Effect of emerging pollutants on the gut microbiota of freshwater animals: Focusing on microplastics and pesticides.

In recent years, emerging environmental pollutants have increasingly endangered the health of freshwater organisms. The gut microbiota exhibits sensitivity to medications, dietary factors and environmental pollutants, rendering it a novel target for toxicological studies. The gut microbiota can be a potential exposure route affecting the host's health. Herein, we review the current knowledge on two different but concurrent pollutants, microplastics and pesticides, regarding their impact on the gut microbiota, which includes alterations in microbial composition, gene expression, function, and health effects in the hosts. Moreover, synergetic interactions between microplastics and pesticides can exacerbate dysbiosis and health risks. We discuss health-related implications of gut microbial changes based on the consequences in metabolism, immunity, and physiology function. Further research is needed to discover the mechanisms underlying these effects and develop strategies for mitigating their harmful impacts on freshwater animals.

Methylotrophic methanogenesis induced by ammonia nitrogen in an anaerobic digestion system.

OBJECTIVES: This lab-scale study aimed to investigate the effect of total ammonia nitrogen (TAN) stress on the methanogenic activity and the taxonomic and functional profiles of the microbial community of anaerobic sludge (AS) from a full-scale bioreactor. METHODS: The AS was subjected to a stepwise increase in TAN every 14 days at concentrations of 1, 2, 2.5, 3, 3.5, and 4 g TAN/L (Acclimated-AS or AAS). This acclimation stage was followed by an ammonia stress stage (4 g/L). A blank-AS (BAS) was maintained without TAN during the acclimation stage. In the second stress stage (ST), the BAS was divided into two new treatments: a control (BAS') and one that received a shock load of TAN of 4 g/L (SBAS'). Methane production was measured, and a metagenomic analysis was conducted to describe the microbial community. RESULTS: A decrease in the relative abundance of Methanothrix soehngenii of 16 % was related to a decrease of 23 % in the methanogenic capacity of AAS when comparing with the final stage of BAS. However, recovery was observed at 3.5 g TAN/L, and a shift to methylotrophic metabolism occurred, indicated by a 4-fold increase in abundance of Methanosarcina mazei. The functional analysis of sludge metagenomes indicated that no statistical differences (p > 0.05, RM ANOVA) were found in the relative abundance of methanogenic genes that initiate acetoclastic and hydrogenotrophic pathways (acetyl-CoA synthetase, ACSS; acetate kinase, ackA; phosphate acetyltransferase, pta; and formylmethanofuran dehydrogenase subunit A, fwdA) into the BAS and AAS during the acclimation phase. The same was observed between groups of genes associated with methanogenesis from methylated compounds. In contrast, statistical differences (p < 0.05, one-way ANOVA) in the relative abundance of these genes were recorded during ST. The functional profiles of the genes involved in acetoclastic, hydrogenotrophic, and methylotrophic methanogenic pathways were brought to light for acclimatation and stress experimental stages. CONCLUSIONS: TAN inhibited methanogenic activity and acetoclastic metabolism. The gradual acclimatization to TAN leads to metabolic and taxonomic changes that allow for the subsequent recovery of methanogenic functionality. The study highlights the importance of adequate management of anaerobic bioprocesses with high nitrogen loads to maintain the methanogenic functionality of the microbial community.

Micronuclei in embryos of eight seabird species in northwestern Mexico: A biomarker of exposure to coastal pollution?

The micronucleus (MN) test may be used to evaluate genome instability in birds and the potential of different species to function as biomarkers of genotoxicity. However, little is known regarding genome instability in seabird embryos or the instability present among embryonic development stages. Therefore, the present study aimed to describe the frequencies of micronucleated erythrocytes (MNE) and micronucleated polychromatic erythrocytes (MNPCE) in blood samples collected from the embryos of eight seabird species nesting on the coast of Sinaloa, Mexico. An additional description of blood cell maturation along with embryo development during incubation was conducted based on the proportion of polychromatic erythrocytes (PCE), and the potential relationships between metals (Hg and Cd concentrations in egg content) and the MN frequencies in embryo blood were evaluated. The PCE proportion appears to decline as incubation advances (initial stage > intermediate stage > advanced stage), and the values varied between species (Suliformes/Pelecaniformes < Charadriiformes: Laridae), which may be related to differences among incubation periods and reproductive strategies. Interspecific variation in the MNPCE frequency was found in embryos showing advanced development, which could be related to both variations in life-history traits and ecological factors and not Hg or Cd exposure. The genomic instability values in this study are the first to be reported for embryos of seabird species nesting in a subtropical coastal region.

Assessing metal(loid)s concentrations and biomarkers in tilapia (Oreochromis niloticus) and largemouth bass (Micropterus salmoides) of three ecosystems of the Yaqui River Basin, Mexico.

Aquatic ecosystems have been suffering deleterious effects due to the development of different economic activities. Metal(loid)s are one of the most persistent chemicals in environmental reservoirs, and may produce adverse effects on different organisms. Since fishes have been largely used in studies of metal(loid)s exposure, tilapia and largemouth bass were collected in three ecosystems from the Yaqui River Basin to measure the concentrations of metal(loid)s (chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), zinc (Zn) arsenic (As), mercury (Hg), and selenium (Se)) and some biomarkers (somatic indices, metallothionein expression and histopathological analysis) in tissues of both species. Metal(loid) concentrations varied seasonally among ecosystems in tissues of both species. The elements varied seasonally and spatially in tissues of both species, with a general distribution of liver > gills > gonads. Also, biomarkers showed variations indicative that the fish species were exposed to different environmental stressor conditions. The highest values of some biomarkers were in largemouth bass, possibly due to differences in their biological characteristics, mainly feeding habits. The multivariate analysis showed positive associations between metal(loid)s and biomarkers, which are usually associated to the use of these elements in metabolic and/or regulatory physiological processes. Both fish species presented histological damage at different levels, from SI types (changes that are reversible for organ structure) to SII types (changes that are more severe but may be repairable). Taken together, the results from this study suggest that the Yaqui River Basin is moderately impacted by metals and metalloids.

Multi-and transgenerational synergistic effects of glyphosate and chlorpyrifos at environmentally relevant concentrations in the estuarine rotifer Proales similis.

We evaluated the multi-and transgenerational effects of single and combined environmentally relevant concentrations of glyphosate (GLY) and chlorpyrifos (CPF) in the estuarine rotifer Proales similis. The acute and chronic toxicities of GLY and CPF were determined as individual compounds and as a mixture. Rotifers were exposed to environmental concentrations of GLY (1, 10, 100, and 1000 µg/L) and CPF (0.1, 1, 5, and 10 µg/L). The main findings were as follows: (i) the LC50 values were 33.91 mg/L (GLY) and 280 µg/L (CPF); (ii) the toxic unit (TU50) of the mixture was 0.30, corresponding to 10.17 mg/L GLY and 83 µg/L CPF; (iii) the multigenerational study indicated that the tested concentrations of GLY and CPF, both single and combined, significantly and consistently decreased the growth rates of P. similis from the F0 to F6 generations; (iv) in most cases, GLY and CPF mixtures induced a strong synergistic effect; and (v) transgenerational effects were detected in the F4 generation, especially GLY and CPF in higher equitoxic proportions. These effects seem to dissipate in F5. Across multigeneration, a slight recovery could indicate population resilience to pollution. Our findings suggest that a mixture of GLY and CPF at environmental concentrations is likely to occur under real field conditions, increasing the risk to marine and estuarine invertebrates such as rotifers.

Microbial gut dysbiosis induced by xenobiotics in model organisms and the relevance of experimental criteria: a minireview.

The gut microbiota is a dynamic ecosystem involved in multiple physiological processes that affect host health. Several factors affect intestinal microbial communities including dietary exposure to xenobiotics, which is highly concerning due to their widespread distribution. Current knowledge of this topic comes from culture-dependent methods, 16S rRNA amplicon fingerprinting, and metagenomics, but a standardised procedures framework remains lacking. This minireview integrates 45 studies from a systematic search using terms related to gut microbiota and its disruption. Only publications encompassing dietary-oral exposure and experimental gut microbiota assessments were included. The results were divided and described according to the biological model used and the disruption observed in the gut microbiota. An overall dysbiotic effect was unclear due to the variety of contaminants and hosts evaluated and the experimental gaps between publications. More standardised experimental designs, including WGS and physiological tests, are needed to establish how a particular xenobiotic can alter the gut microbiota and how the results can be extrapolated.

Risk and Benefit Analysis of Fish Consumption in NW Mexico: Mercury, Selenium, and Fatty Acids.

To balance the risks and benefits of fish consumption, selenium, fatty acids (DHA + EPA), and mercury in fishery products were determined. Analyzed products were canned tuna, frozen tuna (Thunnus albacares), smoked striped marlin (Tetrapturus audax), fresh Pacific sierra (Scomberomorus sierra), fresh dolphinfish (Coryphaena hippurus), fresh tilapia (Gerres cinereus), and fresh bullseye puffer (Sphoeroides annulatus). Mercury (µg g-1 wet weight) ranged from 0.01 (dolphinfish) to 0.23 (bullseye puffer); Se ranged from 0.12 to 0.25. EPA + DHA ranged from 1.16 to 10.72 mg g-1. Intake of EPA + DHA was comparable or above the recommended daily intake; Hg intake was below the reference dose but Se intake was below than recommended values for the different population groups. Considering the HBVSe, fishery products had positive values; i.e., they are healthy food items. According to the interaction of Hg and Se and the rate of fishery product consumption, the risk for consumers is below one percent.

Epigenetic Transgenerational Modifications Induced by Xenobiotic Exposure in Zebrafish.

Zebrafish (Danio rerio) is a well-established vertebrate model in ecotoxicology research that responds to a wide range of xenobiotics such as pesticides, drugs, and endocrine-disrupting compounds. The epigenome can interact with the environment and transform internal and/or external signals into phenotypic responses through changes in gene transcription. Environmental exposures can also generate epigenetic variations in offspring even by indirect exposure. In this review, we address the advantages of using zebrafish as an experimental animal model to study transgenerational epigenetic processes upon exposure to xenobiotics. We focused mostly on DNA methylation, although studies on post-translational modifications of histones, and non-coding RNAs related to xenobiotic exposure in zebrafish are also discussed. A revision of the methods used to study epigenetic changes in zebrafish revealed the relevance and reproducibility for epigenetics-related research. PubMed and Google Scholar databases were consulted for original research articles published from 2013 to date, by using six keywords: zebrafish, epigenetics, exposure, parental, transgenerational, and F2. From 499 articles identified, 92 were considered, of which 14 were selected as included F2 and epigenetic mechanisms. Current knowledge regarding the effect of xenobiotics on DNA methylation, histone modifications, and changes in non-coding RNAs expressed in F2 is summarized, along with key experimental design considerations to characterize transgenerational effects.

Potential fertilizer of spermatozoa in porcine epididymal tail post-orchiectomy.

The aim of this study was to determine the potential fertilizing of spermatozoa from the epididymal tail in different periods of time post-orchiectomy (P-OQ). Therefore, the study was approached in two stages. In the first stage, the orchiectomy was performed in 30 adult pigs. The testicles were stored at 5.00 ˚C in physiological saline solution for 5, 24, 48, 72, 96 and 120 hr. The spermatozoa were obtained by backflushing the vas deferens. The spermogram and fluorometric study were performed for each sample to evaluate the exposure of phosphatidyl-serine (PS) and acrosome reaction (AR). The second stage included the fertilization test, 16 prepubertal sows were selected, after synchronizing the oestrous cycle and the post-cervical artificial insemination was performed with the refrigerated sperm samples from each P-OQ time. The percentage of live sperm remained without significant changes until 96 hr P-OQ. An increase in the percentage of spermatozoa that showed a PS exposure was observed. The premature AR was evident after 72 hr. Considering that the artificial insemination was performed ensuring a minimum number of live sperms, no significant differences were observed in the number of embryos and corpora lutea. The results indicated that pig sperm collected from the epididymal tail P-OQ and stored for 5 and up to 72 hr at 5.00 ˚C had viable characteristics and maintained their fertilization ability. However, there was an increase in the loss of phospholipid asymmetry of the plasma membrane as time increased (72 and 96 hr), therefore, sperm viability was decreased.

Short exposure to glyphosate induces locomotor, craniofacial, and bone disorders in zebrafish (Danio rerio) embryos.

Glyphosate [N-(phosphonomethyl)glycine] is the active ingredient in widely used broad-spectrum herbicides. Even though the toxicity mechanism of this herbicide in vertebrates is poorly understood, evidence suggests that glyphosate is an endocrine disruptor capable of producing morphological anomalies as well as cardiotoxic and neurotoxic effects. We used the zebrafish model to assess the effects of early life glyphosate exposure on the development of cartilage and bone tissues and organismal responses. We found functional alterations, including a reduction in the cardiac rate, significant changes in the spontaneous tail movement pattern, and defects in craniofacial development. These effects were concomitant with alterations in the level of the estrogen receptor alpha osteopontin and bone sialoprotein. We also found that embryos exposed to glyphosate presented spine deformities as adults. These developmental alterations are likely induced by changes in protein levels related to bone and cartilage formation.

A comparison of pesticide residues in soils from two highly technified agricultural valleys in northwestern Mexico.

A pesticide characterization is presented for two highly technified valleys in northwest Mexico: Culiacan Valley (CV) in Sinaloa and Yaqui Valley (YV) in Sonora. Approximately 250,000 kg of active ingredients are used every year, half of which are considered highly hazardous pesticides. Legacy pesticides are still present in the soils of these valleys. The aim of the present study was to identify and quantify a wide variety of pesticides in soils and correlate their concentrations with historical and current use. Agricultural soils from both valleys were sampled and analyzed using accelerated solvent extraction and subsequent quantification by gas chromatography with selective detectors. The most frequently detected pesticides (mean, µg g-1) in CV were organochlorines (0.1967), organophosphates (0.0928), synthetic pyrethroids (0.2565), organonitrogen (0.0552), and miscellaneous pesticides (0.1851). In YV, the most frequently detected pesticides were organochlorines (0.8607), organophosphates (0.0001), synthetic pyrethroids (0.0124), and miscellaneous pesticides (0.0009). The pesticides were more diverse in CV compared to those of YV, which was based on the types of crops produced. Both locations presented highly hazardous pesticides, including concentrations above the action levels established by the Canadian Soil Quality Guide. A follow-up risk assessment is recommended to assess potential effects.

Changes in microtubule stability in zebrafish (Danio rerio) embryos after glyphosate exposure.

Glyphosate, the most commonly used pesticide worldwide, blocks aromatic amino acid biosynthetic pathways and inhibits growth in plants. Although the specific mode of action of glyphosate in animals remains unclear, adverse effects during embryonic development have been reported, including epiboly delays, morphological alterations, and changes in central nervous system development and cardiogenesis. In this study, we suggest a possible toxicity mechanism for this herbicide related to changes in microtubule stability, which could alter the distribution and dynamics of cytoskeleton components. Using zebrafish embryos to evaluate in vivo effects of glyphosate exposure (5, 10, and 50 µg/ml), we found significant reductions in the levels of acetylated α-tubulin (50 µg/ml) and in the polymeric tubulin percentage in zebrafish embryos that had been exposed to 10 and 50 µg/ml glyphosate, without any changes in either the expression patterns of α-tubulin or the stability of actin filaments. These results indicate that high concentrations of glyphosate were associated with reduced levels of acetylated α-tubulin and altered microtubule stability, which may explain some of the neurotoxic and cardiotoxic effects that have been attributed to this herbicide.

Temporal and sex-based variation in organochlorine pesticide levels in the blue-footed booby in two coastal colonies of Sinaloa, Mexico.

The temporal, inter-site, and sex-based variation of 19 organochlorine pesticides (OCPs) in blood plasma samples collected from blue-footed boobies of two islands in Sinaloa, Mexico, was evaluated. The effect of OCPs was evaluated with the heterophil/lymphocyte ratio, micronucleated erythrocyte frequency, and scaled mass index. The OCP-group levels decreased as the breeding season progressed, and interannual (but not inter-colony) differences were detected. Intra-annual variation in OCP levels seemed to reflect run-off inputs, although other environmental processes may better explain the variation between years. Sex-based differences in OCP levels were likely related to ecological and physiological processes linked to breeding (e.g., egg-laying and use of lipid reserves). No correlations between OCP-group levels and biomarkers were detected. Small pelagic fishes are the main prey sources of blue-footed boobies and the targets of regional industrial fisheries, and thus blue-footed booby OCP levels could reflect ecosystem health and indicate potential risks for human consumers.

Hypothermia in newly born piglets: Mechanisms of thermoregulation and pathophysiology of death

Mortality in piglets during the perinatal period, especially the first days after birth, is frequently caused by non infectious conditions, such as hypoglucemia or low birth weight, which can be associated with hypothermia experienced at birth. The thermal stability of newborn piglets is a fundamental aspect of neonatal care, so maintaining a constant, ideal temperature will substantially reduce newborn mortality. Species-specific characteristics, such as a limited capacity for thermoregulation, low energy reserves, a lack of brown adipose tissue (BAT) (-, and environmental conditions that are adverse for the piglet around the time of birth, including the absence of a microclimate, all of them contribute to difficulties in reaching thermal homeostasis in the first hours post-birth. Shivering thermogenesis and behavioral modifications to regulate body temperature through innate mechanisms allow animals to reduce their energy expenditures. Some body postures are effective in reducing contact with the floor and also nestling are useful to avoid heat loss, and also decreases heat dissipation. Achieving optimal development of thermoregulation is a challenge that newborns must confront to successfully adapt to extrauterine life. The objectives of this review, are to discuss the adverse factors that can lead to a death event due to hypothermia by analyzing the thermoregulation mechanisms at the central and cutaneous levels, also to analyze the harmful impacts that surviving neonate piglets confront in an unfavorable thermal environment, and to describe the pathophysiological mechanisms of death caused by hypothermia.

Hypothermia in newly born piglets: Mechanisms of thermoregulation and pathophysiology of death

Mortality in piglets during the perinatal period, especially the first days after birth, is frequently caused by non infectious conditions, such as hypoglucemia or low birth weight, which can be associated with hypothermia experienced at birth. The thermal stability of newborn piglets is a fundamental aspect of neonatal care, so maintaining a constant, ideal temperature will substantially reduce newborn mortality. Species-specific characteristics, such as a limited capacity for thermoregulation, low energy reserves, a lack of brown adipose tissue (BAT) (-, and environmental conditions that are adverse for the piglet around the time of birth, including the absence of a microclimate, all of them contribute to difficulties in reaching thermal homeostasis in the first hours post-birth. Shivering thermogenesis and behavioral modifications to regulate body temperature through innate mechanisms allow animals to reduce their energy expenditures. Some body postures are effective in reducing contact with the floor and also nestling are useful to avoid heat loss, and also decreases heat dissipation. Achieving optimal development of thermoregulation is a challenge that newborns must confront to successfully adapt to extrauterine life. The objectives of this review, are to discuss the adverse factors that can lead to a death event due to hypothermia by analyzing the thermoregulation mechanisms at the central and cutaneous levels, also to analyze the harmful impacts that surviving neonate piglets confront in an unfavorable thermal environment, and to describe the pathophysiological mechanisms of death caused by hypothermia.(AU)

Comparative Assessment of Metal Bioaccumulation in Tilapia and Largemouth Bass from Three Dams of the Yaqui River.

In the present paper, we investigated the accumulation of six metals in tilapia (Oreochromis nilocticus) and largemouth bass (Micropterus salmoides) as indicators of the environmental pollution present at three constructed dams in the Yaqui River basin in Sonora, Mexico. The La Angostura (ANG), El Cajon de Onapa (ECO), and El Oviachic (OVI) dams are ecosystems under different degrees of anthropogenic stress. The collected fishes were dissected to obtain liver, gonad, stomach, gill, and muscle samples to determine the metal concentrations of Fe, Mn, Ni, Cu, Zn, and Cr. The results of a PERMANOVA showed that the concentrations of Fe, Cu, and Zn were significantly higher in tilapia liver, stomach, and gill tissues compared with those of the largemouth bass. Also, differences were detected between seasons, with the metal concentrations during the dry season being significantly higher than those of the rainy season (p < 0.001). The results of a principal component analysis showed an association between metals, tissues, and dams with significantly higher (p < 0.001) concentrations in tilapia from the ECO dam compared with those from the ANG and OVI dams. The general distribution of metals in the tissues was as follows: liver > stomach-gills > gonads > muscle. Variations in metal concentrations may be indicative of the different sources of anthropogenic stress in each ecosystem.

A metagenomic assessment of microbial communities in anaerobic bioreactors and sediments: Taxonomic and functional relationships.

The present study used metagenomic sequencing, metagenome assembly and physical-chemical analysis to describe taxonomically and functionally 3 anaerobic bioreactors treating manure (LI), brewery (BR) and cornmeal (CO) wastes, and an anaerobic estuarine sediment (ES). Proteobacteria, Firmicutes, Euryarchaeota and Bacteroidetes were the most abundant Phyla in all metagenomes. A bacteria/archaea ratio of 3.4 was found in the industrial full-scale anaerobic bioreactors BR and CO, while ratios greater than 10 were found for LI and ES. Canonical correspondence analysis showed that environmental variables such as chemical oxygen demand, lipid content, and ammonium nitrogen influenced the ordination of taxonomic groups. Mesotoga prima was linked to high-temperature conditions, particularly in the BR bioreactor, along with the presence of heat shock proteins genes. Likewise, the hydrogenotrophic methanogen, Methanoregula formicica, was associated with high ammonium concentration in LI bioreactor. The interactions of microbes with specific methanogenic pathways were identified using Clusters of Orthologous Groups (COG) functions, while metagenome-assembled genomes (MAGs) further confirmed relationships between taxa and functions. Our results provide valuable information to understand microbial processes in anaerobic environments.

Neurological modulation of facial expressions in pigs and implications for production

The facial expressions of animals constitute a means of manifesting emotions, fulfilling functions related to social interactions in several species. Interest has come to use facialexpressions as a tool for predicting intentions; in the case of aggression, for example, impeding attacks between individuals prevents negative economic and emotional impacts. Recent research has sought to associate facial expressions with painful events as tail-cropping and castration on the assumption thatobjective evaluations of the presence or absence of grimaces in pigs' snouts may allow us to determine the intensity of the pain they perceive. Furthermore, to continue developing scales that will complement the existing piglet grimace scale (PGS), which is not yet fully-validated in terms of reliability. Another area of research is interpreting expressions of fear during traumatic events like pre-slaughter handling. Also, the phenomenon of emotional contagion in groups of animals suggests the need to focus on their emotions, since recognizing them could allow us to prevent alterations of meat quality.These approaches reveal the need for a detailed compilation of the facial expressions of pigs based on current scientific literature regarding emotions, alimentation, and pain-related behavioral responses in pigs.

Neurological modulation of facial expressions in pigs and implications for production

The facial expressions of animals constitute a means of manifesting emotions, fulfilling functions related to social interactions in several species. Interest has come to use facialexpressions as a tool for predicting intentions; in the case of aggression, for example, impeding attacks between individuals prevents negative economic and emotional impacts. Recent research has sought to associate facial expressions with painful events as tail-cropping and castration on the assumption thatobjective evaluations of the presence or absence of grimaces in pigs' snouts may allow us to determine the intensity of the pain they perceive. Furthermore, to continue developing scales that will complement the existing piglet grimace scale (PGS), which is not yet fully-validated in terms of reliability. Another area of research is interpreting expressions of fear during traumatic events like pre-slaughter handling. Also, the phenomenon of emotional contagion in groups of animals suggests the need to focus on their emotions, since recognizing them could allow us to prevent alterations of meat quality.These approaches reveal the need for a detailed compilation of the facial expressions of pigs based on current scientific literature regarding emotions, alimentation, and pain-related behavioral responses in pigs.(AU)

Síndrome de Cushing exógeno de difícil diagnóstico / Exogenous Cushings syndrome with a difficult diagnosis

Resumen Introducción: el síndrome de Cushing (SC) es un grupo de signos y síntomas causados por la exposición crónica al exceso de glucocorticoides. El uso de fármacos con glucocorticoides es la causa más frecuente, pero algunos productos vendidos como suplementos nutricionales o medicamentos naturistas para el control de los dolores articulares pueden contenerlos de forma oculta, lo cual dificulta el enfoque diagnóstico Presentación del caso: paciente de 40 años con signos clínico típicos de síndrome de Cushing con resultados discordantes en las pruebas diagnósticas para identificar su origen. Finalmente se logra establecer que el paciente consumía de forma crónica un producto "naturista" conocido como artrin®, el cual fue analizado en el laboratorio de la institución con resultados positivos para cortisol. Conclusión: la exposición crónica a glucocorticoides exógenos, ya sea subrepticia, desconocida o prescrita, causa SC y debe distinguirse tempranamente de las formas endógenas para evitar la realización de pruebas diagnósticas y tratamientos inadecuados.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1500).

Abstract Introduction: Cushing's syndrome (CS) is a group of signs and symptoms caused by chronic exposure to excessive glucocorticoids. The use of medications containing glucocorticoids is the most common cause, but they may be hidden in some products sold as nutritional supplements or naturopathic medications, which makes the diagnostic approach more difficult. Case presentation: this was a 40-year-old patient with typical clinical signs of Cushing's syndrome and discordant results of diagnostic tests to identify its origin. It was ultimately determined that the patient had been chronically taking a "naturopathic" product known as artrin®, which was analyzed in the institution's lab and found to contain cortisol. Conclusion: chronic exposure to exogenous glucocorticoids, whether surreptitious, unknown or prescribed, causes CS and should be promptly distinguished from endogenous forms to avoid inappropriate diagnostic tests and treatments.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1500).