Incidence of metabolic bone disease in neonates under 32 gestational weeks at the Hospital Universitario de Santander in Colombia. / Incidencia de enfermedad metabólica ósea en neonatos con menos de 32 semanas de gestación en el Hospital Universitario de Santander en Colombia

INTRODUCTION: Metabolic bone disease of premature infants is a rare complication characterized by a lower mineral content in bone tissue. OBJECTIVE: To establish the incidence of metabolic bone disease in premature infants and to determine associated risk factors. MATERIALS AND METHOD: We conducted a descriptive prospective cohort study for one year in all newborns under 32 gestational weeks, or 1,500 g, at the Hospital Universitario de Santander to determine the incidence of metabolic bone disease. We collected demographic data and prenatal histories of the selected patients, and later, we measured serum alkaline phosphatase and serum phosphorus at the third week of birth, having as reference values for diagnosis less than 5.6 mg/dl for the first one and more than 500 UI/L for the second one. We applied statistical tools for data analysis, such as average proportions, dispersion, distribution and association measures, and binomial regression. RESULTS: From a total of 58 patients, 7 had a diagnosis of metabolic bone disease, with an incidence of 12%. The weight was reported as an independent variable for the development of the disease, being significant in children under 1,160 g, as well as prolonged parenteral nutrition for more than 24 days. When performing the multivariate analysis, low weight and short time of parenteral nutrition appeared as risk factors; in the same way, maternal age below 22 years is associated with a higher relative risk, even more than a newborn weight inferior to 1,160 g. CONCLUSION: Establishing an early intervention in patients with metabolic bone disease enhancing risk factors, such as low weight and prolonged parenteral nutrition, is critical to prevent severe complications.

Introducción. La enfermedad metabólica ósea de neonatos prematuros es una complicación poco común que se caracteriza por una disminución del contenido mineral en el hueso. Objetivo. Establecer la incidencia de la enfermedad metabólica ósea en neonatos prematuros y los factores de riesgo asociados. Materiales y métodos. Durante un año, se realizó un estudio prospectivo de cohorte, descriptivo, con todos los neonatos nacidos con menos de 32 semanas de gestación o un peso menor de 1.500 g en el Hospital Universitario de Santander. Se recolectaron datos demográficos y antecedentes prenatales de los pacientes seleccionados. A la tercera semana de nacimiento, se midieron la fosfatasa alcalina y el fósforo sérico, tomando como valores de referencia diagnóstica aquellos inferiores a 5,6 mg/dl para el primero y aquellos mayores de 500 UI/L para la segunda. Para el análisis de la información, se emplearon herramientas estadísticas, como proporciones de promedios, medidas de dispersión, distribución y asociación, y regresión binomial. Resultados. De un total de 58 pacientes, 7 tuvieron diagnóstico de enfermedad metabólica ósea, con una incidencia del 12 %. De las variables estudiadas, el peso se reportó como una variable independiente para el desarrollo de la enfermedad, significativa en aquellos neonatos con peso menor de 1.160 g, al igual que la nutrición parenteral prolongada por más de 24 días. Al hacer el análisis multivariado, La edad materna menor de 22 años representó un riesgo relativo mayor, en comparación con un peso inferior a 1.160 g. Conclusión. Se estableció la importancia de una intervención temprana en pacientes con factores de riesgo para enfermedad metabólica ósea, como bajo peso (menor de 1.160 g) y nutrición parenteral prolongada (mayor de 24 días), con el fin de prevenir complicaciones graves.

Epidemiology of childhood acute leukemias in marginalized populations of the central-south region of Mexico: results from a population-based registry.

Introduction: Acute leukemias (AL) are the main types of cancer in children worldwide. In Mexico, they represent one of the main causes of death in children under 20 years of age. Most of the studies on the incidence of AL in Mexico have been developed in the urban context of Greater Mexico City and no previous studies have been conducted in the central-south of the country through a population-based study. The aim of the present work was to identify the general and specific incidence rates of pediatric AL in three states of the south-central region of Mexico considered as some of the marginalized populations of Mexico (Puebla, Tlaxcala, and Oaxaca). Methods: A population-based study was conducted. Children aged less than 20 years, resident in these states, and newly diagnosed with AL in public/private hospitals during the period 2021-2022 were identified. Crude incidence rates (cIR), standardized incidence rates (ASIRw), and incidence rates by state subregions (ASIRsr) were calculated. Rates were calculated using the direct and indirect method and reported per million children under 20 years of age. In addition, specific rates were calculated by age group, sex, leukemia subtype, and immunophenotype. Results: A total of 388 cases with AL were registered. In the three states, the ASIRw for AL was 51.5 cases per million (0-14 years); in Puebla, it was 53.2, Tlaxcala 54.7, and Oaxaca de 47.7. In the age group between 0-19 years, the ASIRw were 44.3, 46.4, 48.2, and 49.6, in Puebla, Tlaxcala, and Oaxaca, respectively. B-cell acute lymphoblastic leukemia was the most common subtype across the three states. Conclusion: The incidence of childhood AL in the central-south region of Mexico is within the range of rates reported in other populations of Latin American origin. Two incidence peaks were identified for lymphoblastic and myeloid leukemias. In addition, differences in the incidence of the disease were observed among state subregions which could be attributed to social factors linked to the ethnic origin of the inhabitants. Nonetheless, this hypothesis requires further investigation.

Sinonasal Symptom Correlation With the Postoperative Polyp Scale (POPS).

BACKGROUND: Commonly used endoscopic nasal polyp grading scales have been shown to correlate poorly with symptom scores and quality of life metrics. The recently described Postoperative Polyp Scale (POPS) is a grading system that more accurately characterizes polyp recurrence in postoperative sinus cavities by describing incremental recurrence in relation to the surgically opened sinus cavities. OBJECTIVE: The objective of this study was to determine if the POPS correlated with sinonasal symptoms. METHODS: CRSwNP patients were prospectively administered SNOT-22 questionnaires and graded according to the POPS starting at their 1-month postoperative appointments. Total POPS scores (sum of each side) and Max POPS score (larger value of left and right) were correlated with SNOT-22 total scores and subdomains using Kendall correlation testing. RESULTS: A total of 127 patients were enrolled in the study. Both Total POPS or Max POPS were significantly correlated to the SNOT-22 total score (P < .001, P < .001), Rhinologic (P < .001, P < .001), Extra-Nasal Rhinologic (P < .001, P < .001), Ear/Facial (P < .001, P < .001), and Psychologic (P = .028, P = .017) subdomains. Kendall's tau indicated strong correlation (≥0.3) with Rhinologic subdomain, moderate correlation (.21-.29) with Extra-Nasal Rhinologic and Ear/Facial subdomains, and weak correlation (.1-.19) with Psychologic subdomain. CONCLUSION: Previous endoscopic nasal polyp grading scales poorly correlate with symptoms and patient reported outcome measures. The new POPS moderately correlates with the total SNOT-22 score and strongly correlates with the Rhinologic subdomain, indicating that it may have good potential as a tool to evaluate postoperative CRSwNP patients.

Widely used herbicide metolachlor can promote harmful bloom formation by stimulating cyanobacterial growth and driving detrimental effects on their chytrid parasites.

Metolachlor (MET) is a widely used herbicide that can adversely affect phytoplanktonic non-target organisms, such as cyanobacteria. Chytrids are zoosporic fungi ubiquitous in aquatic environments that parasitize cyanobacteria and can keep their proliferation in check. However, the influence of organic pollutants on the interaction between species, including parasitism, and the associated ecological processes remain poorly understood. Using the host-parasite system consisting of the toxigenic cyanobacterium Planktothrix agardhii and its chytrid parasite Rhizophydium megarrhizum, we investigated the effects of environmentally relevant concentrations of MET on host-parasite interactions under i) continuous exposure of chytrids and cyanobacteria, and ii) pre-exposure of chytrids. During a continuous exposure, the infection prevalence and intensity were not affected, but chytrid reproductive structures were smaller at the highest tested MET concentration. In the parasite's absence, MET promoted cyanobacteria growth possibly due to a hormesis effect. In the pre-exposure assay, MET caused multi- and transgenerational detrimental effects on parasite fitness. Chytrids pre-exposed to MET showed reduced infectivity, intensity, and prevalence of the infection, and their sporangia size was reduced. Thus, pre-exposure of the parasite to MET resulted in a delayed decline of the cyanobacterial cultures upon infection. After several parasite generations without MET exposure, the parasite recovered its initial fitness, indicating that detrimental effects are transient. This study demonstrates that widely used herbicides, such as MET, could favor cyanobacterial bloom formation both directly, by promoting cyanobacteria growth, and indirectly, by inhibiting their chytrid parasites, which are known to play a key role as top-down regulators of cyanobacteria. In addition, we evidence the relevance of addressing multi-organism systems, such as host-parasite interactions, in toxicity assays. This approach offers a more comprehensive understanding of the effects of pollutants on aquatic ecosystems.

The role of self-compassion and compassion toward others in burnout syndrome in a sample of medical students.

Burnout produces negative effects on academic performance, and, in turn, feelings of inefficiency that are detrimental to students' psychosocial well-being. The aim of this research is to determine the effects that self-compassion and compassion toward others have on various burnout dimensions in a sample of medical students. A total of 235 medical students (61.7% women) aged between 16 and 32 years old (M = 19.82; SD = 2.37) belonging to a Colombian university participated. A cluster analysis to segment the population according to burnout was carried out along with nonparametric contrasts to identify differences in the levels of self-compassion and compassion toward others between each profile. A series of regression analyses was designed to find out how each type of compassion was associated with burnout on each profile. The cluster analysis allowed us to identify three profiles. The low-involvement profile (n = 51) is characterized by low depersonalization, intermediate levels of emotional exhaustion and personal accomplishment and exhibits low levels of self-compassion and compassion fatigue compared with the other profiles. The positive-adaptation profile (n = 104) is characterized by low depersonalization levels, intermediate degrees of emotional exhaustion and high levels of personal accomplishment and exhibits the highest levels of self-compassion and compassion fatigue compared with the other profiles. The high-demand profile (n = 104) is characterized by intermediate depersonalization levels, medium-high levels of emotional exhaustion and high levels of personal accomplishment and exhibits intermediate levels of self-compassion and low levels of compassion fatigue. Establishing profiles based on burnout allows students to be segmented and for precise knowledge to be acquired about the effects that both types of compassion have on the dimensions of burnout.

Compassion and Self-Compassion: Counterfactors of Burnout in Medical Students and Physicians.

OBJECTIVE: To examine the relationship between self-compassion, compassion for others and Burnout in medical students and physicians. METHODS: A cross-sectional study was conducted. Medicine students and general physicians from two Colombian cities participated (n = 359). The Compassion Scales and the Maslach Inventory were administered. An Exploratory Structural Equation approach was used for validating new measures and testing for relationships between latent variables. RESULTS: Most participants were students (85.9%), mean age was 22 years (SD = 7), 55.2% were female, 62,6% dedicated more than 48 weekly hours to study or practice, while physicians had worked a mean of 10.34 years (SD = 8.67). Self-compassion and Compassion for others action subscales were validated, but engagement subscales of were not. Participant´s compassion actions for others and self-compassion actions are negatively related to depersonalization and emotional exhaustion, respectively. Additionally, compassion dimensions were positively associated with professional accomplishment. CONCLUSION: Our findings indicate that compassion and self-compassion actions inversely relate to different components of Burnout and could constitute protective factors against the stress of healthcare. Compassion and self-compassion training programs for medical students and physicians might be an alternative to avoid Burnout, diminishing physicians' depersonalization and emotional exhaustion while enhancing their professional accomplishment.

The LEGACy study: a European and Latin American consortium to identify risk factors and molecular phenotypes in gastric cancer to improve prevention strategies and personalized clinical decision making globally.

BACKGROUND: Gastric Cancer (GC) is the fourth most deadly cancer worldwide. Enhanced understanding of its key epidemiological and molecular drivers is urgently needed to lower the incidence and improve outcomes. Furthermore, tumor biology in European (EU) and Latin American (LATAM) countries is understudied. The LEGACy study is a Horizon 2020 funded multi-institutional research approach to 1) detail the epidemiological features including risk factors of GC in current time and 2) develop cost-effective methods to identify and integrate biological biomarkers needed to guide diagnostic and therapeutic approaches with the aim of filling the knowledge gap on GC in these areas. METHODS: This observational study has three parts that are conducted in parallel during 2019-2023 across recruiting centers from four EU and four LATAM countries: Part 1) A case-control study (800 cases and 800 controls) using questionnaires on candidate risk factors for GC, which will be correlated with clinical, demographic and epidemiological parameters. Part 2) A case-control tissue sampling study (400 cases and 400 controls) using proteome, genome, microbiome and immune analyses to characterize advanced (stage III and IV) GC. Patients in this part of the study will be followed over time to observe clinical outcomes. The first half of samples will be used as training cohort to identify the most relevant risk factors and biomarkers, which will be selected to propose cost-effective diagnostic and predictive methods that will be validated with the second half of samples. Part 3) An educational study, as part of our prevention strategy (subjects recruited from the general public) to test and disseminate knowledge on GC risk factors and symptoms by a questionnaire and informative video. Patients could be recruited for more than one of the three LEGACy studies. DISCUSSION: The LEGACy study aims to generate novel, in-depth knowledge on the tumor biological characteristics through integrating epidemiological, multi-omics and clinical data from GC patients at an EU-LATAM partnership. During the study, cost-effective panels with potential use in clinical decision making will be developed and validated. TRIAL REGISTRATION: ClinicalTrials.gov Identifiers: Part 1: NCT03957031 . Part 2: NCT04015466 . Part 3: NCT04019808 .

Genome analysis of Pseudomonas sp. OF001 and Rubrivivax sp. A210 suggests multicopper oxidases catalyze manganese oxidation required for cylindrospermopsin transformation.

BACKGROUND: Cylindrospermopsin is a highly persistent cyanobacterial secondary metabolite toxic to humans and other living organisms. Strain OF001 and A210 are manganese-oxidizing bacteria (MOB) able to transform cylindrospermopsin during the oxidation of Mn2+. So far, the enzymes involved in manganese oxidation in strain OF001 and A210 are unknown. Therefore, we analyze the genomes of two cylindrospermopsin-transforming MOB, Pseudomonas sp. OF001 and Rubrivivax sp. A210, to identify enzymes that could catalyze the oxidation of Mn2+. We also investigated specific metabolic features related to pollutant degradation and explored the metabolic potential of these two MOB with respect to the role they may play in biotechnological applications and/or in the environment. RESULTS: Strain OF001 encodes two multicopper oxidases and one haem peroxidase potentially involved in Mn2+ oxidation, with a high similarity to manganese-oxidizing enzymes described for Pseudomonas putida GB-1 (80, 83 and 42% respectively). Strain A210 encodes one multicopper oxidase potentially involved in Mn2+ oxidation, with a high similarity (59%) to the manganese-oxidizing multicopper oxidase in Leptothrix discophora SS-1. Strain OF001 and A210 have genes that might confer them the ability to remove aromatic compounds via the catechol meta- and ortho-cleavage pathway, respectively. Based on the genomic content, both strains may grow over a wide range of O2 concentrations, including microaerophilic conditions, fix nitrogen, and reduce nitrate and sulfate in an assimilatory fashion. Moreover, the strain A210 encodes genes which may convey the ability to reduce nitrate in a dissimilatory manner, and fix carbon via the Calvin cycle. Both MOB encode CRISPR-Cas systems, several predicted genomic islands, and phage proteins, which likely contribute to their genome plasticity. CONCLUSIONS: The genomes of Pseudomonas sp. OF001 and Rubrivivax sp. A210 encode sequences with high similarity to already described MCOs which may catalyze manganese oxidation required for cylindrospermopsin transformation. Furthermore, the analysis of the general metabolism of two MOB strains may contribute to a better understanding of the niches of cylindrospermopsin-removing MOB in natural habitats and their implementation in biotechnological applications to treat water.

Manganese-oxidizing bacteria form multiple cylindrospermopsin transformation products with reduced human liver cell toxicity.

Cylindrospermopsin (CYN) is a toxic alkaloid highly persistent in aquatic environments. Biological removal of CYN was described previously. However, no transformation products formed by biological processes could be identified so far. Here, we describe that various manganese-oxidizing bacteria (MOB) transform CYN completely at an initial mean concentration of 7 mg L-1 (17 µM) within 3 to 34 days. Regardless of the strain, and transformation rate, transformation of CYN by MOB led to the same seven transformation products identified by mass spectrometry, which suggests that the removal of CYN by MOB follows a similar mechanism. Oxidation was the main transformation process, and the uracil moiety was the most susceptible part of the CYN molecule. In vitro cytotoxicity tests with the transformation products of CYN formed by one of the tested strains against the two human liver cell lines HepG2 and HepaRG, revealed that the transformation products were substantially less toxic than pure CYN for both cell lines. The results suggest that incubation with MOB might be an option for water treatment to remove CYN and may allow more detailed studies on the fate of CYN in the environment.

Manganese-oxidizing bacteria isolated from natural and technical systems remove cylindrospermopsin.

The cyanotoxin cylindrospermopsin was discovered during a drinking water-related outbreak of human poisoning in 1979. Knowledge about the degradation of cylindrospermopsin in waterbodies is limited. So far, only few cylindrospermopsin-removing bacteria have been described. Manganese-oxidizing bacteria remove a variety of organic compounds. However, this has not been assessed for cyanotoxins yet. We investigated cylindrospermopsin removal by manganese-oxidizing bacteria, isolated from natural and technical systems. Cylindrospermopsin removal was evaluated under different conditions. We analysed the correlation between the amount of oxidized manganese and the cylindrospermopsin removal, as well as the removal of cylindrospermopsin by sterile biogenic oxides. Removal rates in the range of 0.4-37.0 µg L-1 day-1 were observed. When MnCO3 was in the media Pseudomonas sp. OF001 removed ∼100% of cylindrospermopsin in 3 days, Comamonadaceae bacterium A210 removed ∼100% within 14 days, and Ideonella sp. A288 and A226 removed 65% and 80% within 28 days, respectively. In the absence of Mn2+, strain A288 did not remove cylindrospermopsin, while the other strains removed 5-16%. The amount of manganese oxidized by the strains during the experiment did not correlate with the amount of cylindrospermopsin removed. However, the mere oxidation of Mn2+ was indispensable for cylindrospermopsin removal. Cylindrospermopsin removal ranging from 0 to 24% by sterile biogenic oxides was observed. Considering the efficient removal of cylindrospermopsin by the tested strains, manganese-oxidizing bacteria might play an important role in cylindrospermopsin removal in the environment. Besides, manganese-oxidizing bacteria could be promising candidates for biotechnological applications for cylindrospermopsin removal in water treatment plants.

Osteopontin expression and its relationship with prognostic factors in diffuse large B-cell lymphoma.

The aim of this study is to explore the expression of osteopontin (OPN) and its relationship with prognostic factors and survival in diffuse large B cell lymphoma (DLBCL). A tissue microarray was performed for immunohistochemical evaluation. Contingency tables were analyzed for trends; chi-square test was used to determine differences between groups. Univariate and multivariate Cox proportional hazards-regression analyses were performed to evaluate the impact of prognostic factors on survival. Expression of OPN was observed in 28%. It was different in non-germinal center DLBCL (P=0.04). The mean overall survival (OS) was lower in patients with positive OPN expression (19.762; CI 95% 14.269-25.255) it was not significant (P=0.123). It is not possible to establish a clear relationship between the expression by immunohistochemistry of osteopontin and a poor prognosis but it would be important to complement the analysis with other techniques as PCR or NGS that allow us to assess the influence of the isoforms and post-translational modifications of OPN on the biological behavior of DLBCL. Our findings indicate that OPN expression could be associated with a more aggressive variant of lymphoma: non-germinal center DLBCL.

Subjective well-being among Latino day laborers: Examining the role of religiosity, social networks, and cigarette use.

Background: Latino day laborers (LDLs) experience chronic stressors, that adversely affects their subjective well-being (SWB). The purpose of the study was to determine whether LDLs' sociodemographic characteristics, religiosity, social networks, and cigarette use were significantly associated with SWB. Methods: AApproximately 150 LDLs from 4 informal day laborer sites in Dallas and Arlington, Texas, participated in the cross-sectional survey. Informed consent was obtained from all participants and data on SWB were collected face-to-face from April 2013 through July 2013. Results: Most respondents were of Mexican ancestry, (n = 112; 75%), were foreign-born (n = 140; 93%), and undocumented (n = 108; 72%). LDLs reported a mean satisfaction with life score of 19.07 (SD=8.52). Thirty percent of LDLs reported not smoking any cigarettes in the past 30 days. However, 20% reported smoking 20-39 cigarettes, while another 20% reported smoking 40 or more cigarettes in the past 30 days. Hierarchical multiple regression results indicated that marital status (ß = 0.13, P ≤ 0.05), connectedness to friends (ß = 0.21, P ≤ 0.001), the influence of religion on life (ß = 0.57, P ≤ 0.01), frequency of attendance to religious institution (ß = 0.11, P ≤ 0.005), and cigarette use (ß = -0.15, P ≤ 0.05) were significantly associated with the SWB appraisals of LDLs. Conclusion: These findings show that LDLs are resilient and rely on noneconomic factors to enhance their perceived quality of life. The results underscore the need to identify pathways to improve SWB among LDLs. Doing so may address the broader mental health and occupational health disparities gaps that affect LDLs.

[Coinfection of dengue and chikungunya viruses. Narrative review]. / Co-infección por los virus del dengue y chikungunya. Revisión narrativa.

BACKGROUND: Dengue and chikungunya viruses are transmitted by the female Aedes aegypti and Aedes albopictus, which are widely distributed in tropical and subtropical areas, facilitating coinfection. AIM: To determine the magnitude, geographical distribution and clinical picture of dengue and chikungunya coinfection. MATERIAL AND METHODS: Narrative review. A search in the PubMed and Lilacs databases was made, using the MeSH terms "Chikungunya", "CHIKV", "DENV", "Dengue" and "coinfection. The articles of the last 20 years were included. RESULTS: A total of 45 articles were included. The largest coinfection report was in Asia followed by Africa. In the Americas, the information is limited because of the recent circulation of chikungunya. The magnitude of coinfection varies between 0% and 31.9%. No differences were found in the distribution of coinfection by sex and age. The clinical picture of monoinfection and coinfection was similar. Some case reports show severe cases with central nervous system involvement, hemorrhagic manifestations and Still's disease. CONCLUSION: The clinical manifestations of coinfection by dengue and chikungunya viruses are similar to those due to monoinfection, which difficult the diagnosis and measurement of its magnitude.

Exposure to the herbicide 2,4-D produces different toxic effects in two different phytoplankters: A green microalga (Ankistrodesmus falcatus) and a toxigenic cyanobacterium (Microcystis aeruginosa).

The extensive use of 2,4-dichlorophenoxiacetic acid (2,4-D) in agriculture is an important source of pollution to water and soil. Toxicity of commonly used herbicides to non-target, planktonic photosynthetic organisms has not been described completely yet. Therefore, we determined the effect of subinhibitory 2,4-D concentrations on the Chlorophycean alga Ankistrodesmus falcatus and on a toxigenic strain of the cyanobacterium Microcystis aeruginosa. Population growth, photosynthetic pigments, macromolecular biomarkers (carbohydrates, lipids, and protein), and antioxidant enzymes (catalase [CAT], glutathione peroxidase [GPx], and superoxide dismutase [SOD]) were quantified, and the integrated biomarker response (IBR) was calculated. Scanning electron microscope (SEM) and transmission electron microscope (TEM) observations were also performed. The 96-h median inhibitory concentration (IC50) for 2,4-D was 1353.80 and 71.20mgL-1 for the alga and the cyanobacterium, respectively. Under 2,4-D stress, both organisms increased pigments and macromolecules concentration, modified the activity of all the evaluated enzymes, and exhibited ultrastructural alterations. M. aeruginosa also increased microcystins production, and A. falcatus showed external morphological alterations. The green alga was tolerant to high concentrations of the herbicide, whereas the cyanobacterium exhibited sensitivity comparable to other phytoplankters. Both organisms were tolerant to comparatively high concentrations of the herbicide; however, negative effects on the assessed biomarkers and cell morphology were significant. Moreover, stimulation of the production of cyanotoxins under chemical stress could increase the risk for the biota in aquatic environments, related to herbicides pollution in eutrophic freshwater ecosystems.

Co-infección por los virus del dengue y chikungunya: revisión narrativa / Coinfection of dengue and chikungunya viruses: narrative review

Resumen Introducción: Los virus del dengue y chikungunya son transmitidos por la hembra de los mosquitos Aedes aegypti y Aedes albopictus, ampliamente distribuidos en zonas tropicales y subtropicales, lo que facilita la co-infección. Objetivo: Determinar la magnitud, la distribución geográfica y el cuadro clínico de la co-infección por dengue y chikungunya. Material y Métodos: Revisión narrativa. Búsqueda en las bases de datos PubMed y Lilacs, utilizando los términos MeSH "Chikungunya", "CHIKV", "DENV", "Dengue" y "coinfection. Se incluyeron los artículos de los últimos 20 años. Resultados: Se incluyeron 45 artículos. El mayor reporte de co-infección fue en Asia seguido de África. En las Américas la información es limitada por la reciente circulación del chikungunya. La magnitud de la co-infección varió entre 0 y 31,9%. No se encontraron diferencias en la distribución de la co-infección por sexo y edad. El cuadro clínico de la mono-infección y la co-infección fue similar. Algunos reportes de caso exponen cuadros graves con afección del sistema nervioso central, manifestaciones hemorrágicas y enfermedad de Still. Conclusión: Las manifestaciones clínicas de la co-infección por dengue y chikungunya son similares a la mono-infección, situación que dificulta el diagnóstico y la medición de su magnitud.

Background: Dengue and chikungunya viruses are transmitted by the female Aedes aegypti and Aedes albopictus, which are widely distributed in tropical and subtropical areas, facilitating coinfection. Aim: To determine the magnitude, geographical distribution and clinical picture of dengue and chikungunya coinfection. Material and Methods: Narrative review. A search in the PubMed and Lilacs databases was made, using the MeSH terms "Chikungunya", "CHIKV", "DENV", "Dengue" and "coinfection. The articles of the last 20 years were included. Results: A total of 45 articles were included. The largest coinfection report was in Asia followed by Africa. In the Americas, the information is limited because of the recent circulation of chikungunya. The magnitude of coinfection varies between 0% and 31.9%. No differences were found in the distribution of coinfection by sex and age. The clinical picture of monoinfection and coinfection was similar. Some case reports show severe cases with central nervous system involvement, hemorrhagic manifestations and Still's disease. Conclusion: The clinical manifestations of coinfection by dengue and chikungunya viruses are similar to those due to monoinfection, which difficult the diagnosis and measurement of its magnitude.

Maternal-embryonic metabolic and antioxidant response of Chapalichthys pardalis (Teleostei: Goodeidae) induced by exposure to 3,4-dichloroaniline.

Chapalichthys pardalis is a viviparous fish, microendemic to the Tocumbo Region in the state of Michoacán, Mexico. Despite the peculiar type of reproduction of goodeid fish and their mother-embryo interaction, the effects on embryos induced by maternal exposure to aquatic xenobiotics are still unknown. The objective of the present work was to determine the maternal-embryonic metabolic and antioxidant response of C. pardalis exposed to 3,4-dichloroaniline (3,4-DCA), a compound considered highly noxious to the environment because of its high toxicity and persistence, which has been used as reference toxicant in toxicological bioassays. We determined the median lethal concentration (LC50, 96 h) and then exposed pregnant females to 3.3, 2.5, and 0.5 mg L-1 of 3,4-DCA (equivalent to LC1, LC0.01, and LC50/10, respectively) during 21 days. We assessed the activity of antioxidant enzymes like superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), macromolecules content (proteins, lipids, carbohydrates), glucose, and lactate concentration, as well as the oxidative damage, by measuring thiobarbituric acid reactive substances, and protein oxidation. To interpret results, we used the integrated biomarker response (IBRv2). The average LC50 was of 5.18 mg L-1 (4.8-5.5 mg L-1; p = 0.05). All females exposed to concentrations of 3.3 and 2.5 mg L-1 lost 100% of the embryos during the bioassay, whereas those exposed to 0.5 mg L-1 showed alterations in the antioxidant activity and oxidative damage, being the embryos and the maternal liver the most affected, with IBRv2 values of 10.09 and 9.21, respectively. Damage to macromolecules was greater in embryos and the maternal liver, with IBRv2 of 16.14 and 8.40, respectively. We conclude that exposure to xenobiotics, like 3,4-DCA, in species with a marked maternal-embryonic interaction represents a potential risk for the development and survival of the descendants, thereby, potentially affecting the future of the population.

Exposure to silver nanoparticles produces oxidative stress and affects macromolecular and metabolic biomarkers in the goodeid fish Chapalichthys pardalis.

Silver nanoparticles (AgNPs) are the most commercialized nanomaterial worldwide, mainly due to their microbicidal activity. Although, AgNPs have been shown to be toxic to aquatic species, their effect on endemic fish, like Goodeidae, has not been demonstrated. Endemic species are under strong pressures by anthropogenic contamination and destruction of their habitat; therefore, we studied adult Chapalichthys pardalis, an endemic fish of Mexico. We evaluated the toxic effect of AgNPs through oxidative stress, macromolecular and metabolic biomarkers. We determined the LC50 (96h) and performed subchronic tests (21days) using sublethal AgNPs concentrations (equivalent to CL1 and CL10). At the end of the bioassay, we quantified 10 stress biomarkers in the liver, gills, and muscle, including the antioxidant enzymes (superoxide dismutase [SOD], catalase [CAT], and glutathione [GPx]), thiobarbituric acid reactive species (TBARS), protein oxidation (CO), macromolecules (proteins, lipids, and carbohydrates), and metabolites (glucose and lactate). In addition, we determined the integrated biomarkers response (IBR). LC50 was of 10.32mgL-1. Results of subchronic exposure (21days) revealed that AgNPs produce oxidative stress in C. pardalis adults, as evidenced by a diminution in antioxidant enzymes activity and an increase in TBARS and oxidized proteins. AgNPs also diminished levels of macromolecules and generated a high-energy consumption, reflected in the reduction of glucose levels, although lactate levels were not altered. The IBR analysis evidenced that the largest effect was produced in organisms exposed to LC10, being the liver and gills the organs with the greatest damage. Results demonstrated that exposure to AgNPs induces acute and chronic toxic effects on C. pardalis and forewarns about the impact that these nanomaterials can exert on these ecologically relevant aquatic organisms.

How do toxic metals affect harmful cyanobacteria? An integrative study with a toxigenic strain of Microcystis aeruginosa exposed to nickel stress.

Nickel (Ni) is an essential metal for some organisms, but also a common toxic pollutant released into the water. Toxicity of Ni has not been completely established for cyanobacteria; for this reason, we evaluated the effect of sub-inhibitory Ni concentrations on a toxigenic strain of Microcystis aeruginosa and on microcystins production. Population growth, photosynthetic pigments concentration, biomarkers, including antioxidant enzymes (catalase [CAT], glutathione peroxidase [GPx], and superoxide dismutase [SOD]), as well as macromolecules (proteins, carbohydrates and lipids) were quantified; SEM and TEM observations were also performed. Population growth was affected starting at 3µgL(-1), and at 24µgL(-1) growth was completely inhibited; the 96-h Ni(2+) IC50 was 3.7µgL(-1). Ni exposure increased pigments concentration, augmented all the macromolecules, and increased activities of CAT and GPx; alterations on the internal cell structure were also observed. The integrated biomarker response revealed that Ni(2+) augmented the antioxidant response and the macromolecules content. Ni stress also increased microcystins production. M. aeruginosa was affected by Ni at very low concentrations, even lower than those established as safe limit to protect aquatic biota. Aside from the toxic effects produced in this cyanobacterium, stimulation to produce toxins could potentiate the environmental risks associated with water pollution and eutrophication.

Deciphering the Lived Experience of Latinos with Diabetes and Depression: A Qualitative Interpretive Meta-Synthesis.

The purpose of this study was to understand Latinos' experiences with diabetes and depression. The authors conducted a qualitative interpretive meta-synthesis of studies describing Latinos' experiences with diabetes and depression. Themes included (a) perceptions of diabetes, (b) bidirectional relationship between emotions and diabetes, (c) perceptions of depression, (d) perceptions of depression treatment, and (e) religion as strength. Additionally, a negative case was identified and is discussed. Practice implications are that Latinos are in need of psychoeducation to improve diabetes literacy, understand the comorbidity of depression and diabetes, and understand depression and diabetes treatment. Also, there is a need for policies removing barriers to health care and promoting depression assessment among Latinos who have a high prevalence of diabetes. Finally, there is a need for further research on spirituality and health.

Nickel has biochemical, physiological, and structural effects on the green microalga Ankistrodesmus falcatus: An integrative study.

In recent years, the release of chemical pollutants to water bodies has increased due to anthropogenic activities. Ni(2+) is an essential metal that causes damage to aquatic biota at high concentrations. Phytoplankton are photosynthesizing microscopic organisms that constitute a fundamental community in aquatic environments because they are primary producers that sustain the aquatic food web. Nickel toxicity has not been characterized in all of the affected levels of biological organization. For this reason, the present study evaluated the toxic effects of nickel on the growth of a primary producer, the green microalga Ankistrodesmus falcatus, and on its biochemical, enzymatic, and structural levels. The IC50 (96h) was determined for Ni(2+). Based on this result, five concentrations were determined for additional tests, in which cell density was evaluated daily. At the end of the assay, pigments and six biomarkers, including antioxidant enzymes (catalase [CAT], glutathione peroxidase [GPx], superoxide dismutase [SOD]), and macromolecules (proteins, carbohydrates and lipids), were quantified; the integrated biomarker response (IBR) was determined also. The microalgae were observed by SEM and TEM. Population growth was affected starting at 7.5 µg L(-1) (0.028 µM), and at 120 µg L(-1) (0.450 µM), growth was inhibited completely; the determined IC50 was 17 µg L(-1). Exposure to nickel reduced the concentration of pigments, decreased the content of all of the macromolecules, inhibited of SOD activity, and increased CAT and GPx activities. The IBR revealed that Ni(2+) increased the antioxidant response and diminished the macromolecules concentration. A. falcatus was affected by nickel at very low concentrations; negative effects were observed at the macromolecular, enzymatic, cytoplasmic, and morphological levels, as well as in population growth. Ni(2+) toxicity could result in environmental impacts with consequences on the entire aquatic community. Current regulations should be revised to protect primary producers.