Persistent organic pollutants and chlorpyrifos in tissues of a histotrophic viviparous species, the Southern Eagle Ray Myliobatis goodei.

Elasmobranchs are good indicators of marine pollution as they accumulate pollutants from water and food, and occupy different trophic levels. Concentrations of organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and chlorpyrifos were quantified in muscle, liver, gonads, gills, and brain in both sexes and maturity stages of the Southern Eagle Ray, Myliobatis goodei, captured in Argentine coastal waters. Moreover, possible histological alterations in the liver and gonads were analyzed. Pollutant concentrations were pervasive across all tissues, with PCBs > OCPs > chlorpyrifos. Elevated pollutant levels were notably found in the liver and gills. We identified thirty-six PCB congeners in tissues, with low-chlorine congeners prevailing. Among OCPs, ∑DDT and ∑endosulfan were predominant. Females exhibited higher pollutant levels in most tissues compared to males, except in the gonads, and adults generally displayed elevated pollutant levels. Histological analysis revealed the presence of atretic follicles and melanomacrophages (MM). Continuous monitoring of pollutant levels, alongside their effects on physiological and ecological traits, is imperative for effective management and conservation efforts.

Comparison of the blood biochemical values of foraging and nesting Olive Ridley turtles (Lepidochelys olivacea) from Sinaloa, Mexico.

Our study aimed to establish reference values for nesting females and compare them with those previously reported to understand olive ridley turtles' health status and contribute to long-term health assessment and monitoring in foraging and nesting areas from the state of Sinaloa, Mexico. In August and September 2018, morphometric data and biochemical profiles were collected from 33 nesting olive ridley turtles from Ceuta Beach Sanctuary (CBS) and 14 foraging female turtles captured at the foraging site, Navachiste Marine Area (NMA). Nesting turtles sampled had greater CCL (65.86 ± 1.70 cm) than those from the foraging area (61.54 ± 1.22) (p < 0.05). Regarding biochemical profiles, post-nesting turtles had higher packed cell volume (PCV), albumin, blood urea nitrogen (BUN), cholesterol, triglycerides, and calcium than turtles from the foraging area (p < 0.05). Phosphorus levels were higher in foraging turtles than in nesting turtles (p = 0.001), while the remaining parameters showed no significant differences. The present study describes for the first time the blood biochemical values of nesting turtles from the Ceuta Beach Sanctuary in southern Sinaloa, Mexico, similar to those of foraging turtles from the north of the state. The significant differences observed between the two analysis groups may be due to the energy reserves and reproductive and nesting activity of the nesting turtles, so the blood biochemistry values described in this study can be used as a standard reference blood value for the olive ridley turtle population of Sinaloa, Mexico.

Life-history traits of an exploited skate: The short-tail yellownose skate Zearaja brevicaudata (Chondrichthyes: Rajiformes).

The short-tail yellownose skate, Zearaja brevicaudata, occurs off southern Brazil and along the Argentine continental shelf, including waters surrounding the Islas Malvinas and the upper slope, and is very frequently caught by trawl fisheries throughout its range. The age, growth, and maturity of Z. brevicaudata were investigated using 204 individuals collected by commercial fishing vessels from northern Argentina, between March 2016 and September 2019. Age was determined on a sample comprising vertebrae from 151 individuals, 60 males, ranging in size from 391 to 956 mm total length (TL), and 91 females, ranging in size from 324 to 1060 mm TL. Maximum ages determined for males and females were 22 and 29 years, respectively. A Bayesian framework was employed with a set of three candidate models to estimate growth parameters (von Bertalanffy, Gompertz, and Logistic). The von Bertalanffy model had the best fit, and the sexes showed undistinguishable growth parameters. For sexes combined, derived growth mean parameters (± S.D.) were L∞ = 1081 mm ± 64.34 mm, k = 0.09 ± 0.01 years-1, and L0 = 248 mm ± 23.52 mm. The age at maturity was estimated at 13.15 and 14.66 years for males and females, respectively.

Distribution and virulence of Escherichia coli harboring cyclomodulins and supplementary virulence genes isolates from clinical and environmental samples.

This study aimed to determine the prevalence of cyclomodulins (cdt, cnf, pks and cif) in Escherichia coli (E. coli) isolated from clinical and environmental samples, the presence of supplementary virulence genes (SVG), antibiotic resistance, and in vitro cytotoxicity. 413 E. coli were isolated from clinical (stool from obese subjects, normal weight subjects, children with diarrhea, and children without diarrhea; and urine from pregnant and non-pregnant women with urinary tract infections) and environmental (water and different foods) samples. PCR was performed to identify E. coli pathotypes, the four cyclomodulins, and 18 SVG; virulence score, cytotoxic assay, and antibiotic resistance assay were performed. Fifteen percent of E. coli were positive for cyclomodulins and were found in all isolation sources; however, in children with diarrhea, they were more frequent. The most frequent cyclomodulin was cdt. More DEC strains harbor cyclomodulins than non-DEC, and cyclomodulins were most frequent among aEPEC pathotype. SVG ehaC was associated with cyclomodulin-positive strains. Cyclomodulin-positive E. coli had a higher virulence score but no significant cytotoxic activity. They were slightly more resistant to antibiotics. In conclusion, cyclomodulins-positive E. coli was widely distributed in humans, food, and the environment, and they were associated with SVG ehaC, suggesting that these genes may play a role in the pathogenesis of the cyclomodulins. However, more research is needed.

Association of PCSK1 and PPARG1 Allelic Variants with Obesity and Metabolic Syndrome in Mexican Adults.

Metabolic diseases, including obesity, diabetes, and metabolic syndrome, are among the most important public health challenges worldwide. Metabolic diseases are classified as multifactorial diseases in which genetic variants such as single-nucleotide polymorphisms (SNPs) may play an important role. The present study aimed to identify associations linking allelic variants of the PCSK1, TMEM18, GPX5, ZPR1, ZBTB16, and PPARG1 genes with anthropometric and biochemical traits and metabolic diseases (obesity or metabolic syndrome) in an adult population from northwestern Mexico. METHODS: Blood samples were collected from 523 subjects, including 247 with normal weight, 276 with obesity, and 147 with metabolic syndrome. Anthropometric and biochemical characteristics were recorded, and single-nucleotide polymorphisms (SNPs) were genotyped by real-time PCR. RESULTS: PCSK1 was significantly (p < 0.05) associated with BMI, weight, and waist-to-hip ratio; TMEM18 was significantly associated with systolic blood pressure and triglyceride levels; GPX5 was significantly associated with HDL cholesterol levels. In addition, PCSK1 was associated with obesity (p = 1.0 × 10-4) and metabolic syndrome (p = 3.0 × 10-3), whereas PPARG1 was associated with obesity (p = 0.044). CONCLUSIONS: The associations found in this study, mainly between allelic variants of PCSK1 and metabolic traits, obesity, and metabolic syndrome, may represent a risk for developing metabolic diseases in adult subjects from northwestern Mexico.

Seroprevalence and Risk Factors Related to Bovine Brucellosis in Continental Ecuador.

Bovine brucellosis is a worldwide zoonotic contagious disease. According to World Animal Health Information System reports Ecuador has presented an increasing number of bovine brucellosis outbreaks in the continental territory over the past years (756 in 2018 versus 964 in 2021), generating economic losses for producers and causing a risk to public health. A cross-sectional study was conducted to investigate the seroprevalence of bovine brucellosis and associated risk or protective factors between May and June 2018. This stratified random study was implemented in 290 cattle herds located in the 23 provinces of continental Ecuador, which represents a total of 3737 cows aged 24 months or older. A competitive ELISA was used to detect Brucella antibodies. Simultaneously, an epidemiological survey was implemented to assess the brucellosis risk or protective factors. The apparent prevalence of bovine brucellosis at the herd level was 21.3% (95% CI: 16.8-26.6) and 6.2% (95% CI: 5.5-7) at the animal level. Univariate and multivariate logistic regression analyses were performed to determine the relationship between the potential factors associated with the presence of bovine brucellosis. The risk factors identified after multivariate analysis were a surface in ha per herd > 70 ha (OR = 2.73; 95% CI: 1.18-6.32) and the number of parturitions per animal (two or more with OR ≥ 1.8 and p-value ≤ 0.047). On the contrary, the protective factors were the region (farms located in the eastern region) and the absence of reported clinical signs. In addition, in herds where extensive production predominates, farmers have a low level of knowledge, and the farm biosecurity level is low. These results can guide the authorities in managing the risk factors identified, understanding the current epidemiological situation in Ecuador, improving the bovine brucellosis control program and food safety, as well as increase the one-health approach.

Molecular identification of Trypanosoma theileri (Laveran, 1902) in cattle from two slaughterhouses in Ecuador and its relation with other haemotropic agents.

Trypanosoma theileri is a worldwide distributed haemoparasite that has been reported throughout the American continent in various species, including bovines, buffaloes and bats. In bovines, high incidence of T. theileri can be harmful when associated with other infections or under stress situations. There is little information on this hemoflagellate in Ecuador, which prompted the study and molecular identification of the trypanosomes collected in two slaughtering centers. Between February and April 2021, a total of 218 samples of bovine blood were collected in abattoirs located in the Andean region of Quito (n = 83) and in the coastal region, in Santo Domingo (n = 135). Quito public Slaughterhouse is the biggest in Ecuador, and for that, they receive animals from all country; on the other hand, Santo Domingo's Slaughterhouse is a small one where mainly females from the region are sacrificed and some males. The samples were evaluated using two molecular tests, the PCR cathepsin L-like (CatL) specific for T. theileri and for the positive samples, a Nested PCR that targets the ITS of the 18S gene. The corresponding PCR products were sequenced, analyzed by BLAST/NCBI and the sequences were used to build a concatenated phylogenetic tree, using the MEGA XI software. Overall, 34 out of the 218 samples, (15.6%) were positive to T. theileri by PCR CatL, resulting from 20/83 (24.1%) positives from the Quito abattoir and 14/135 (10.4%) from the Santo Domingo slaughterhouse. These prevalence rates were found to be significantly different (p = 0.006). According to the phylogenetic tree based on the CatL and ITS concatenated sequences (n = 13), the two novel Equatorial T. theileri isolates, ThI (n = 7) and ThII (n = 6) are closely related and associated to the IC, IB and IIB genotypes, present in Brazil, Venezuela and Colombia. Thirty-one out of the thirty-four T. theileri-positive bovines were co-infected with other haemotropic pathogens, Anaplasma marginale Babesia spp and T. vivax. This coinfection could be responsible for additional pathologies and harmful effects on the affected cattle. This study presents the molecular identification and genotypification of T. theileri isolated from cattle in Ecuador through the analysis of CAtL and ITS sequences, and the high frequency of coinfection of this hemoflagellate with other blood haemotropic organisms.

The Rapid interaction: a qualitative study of provider approaches to implementing Rapid ART.

BACKGROUND: Offering antiretroviral therapy (ART) to patients directly following an HIV diagnosis ("Rapid ART") improves clinical outcomes and is feasible and acceptable for patients and providers. Despite this, implementation of Rapid ART is not yet standard practice in the USA. Structural-level implementation guidance is available, but research at the individual provider level that explores the patient-provider interaction itself remains scarce. The Consolidated Framework for Implementation Research (CFIR) provides a nuanced guide to investigating the less visible, more social elements of implementation like the knowledge and feelings of people, and the influences of culture and resources on individual approaches. METHODS: We conducted a multi-site qualitative study, exploring intervention commonalities across three HIV clinic environments: an HIV primary care clinic; an HIV/STI testing, treatment, and prevention clinic; and a large federally qualified health center (FQHC). Qualitative data were gathered from 27 provider informants-Rapid ART program staff and clinicians-using an interview guide developed using the CFIR. An experienced qualitative team conducted a comprehensive thematic analysis and identified cross-cutting themes in how providers approach and engage in the Rapid interaction, as well as longer-form narratives from providers that describe more fully what this interaction looks like for them. RESULTS: Three main themes represent the range and content of individual provider approaches to the Rapid interaction: (1) patient-centeredness; (2) emotional support and partnership; and (3) correcting misperceptions about HIV. Each theme encompassed both conceptual approaches to offering Rapid ART and concrete examples of messaging to the patient that providers used in the Rapid interaction. We describe and show examples of these themes, offer key take-aways for implementation, and provide expanded narratives of providers' personal approaches to the Rapid interaction. CONCLUSIONS: Exploration of provider-level approaches to Rapid ART implementation, as carried out in the patient-provider Rapid interaction, contributes a critical layer of evidence for wider implementation. It is our hope that, together with existing research showing positive outcomes and core components of systems-level implementation, these findings add to an instructive body of findings that facilitates the implementation of Rapid ART as an enhanced model of HIV care.

Low-grade Hidradenocarcinomas: A Clinicopathologic Study of an Unusual Carcinoma That Can Mimic its Benign Counterpart.

Hidradenocarcinomas are rare cutaneous adnexal malignancies with sweat gland differentiation that can show a broad spectrum of histomorphologic appearances, ranging from low to high grade. The diagnosis of low-grade hidradenocarcinoma can be challenging and may be mistaken for benign hidradenomas, especially on superficial and partial samples. We performed a retrospective analysis of 16 low-grade hidradenocarcinomas, obtained from 4 large academic institutions. All neoplasms presented clinically as nodular lesions that ranged in size from 1.5 to 6.0 cm. All patients were adults and their age ranged from 33 to 74 years of age. All cases shared features similar to hidradenomas in the surface and mid portion of the tumors and all tumors had 1 or more histomorphologic clues to malignancy, including the presence of an asymmetric and infiltrative growth pattern (especially at the base of the tumors), perineurial invasion, and a desmoplastic stromal reaction. In the tumors evaluated for immunohistochemistry, the tumor cells were positive for p63, EMA, AE1/AE3, MNF116, and CK7. Three patients underwent sentinel lymph node biopsy, and 2 cases showed metastatic disease to regional lymph nodes. All cases (including the 2 cases that had regional lymph node metastasis), showed no local recurrence or distant metastasis observed after a complete re-excision of the tumors (follow-up range from 6 to 72 mo). Our study highlights the salient clinical and histopathologic features of low-grade hidradenocarcinomas and emphasizes the potential diagnostic pitfalls in distinguishing this entity from other neoplasms. Our results indicate that a combination of thorough histopathologic inspection is necessary to support the diagnosis of this rare neoplasm. These tumors can be exceedingly difficult to diagnose and awareness of the subtle features of low-grade hidradenocarcinoma is of importance are as it remains a diagnostic challenge for practicing pathologists.

Evaluation Survey on Agreement with Existing Definitions of Biosecurity with a Focus on Livestock.

Disease prevention, including biosecurity, surveillance, and traceability are key aspects to minimize the risk of animal diseases causing harm to society. Diseases for which biosecurity are needed depend on species of interest, e.g., African swine fever, avian influenza, or foot-and-mouth disease. However, several definitions of biosecurity co-exist in the literature. Under the new COST Action "Biosecurity Enhanced Through Training Evaluation and Raising Awareness" (BETTER) CA20103, we launched an initial survey on the agreement with eight existing definitions of (livestock) biosecurity, to rank keywords to consider before attempting a more consolidated definition, and to select the desirable qualities of a definition of livestock biosecurity. Respondents (N = 316) had a male-female gender ratio close to one, were mostly between 25 and 54 years old, and had animal health as the main field of expertise (30% were government officials). The significant most popular biosecurity definition was the one that conceptualized the rules of 5B's (bio-exclusion, bio-containment, bio-compartmentation, bio-prevention, and bio-preservation). The top two keywords to consider for the consolidation of the biosecurity definition were "prevention" and "measures". The optimal biosecurity definition needs to be operational and related to animal health but also comprehensible, simple, and related to public health. The survey results highlight the need for the integration of more aspects in the existing definitions of livestock biosecurity (prevention of zoonoses and preservation of the environment and diversity).

Low-Grade Hidradenocarcinoma of the Foot With Metastasis to a Lymph Node.

ABSTRACT: Hidradenocarcinoma (HAC) is a rare adnexal tumor associated with the potential for locoregional recurrence and systemic metastasis. The clinical appearance of HAC is nonspecific, frequently presenting as a solitary firm subcutaneous nodule or plaque on the head and neck region or distal extremities. These tumors show histomorphologic heterogeneity, as they can be low and high grade. Distinguishing HAC from hidradenoma, especially the low-grade variant of HAC, can be challenging as both tumors can show histologic overlapping features. In this article, we describe a case of a 33-year-old patient presenting with a low-grade HAC of the plantar foot who was subsequently found to have lymph node metastasis.

Antitumor activity of bovine lactoferrin and its derived peptides against HepG2 liver cancer cells and Jurkat leukemia cells.

Liver cancer and leukemia are the fourth and first causes, respectively, of cancer death in children and adults worldwide. Moreover, cancer treatments, although beneficial, remain expensive, invasive, toxic, and affect the patient's quality of life. Therefore, new anticancer agents are needed to improve existing agents. Because bovine lactoferrin (bLF) and its derived peptides have antitumor properties, we investigated the anticancer effect of bLF and LF peptides (LFcin17-30, LFampin265-284 and LFchimera) on liver cancer HepG2 cells and leukemia Jurkat cells. HepG2 and Jurkat cells were incubated with bLF and LF peptides. Cell proliferation was quantified by an MTT assay, and cell morphology and damage were visualized by light microscopy or by phalloidin-TRITC/DAPI staining. The discrimination between apoptosis/necrosis was performed by staining with Annexin V-Alexa Fluor 488 and propidium iodide, and the expression of genes related to apoptosis was analyzed in Jurkat cells. Finally, the synergistic interaction of bLF and LF peptides with cisplatin or etoposide was assessed by an MTT assay and the combination index. The present study demonstrated that bLF and LF peptides inhibited the viability of HepG2 and Jurkat cells, inducing damage to the cell monolayer of HepG2 cells and morphological changes in both cell lines. bLF, LFcin17-30, and LFampin265-284 triggered apoptosis in both cell lines, whereas LFchimera induced necrosis. These results suggested that bLF and LF peptides activate apoptosis by increasing the expression of genes of the intrinsic pathway. Additionally, bLF and LF peptides synergistically interacted with cisplatin and etoposide. In conclusion, bLF and LF peptides display anticancer activity against liver cancer and leukemia cells, representing an alternative or improvement in cancer treatment.

Elaboración de la guia de desarrollo infantil temprano con un enfoque comunitario para niñas y niños 48 a 72 meses de edad de la ciudad de El Alto distrito 8 Senkata / Elaboration of the early childhood development guide with a community focus for children 48 to 72 months of age in the city of El Alto district 8 Senkata

El presente trabajo muestra la importancia que se le debe dar a la atención integral de las niñas y niños menores de 48 a 72 meses de edad, del Distrito 8 Senkata de la ciudad de El Alto, es por eso que se pide el asesoramiento de la USB a través de una consultoría con el fin de elaborar la Guia de Desarrollo infantil temprano con un enfoque comunitario.

Pollen preferences of stingless bees in the Amazon region and southern highlands of Ecuador by scanning electron microscopy and morphometry.

Stingless bees are effective pollinators of native tropical flora. Their environmental service maintains flow of pollen through pollination, increase reproductive success and influence genetic structure in plants. The management of stingless bees "meliponiculture", is an activity limited to the countryside in Ecuador. The lack of knowledge of their managers about pollen resources can affect the correct maintenance/production of nests. The objective is to identify botanical families and genera of pollen grains collected by stingless bees by morphological features and differentiate potential species using geometric morphometry. Thirty-six pot pollen samples were collected from three Ecuadorian provinces located in two climatically different zones. Pollen type identification was based on the Number, Position, Character system. Using morphological features, the families and genera were established. Morphometry landmarks were used to show variation for species differentiation. Abundance, diversity, similarity and dominance indices were established by counting pollen grains, as well as spatial distribution relationships by means of Poisson regression. Forty-six pollen types were determined in two study areas, classified into 27 families and 18 genera. In addition, it was possible to identify more than one species, classified within the same family and genus, thanks to morphometric analysis. 1148 ± 799 (max 4211; min 29) pollen grains were counting in average. The diversity showed a high richness, low dominance and similarity between pollen resources. Families Melastomataceae and Asteraceae, genera Miconia and Bidens, were found as the main pollen resources. The stingless bee of this study are mostly generalist as shown the interaction network. The results of the present survey showed that stingless bees do not collect pollen from a single species, although there is evidence of a predilection for certain plant families. The diversity indexes showed high richness but low uniformity in the abundance of each family identified. The results of the study are also meaningful to the meliponiculture sector as there is a need to improve management practices to preserve the biodiversity and the environment.

Vibrio parahaemolyticus Is Associated with Diarrhea Cases in Mexico, with a Dominance of Pandemic O3:K6 Clones.

In the present study, we conducted surveillance of the V. parahaemolyticus strains present in clinical samples from six geographical regions of Mexico (22 states) from 2004 to 2011. The serotype dominance, virulence genes, presence of pandemic O3:K6 strains, and antibiotic resistance of the isolates were investigated. In total, 144 strains were isolated from the clinical samples. Seven different O serogroups and twenty-five serovars were identified. Most clinical isolates (66%, 95/144) belonged to the pandemic clone O3:K6 (tdh+, toxRS/new+ and/or orf8+) and were detected in 20 of the 22 states. Among the pandemic clones, approximately 17.8% (17/95) of the strains cross-reacted with the antisera for the K6 and K59 antigens (O3:K6, K59 serotype). Other pathogenic strains (tdh+ and/or trh+, toxRS/new-, orf8-) accounted for 26.3%, and the nonpathogenic strains (tdh- and/or trh-) accounted for 7.6%. Antimicrobial susceptibility testing showed that most of the strains were resistant to ampicillin (99.3%) but were sensitive to most tested antibiotics. The level of multidrug resistance was 1.3%. Our results indicate that pandemic O3:K6 is present in most Mexican states, thus, constant surveillance of V. parahaemolyticus strains in diarrhea patients is a public health priority and is useful for conducting risk assessments of foodborne illnesses to prevent V. parahaemolyticus outbreaks. Overall, our observations indicate that the pandemic O3:K6 clone of V. parahaemolyticus has become a relatively stable subpopulation and may be endemically established in Mexico; therefore, constant surveillance is needed to avoid new outbreaks of this pathogen.

Poder mecánico como predictor de mortalidad en los pacientes con diagnóstico de neumonía por SARS-CoV-2 que recibieron ventilación mecánica invasiva / Mechanical power as a predictor of mortality in patients diagnosed with SARS-CoV-2 pneumonia who received invasive mechanical ventilation / Potência mecânica como preditor de mortalidade em pacientes diagnosticados com pneumonia por SARS-CoV-2 que receberam ventilação mecânica invasiva

Resumen: Introducción: Las fuerzas mecánicas generadas durante la ventilación mecánica por la interacción entre el ventilador y el sistema respiratorio pueden dañar al pulmón en un proceso que se ha denominado lesión inducida por el ventilador. El grado de lesión se ha relacionado con la cantidad de energía transferida desde el ventilador mecánico al sistema respiratorio dentro de un periodo de tiempo determinado, denominado poder mecánico; datos experimentales basados en tomografías sugieren que el poder mecánico mayor de 12 J/min podría generar lesión. Se proyecta como otra de las variables a controlar dentro de las estrategias de protección pulmonar, determinado en estudios experimentales como un umbral de energía a partir del cual inician los cambios mecánicos en el pulmón que pueden conducir a lesión inducida por el ventilador. Material y métodos: Se realizó un estudio retrospectivo, analítico, comparativo, se incluyeron todos los pacientes con diagnóstico de neumonía por SARS-CoV-2 que requieren ventilación mecánica invasiva; en un periodo de tiempo comprendido de marzo-agosto de 2021 que ingresaron a la Unidad de Cuidados Intensivos y utilizaron el poder mecánico como variable para predecir la mortalidad. Resultados: La población estudiada se compuso de 67 pacientes; se evaluó la asociación entre el poder mecánico alto a las 48 horas y la mortalidad, se documentó que 49.25% (n = 33) de los casos que mantuvieron el poder mecánico alto en 48 horas murieron, 28.35% (n = 19) con poder mecánico alto no se asoció con mortalidad, 8.95% (n = 6) que no mantuvieron cálculo de poder mecánico alto murieron y 13.43% (n = 9) de los pacientes con poder mecánico menor a 12 J/min no murieron. Se realizó una prueba de asociación con χ2 de Pearson en la que se obtiene un valor de p = 0.105, por lo que no existe diferencia estadísticamente significativa y no se corrobora la asociación entre la mortalidad de los pacientes con poder mecánico alto (> 12 J/min) a las 48 horas. Conclusión: El poder mecánico puede considerarse como otra variable a controlar como estrategia de protección pulmonar del paciente con infección por SARS-CoV-2, basado en que la energía transmitida al pulmón tiene mayor impacto en los pacientes que reciben ventilación mecánica por un intervalo de tiempo mayor de siete días, con un promedio de estancia en la Unidad de Cuidados Intensivos 12.3 + 6.2 días y el promedio de días de ventilación mecánica invasiva 9.2 + 5.6.

Abstract: Introduction: The mechanical forces generated during mechanical ventilation by the interaction between the ventilator and the respiratory system can damage the lung in a process that has been called ventilator induced injury. The degree of injury has been related to the amount of energy transferred from the mechanical ventilator to the respiratory system within a given period of time, called mechanical power, experimental data based on tomographies suggest that mechanical power greater than 12 J/min could generate injury. It is projected as another variables to control within lung protection strategies, determining in experimental studies as an energy threshold from which mechanical changes in the lung begin that can lead to ventilator induced injury. Material and methods: A retrospective, analytical, comparative study was carried out. All patients with a diagnosis of SARS-CoV-2 pneumonia who required invasive mechanical ventilation were admitted; In a period of time between March-August 2021, they were admitted to the intensive care unit and used mechanical power as a variable to predict mortality. Results: The studied population consisted of 67 patients; the association between high mechanical power at 48 hours and mortality was evaluated, it was documented that 49.25% (n = 33) of the patients who maintained high mechanical power in 48 hours died, 28.35% (n = 19) with power high mechanical was not associated with mortality, 8.95% (n = 6) who did not have high mechanical power calculation died and 13.43% (n = 9) of patients with mechanical power less than 12 J/min survived. An association test was performed with Pearson's χ2 in which a p value of 0.105 was obtained, so there is no statistically significant difference and the association between the mortality of the patients is not corroborated. with high mechanical power (> 12 J/min) at 48 hours. Conclusion: Mechanical power can be considered as another variable to control as a lung protection strategy for patients with SARS-CoV-2 infection, based on the fact that the energy transmitted to the lung has a greater impact on patients who receive mechanical ventilation for an interval time greater than seven days, with an average stay in the intensive care unit 12.3 + 6.2 days and the average days of invasive mechanical ventilation 9.2 + 5.6.

Resumo: Introdução: As forças mecânicas geradas durante a ventilação mecânica pela interação entre o ventilador e o sistema respiratório podem lesar o pulmão em um processo que tem sido chamado de lesão induzida pelo ventilador. O grau de lesão tem sido relacionado à quantidade de energia transferida do ventilador mecânico para o sistema respiratório em um determinado período de tempo, denominado potência mecânica. Dados experimentais baseados em tomografia sugerem que potência mecânica superior a 12 J/min pode gerar lesão. Ele é projetado como mais uma das variáveis a serem controladas dentro das estratégias de proteção pulmonar, determinando em estudos experimentais como um limiar de energia a partir do qual se iniciam as alterações mecânicas no pulmão que podem levar à lesão induzida pelo ventilador. Material e métodos: Realizou-se um estudo retrospectivo, analítico e comparativo, foram admitidos todos os pacientes com diagnóstico de pneumonia por SARS-CoV-2 que necessitaram de ventilação mecânica invasiva; em um período de março a agosto de 2021 que foram internados na unidade de terapia intensiva e utilizaram a potência mecânica como variável para predizer mortalidade. Resultados: A população do estudo foi composta por 67 pacientes; Foi avaliada a associação entre alta potência mecânica em 48 horas e mortalidade, foi documentado que 49.25% (n = 33) dos pacientes que mantiveram potência mecânica alta em 48 horas morreram, 28.35% (n = 19) com potência mecânica alta não foi associado à mortalidade, 8.95% (n = 6) que ñao mantiveran o calculo de alta potencia mecanoca morreram e 13.4% (n = 9) dos pacientes com potencia mecanica menor que 12 J/min nao morreram. Realizou-se um teste de associação com o χ2 de Pearson, no qual se obtém um valor de p de 0.105, portanto não há diferença estatisticamente significante e a associação entre mortalidade do paciente não é corroborada com alta potência mecânica (> 12 Joul/min) em 48 horas. Conclusão: A potência mecânica pode ser considerada mais uma variável a ser controlada como estratégia de proteção pulmonar para pacientes com infecção por SARS-CoV-2, tendo em vista que a energia transmitida ao pulmão tem maior impacto em pacientes que recebem ventilação mecânica por um intervalo de tempo superior a 7 dias, com média de permanência na unidade de terapia intensiva 12.3 + 6.2 dias e média de dias de ventilação mecânica invasiva 9.2 + 5.6.

Epidemiological and clinical characteristics of pregnant women and neonates with COVID-19 in Northwest Mexico.

INTRODUCTION: The SARS-CoV-2 virus, which causes COVID-19, has spread quickly worldwide, causing millions of cases and thousands of deaths. Some risk factors in the general population are related to the development of severe COVID-19 or death, but in pregnant women and neonates, the information is limited. OBJECTIVE: To determine the epidemiological and clinical characteristics of pregnant women and neonates diagnosed with COVID-19 by RT-PCR and serological tests, and analyze the relationship between the influenza vaccination and COVID-19 symptoms in infected pregnant women in Sinaloa state. METHODS: We collected samples from 116 pregnant women and 84 neonates from the Women´s Hospital of Sinaloa. They were diagnosed with COVID-19 by RT-PCR and serological tests (IgG), and sociodemographic, clinical and laboratory parameters were recorded. RESULTS: A total of 11.2% (13/116) of the pregnant women were RT-PCR+, 25% (29/116) were IgG+ and 4.3% (5/116) were positive for both tests. Symptoms such as rhinorrhea (P = .04), cough (P = .02) and polypnea (P = .04) in pregnant women were related to COVID-19, also leukocyte index was higher in pregnant women with COVID-19 (P = .03), but the associations were lost after the Bonferroni correction. No laboratory parameters or underlying diseases were associated with COVID-19, and most infected pregnant women had mild cases. We found an association between the influenza vaccine and less common COVID-19 symptoms in pregnant women who were infected (P = .01). A total of 7.2% (6/84) of neonates were RT-PCR+, 35.7% (30/84) were IgG+, and there were no symptoms or underlying diseases associated with neonates who were infected. In conclusion, this work demonstrated that some symptoms were related to COVID-19, most pregnant women and neonates had mild cases, and the influenza vaccine could decrease the severity of COVID-19 cases in pregnant women.