Biodiversity of Lecanosticta pine-needle blight pathogens suggests a Mesoamerican Centre of origin.

Lecanosticta acicola causes the disease known as brown spot needle blight (BSNB), on Pinus species. The pathogen is thought to have a Central American centre of origin. This was based on the morphological variation between isolates believed to represent L. acicola from native Pinus spp. Two species of Lecanosticta, L. brevispora and L. guatemalensis, have recently been described from Mexico and Guatemala respectively based on morphology and sequence-derived phylogenetic inference. However, the putative native pathogen, L. acicola, was not found in those areas. In this study, the species diversity of a large collection of Lecanosticta isolates from Central America was considered. Phylogenetic analyses of the BT1, ITS, MS204, RPB2 and TEF1 gene regions revealed six species of Lecanosticta, four of which represented undescribed taxa. These are described here as Lecanosticta jani sp. nov. from Guatemala and Nicaragua, L. pharomachri sp. nov. from Guatemala and Honduras, L. tecunumanii sp. nov. from Guatemala and L. variabilis sp. nov. from Guatemala, Honduras, and Mexico. New host and country records were also found for the previously described L. brevispora and L. guatemalensis. Lecanosticta acicola was not found in any of the samples from Central America, and we hypothesize that it could be a northern hemisphere taxon. The high species diversity of Lecanosticta found in Mesoamerica suggests that this is a centre of diversity for the genus.

Surgical treatment of congenital torticollis, at the shriners hospital, mexico city / Tratamento cirúrgico de torcicolo congênito no hospital shriners, cidade do méxico / Tratamiento quirúrgico de tortícolis congénito en el hospital shriners, ciudad de méxico

ABSTRACT Objective: This study aims to evaluate the outcome of surgical treatment of congenital torticollis in our hospital. Methods: We collected the medical records of all patients diagnosed with congenital torticollis in the last 3 years at Shriners Hospital, Mexico City. The cases of congenital torticollis treated with surgery were selected and we evaluated the type of surgical technique, bleeding, time of surgery and complications, as well as the associated diagnoses of hip dysplasia. Results: We found 11 patients, of whom 7 met the inclusion criteria. Three women and four men with mean age of 10.7 years, five of whom had right, and two left side affections. All were surgically treated, five with unipolar and two with bipolar release. The surgery time was similar in both techniques and no complications were found in any of the groups. In two cases there were associated diagnoses, Klippel-Feil syndrome and congenital talipes equinovarus (CTEV) in one and psychomotor retardation in another. No association was found with hip dysplasia. All patients had improved range of movement and head tilt. There were no complications related to the surgical procedure or need for reintervention in our patients. Conclusions: Surgical treatment of congenital torticollis by uni- or bipolar release is an effective and safe method for these patients, presenting aesthetic and functional benefits.

RESUMO Objetivo: Este estudo visa avaliar o resultado do tratamento cirúrgico de torcicolo congênito em nosso hospital. Métodos: Foram coletados os registros de todos os pacientes com diagnóstico de torcicolo congênito nos últimos 3 anos no Hospital Shriners, Cidade do México. Selecionaram-se os casos de torcicolo congênito tratados com cirurgia, avaliando-se tipo de técnica cirúrgica, sangramento, tempo de cirurgias e complicações, assim como os diagnósticos associados e a presença de displasia de quadril. Resultados: Foram encontrados 11 pacientes, dos quais 7 satisfizeram os critérios de inclusão. Três mulheres e quatro homens com média de idade de 10,7 anos, dos quais, cinco tinham afecção do lado direito e dois do lado esquerdo. Todos foram tratados cirurgicamente, cinco com liberação unipolar e dois com bipolar. O tempo de cirurgia foi semelhante nas duas técnicas e não se constataram complicações em nenhum dos grupos. Em dois casos havia diagnósticos associados, síndrome de Klippel-Feil e pé torto equinovaro (PTC) em um e atraso psicomotor em outro. Não se encontrou associação com displasia de quadril. Todos apresentaram melhoras da amplitude de movimento e da inclinação da cabeça. Não houve complicações relacionadas com o procedimento cirúrgico nem necessidade de reintervenção em nossos pacientes. Conclusões: O tratamento cirúrgico do torcicolo congênito por liberação uni ou bipolar é um método efetivo e seguro para esses pacientes, apresentando benefício estético e funcional.

RESUMEN Objetivo: El objetivo de este estudio es evaluar el resultado del tratamiento quirúrgico del tortícolis congénito en nuestro hospital. Métodos: Se recabaron todos los pacientes con diagnóstico de tortícolis congénito en los últimos 3 años en el Hospital Shriners, ciudad de México. Se seleccionaron los casos de tortícolis congénito tratados quirúrgicamente, valorando el tipo de técnica quirúrgica, sangrado, tiempo quirúrgico y complicaciones, así como diagnósticos asociados y la presencia de displasia de cadera. Resultados: Se encontraron 11 pacientes de los cuales 7 cumplieron con los criterios de inclusión. Tres mujeres y cuatro hombres con un promedio de edad de 10.7 años, en los cuales cinco tenían afección en el lado derecho y dos en el izquierdo. Todos fueron manejados quirúrgicamente, cinco con liberación unipolar y dos con bipolar. El tiempo quirúrgico fue similar para las dos técnicas y no se encontraron complicaciones en ninguno de los grupos. En dos casos existieron diagnósticos asociados, síndrome de Klippel-Feil y pie equino varo congénito (PEVC) en uno y retraso psicomotor en otro. No se encontró asociación con displasia de cadera. Todos presentaron mejoría de los arcos de movilidad y de la inclinación de cabeza. No hubo complicaciones relacionadas al procedimiento quirúrgico ni necesidad de reintervenciones en nuestros pacientes. Conclusiones: El tratamiento quirúrgico del tortícolis congénito mediante liberación uni o bipolar es un método efectivo y seguro para estos pacientes, presentando un beneficio estético y funcional.

Spatial-Temporal Distribution of Hantavirus Rodent-Borne Infection by Oligoryzomys fulvescens in the Agua Buena Region--Panama.

BACKGROUND: Hotspot detection and characterization has played an increasing role in understanding the maintenance and transmission of zoonotic pathogens. Identifying the specific environmental factors (or their correlates) that influence reservoir host abundance help increase understanding of how pathogens are maintained in natural systems and are crucial to identifying disease risk. However, most recent studies are performed at macro-scale and describe broad temporal patterns of population abundances. Few have been conducted at a microscale over short time periods that better capture the dynamical patterns of key populations. These finer resolution studies may better define the likelihood of local pathogen persistence. This study characterizes the landscape distribution and spatio-temporal dynamics of Oligoryzomys fulvescens (O. fulvescens), an important mammalian reservoir in Central America. METHODS: Information collected in a longitudinal study of rodent populations in the community of Agua Buena in Tonosí, Panama, between April 2006 and December 2009 was analyzed using non-spatial analyses (box plots) and explicit spatial statistical tests (correlograms, SADIE and LISA). A 90 node grid was built (raster format) to design a base map. The area between the nodes was 0.09 km(2) and the total study area was 6.43 km(2) (2.39 x 2.69 km). The temporal assessment dataset was divided into four periods for each year studied: the dry season, rainy season, and two months-long transitions between seasons (the months of April and December). RESULTS: There were heterogeneous patterns in the population densities and degrees of dispersion of O. fulvescens that varied across seasons and among years. The species typically was locally absent during the late transitional months of the season, and re-established locally in subsequent years. These populations re-occurred in the same area during the first three years but subsequently re-established further south in the final year of the study. Spatial autocorrelation analyses indicated local populations encompassed approximately 300-600 m. The borders between suitable and unsuitable habitats were sharply demarcated over short distances. CONCLUSION: Oligoryzomys fulvescens showed a well-defined spatial pattern that evolved over time, and led to a pattern of changing aggregation. Thus, hot spots of abundance showed a general shifting pattern that helps explain the intermittent risk from pathogens transmitted by this species. This variation was associated with seasonality, as well as anthropogenic pressures that occurred with agricultural activities. These factors help define the characteristics of the occurrence, timing, intensity and duration of synanthropic populations affected by human populations and, consequently, possible exposure that local human populations experience.

Spatial Models for Prediction and Early Warning of Aedes aegypti Proliferation from Data on Climate Change and Variability in Cuba.

INTRODUCTION: Climate variability, the primary expression of climate change, is one of the most important environmental problems affecting human health, particularly vector-borne diseases. Despite research efforts worldwide, there are few studies addressing the use of information on climate variability for prevention and early warning of vector-borne infectious diseases. OBJECTIVE: Show the utility of climate information for vector surveillance by developing spatial models using an entomological indicator and information on predicted climate variability in Cuba to provide early warning of danger of increased risk of dengue transmission. METHOD: An ecological study was carried out using retrospective and prospective analyses of time series combined with spatial statistics. Several entomological and climatic indicators were considered using complex Bultó indices -1 and -2. Moran's I spatial autocorrelation coefficient specified for a matrix of neighbors with a radius of 20 km, was used to identify the spatial structure. Spatial structure simulation was based on simultaneous autoregressive and conditional autoregressive models; agreement between predicted and observed values for number of Aedes aegypti foci was determined by the concordance index Di and skill factor Bi. RESULTS: Spatial and temporal distributions of populations of Aedes aegypti were obtained. Models for describing, simulating and predicting spatial patterns of Aedes aegypti populations associated with climate variability patterns were put forward. The ranges of climate variability affecting Aedes aegypti populations were identified. Forecast maps were generated for the municipal level. CONCLUSIONS: Using the Bultó indices of climate variability, it is possible to construct spatial models for predicting increased Aedes aegypti populations in Cuba. At 20 x 20 km resolution, the models are able to provide warning of potential changes in vector populations in rainy and dry seasons and by month, thus demonstrating the usefulness of climate information for epidemiological surveillance.

Approaches to Climate Change & Health in Cuba: Guillermo Mesa MD MPhil, Director, Disasters & Health, National School of Public Health. Paulo Ortiz MS PhD, Senior Researcher, Climate Center, Cuban Meteorology Institute.

The US National Institutes of Health predict climate change will cause an additional 250,000 deaths between 2030 and 2050, with damages to health costing US$2-$4 billion by 2030. Although much debate still surrounds climate change, island ecosystems-such as Cuba's-in the developing world are arguably among the most vulnerable contexts in which to confront climate variability. Beginning in the 1990s, Cuba launched research to develop the evidence base, set policy priorities, and design mitigation and adaptation actions specifically to address climate change and its effects on health. Two researchers at the forefront of this interdisciplinary, intersectoral effort are epidemiologist Dr Guillermo Mesa, who directed design and implementation of the nationwide strategy for disaster risk reduction in the Cuban public health system as founding director of the Latin American Center for Disaster Medicine (CLAMED) and now heads the Disasters and Health department at the National School of Public Health; and Dr Paulo Ortiz, a biostatistician and economist at the Cuban Meteorology Institute's Climate Center (CENCLIM), who leads the research on Cuba's Climate and Health project and is advisor on climate change and health for the UN Economic Commission for Latin America and the Caribbean (ECLAC).

Influence of climate variability on acute myocardial infarction mortality in Havana, 2001-2012.

INTRODUCTION: Death from acute myocardial infarction is due to many factors; influences on risk to the individual include habits, lifestyle and behavior, as well as weather, climate and other environmental components. Changing climate patterns make it especially important to understand how climatic variability may influence acute myocardial infarction mortality. OBJECTIVES: Describe the relationship between climate variability and acute myocardial infarction mortality during the period 2001-2012 in Havana. METHODS: An ecological time-series study was conducted. The universe comprised 23,744 deaths from acute myocardial infarction (ICD-10: I21-I22) in Havana residents from 2001 to 2012. Climate variability and seasonal anomalies were described using the Bultó-1 bioclimatic index (comprising variables of temperature, humidity, precipitation, and atmospheric pressure), along with series analysis to determine different seasonal-to-interannual climate variation signals. The role played by climate variables in acute myocardial infarction mortality was determined using factor analysis. The Mann-Kendall and Pettitt statistical tests were used for trend analysis with a significance level of 5%. RESULTS: The strong association between climate variability conditions described using the Bultó-1 bioclimatic index and acute myocardial infarctions accounts for the marked seasonal pattern in AMI mortality. The highest mortality rate occurred during the dry season, i.e., the winter months in Cuba (November-April), with peak numbers in January, December and March. The lowest mortality coincided with the rainy season, i.e., the summer months (May-October). A downward trend in total number of deaths can be seen starting with the change point in April 2009. CONCLUSIONS: Climate variability is inversely associated with an increase in acute myocardial infarction mortality as is shown by the Bultó-1 index. This inverse relationship accounts for acute myocardial infarction mortality's seasonal pattern.

Assessment of human health vulnerability to climate variability and change in cuba.

Reprinted with permission from Environmental Health Perspectives. Dec 2006;114:1942-1949. In this study we assessed the potential effects of climate variability and change on population health in Cuba. We describe the climate of Cuba as well as the patterns of climate-sensitive diseases of primary concern, particularly dengue fever. Analyses of the associations between climatic anomalies and disease patterns highlight current vulnerability to climate variability. We describe current adaptations, including the application of climate predictions to prevent disease outbreaks. Finally, we present the potential economic costs associated with future impacts due to climate change. The tools used in this study can be useful in the development of appropriate and effective adaptation options to address the increased climate variability associated with climate change.

Resultados y experiencias de la vigilancia nacionalde meningitis bacteriana en Cuba / Resultados y experiencias de la vigilancia nacional

Objetivos: Desde 1998 se implementó en Cuba un nuevo sistema de vigilancia nacional de meningitis bacteriana (VNMB) con el objetivo de lograr información en correspondencia con el desarrollo científico actual y las exigencias del programa nacional de prevención y control de estas infecciones. Resultados: Este sistema permitió medir el impacto de la vacuna contra H. influenzae tipo b (Hib) en 1999 sin necesidad de un proyecto y gastos adicionales, demostrando la reducción inmediata de la incidencia (52por ciento). Hasta el 2002 fueron reportados 82 niños < 5 años de los cuales 61(74,4por ciento) no estaban vacunados. Entre los vacunados hubo 14 (66,7por ciento) con una sola dosis aplicada.A partir de esta intervención S. pneumoniae resultó el principal agente causal de meningitis. Los serogrupos/ serotipos más frecuentes han sido 19, 6, 14, 18, 1, 7 y 23, mostrando un 40por ciento de susceptibilidad disminuida a la penicilina. Por primera vez identificamos: - fuerte asociación (RR > 20) de los estudiantes internos de primaria con la enfermedad, - incidencia elevada entre amas de casa (> 2/100 000) y jubilados (> 8/100 000), - fuerte asociación (Razón de disparidad > 20) de la muerte con jubilados y amas de casa en el análisis multivariado. Los resultados microbiológicos posibilitaron la caracterización de agentes y la política antibiótica más adecuada. La letalidad general de la meningitis neumocócica fue > 32 por ciento y fundamentalmente en ancianos. Conclusiones: LaVNMB aportó novedosa información clínico - epidemiológica y microbiológica, permitiendo ampliar el marco integral de los conocimientos y garantizando acciones más efectivas y eficientes en un proyecto multidisciplinario e intersectorial generalizado (AU)