Admixture mapping analysis reveals differential genetic ancestry associated with Chagas disease susceptibility in the Colombian population.

Chagas disease is an infection caused by the parasite Trypanosoma cruzi, endemic in Latino America. Leveraging the three-way admixture between Native American (AMR), European (EUR) and African (AFR) populations in Latin Americans, we aimed to better understand the genetic basis of Chagas disease by performing an admixture mapping study in a Colombian population. A two-stage study was conducted, and subjects were classified as seropositive and seronegative for T. cruzi. In stage 1, global and local ancestries were estimated using reference data from the 1000 Genomes Project (1KGP), and local ancestry associations were performed by logistic regression models. The AMR ancestry showed a protective association with Chagas disease within the major histocompatibility complex region [Odds ratio (OR) = 0.74, 95% confidence interval (CI) = 0.66-0.83, lowest P-value = 4.53 × 10-8]. The fine mapping assessment on imputed genotypes combining data from stage 1 and 2 from an independent Colombian cohort, revealed nominally associated variants in high linkage disequilibrium with the top signal (rs2032134, OR = 0.93, 95% CI = 0.90-0.97, P-value = 3.54 × 10-4) in the previously associated locus. To assess ancestry-specific adaptive signals, a selective sweep scan in an AMR reference population from 1KGP together with an in silico functional analysis highlighted the Tripartite Motif family and the human leukocyte antigen genes, with crucial role in the immune response against pathogens. Furthermore, these analyses emphasized the macrophages, neutrophils and eosinophils, as key players in the defense against T. cruzi. This first admixture mapping study in Chagas disease provided novel insights underlying the host immune response in the pathogenesis of this neglected disease.

Persistent high levels of immune activation and their correlation with the HIV-1 proviral DNA and 2-LTR circles loads, in a cohort of Mexican individuals following long-term and fully suppressive treatment.

OBJECTIVES: The aim of this study was to investigate the correlation between the HIV-1 reservoir and the levels of immune activation in chronic patients under fully suppressive cART. METHODS: We quantified the HIV proviral DNA and 2-LTR circles loads from PBMCs, the levels of CD38+ and Ki-67+ T-cells, and the levels of IL-7 in a cohort of patients with more than 5 years of ART at enrollment and after 1 year. RESULTS: In 29 participants with a median of 8 years (IQR, 6.9-9.4) under suppressive cART we found higher levels of CD8+ CD38+ T-cells after 1-year (P = .000). There was a non-statistically significant poor correlation between the levels of immune activation and the proviral DNA of CD4+ and CD8+ T-cells. Ki-67+ T-cells declined without significant differences, and there was no significant correlation with the proportion of CD38+. IL-7 decreased at the follow-up observation (P = .094), but there was no correlation with the levels of CD38+ and Ki-67+ T-cells. CONCLUSIONS: We found a weak but non-statistically significant correlation of the levels of T-cell activation with the proviral DNA and 2-LTR circles. This suggests the likely occurrence of further mechanisms driving chronic versus early immune activation other than viral replication by itself in chronic patients.

Location and removal of non-palpable subdermal single-rod contraceptive implant.

OBJECTIVE: The objective of the study was to present the experience of the family planning service Hospital General de México, in locating and removing no palpable subdermal single-rod contraceptive implants. MATERIALS AND METHODS: A descriptive, prospective, and cross-sectional study was performed from January 2011 to April 2018. RESULTS: Hundred and sixty-four patients in whom the implant was not palpable were reviewed, the time between insertion and removal averaged 3.3 years (maximum 10 years and minimum 3 months). Three implants were inserted in the right arm, the rest on the left one. Forty-seven implants were found in fatty tissue (29%), 18 in fascia (11%), 94 in muscle (57%), 2 in the armpit (1.2%), and 3 were not found (1.8%). CONCLUSIONS: The no palpable implant is caused by an incorrect insertion technique. Migration should not be assumed as a cause of difficult location. Amount of non-palpable implants is not possible to determine due to a lack of records, but approximately 3% are considered non-palpable. Ultrasound has proven to be the study of choice to locate an incorrect inserted implant. In this case, the total number of implants was located, except in two patients.

OBJETIVO: Presentar la experiencia del servicio de planificación familiar del Hospital General de México Dr. Eduardo Liceaga en la localización y la extracción de implantes anticonceptivos subdérmicos no palpables. MATERIALS Y MÉTODOS: Estudio clínico descriptivo, prospectivo y transversal, realizado desde enero de 2011 hasta abril de 2018 en el servicio de planificación familiar del Hospital General de México Dr. Eduardo Liceaga. RESULTADOS: Se incluyeron 164 pacientes con implantes no palpables, de los cuales 161 se localizaron por ultrasonido. El promedio entre la inserción y el retiro fue de 3.3 años. Tres implantes fueron insertados en el brazo derecho y el resto en el izquierdo; tres no se encontraron. CONCLUSIÓN: Por su fácil acceso y simplicidad, el ultrasonido es el método de elección para localizar implantes profundos no palpables.

Enfermedad de Chagas agudo: transmisión oral de Trypanosoma cruzi como una vía de transmisión re-emergente

La forma clínica más común de la enfermedad de Chagas en Colombia es la cardiomiopatía chagásica crónica. Sin embargo, recientemente se han presentado nueve brotes de Chagas agudo (EChA) de probable transmisión oral en áreas de baja endemia con escasa presencia de vectores domiciliados. Estos brotes han presentado altas tasas de morbilidad y mortalidad. La transmisión oral de Trypanosoma cruzi ocurre por ingestión de alimentos contaminados con heces de insectos vectores o secreciones de reservorios silvestres contaminadas. Se considera un brote de transmisión oral cuando se detecta más de un caso agudo de enfermedad febril, sin vía de inoculación aparente, asociado con ingesta de alimentos sospechosos. El diagnóstico se hace por la detección del parásito en sangre u otros fluidos biológicos, en los primeros días de presentación del síndrome febril.

The most common clinical form of Chagas disease in Colombia is the chronic Chagas cardiomyopathy. However, recently nine outbreaks of acute Chagas disease by probable oral transmission have been described in low endemic areas with scarce presence of domiciliated vectors. These outbreaks have had high rates of morbidity and mortality. The oral transmission of Trypanosoma cruzi occurs by the ingestion of contaminated food with feces of vectors or secretions of wild reservoirs. An oral transmission outbreak is considered when more than one individual shows an acute febrile illness without an inoculation route, and associated with suspected food intake. The diagnosis is made by detection of parasite in blood or other biological fluids, in the early days of presentation of febrile syndrome.

Biomedical engineering education--status and perspectives.

Biomedical Engineering programs are present at a large number of universities all over the world with an increasing trend. New generations of biomedical engineers have to face the challenges of health care systems round the world which need a large number of professionals not only to support the present technology in the health care system but to develop new devices and services. Health care stakeholders would like to have innovative solutions directed towards solving problems of the world growing incidence of chronic disease and ageing population. These new solutions have to meet the requirements for continuous monitoring, support or care outside clinical settlements. Presence of these needs can be tracked through data from the Labor Organization in the U.S. showing that biomedical engineering jobs have the largest growth at the engineering labor market with expected 72% growth rate in the period from 2008-2018. In European Union the number of patents (i.e. innovation) is the highest in the category of biomedical technology. Biomedical engineering curricula have to adopt to the new needs and for expectations of the future. In this paper we want to give an overview of engineering professions in related to engineering in medicine and biology and the current status of BME education in some regions, as a base for further discussions.