Swim Bladder of Farmed Totoaba macdonaldi: A Source of Value-Added Collagen.

Finding strategies to use the swim bladder of farmed totoaba (Totoaba macdonaldi) is of the utmost need to reduce waste. Fish swim bladders are rich in collagen; hence, extracting collagen is a promising alternative with benefits for aquaculture of totoaba and the environment. The elemental biochemical composition of totoaba swim bladders, including their proximate and amino acid compositions, was determined. Pepsin-soluble collagen (PSC) was used to extract collagen from swim bladders, and its characteristics were analyzed. Alcalase and papain were used for the preparation of collagen hydrolysates. Swim bladders contained 95% protein, 2.4% fat, and 0.8% ash (on a dry basis). The essential amino acid content was low, but the functional amino acid content was high. The PSC yield was high, at 68% (dry weight). The amino acid composition profile, electrophoretic pattern, and structural integrity analyses of the isolated collagen suggested it is a typical type-I collagen with high purity. The denaturalization temperature was 32.5 °C, probably attributable to the imino acid content (205 residues/1000 residues). Papain-hydrolysates (≤3 kDa) of this collagen exhibited higher radical scavenging activity than Alcalase-hydrolysates. The swim bladder from the farmed totoaba could be an ideal source to produce high-quality type I collagen and may be considered an alternative to conventional collagen sources or bioactive peptides.

Asociación entre obesidad y síntomas de depresión en adolescentes en Querétaro, México

Objetivo: Identificar la asociación entre obesidad y síntomas de depresión en adolescentes atendidos en una unidad de salud familiar. Materiales y Métodos: Estudio observacional, transversal comparativo en adolescentes mexicanos de 10 a 19 años, se integraron dos grupos de comparación, adolescentes con obesidad y sin obesidad. El tamaño de la muestra fue de 97 adolescentes por cada grupo, se empleó muestreo no probabilístico por cuota. La depresión se evaluó con la versión revisada de la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R). El análisis estadístico incluyó promedios, porcentajes, desviaciones estándar, prueba chi cuadrado, razón de momios (RM), e intervalos de confianza para RM. Resultados: En el grupo de adolescentes con obesidad 48,5% presentaron síntomas depresivos y en el grupo de adolescentes sin obesidad 33% también presentaron síntomas depresivos (p=0,02), RM de 1,90 (IC 95%: 1,06-3,41). Conclusiones: Se encontró asociación entre obesidad y síntomas de depresión en adolescentes.

Objective: To identify the association between obesity and depression symptoms in adolescents attended in a family health center. Materials and Methods: An observational, cross-sectional, comparative study of Mexican adolescents aged 10 to 19 years integrated two comparison groups, adolescents with obesity and without obesity. The sample size was 97 adolescents per group, non-probabilistic sampling per quota was used. Depression was evaluated with the revised version of the Center for Epidemiological Studies (CESD-R) Depression Scale. The statistical analysis included averages, percentages, standard deviations, chi square test, odds ratio (OR), and confidence intervals for OR. Results: In the group of adolescents with obesity 48,5% presented depressive symptoms and in the group of adolescents without obesity 33% also presented depressive symptoms (p=0,02), RM was 1,90 (95%CI; 1,06-3,41). Conclusions: We found an association between obesity and depression symptoms in adolescents.

Creencias de enfermedad, creencias de medicación y adherencia al tratamiento en pacientes con hipertensión arterial / Disease belief, medication belief and adherence to treatment in patients with high blood pressure

Resumen Objetivo: Comparar las creencias de enfermedad y las creencias de medicación con la adherencia al tratamiento en pacientes con hipertensión arterial. Método: Diseño transversal comparativo en población hipertensa sin diabetes mellitus, grupo de 137 pacientes adherentes y grupo de 129 pacientes no adherentes. Se evaluaron las creencias de la enfermedad y las creencias de la medicación. El análisis estadístico incluyó prueba de ji al cuadrado, razón de momios e intervalo de confianza para razón de momios. Resultados: En el grupo de pacientes adherentes, el 71.5% tienen creencias adecuadas de la enfermedad, y en el grupo de pacientes no adherentes el 43.4% también tienen creencias adecuadas de la enfermedad (p = 0.000). Cuando se agrupan las creencias de la enfermedad y las creencias sobre la medicación existe una asociación con la adherencia al tratamiento en los pacientes hipertensos. Conclusiones: Existe asociación entre las creencias de la enfermedad y las creencias de la medicación con la adherencia al tratamiento antihipertensivo.

Abstract Objective: Compare disease beliefs and medication beliefs with adherence to treatment in patients with hypertension without diabetes mellitus. Method: Comparative transverse design in hypertensive population, a group of 137 adherent patients and a group of 129 non-adherent patients. The beliefs of the disease and beliefs about the medication were evaluated. The statistical analysis included chi squared, odds ratio and confidence interval for odds ratio. Results: In the group of adherent patients, 71.5% have an adequate belief of the disease and in the group of non-adherent patients, 43.4% also have an adequate belief of the disease (p = 0.000). When the belief of the disease and beliefs about the medication are grouped, there is an association with adherence to treatment in hypertensive patients. Conclusions: There is an association between beliefs about the disease and medication with adherence to antihypertensive treatment.

Disease belief, medication belief and adherence to treatment in patients with high blood pressure / Creencias de enfermedad, creencias de medicación y adherencia al tratamiento en pacientes con hipertensión arterial

Objective: Compare disease beliefs and medication beliefs with adherence to treatment in patients with hypertension without diabetes mellitus. Method: Comparative transverse design in hypertensive population, a group of 137 adherent patients and a group of 129 non-adherent patients. The beliefs of the disease and beliefs about the medication were evaluated. The statistical analysis included chi squared, odds ratio and confidence interval for odds ratio. Results: In the group of adherent patients, 71.5% have an adequate belief of the disease and in the group of non-adherent patients, 43.4% also have an adequate belief of the disease (p = 0.000). When the belief of the disease and beliefs about the medication are grouped, there is an association with adherence to treatment in hypertensive patients. Conclusions: There is an association between beliefs about the disease and medication with adherence to antihypertensive treatment.

Objetivo: Comparar las creencias de enfermedad y las creencias de medicación con la adherencia al tratamiento en pacientes con hipertensión arterial. Método: Diseño transversal comparativo en población hipertensa sin diabetes mellitus, grupo de 137 pacientes adherentes y grupo de 129 pacientes no adherentes. Se evaluaron las creencias de la enfermedad y las creencias de la medicación. El análisis estadístico incluyó prueba de ji al cuadrado, razón de momios e intervalo de confianza para razón de momios. Resultados: En el grupo de pacientes adherentes, el 71.5% tienen creencias adecuadas de la enfermedad, y en el grupo de pacientes no adherentes el 43.4% también tienen creencias adecuadas de la enfermedad (p = 0.000). Cuando se agrupan las creencias de la enfermedad y las creencias sobre la medicación existe una asociación con la adherencia al tratamiento en los pacientes hipertensos. Conclusiones: Existe asociación entre las creencias de la enfermedad y las creencias de la medicación con la adherencia al tratamiento antihipertensivo.

Prevalencia del uso de medicina tradicional herbolaria y el perfil de uso en pacientes con diabetes tipo 2 de una zona urbana

RESUMEN En México la interculturalidad en salud se plantea como una integración de dos sistemas de conocimiento, el conocimiento ancestral carente de bases científicas y que se transmite a través de las generaciones, y el modelo médico convencional. En múltiples estudios se describe que existe un gran porcentaje de médicos que han recibido pacientes que hacen uso de esta terapéutica. El objetivo fue identificar la prevalencia del uso de medicina tradicional herbolaria y el perfil de uso en pacientes con diabetes tipo 2 en una zona urbana. Se realizó un estudio observacional, transversal descriptivo en pacientes con diagnóstico de diabetes mellitus tipo 2, pertenecientes a un sistema de seguridad social de la ciudad de Querétaro, en un periodo mayor a 6 meses. El plan de análisis estadístico incluyó promedios, porcentajes, intervalos de confianza para promedios e intervalos de confianza para porcentajes. Se identificó que la prevalencia de uso de la medicina tradicional herbolaria era de 22.2%, con una edad promedio de 60.98 años, con predominio en el sexo femenino y una escolaridad secundaria o menos, la planta más utilizada fue moringa en un 45%, el uso más frecuente para el control glucémico en un 97% y su consumo era como agua de tiempo en la mayoría de las plantas. En este estudio se pudo describir la prevalencia de uso en una zona urbana, así como el perfil de las personas que hacen uso de esta terapéutica, con la finalidad de generar nuevas informaciones y promover el estudio de estas prácticas.

ABSTRACT In Mexico the interculturality in health is posed as an integration of the two systems of knowledge, the ancient knowledge lacking scientific bases which is transmitted through generations, and the conventional medical model. In multiple studies, the existence of a great percentage of medical doctors that have received patients using this therapy is described. The objective was to identify the prevalence of the use of herbal traditional medicine and the profile of use in patients with diabetes type 2 in an urban zone. This was an observational, transversal descriptive study performed in patients with diagnostic of diabetes mellitus type 2, belonging to a system of social security in Queretaro city, in a period greater than 6 months. The plan of statistical analysis included averages, percentages, confidence intervals for averages and percentages. The prevalence of use of the herbal traditional medicine was 22.2% with and average age of 60.98 years old, with predominance of the female sex and a scholarship of middle school or less, the plant mostly used was moringa in a 45%, the most frequent use was the glycemic control in 97% and the consumption was as natural water in most plants. In this study, it was described the prevalence of the use in an urban zone, as well as the profile of the people that use this therapy, with the purpose of generate new information and promote the study of these practices.

Comparison of collagen characteristic from the skin and swim bladder of Gulf corvina (Cynoscion othonopterus).

Collagens extracted from different tissues and fish species display different physicochemical properties, thus novel sources require characterization. Gulf corvina (Cynoscion othonopterus) is processed industrially for food. Of the by-products, the swim bladder is used for fish maw, but other tissues are treated as waste. In the present study, pepsin-soluble collagen from Gulf corvina skin and swim bladder was extracted and characterized. Skin produced a higher collagen yield (82 ± 1.53 %) than swim bladder (69 ± 1.60 %). Both collagens exhibited electrophoresis bands corresponding to ([α1(I)]2α2(I)) and ß chains, all characteristic of type I collagen. Spectra analysis showed the collagens to maintain their triple-helix structure. The skin collagen had a lower denaturation temperature (29.8 °C) than the swim bladder collagen (32.5 °C), due to its relatively low imino acid content (168 vs. 190 /1000 residues, respectively). Both collagens were highly soluble in acidic pH ranges; Zeta potential values were 5.5 for the skin collagen and 6.2 for the swim bladder collagen. Gulf corvina skin and swim bladder are excellent sources of type I collagen with similar physicochemical properties.

Comparative Transcriptomes of the Body Wall of Wild and Farmed Sea Cucumber Isostichopus badionotus.

Overfishing of sea cucumber Isostichopus badionotus from Yucatan has led to a major population decline. They are being captured as an alternative to traditional species despite a paucity of information about their health-promoting properties. The transcriptome of the body wall of wild and farmed I. badionotus has now been studied for the first time by an RNA-Seq approach. The functional profile of wild I. badionotus was comparable with data in the literature for other regularly captured species. In contrast, the metabolism of first generation farmed I. badionotus was impaired. This had multiple possible causes including a sub-optimal growth environment and impaired nutrient utilization. Several key metabolic pathways that are important in effective handling and accretion of nutrients and energy, or clearance of harmful cellular metabolites, were disrupted or dysregulated. For instance, collagen mRNAs were greatly reduced and deposition of collagen proteins impaired. Wild I. badionotus is, therefore, a suitable alternative to other widely used species but, at present, the potential of farmed I. badionotus is unclear. The environmental or nutritional factors responsible for their impaired function in culture remain unknown, but the present data gives useful pointers to the underlying problems associated with their aquaculture.

Chronic feeding with 3% dried raw blueberries (V. corymbosum) reduces apomorphine-induced rotations and striatal dopaminergic loss in hemiparkinsonian rats.

Blueberries (BB) are rich in antioxidant polyphenols, and their intake could prevent Parkinson's disease (PD). Here we assessed whether rats chronically fed dried raw BB develop resistance to dopaminergic denervation and motor disorders caused by unilateral intrastriatal injection of 6-hydroxydopamine (6-OHDA), a dopaminergic neurotoxin acting mainly by inducing oxidative stress. Male rats were fed either with LabDiet® alone or supplemented with 3% lyophilized raw BB for 2 weeks before and 3 weeks after injecting 6-OHDA (day 0) or vehicle (mock lesion) into the right striatum. The cylinder test was performed on days -14, -7, -1, +7, +14, and +21; the percentage of ipsilateral forepaw (IF) use asymmetry was determined by counting the wall contacts made with either forepaw or with both. Apomorphine (0.25 mg/kg, s.c.)-induced rotation was performed on days -1, +7, +14, and +21. Full contralateral rotations were counted in 3-min periods, every 15 min, up to 90 min. Striatal slices were immunostained for tyrosine hydroxylase (TH) and the ionized calcium-binding protein-1 adapter (Iba1) [immunoreactive area or microglia count in right striatum expressed as % of the left striatum]. Antioxidants in BB methanolic extracts neutralized the free radical 2,2-diphenyl-1-picrylhydrazyl in a concentration-dependent manner. Anthocyanins have been reported as the most abundant polyphenols in BB. Using the pH differential method, the total anthocyanin content (malvidin-3-glucoside equivalents) in raw BB averaged 21.04 mg/g dry weight. The range of anthocyanin intake by rats throughout the study varied from 37.7 to 72.2 mg/kg body weight. The time and food type factors, as well as their interaction were significant according to two-way RM-ANOVA in both the apomorphine-induced rotations and the cylinder test. Compared with LabDiet® alone, chronic supplementation with 3% dried raw BB decreased apomorphine-induced rotations on days +14 and +21 (p < 0.001) and produced a 46% reduction in total rotations post-surgery (p < 0.05), but only caused a partial, non-significant, decrease of IF asymmetry. BB supplementation reduced TH loss in the striatum (p < 0.05) but did not attenuate the increase of Iba1+ microglia. The consumption of 3% dried raw blueberries attenuates dopaminergic denervation and partially reverses motor disorders in the 6-OHDA-induced PD model in rats. The phytochemicals of raw blueberries that contribute to the observed neuroprotective effect are yet to be identified.

Rainfall decrease and red deer rutting behaviour: Weaker and delayed rutting activity though higher opportunity for sexual selection.

In the last decades, climate change has caused an increase in mean temperatures and a reduction in average rainfall in southern Europe, which is expected to reduce resource availability for herbivores. Resource availability can influence animals' physical condition and population growth. However, much less is known on its effects on reproductive performance and sexual selection. In this study, we assessed the impact of three environmental factors related to climate change (rainfall, temperature and vegetation index) on Iberian red deer Cervus elaphus hispanicus reproductive timing and sexual behaviour, and their effects on the opportunity for sexual selection in the population. We measured rutting phenology as rut peak date, the intensity of male rutting activity as roaring rate, and the opportunity for sexual selection from the distribution of females among harem holding males in Doñana Biological Reserve (Southwest Spain), from data of daily observations collected during the rut over a period of 25 years. For this study period, we found a trend for less raining and hence poorer environmental conditions, which associated with delayed rutting season and decreased rutting intensity, but that appeared to favour a higher degree of polygyny and opportunity for sexual selection, all these relationships being modulated by population density and sex ratio. This study highlights how climate change (mainly rainfall reduction in this area) can alter the conditions for mating and the opportunity for sexual selection in a large terrestrial mammal.

The dark ventral patch: A bimodal flexible trait related to male competition in red deer.

Sexual signals play a central role in male-male competition in polygynous species. In red deer (Cervus elaphus), male's ventral area become dark during the rutting season due to urine spraying behaviour and retains many chemical compounds potentially revealing individual features. Here we investigate the variation in size of this trait, exploring its relationship with age and male competitive features such as antlers or body size, as well as populational level of intrasexual competition for mates. We found that the size of the dark ventral patch followed a clearly bimodal distribution, i.e. males mostly expressed the full-size trait or just developed a very small one. For these two groups of males according to trait expression, the relationships of trait size with age and antler size differed. Populational level of intrasexual competition appeared to affect the relationship between antler size and the probability of a fully developed ventral patch. These results indicate that the trait encodes information on body size, antler size, age and populational level of mate competition, thus suggesting a role in signalling male's competitive features and willingness to allocate reproductive effort within a particular season.

Costo del subsidio por incapacidad temporal para el trabajo en pacientes con retinopatía diabética / Cost of temporary disability allowance for work in patients with diabetic retinopathy

OBJETIVO: Determinar el costo de subsidio por incapacidad temporal para el trabajo en pacientes con retinopatía diabética. MATERIAL Y MÉTODOS: Diseño de costo en expediente de pacientes con retinopatía diabética e incapacidad temporal para el trabajo. Se estudiaron 201 expedientes registrados en el servicio de salud en el trabajo. El costo total de la incapacidad incluyó salario nominal, días de incapacidad hasta la invalidez, y porcentaje pagado del salario nominal. RESULTADOS: El sueldo promedio pagado por día es €5.64. El promedio de días de incapacidad expedida por trabajador fue 129.52 (IC 95%; 114.81-144.23). El costo total promedio de incapacidad pagada por trabajador desde que presenta complicaciones oftalmológicas con repercusión laboral hasta que se expida el trámite por invalidez es €959.41 (IC 95%; 658.46-1,233.35). CONCLUSIÓN: La incapacidad temporal por retinopatía diabética consume recursos

OBJECTIVE: To determine the cost of temporary disability allowance for work in patients with diabetic retinopathy. MATERIAL AND METHODS: Cost design on file of patients with diabetic retinopathy and temporary incapacity for work. 201 files registered in the occupational health service were studied. The total cost of disability included nominal salary, days of disability, and the percentage paid of the salary. RESULTS: The average daily wage paid is €5.64. The average number of days of disability issued per worker was 129.52 (95% CI; 114.81- 144.23). The average total cost of disability paid per worker from the moment he presents ophthalmological complications with labor repercussions until the disability process is issued is €959.41 (IC 95%; 658.46-1,233.35). CONCLUSION: Temporary disability due to diabetic retinopathy consumes institutional resources that must be considered in budget planning

Effect of the addition of Enterolobium cyclocarpum pods and Gliricidia sepium forage to Brachiaria brizantha on dry matter degradation, volatile fatty acid concentration, and in vitro methane production.

The purpose of this study was to determine the in vitro fermentation and methane (CH4) production in the grass Brachiaria brizantha (B) alone or when mixed with Gliricidia sepium forage (G) and/or Enterolobium cyclocarpum pods (E). Theses substrates were incubated in the following proportions: B100 (B100%), B85E15 (B85% + E15%), B85G15 (B85% + G15%), B85GE15 (B85% + G7.5% + E7.5%), and B70GE30 (B70% + G15% + E15%). Dry matter degradation (DMD), volatile fatty acid (VFA) concentration, and CH4 production were measured at 12, 24, and 48 h of incubation. Experimental design was a randomized complete block. At 48-h incubation, DMD ranged between 46.5 and 51.2% (P = 0.0015). The lowest cumulative gas production (CGP) was observed in B85E15 and B85G15 (160 mL CGP/g organic matter, on average). At 48 h, B85G15 and B100 produced 28.8 and 30.2 mg CH4/g DMD, respectively, while B85E15 or the mixtures, 33.5 mg CH4/g DMD, on average (P ≤ 0.05). B85E15 and B70G30 had the highest concentration of total VFA (P ≤ 0.05). Results showed that B85E15 and B70GE30 favor DMD and increased total production of VFA and CH4 at 48 h. Supplementing livestock feed with legume forages and pods allows improves the nutritional quality of the diet and the fermentation patterns.

Social environment modulates investment in sex trait versus lifespan: red deer produce bigger antlers when facing more rivalry.

Theory predicts that the plastic expression of sex-traits should be modulated not only by their production costs but also by the benefits derived from the presence of rivals and mates, yet there is a paucity of evidence for an adaptive response of sex-trait expression to social environment. We studied antler size, a costly and plastic sex trait, and tooth wear, a trait related to food intake and longevity, in over 4,000 male Iberian red deer (Cervus elaphus hispanicus) from 56 wild populations characterized by two contrasting management practices that affect male age structure and adult sex-ratio. As a consequence, these populations exhibit high and low levels of male-male competition for mating opportunities. We hypothesized that males under conditions of low intra-sexual competition would develop smaller antlers, after controlling for body size and age, than males under conditions of high intra-sexual competition, thus reducing energy demands (i.e. reducing intake and food comminution), and as a consequence, leading to less tooth wear and a concomitant longer potential lifespan. Our results supported these predictions. To reject possible uncontrolled factors that may have occurred in the wild populations, we carried out an experimental design on red deer in captivity, placing males in separate plots with females or with rival males during the period of antler growth. Males living with rivals grew larger antlers than males living in a female environment, which corroborates the results found in the wild populations. As far as we know, these results show, for the first time, the modulation of a sexual trait and its costs on longevity conditional upon the level of intra-sexual competition.

A Glycosaminoglycan-Rich Fraction from Sea Cucumber Isostichopus badionotus Has Potent Anti-Inflammatory Properties In Vitro and In Vivo.

Sea cucumber body wall contains several naturally occurring bioactive components that possess health-promoting properties. Isostichopus badionotus from Yucatan, Mexico is heavily fished, but little is known about its bioactive constituents. We previously established that I. badionotus meal had potent anti-inflammatory properties in vivo. We have now screened some of its constituents for anti-inflammatory activity in vitro. Glycosaminoglycan and soluble protein preparations reduced 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced inflammatory responses in HaCaT cells while an ethanol extract had a limited effect. The primary glycosaminoglycan (fucosylated chondroitin sulfate; FCS) was purified and tested for anti-inflammatory activity in vivo. FCS modulated the expression of critical genes, including NF-ĸB, TNFα, iNOS, and COX-2, and attenuated inflammation and tissue damage caused by TPA in a mouse ear inflammation model. It also mitigated colonic colitis caused in mice by dextran sodium sulfate. FCS from I. badionotus of the Yucatan Peninsula thus had strong anti-inflammatory properties in vivo.

Hepatoprotective effect of a fucoidan extract from Sargassum fluitans Borgesen against CCl4-induced toxicity in rats.

The in vivo antifibrotic effect of a fucoidan extract (FE) from Sargassum fluitans Borgesen was evaluated in a carbon tetrachloride-induced liver damage model in rats over twelve weeks. Chemical analysis showed the FE to contain carbohydrates, sulfates, uronic acids, protein, phenols, and to have a molecular weight of ~60 kDa. Physiological, biochemical, histological and genetic assays were done. Daily oral administration of FE (50 mg/kg) reduced liver enzymatic activity, liver infiltration of inflammatory cells, collagen fiber deposition and gene expression cytokines such as interleukin beta 1 (IL-ß1), tumor necrosis factor alpha (TNF-α), transforming growth factor beta 1 (TGF-ß1), Smad-3, Smad-2, collagen 1 alpha 1 (col1α1) and tissue inhibitor of metalloproteinase 1 (TIMP-1). It also increased RNA expression of Smad-7 and metalloproteinase 2 and 9 (MMP2 and MMP9). The fucoidan extract exhibited an antifibrotic effect mediated by the inhibiting TGF-ß1/Smad pathway, as well as anti-inflammatory effects.

22-Oxocholestane oximes as potential anti-inflammatory drug candidates.

22-Oxocholestanes bearing the oxime functionality in the side chain have been synthesized from diosgenin and evaluated in vivo as anti-inflammatory agents in an acute inflammation mouse ear model, against the commercial glucocorticoid dexamethasone. The final compounds were all regioselectively obtained with an E configuration at the oxime double bond. The title compounds reduced ear-induced inflammation and edema. The most active oximes repressed the expression of proinflammatory genes TNF-α, COX-2, and IL-6; including macrophage migration inhibitory factor. Overall, our data suggest that 22-oxocholestane oximes exert a strong in vivo anti-inflammatory activity.

Hospitalization and death among patients with influenza, Guatemala, 2008-2012.

BACKGROUND: Influenza is a major cause of respiratory illness resulting in 3-5 million severe cases and 291,243-645,832 deaths annually. Substantial health and financial burden may be averted by annual influenza vaccine application, especially for high risk groups. METHODS: We used an active facility-based surveillance platform for acute respiratory diseases in three hospitals in Guatemala, Central America, to estimate the incidence of laboratory-confirmed hospitalized influenza cases and identify risk factors associated with severe disease (defined as admission to the intensive care unit (ICU) or death). We enrolled patients presenting with signs and symptoms of acute respiratory infection (ARI) and obtained naso- and oropharyngeal samples for real-time reverse transcriptase polymerase chain reaction (RT-PCR). We used multivariable logistic regression to identify risk factors for ICU admission or death, adjusted for age and sex. RESULTS: From May 2008 to July 2012, among 6326 hospitalized ARI cases, 446 (7%) were positive for influenza: of those, 362 (81%) had influenza A and 84 (18%) had influenza B. Fifty nine percent of patients were aged ≤ 5 years, and 10% were aged ≥ 65 years. The median length of hospitalization was 5 days (interquartile range: 5). Eighty of 446 (18%) were admitted to the ICU and 28 (6%) died. Among the 28 deaths, 7% were aged ≤ 6 months, 39% 7-60 months, 21% 5-50 years, and 32% ≥ 50 years. Children aged ≤ 6 months comprised 19% of cases and 22% of ICU admissions. Women of child-bearing age comprised 6% of cases (2 admitted to ICU; 1 death). In multivariable analyses, Santa Rosa site (adjusted odds ratio [aOR] = 10, 95% confidence interval [CI] = 2-50), indigenous ethnicity (aOR = 4, 95% CI = 2-13, and radiologically-confirmed pneumonia (aOR = 5, 95% CI = 3-11) were independently associated with severe disease. Adjusted for hospital utilization rate, annual incidence of hospitalized laboratory-confirmed influenza was 24/100,000 overall, 93/100,000 for children aged < 5 years and 50/100,000 for those ≥ 65 years. CONCLUSIONS: Influenza is a major contributor of hospitalization and death due to respiratory diseases in Guatemala. Further application of proven influenza prevention and treatment strategies is warranted.

Asociación de sobrepeso u obesidad con trastornos del estado de ánimo en adolescentes / Association of overweight or obesity with mood disorders in adolescents Abstract

Determinar la asociación entre sobrepeso-obesidad y trastornos del estado de ánimo en adolescentes, específicamente depresión, ansiedad, baja autoestima y dismorfia corporal. Metodología: Diseño transversal comparativo en adolescentes de 12 a 14 años, se integraron dos grupos el primero con sobrepeso-obesidad y el segundo con normopeso. Los trastornos del estado de ánimo fueron evaluados con Inventario de Depresión de Beck-II, Escala de ansiedad de Hamilton, Escala de autoestima de Rosenberg y Cuestionario de forma corporal de Cooper. El análisis estadístico incluyó chi cuadrada y razón de momios. Resultados: Se encontró asociación de sobrepeso-obesidad con depresión RM 17,94 (IC 95%; 8,17-39,38), ansiedad RM 11,11 (IC 95%; 4,75-25,97), autoestima RM 8,40 (IC 95%; 4,08-17,24) y dismorfia corporal RM 9,64 (IC 95%; 2,14-43,17). Conclusión: Existe asociación entre sobrepeso-obesidad y trastornos del estado de ánimo en adolescentes(AU)

To determine the association between overweight-obesity and mood disorders in adolescents, specifically depression, anxiety, low self- esteem and body dysmorphism. Methodology: Comparative cross-sectional design in adolescents aged 12 to 14 years, two groups were integrated the first with overweight-obesity and the second with normal weight. Mood disorders were evaluated with Beck-II Depression Inventory, Hamilton Anxiety Scale, Rosenberg Self-Esteem Scale and Cooper Body Form Questionnaire. The statistical analysis included chi square and odds ratio. Results: Overweight-obesity association with depression was found in OR 17,94 (IC 95% 8,17-39,38), OR 11,11 anxiety (IC 95% 4,75-25,97), OR self-esteem 8,40 (IC 95% 4.08-17.24) and body dysmorphism OR 9.64 (IC 95% 2.14-43.17). Conclusion: There is an association between overweight-obesity and mood disorders in adolescents(AU)

Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014.

BACKGROUND: Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases). METHODS: For each virus, we calculated a Relative Illness Ratio (defined as the ratio of the percentage of cases in an age group to the percentage of the country population in the same age group) for young children (0-4 years), older children (5-17 years), young adults (18-39 years), older adults (40-64 years), and the elderly (65+ years). We used random-effects meta-analysis models to obtain summary relative illness ratios (sRIRs), and conducted meta-regression and sub-group analyses to explore causes of between-estimates heterogeneity. RESULTS: The influenza virus with highest sRIR was A(H1N1) for young children, B for older children, A(H1N1)pdm2009 for adults, and (A(H3N2) for the elderly. As expected, considering the diverse nature of the national surveillance datasets included in our analysis, between-estimates heterogeneity was high (I2>90%) for most sRIRs. The variations of countries' geographic, demographic and economic characteristics and the proportion of outpatients among reported influenza cases explained only part of the heterogeneity, suggesting that multiple factors were at play. CONCLUSIONS: These results highlight the importance of presenting burden of disease estimates by age group and virus (sub)type.

Characteristics of seasonal influenza A and B in Latin America: Influenza surveillance data from ten countries.

INTRODUCTION: The increased availability of influenza surveillance data in recent years justifies an actual and more complete overview of influenza epidemiology in Latin America. We compared the influenza surveillance systems and assessed the epidemiology of influenza A and B, including the spatio-temporal patterns of influenza epidemics, in ten countries and sub-national regions in Latin America. METHODS: We aggregated the data by year and country and characteristics of eighty-two years were analysed. We calculated the median proportion of laboratory-confirmed influenza cases caused by each virus strain, and compared the timing and amplitude of the primary and secondary peaks between countries. RESULTS: 37,087 influenza cases were reported during 2004-2012. Influenza A and B accounted for a median of 79% and, respectively, 21% of cases in a year. The percentage of influenza A cases that were subtyped was 82.5%; for influenza B, 15.6% of cases were characterized. Influenza A and B were dominant in seventy-five (91%) and seven (9%) years, respectively. In half (51%) of the influenza A years, influenza A(H3N2) was dominant, followed by influenza A(H1N1)pdm2009 (41%) and pre-pandemic A(H1N1) (8%). The primary peak of influenza activity was in June-September in temperate climate countries, with little or no secondary peak. Tropical climate countries had smaller primary peaks taking place in different months and frequently detectable secondary peaks. CONCLUSIONS: We found that good influenza surveillance data exists in Latin America, although improvements can still be made (e.g. a better characterization of influenza B specimens); that influenza B plays a considerable role in the seasonal influenza burden; and that there is substantial heterogeneity of spatio-temporal patterns of influenza epidemics. To improve the effectiveness of influenza control measures in Latin America, tropical climate countries may need to develop innovative prevention strategies specifically tailored to the spatio-temporal patterns of influenza in this region.