. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.

Development of mask design as personal protective equipment through 3D printing.

This project aimed to develop an innovative mask design, aided by 3D printing technology that was able to protect its wearers against virus infection. The project was motivated with the intention of helping to fight Covid-19, but that its use was extensive as an option to N95 and similar masks, already on the market, even after the pandemic. Whose main design objective was that the mask had a sealing efficiency based on a half-face mask and that it could be used in conjunction with masks made of antiviral fabrics, such as, for example, a surgical mask that has its filtering capacity already tested and approved and, which would be the filter element of the mask. The mask was also intended to be reusable so that it could be washed for cleaning, with only the fabric filter element being disposable.

White Light-Photolysis for the Removal of Polycyclic Aromatic Hydrocarbons from Proximity Firefighting Protective Clothing.

The presence of polycyclic aromatic hydrocarbons (PAHs) on firefighters' personal protective equipment is a concern. One form of preventing from these compounds is to decontaminate proximity firefighting protective clothing (PFPC). Traditional decontamination methods do not promote total removal of pollutants and alter the properties of PFPC. The objective of this work was to evaluate the effectiveness of white light-photolysis (WLP), an advanced oxidation process (AOP), for removing PAHs from PFPC, while maintaining the integrity of the fabric fibers. Experiments were carried out, varying reaction time and concentration of H2O2. With WLP (without H2O2), it was possible to remove more than 73% of the PAHs tested from the outer layer of PFPC in 3 days. The WLP provided the greatest removal of PAHs, compared with the most common mechanical decontamination techniques (laundering and wet-soap brushing). The fibers' integrity after exposure to the white light was evaluated with infrared spectroscopy and scanning electron microscopy/energy dispersive X-ray spectrometry. In addition, a tearing strength test was performed. No remarkable fabric degradation was observed, indicating a possible, routine-compatible, simple, and inexpensive method of decontamination of PFPC, based on photolysis, which is effective in the degradation of PAHs and maintains the integrity of fabric fibers.

Face masks invading protected areas: Risks and recommendations.

Among the indirect environmental impacts generated by the global COVID-19 pandemic, contamination with personal protective equipment (PPE), like face masks, may be one of the most relevant ones. PPE has been found in multiple aquatic, marine, and terrestrial environments, including places of absolute relevancy to biodiversity conservation, such as protected areas (PAs). Here, a brief report of the presence of PPE in six PAs of Peru is presented. PPE pollution in PAs consisted mainly of single-use and reusable face masks, as well as plastics associated with PAs, such as KN95 respirator wrappings. The mean PPE density was estimated as 1.32 × 10-3 PPE/m2. FTIR spectroscopy confirmed that face masks and wrappers mainly consisted of polypropylene and polyethylene, two of the most commonly available synthetic polymers. The material was poorly degraded according to their FTIR spectra, possibly suggesting that they were discarded recently. The recent ban on single-use plastic in Peruvian PAs is regarded as a great step forward toward the efforts made to preserve these invaluable places. However, these measures seemed insufficient to prevent PPE and other types of litter from contaminating areas of ecological importance. Considering the current scenario, several recommendations were proposed to be implemented in PAs in order to prevent PPE from becoming a new plastic issue to tackle. These recommendations are expected to also serve for future events where the use of single-use plastics becomes inevitable, like global pandemics.

Physical and chemical degradation of littered personal protective equipment (PPE) under simulated environmental conditions.

Investigations of the physicochemical degradation of personal protective equipment (PPE) under controlled environmental conditions are largely lacking. Here the chemical and physical changes of face masks and gloves (recovered from the marine environment) were evaluated after exposure time up to 60 days of simulated environmental conditions. The results suggested that the polymer backbone of PPE suffers typical changes induced by sun exposure. Changes in the intensity of diffraction peaks indicated shifts in the crystallinity of PPE, possibly altering their thermal behavior. Signs of physical degradation in PPE, such as ruptures, and rough surfaces, which exacerbated over time were also detected. Additionally, signals of some elements of concern, such as Cu and Mo, and elements typically found in seawater were detected. The results of this study allowed us to better understand the degradation of typical PPE items in the marine environment, ultimately resulting in the release of microplastics and chemical contaminants.

Collaborative manufacturing of ergonomic personal protective equipment (PPE) accessories to prevent infectious disease.

Throughout history there have been epidemics and pandemics of all kinds, however the most recent ones have been respiratory diseases that have had a significant effect on the society and that have caused high mortality rates. The preventive measures to minimize the risk of contagion by contact with infected surfaces include ergonomic accessories including personal protective equipment (PPE) to prevent hands to be in contact with surfaces that could be infected by viruses, bacteria, fungi, etc., thus avoiding infection by the usual entry routes (mouth, nose, and eyes) to the human body of highly contagious diseases such as COVID-19. The collaborative manufacture of these safety accessories at the site of consumption is a current option that minimizes infectious diseases and reduces costs. Accessories such as the so-called "ear saver" and "anti-contact keys" can be produced by 3D printing with a general CAD/CAM and allow users in hospitals, and schools, such as medical and teaching staff and society in general to extend the life of N95 respirator fasteners (protective masks) and avoid contagion. These devices can be used to open doors and windows and control elevators, etc. The accessories can be optimized ergonomically for individual use by providing a custom design. The collaborative manufacture of these elements allows the product design stages to be carried out autonomously. In the manufacturing stage, 3D printers can be used to produce the devices at the point of use, thus saving on transport and distribution costs. This paper describes a comparative analysis of their design, manufacture and use in hospitals, schools, universities, and commercial areas with the aim of improving the current design.

Ozone as an alternative decontamination process for N95 facemask and biosafety gowns.

COVID-19 pandemic created a global shortage of medical protective equipment. Here, we considered ozone (O3) a disinfectant alternative due to its potent oxidative activity against biological macromolecules. The O3 decontamination assays were done using SARS-CoV-2 obtained from patients to produce artificial contamination of N95 masks and biosecurity gowns. The quantification of SARS-CoV-2 was performed before and after exposing the samples to different ozone gas concentrations for times between 5 and 30 min. Viral loads as a function of the O3 exposure time were estimated from the data obtained by the RT-PCR technique. The genetic material of the virus was no longer detected for any tested concentrations after 15 min of O3 exposure, which means a disinfection Concentration-Time above 144 ppm min. Vibrational spectroscopies were used to follow the modifications of the polymeric fibers after the O3 treatment. The results indicate that the N95 masks could be safely reused after decontamination with treatments of 15 min at the established O3 doses for a maximum of 6 cycles.

Avaliação do perfil de trabalhadores e das condições de trabalho na pesca da Baía do Sol, Belém, PA, Brasil / Evaluation of workers' profile and work conditions in fishing in Baía do Sol, Belém, PA, Brazil / Evaluación del perfil de los trabajadores y condiciones de trabajo en la pesca en Baía do Sol, Belém, PA, Brasil

Considerada uma atividade de risco, a pesca registra um elevado índice de sinistralidades, sendo a maioria não notificada, e pouco treinamento na prevenção de acidentes. Neste sentido, com o objetivo de avaliar o perfil e as condições de trabalho de pescadores da Baía do Sol, Ilha de Mosqueiro, em Belém do Pará, foi efetivado um levantamento por meio de um questionário aplicado em forma de entrevista entre os meses de setembro e novembro de 2017. Com base nos questionários aplicados (n=74), observa-se que a comunidade de pescadores da Baía do Sol não difere de maneira significativa de outras comunidades pesqueiras já estudadas. No entanto, duas características ganharam destaque no perfil dos entrevistados: o nível de escolaridade, bem acima da média para o estado do Pará; e a faixa etária, onde grande parte dos pescadores encontra-se na faixa de idade abaixo dos 40 anos. Por outro lado, devido a condições socioeconômicas, essa comunidade pesqueira e talvez toda a categoria de pescadores artesanais precisa de atenção por parte dos órgãos governamentais, no sentido do desenvolvimento de tecnologias adequadas para EPI's, com distribuição gratuita.(AU)

Fishing is considered one risky activity, with a high accident rate, most of which are not notified, and little training in accident prevention. In order to assess the profile and working conditions of fishermen from Baía do Sol, Mosqueiro Island, in Belém do Pará, a survey was carried out through a questionnaire applied in the form of an interview from September to November 2017. Based on the questionnaires applied (n=74), it is observed that the fishing community of Baía do Sol does not differ significantly from other fishing communities already studied. However, two characteristics gained prominence in the profile of the interviewees: the level of education, well above the average for the state of Pará; and the age group, since most of the fishermen are in the age group below 40 years. On the other hand, due to socioeconomic conditions, this fishing community and perhaps the entire category of artisanal fishermen needs attention from government agencies, in the sense of developing appropriate technologies for PPE's, with free distribution.(AU)

Considerada una actividad de riesgo, la pesca tiene una alta tasa de accidentes, la mayoría de los cuales no se denuncian, y poca formación en prevención de accidentes. En este sentido, con el fin de evaluar el perfil y las condiciones laborales de los pescadores de Baía do Sol, Ilha de Mosqueiro, en Belém do Pará, se realizó una encuesta a través de un cuestionario aplicado en forma de entrevista entre los meses de septiembre. y noviembre de 2017. Con base en los cuestionarios aplicados (n = 74), se observa que la comunidad pesquera de Baía do Sol no difiere significativamente de otras comunidades pesqueras ya estudiadas. Sin embargo, dos características destacaron en el perfil de los entrevistados: el nivel de educación, muy por encima del promedio del estado de Pará; y el grupo de edad, donde la mayoría de los pescadores tienen menos de 40 años. Por otro lado, debido a las condiciones socioeconómicas, esta comunidad pesquera y quizás toda la categoría de pescadores artesanales necesitan la atención de las agencias gubernamentales, en el sentido de desarrollar tecnologías apropiadas para PPE, con distribución gratuita.(AU)

Tips and Pearls for Tracheostomy during the Covid-19 Pandemic.

The number of critically-ill coronavirus disease 2019 (Covid-19) patients requiring mechanical ventilation is on the rise. Most guidelines suggest keeping the patient intubated and delay elective tracheostomy. Although the current literature does not support early tracheostomy, the number of patients undergoing it is increasing. During the pandemic, it is important that surgeons and anesthesiologists know the different aspects of tracheostomy in terms of indication, procedure, tube care and complications. A literature search was performed to identify different guidelines and available evidence on tracheostomy in Covid-19 patients. The purpose of the present article is to generate an essential scientific evidence for life-saving tracheostomy procedures.

Safety and structural integrity of N95/PFF2 respirators decontamination.

BACKGROUND: COVID-19 is caused by the SARS-CoV-2 virus, an emerging respiratory pathogen. The work environment represents a high-risk factor for health professionals. Given the scarcity of protective personal equipment due to global demand, decontamination and reuse studies should be carried out. Thus, the aim of this study was to evaluate the safety of a method of decontamination of N95/PFF2 respirators, especially regarding structural integrity. METHODS: N95/PFF2 respirators were subjected to hydrogen peroxide decontamination and analyzed using scanning electron microscopy and thermogravimetric analysis. Seven respirators of the same brand and lot were used, one being a control and the other six subjected to decontamination process. As for the sealing, a qualitative test was applied, in order to identify the changes in the structure that could damage the sealing of respirators. RESULTS: Indicated that the fiber morphology in all layers was not affected by the six decontamination cycles. Also, the thermal stability in the different layers was very similar. Fit testing showed that the respiradors submitted to all cycles of decontamination were approved. CONCLUSIONS: Thus, it is possible to conclude that the hydrogen peroxide decontamination method is effective, since it does not alter the physical properties of the respirators.

Comprehensive in silico survey of the Mycolicibacterium mobilome reveals an as yet underexplored diversity.

The mobilome plays a crucial role in bacterial adaptation and is therefore a starting point to understand and establish the gene flow occurring in the process of bacterial evolution. This is even more so if we consider that the mobilome of environmental bacteria can be the reservoir of genes that may later appear in the clinic. Recently, new genera have been proposed in the family Mycobacteriaceae, including the genus Mycolicibacterium, which encompasses dozens of species of agricultural, biotechnological, clinical and ecological importance, being ubiquitous in several environments. The current scenario in the Mycobacteriaceae mobilome has some bias because most of the characterized mycobacteriophages were isolated using a single host strain, and the few plasmids reported mainly relate to the genus Mycobacterium. To fill in the gaps in these issues, we performed a systematic in silico study of these mobile elements based on 242 available genomes of the genus Mycolicibacterium. The analyses identified 156 putative plasmids (19 conjugative, 45 mobilizable and 92 non-mobilizable) and 566 prophages in 86 and 229 genomes, respectively. Moreover, a contig was characterized by resembling an actinomycete integrative and conjugative element (AICE). Within this diversity of mobile genetic elements, there is a pool of genes associated with several canonical functions, in addition to adaptive traits, such as virulence and resistance to antibiotics and metals (mercury and arsenic). The type-VII secretion system was a common feature in the predicted plasmids, being associated with genes encoding virulent proteins (EsxA, EsxB, PE and PPE). In addition to the characterization of plasmids and prophages of the family Mycobacteriaceae, this study showed an abundance of these genetic elements in a dozen species of the genus Mycolicibacterium.

Application of green synthesised copper iodide particles on cotton fabric-protective face mask material against COVID-19 pandemic.

Microorganisms cause variety of diseases that constitutes a severe threat to mankind. Due to the upsurge of many infectious diseases, there is a high requirement and demand for the development of safety products finished with antimicrobial properties. The study involves the antimicrobial activity of natural cotton coated with copper iodide capped with Hibiscus rosa-sinensis L. flower extract (CuI-FE) which is rich in anthocyanin, cyanidin-3-sophoroside by ultrasonication method. The coated and uncoated cotton fabric was characterised through XRD, SEM, AFM, tensile strength and UV-Visible spectroscopic techniques. XRD confirmed the formation of CuI particles, SEM showed that CuI-FE was prismatic in shape. The average size of CuI-FE particles was found to be 552.45 nm. Anti-bacterial studies showed copper iodide particles to be a potent antimicrobial agent. AFM images confirmed the rupture of bacterial cell walls in the presence of prismatic CuI-FE. In-vitro cytotoxicity investigation of CuI-FE was performed against cancer and spleen cell lines to evaluate the cell viability. Cytotoxicity analysis revealed the IC50 value of 233.93 µg/mL in the presence of CuI-FE. Molecular docking study was also carried out to understand the interaction of CuI-FE with COVID-19 main protease. This paper has given an insight on the usage of CuI-FE coated on the cotton fabric that has proved to have strong inhibition against the nano ranged bacterial, cancerous cell line and a strong interaction with the COVID-19 protease. Such eco-friendly material will provide a safe environment even after the disposable of medical waste from the infectious diseases like influenza and current pandemic like COVID-19.

Preparedness Tested: Severe Cerebral Malaria Presenting as a High-Risk Person Under Investigation for Ebola Virus Disease at a US Hospital.

In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a "wet" person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Critical care was delivered within high-risk pathogen isolation in the ED and in our Special Treatment Unit until a diagnosis of severe cerebral malaria was confirmed and EVD was definitively excluded.This report discusses our experience activating a longitudinal preparedness program designed for rare, resource-intensive events at hospitals physically remote from any active epidemic but serving a high-volume international air travel port-of-entry.

The role of 3D printing during COVID-19 pandemic: a review.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread through more than 180 countries, leading to diverse health systems overload around the world. Because of the high number of patients and the supply chain disruption, it generated a shortage of medical devices and personal protective equipment. In this context, initiatives from the additive manufacturing community emerged to fight the lack of devices. Diverse designs were produced and are currently being used in hospitals by patients and health workers. However, as some devices must follow strict standards, these products may not fulfill these standards. Therefore, to ensure the user's health, there is a need for understanding each device, their usage, and standards. This study reviews the use of additive manufacturing during COVID-19 pandemic. It gathers the source of several 3D printed devices such as face shields, face masks, valves, nasopharyngeal swabs, and others, discussing their use and regulatory issues. In this regard, the major drawbacks of the technology, addressed for the next pandemic scenario, are highlighted. Finally, some insights of the future of additive manufacturing during emergency are given and discussed.

Caracterización clínico epidemiológica de pacientes pediátricos con profilaxis postexposición no ocupacional al VIH. Hospital Nacional Mario Catarino Rivas / Clinical epidemiological characterization of pediatric patients with non-occupational post-exposure pro- phylaxis to HiV. Mario Catarino Rivas National Hospital

Antecedentes: La agresión sexual, sigue siendo la principal causa de exposición al VIH no ocupa- cional en niños; se presenta en todas las clases so- cioeconómicas, y casi en todos los países del mun- do únicamente con diferencias en la magnitud. Objetivo: Identificar las características clíni- co epidemiológicas de los pacientes pediátricos que recibieron profilaxis post exposición no ocu- pacional en el Hospital Nacional Doctor Mario Ca- tarino Rivas de enero 2020 a septiembre 2021. Pacientes y métodos: se trató de un estudio cuanti- tativo con un enfoque descriptivo y un diseño no ex- perimental transversal, donde se realizó la revisión de 18 expedientes de pacientes que recibieron la atención inmediata posterior a la exposición no ocupacional al VIH, utilizándose cómo método de recolección la ficha epidemiológica del Protocolo de profilaxis Post Expo- sición PPE al VIH y otras ITS (Infecciones de trans- misión Sexual) de la Secretaria de Salud de Honduras 2017 modificada para esta investigación. Resultados: El 78,0% de los casos se encontraron en el grupo etario de adolescentes, en su mayoría de sexo femenino y el 83,0% de los casos provenían del departamento de Cor- tés. La agresión sexual fue la causa más frecuente, don- de el 44,0% resultó haber tenido exposición en su hogar; siendo el agresor un pariente o conocido en el 52.8%. *Médico Residente tercer año de Pediatría, UNAH-VS **Médico Pediatra, servicio de Atención Integral, HNMCR Fecha de entrega: 06/10/2021 Fecha de aprobado 20/10/2021 Dirigir correspondencia a: eloapuerto@gmail.com Así mismo, el 94,1% de la serología del agresor para VIH era desconocida. Al momento de captación el 89,0% de los casos tenían una serología de VIH negativa, al mes de seguimiento el 46,6% presentó una serología negativa. Sin embargo, a los 12 meses el 100% de los casos fueron perdidos en seguimiento. Únicamente el 53,8% cumplió con la profilaxis con terapia antirretroviral y el 88,0% con la profilaxis para infecciones de transmisión sexual. Conclusiones: El incumplimiento del protocolo es atri- buible a la situación por la pandemia de COVID-19 y/o al desconocimiento general de la población so- bre la importancia del cumplimiento total del mismo...(AU)

Cultivated areas and rural workers' behavior are responsible for the increase in agricultural intoxications in Brazil? Are these factors associated?

In Brazil, the increased use of pesticides has caused several consequences such as mortality of non-target species, contamination of aquatic environments, and changes in biodiversity. Regarding humans, such products could increase the cases of poisoning, the number of different types of cancer, and also neurodegenerative and autoimmune diseases, especially in workers who occupationally handle pesticides. Therefore, this study aimed to evaluate the number of agricultural poisonings from 2007 to 2017 and if there is a correlation between harvested areas, and to analyze the possible factors that contribute to poisonings. Our results demonstrated an increase in poisonings by 8% and a correlation with the growth of the harvested area. We emphasize that other factors are also determinant for the increase of poisonings such as the absence or inappropriate use of personal protective equipment (PPE), the toxicity of mixtures, the mishandling, and the lack of information on how to use and spray such products. Among the circumstances about poisoning, we presented suicide attempts and accidental causes. We found that the area planted and harvested is also associated with the amount of poisoning; however, several other behavioral factors are also determinant for the growth of agricultural poisoning in Brazil.