Association of food insecurity with health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic.

OBJECTIVES: To examine the associations between food insecurity and health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic and examine whether the associations were less pronounced among adults with safety nets. STUDY DESIGN: We conducted a retrospective longitudinal cohort study using the 2020-2021 Medical Expenditure Panel Survey. METHODS: Linear probability models were used to assess the associations between food insecurity in one year and the outcomes of interest in the following year while adjusting for baseline characteristics. We performed the analyses for the entire population and then conducted stratified analyses for adults with and without Supplemental Nutrition Assistance Program (SNAP) benefits or Medicaid coverage. RESULTS: Compared with food-secure adults, food-insecure adults were 9.1 percentage points less likely to report life satisfaction and 9.9, 10.2, and 13.2 percentage points more likely to experience delays in getting medical care, postpone or forgo medical care because of cost, and struggle with paying medical bills. Food-insecure adults were 30.4, 27.2, and 23.5 percentage points more likely to face challenges in affording necessities, paying utility bills, and meeting rent or mortgage payments on time than food-secure adults. Notably, the strengths of these associations were attenuated among adults with SNAP benefits or Medicaid coverage. CONCLUSIONS: Food insecurity was associated with poor health, limited access to and affordability of care, and a greater financial burden of care among US adults during the pandemic. Nevertheless, safety net programs can play a critical role in alleviating adverse consequences.

Lentes de contacto y disbiosis ocular, de lo transitorio a lo patológico / Contact lenses and ocular dysbiosis, from the transitory to the pathological

La microbiota ocular normal está compuesta por diferentes comunidades bacterianas Gram negativas y positivas que actúan en la superficie ocular como comensales. Un desequilibrio en la homeostasis de las especies nativas o disbiosis desencadena alteraciones funcionales que eventualmente pueden conllevar afecciones oculares, señalándose al uso de lentes de contacto como el factor predisponente más relevante. Mediante una revisión bibliográfica que incluyó artículos científicos publicados entre el año 2018 y 2022, se analizó la relación entre la microbiota ocular sana, la disbiosis asociada al uso de lentes de contacto que desencadena afecciones oculares. La microbiota ocular en individuos sanos, se compone principalmente por bacterias de los filos: proteobacterias, actinobacteria y firmicutes. Estas comunidades bacterianas al verse asociadas al uso de lentes de contacto desarrollaron disbiosis, observándose un aumento de ciertos géneros como Staphylococcus spp. y Pseudomonas spp., que en condiciones normales son comensales de la superficie ocular, pero al estar aumentada su abundancia condicionan la aparición de diversas afecciones oculares como eventos infiltrativos corneales, queratitis y úlcera corneal bacterianas. Dichas patologías tienden a evolucionar de manera rápida, lo que, sumado a una detección y tratamiento tardíos, puede determinar un pronóstico visual deficiente. Se sugiere que, frente a diversas afecciones de la superficie ocular, los profesionales en el área de oftalmología conozcan la composición de las comunidades de microorganismos que conforman esta microbiota ocular, de manera de distinguir e identificar correctamente el agente causal y, con ello, brindar un tratamiento adecuado y efectivo al usuario (AU)

Normal ocular microbiota is composed of different Gram-negative and positive bacterial communities that act as commensals on the ocular surface. An imbalance in the homeostasis of the native species or dysbiosis triggers functional alterations that can eventually lead to ocular conditions, indicating the use of contact lenses as the most relevant predisposing factor. Through a bibliographic review that added scientific articles published between 2018 and 2022, the relationship between healthy ocular microbiota and dysbiosis associated with the use of contact lenses that trigger ocular conditions was analyzed. The ocular microbiota in healthy individuals is mainly composed of bacteria from the phyla: proteobacteria, actinobacteria and firmicutes. These bacterial communities associated with the use of contact lenses develop dysbiosis, observing an increase in certain genera such as Staphylococcus spp. and Pseudomonas spp., which under normal conditions are commensals of the ocular surface, but as their abundance is increased, they condition the appearance of various ocular conditions such as corneal infiltrative events, bacterial keratitis and corneal ulcer. These pathologies tend to evolve rapidly, which, added to late detection and treatment, can lead to a poor visual prognosis. It is suggested that professionals in the ophthalmology area learn about the composition of the communities of microorganisms that make up this ocular microbiota, in order to correctly distinguish and identify the causative agent, thereby providing a adequate and effective treatment to the user (AU)

Contact lenses and ocular dysbiosis, from the transitory to the pathological.

Normal ocular microbiota is composed of different Gram-negative and positive bacterial communities that act as commensals on the ocular surface. An imbalance in the homeostasis of the native species or dysbiosis triggers functional alterations that can eventually lead to ocular conditions, indicating the use of contact lenses as the most relevant predisposing factor. Through a bibliographic review that added scientific articles published between 2018 and 2022, the relationship between healthy ocular microbiota and dysbiosis associated with the use of contact lenses that trigger ocular conditions was analyzed. The ocular microbiota in healthy individuals is mainly composed of bacteria from the phyla: Proteobacteria, Actinobacteria and Firmicutes. These bacterial communities associated with the use of contact lenses develop dysbiosis, observing an increase in certain genera such as Staphylococcus spp. and Pseudomonas spp., which under normal conditions are commensals of the ocular surface, but as their abundance is increased, they condition the appearance of various ocular conditions such as corneal infiltrative events, bacterial keratitis and corneal ulcer. These pathologies tend to evolve rapidly, which, added to late detection and treatment, can lead to a poor visual prognosis. It is suggested that professionals in the ophthalmology area learn about the composition of the communities of microorganisms that make up this ocular microbiota, in order to correctly distinguish and identify the causative agent, thereby providing a adequate and effective treatment to the user.

n-3 polyunsaturated fatty acids in the regulation of adipose tissue browning and thermogenesis in obesity: Potential relationship with gut microbiota.

BACKGROUND: Obesity is a worldwide public health problem characterized by fat tissue accumulation, favouring adipose tissue and metabolic alterations. Increasing energy expenditure (EE) through brown adipose tissue activation and white adipose tissue (WAT) browning has gained relevance as a therapeutic approach. Different bioactive compounds, such as n-3 polyunsaturated fatty acids (PUFA), have been shown to induce those thermogenic effects. This process is regulated by the gut microbiota as well. Nevertheless, obesity is characterized by gut microbiota dysbiosis, which can be restored by weight loss and n-3 PUFA intake, among other factors. Knowledge gap: However, the role of the gut microbiota on the n-3 PUFA effect in inducing thermogenesis in obesity has not been fully elucidated. OBJECTIVE: This review aims to elucidate the potential implications of this interrelation on WAT browning adiposw sittue (BAT), BAT activity, and EE regulation in obesity models.

Inquilinus limosus isolated from a patient with chronic cystic fibrosis. First report in Mexico and evidence that co-infection with Pseudomonas aeruginosa promotes the accelerated and increased formation of extracellular neutrophil traps.

Cystic fibrosis is characterized by abnormal mucous secretions in the lungs that favor the proliferation of colonizing bacteria, with Pseudomonas aeruginosa and Staphylococcus aureus being the most isolated, however, other less known species could also have an impact on the health of the patient. Here we demonstrate the isolation and antibiotic resistance profiles of Inquilinus limosus, a rarely reported multidrug resistant bacterium, and compare them to a co-infectant strain of Pseudomonas aeruginosa. Likewise, we found that co-infection with both bacteria promotes increased formation of neutrophil extracellular traps, which can have an impact on the disease severity and make treatment difficult.

Neumonitis por nitrofurantoína, ¿tres episodios en un año? / Nitrofurantoin pneumonitis, three episodes in one year?

La nitrofurantoína es un antimicrobiano ampliamente utilizado en el tratamiento y profilaxis de infecciones urinarias no complicadas, su eficacia clínica parece equivalente a la de otros antibióticos. Su toxicidad pulmonar se conoce desde 1962. Presentamos el caso de una paciente de 82 años que se diagnosticó en agosto de 2009 y que refería dos cuadros pulmo nares previos ese mismo año, compatibles con toxicidad por nitrofurantoína y que en los 12 años siguientes no ha presentado cuadros similares. Se exponen las formas clínicas de presentación, la dificultad diagnóstica y las dudas sobre el tratamiento adecuado (AU)

Nitrofurantoin is an antimicrobial widely used in the treatment and prophylaxis of uncomplicated urinary tract infections, its clinical efficacy seems equivalent to that of other antibiotics. Its pulmonary toxicity has been known since 1962. We present the case of an 82-year-old patient who was diagnosed in August 2006 and who reported two previous pulmo nary symptoms that same year, compatible with nitrofurantoin toxicity and who in the following 12 years had not presented similar symptoms. The clinical forms of presentation, the diagnostic difficulty and the doubts about the appropriate treatment are exposed (AU)

Draft Genome Sequence of Streptococcus agalactiae TA B490, a Multidrug-Resistant Strain Isolated from Bovine Mastitis in Argentina.

Streptococcus agalactiae is a bovine pathogen that causes intramammary infections. For humans, S. agalactiae is a leading cause of neonatal death and an emerging pathogen in adults. Here, we present the draft genome sequence of S. agalactiae TA B490, a multidrug-resistant strain isolated from bovine mastitis in Argentina.

B-type natriuretic peptide over N-terminal pro-brain natriuretic peptide to predict incident atrial fibrillation after cryptogenic stroke.

BACKGROUND AND PURPOSE: B-type natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are well-known surrogates of atrial fibrillation (AF) detection but studies usually present data on either BNP or NT-proBNP. The aim was to determine and directly compare the validity of the two biomarkers as a tool to predict AF and guide prolonged cardiac monitoring in cryptogenic stroke patients. METHODS: Non-lacunar acute ischaemic stroke (<72 h) patients over 55 years of age with cryptogenic stroke after standard evaluation were included in the Crypto-AF study and blood was collected. BNP and NT-proBNP levels were determined by automated immunoassays. AF was assessed by 28 days' monitoring. Highest (optimizing specificity) and lowest (optimizing sensitivity) quartiles were used as biomarker cut-offs to build predictive models adjusted by sex and age. The integrated discrimination improvement index (IDI) and DeLong test were used to compare the performance of the two biomarkers. RESULTS: From 320 patients evaluated, 218 were included in the analysis. AF was detected in 50 patients (22.9%). NT-proBNP (P < 0.001) and BNP (P < 0.001) levels were higher in subjects with AF and their levels correlated (r = 0.495, P < 0.001). BNP showed an increased area under the curve (0.720 vs. 0.669; P = 0.0218) and a better predictive capacity (IDI = 3.63%, 95% confidence interval 1.36%-5.91%) compared to NT-proBNP. BNP performed better than NT-proBNP in a specific model (IDI = 3.7%, 95% confidence interval 0.87%-6.5%), whilst both biomarkers performed similarly in the case of a sensitive model. CONCLUSIONS: Both BNP and NT-proBNP were increased in cryptogenic stroke patients with AF detection. Interestingly, BNP outperforms NT-proBNP, especially in terms of specificity.

Nuevo nomenclátor estandarizado en oftalmología: Criterios e indicadores cuantitativos de baremación de actos médicos / A new standardised nomenclature in ophthalmology: Criteria and quantitative evaluation indicators of medical procedures

OBJETIVO: Elaborar un nuevo nomenclátor de actos y procedimientos médicos en oftalmología, basado en la Clasificación Internacional de Enfermedades CIE-9-MC. Establecer los principios generales y definir los criterios de baremación, indicadores cuantitativos y escalas de valoración. Determinar los algoritmos necesarios para el cómputo de las tarifas retributivas por acto médico. MÉTODOS: Sobre el nomenclátor vigente, se eliminaron los procesos obsoletos, añadieron otros nuevos, modificaron descriptores, agruparon procedimientos con descripciones similares y trasladaron de grupo otros, por razones de complejidad quirúrgica. Se definieron los criterios de baremación para el cálculo de las retribuciones médicas: formación y complejidad (U), responsabilidad profesional (R) y valor salud (V), con sus indicadores cuantitativos, respectivamente: periodo de formación necesario para dominar una técnica, frecuencia de complicaciones que agravan la situación preoperatoria, y días de incapacidad laboral que ocasiona el proceso. Se definieron las Unidades Relativas de Valor (URV) como la suma de puntos de U, R y V. La tarifa final por acto médico se calculará como el producto del número de URV por su coste unitario y por el coeficiente de ponderación (CP). RESULTADOS: Se elaboró un nuevo nomenclátor con 161 actos médicos agrupados en consultas, procedimientos diagnósticos (PR.DX), procedimientos terapéuticos (PR.TX) e intervenciones quirúrgicas (IQ) crecientes en complejidad desde el grupo 0 hasta el grupo 8. Para cada uno de los actos se describieron los siguientes caracteres: códigos OMC y CIE-9-MC, término descriptor, grupo, modificación propuesta: sin cambios o mínimos en los descriptores, agrupación de actos por definiciones similares, cambio de grupo de origen, actos eliminados y nuevos procedimientos. Asimismo, fueron puntuados los tres criterios de baremación: U entre 1-4, R entre 0-3 y V entre 0-3. Mediante su suma se calcularon el número de URV por acto médico (entre 1 y 10), que junto con el coste unitario de la URV y el CP (entre 0,05 y 1) determinarán la tarifa final. CONCLUSIONES: El nuevo nomenclátor de oftalmología actualiza y mejora el catálogo antiguo, adecuando los procedimientos a los descriptores recogidos en la CIE-9-MC e incorporando todas las técnicas actuales. Adicionalmente, la declaración de los principios generales permite definir nuevos criterios de baremación, indicadores cuantitativos, escalas de valoración y algoritmos de cómputo de las tarifas por acto médico

PURPOSE: To create a new list of medical procedures in ophthalmology based on the International Classification of Diseases ICD-9-CM. To establish the general principles that define criteria, quantitative indicators, and scales. To develop the algorithms needed to calculate fees for medical procedures. METHODS: The out-of-date processes were removed from the list, and new techniques were added, descriptors were modified, procedures with similar descriptions were grouped together, and others were relocated to other group according to surgical complexity conditions. The criteria to calculate the medical fees were defined: training and complexity (U), proficient responsibility (R), and health value (V), with their respective quantitative indicators: period of training necessary to master a technique, frequency of complications that worsen the preoperative situation, and days of incapacity for work due to the process. The Relative Value Unit (RVU) was defined as the score sum of R, V and U. The final fee per medical procedure was calculated as the product of the RVU by its unit cost and by the weighting coefficient (WC). RESULTS: A new catalogue was prepared with 161 medical procedures, grouped into consultations, diagnostic procedures (DX.PR), therapeutic procedures (TX.PR), and surgical interventions, increasing in complexity from group 0 to group 8. The following characters were described for each one of the procedures: OMC and ICD-9-MC code, descriptor term, group, proposed modification: no changes or minimums in the descriptors, grouping of acts by similar definitions, change of origin group, new procedures, and procedures removed. The indicators for assessment were also scored: U between 1-4 points, and R and V between 0-3 points. Using their sum, the number of RVUs per medical procedure (between 1 and 10) was calculated which, together with the unit cost of the RVU and the WC (between 0.05 and 1), will determine the final rate. CONCLUSIONS: The new standardised ophthalmological nomenclature updates and improves the old classification, adapting the procedures to the descriptors included in the ICD-9-CM, and incorporating all the new techniques. Additionally, the declaration of the general principles allows defining new criteria, quantitative indicators, rating scales, and algorithms to calculate fees for medical procedures

Pseudomonas aeruginosa isolates from cystic fibrosis patients induce neutrophil extracellular traps with different morphologies that could correlate with their disease severity.

Cystic fibrosis (CF) is a disease characterized by bacterial chronic infection of the respiratory tract and inflammation, which leads to a progressive decrease in lung function. Pseudomonas aeruginosa is commonly isolated from the sputum of patients and their presence is associated with a predominant airway inflammation with neutrophils, causing chronic colonization and higher mortality rates. Neutrophil extracellular traps (NETs) have been observed in response against Pseudomonas, however, these cannot eliminate the pathogen from the respiratory tract, so one possibility is that the bacteria could promote their production to use them as a scaffold to colonize the lungs and as a nutrient source, however, their overproduction could also lead to increased damage to the lungs. In this work, we evaluated NETs formation by Pseudomonas clinical isolates obtained from CF patients and found that these induced NETs formation with globular or spread morphologies, of note, we found that there is a trend by which the spread forms were induced mainly by isolates obtained from patients with severe disease, whereas, the globular morphologies were observed for isolates obtained from patients with mild/moderate disease. Finally, we screened for bacterial molecules implicated in NETs formation and found that Exotoxin S, pyocin S2 and pyoverdine could participate in the process.

A new standardised nomenclature in ophthalmology: Criteria and quantitative evaluation indicators of medical procedures. / Nuevo nomenclátor estandarizado en oftalmología: Criterios e indicadores cuantitativos de baremación de actos médicos.

PURPOSE: To create a new list of medical procedures in ophthalmology based on the International Classification of Diseases ICD-9-CM. To establish the general principles that define criteria, quantitative indicators, and scales. To develop the algorithms needed to calculate fees for medical procedures. METHODS: The out-of-date processes were removed from the list, and new techniques were added, descriptors were modified, procedures with similar descriptions were grouped together, and others were relocated to other group according to surgical complexity conditions. The criteria to calculate the medical fees were defined: training and complexity (U), proficient responsibility (R), and health value (V), with their respective quantitative indicators: period of training necessary to master a technique, frequency of complications that worsen the preoperative situation, and days of incapacity for work due to the process. The Relative Value Unit (RVU) was defined as the score sum of R, V and U. The final fee per medical procedure was calculated as the product of the RVU by its unit cost and by the weighting coefficient (WC). RESULTS: A new catalogue was prepared with 161 medical procedures, grouped into consultations, diagnostic procedures (DX.PR), therapeutic procedures (TX.PR), and surgical interventions, increasing in complexity from group 0 to group 8. The following characters were described for each one of the procedures: OMC and ICD-9-MC code, descriptor term, group, proposed modification: no changes or minimums in the descriptors, grouping of acts by similar definitions, change of origin group, new procedures, and procedures removed. The indicators for assessment were also scored: U between 1-4 points, and R and V between 0-3 points. Using their sum, the number of RVUs per medical procedure (between 1 and 10) was calculated which, together with the unit cost of the RVU and the WC (between 0.05 and 1), will determine the final rate. CONCLUSIONS: The new standardised ophthalmological nomenclature updates and improves the old classification, adapting the procedures to the descriptors included in the ICD-9-CM, and incorporating all the new techniques. Additionally, the declaration of the general principles allows defining new criteria, quantitative indicators, rating scales, and algorithms to calculate fees for medical procedures.

A parsimonious score with a free web tool for predicting disability after an ischemic stroke: the Parsifal Score.

BACKGROUND: Most of the models to predict prognosis after an ischemic stroke include complex mathematical equations or too many variables, making them difficult to use in the daily clinic. We want to predict disability 3 months after an ischemic stroke in an independent patient not receiving recanalization treatment within the first 24 h, using a minimum set of variables and an easy tool to facilitate its implementation. As a secondary aim, we calculated the capacity of the score to predict an excellent/devastating outcome and mortality. METHODS: Eight hundred and forty-four patients were evaluated. A multivariable ordinal logistic regression was used to obtain the score. The Modified Rankin Scale (mRS) was used to estimate disability at the third month. The results were replicated in another independent cohort (378 patients). The "polr" function of R was used to perform the regression, stratifying the sample into seven groups with different cutoffs (from mRS 0 to 6). RESULTS: The Parsifal score was generated with: age, previous mRS, initial NIHSS, glycemia on admission, and dyslipidemia. This score predicts disability with an accuracy of 80-76% (discovery-replication cohorts). It has an AUC of 0.86 in the discovery and replication cohort. The specificity was 90-80% (discovery-replication cohorts); while, the sensitivity was 64-74% (discovery-replication cohorts). The prediction of an excellent or devastating outcome, as well as mortality, obtained good discrimination with AUC > 0.80. CONCLUSIONS: The Parsifal Score is a model that predicts disability at the third month, with only five variables, with good discrimination and calibration, and being replicated in an independent cohort.

Large vessel occlusion is independently associated with atrial fibrillation detection.

BACKGROUND AND PURPOSE: Covert paroxysmal atrial fibrillation (pAF) is the most frequent cause of cardiac embolism. Our goal was to discover parameters associated with early pAF detection with intensive cardiac monitoring. METHOD: Crypto-AF was a multicentre prospective study (four Comprehensive Stroke Centres) to detect pAF in non-lacunar cryptogenic stroke continuously monitored within the first 28 days. Stroke severity, infarct pattern, large vessel occlusion (LVO) at baseline, electrocardiography analysis, supraventricular extrasystolia in the Holter examination, left atrial volume index and brain natriuretic peptide level were assessed. The percentage of pAF detection and pAF episodes lasting more than 5 h were registered. RESULTS: Out of 296 patients, 264 patients completed the monitoring period with 23.1% (61/264) of pAF detection. Patients with pAF were older [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01-1.08], they had more haemorrhagic infarction (OR 4.03, 95% CI 1.44-11.22), they were more likely to have LVO (OR 4.29, 95% CI 2.31-7.97) (P < 0.0001), they had a larger left atrial volume index (OR 1.03, 95% CI 1.01-1.1) (P = 0.0002) and they had a higher level of brain natriuretic peptide (OR 1.01, 95% CI 1.0-1.1). Age and LVO were independently associated with pAF detection (OR 1.06, 95% CI 1.00-1.16, and OR 4.58, 95% CI 2.27- 21.38, respectively). Patients with LVO had higher cumulative incidence of pAF (log rank P < 0.001) and more percentage of pAF > 5 h [29.6% (21/71) vs. 8.3% (12/144); OR 4.62, 95% CI 2.11-10.08; P < 0.001]. In a mean follow-up of 26.82 months (SD 10.15) the stroke recurrence rate was 4.6% (12/260). CONCLUSIONS: Large vessel occlusion in cryptogenic stroke emerged as an independent marker of pAF.

Reduction of high-fat diet-induced liver proinflammatory state by eicosapentaenoic acid plus hydroxytyrosol supplementation: involvement of resolvins RvE1/2 and RvD1/2.

High-fat diet (HFD)-fed mice show obesity with development of liver steatosis and a proinflammatory state without establishing an inflammatory reaction. The aim of this work was to assess the hypothesis that eicosapentaenoic acid (EPA) plus hydroxytyrosol (HT) supplementation prevents the inflammatory reaction through enhancement in the hepatic resolvin content in HFD-fed mice. Male C57BL/6J mice were fed an HFD or a control diet and supplemented with EPA (50 mg/kg/day) and HT (5 mg/kg/day) or their respective vehicles for 12 weeks. Measurements include liver levels of EPA, DHA and palmitate (gas chromatography), liver resolvins and triglyceride (TG) and serum aspartate transaminase (AST) (specific kits) and hepatic and serum inflammatory markers (quantitative polymerase chain reaction and enzyme-linked immunosorbent assay). Compared to CD, HFD induced body weight gain, liver steatosis and TG accumulation, with up-regulation of proinflammatory markers in the absence of histological inflammation or serum AST changes; these results were accompanied by higher hepatic levels of resolvins RvE1, RvE2, RvD1 and RvD2, with decreases in EPA and DHA contents. EPA+HT supplementation in HFD feeding synergistically reduced the steatosis score over individual treatments and increased the hepatic levels of EPA, DHA and resolvins, with attenuation of proinflammatory markers. Lack of progression of HFD-induced proinflammatory state into overt inflammation is associated with resolvin up-regulation, which is further increased by EPA+HT supplementation eliciting steatosis attenuation. These findings point to the importance of combined protocols in hepatoprotection due to the involvement of cross-talk mechanisms, which increase effectiveness and diminish dosages, avoiding undesirable effects.

Touching the Sky: Coccinellids (Coleoptera: Coccinellidae) at High Altitudes in South America.

Records of extreme altitudes where several coccinellid species from South America inhabit the Andes of Argentina, Bolivia, Chile, Colombia, Ecuador, and Peru are provided. After an intensive review of several entomological collections and literature, records for 35 species with at least one location over 3500-m elevation were obtained, including the genera Cycloneda (ten species), Eriopis (15 species and one subspecies), Harmonia (one species), Hippodamia (two species), Mimoscymnus (two species), Psyllobora (one species), and Stenadalia (four species). In total, 184 location records are listed, of which 119 were from between 3000 and 4000 m, 57 between 4000 and 4900 m and eight above 4900 m, with the highest altitude record at 5250 m for Eriopis minima Hofmann. All records above 4000 m were obtained in the Puna biogeographic province within the Paramo Puneña biogeographic subregion. These records are the highest altitudes observed for the American continent and by far surpass others known for coccinellids worldwide. Several species of coccinellids living in sympatry at these high altitudes were verified, and in some cases, in situ development was inferred by the presence of immature stages. These findings are important to foresee the future effects of global warming that will affect especially the biological communities of extreme altitudes.

[Syndrome of vertebral destruction: understanding to practice]. / Síndrome de destrucción vertebral: del entendimiento a la práctica.

The term «vertebral destruction syndrome¼ comprises pathologies causing structural changes in the spine, mainly in the vertebral body, producing mechanical deformity and neurological involvement. The pathologies found in this definition may be infectious, metabolic or tumoral. Vertebral osteomyelitis is a disease that occurs mainly in adults > 50 years; we speak of spondylodiscitis when the condition affects the disc and vertebral body. The most important organism in vertebral osteomyelitis is Staphylococcus aureus, seen in over 50% of cases. Tumors of the spine can start from local or adjacent spinal injuries or distant ones, and spread through the blood or lymphatic system. Metastases account for about 97% of all tumors of the spine. Primary tumors that most commonly spread to the spine are lung, prostate, breast and kidney. Metabolic bone diseases are a group of disorders that occur as a result of changes in the calcium metabolism. The spine contains large amounts of metabolically active cancellous bone, which must withstand axial loads during stance. Osteoporosis is a metabolic disease that most commonly affects the spine; it is characterized by low bone mass. The diagnosis of these entities is important for the treatment and prognosis of the patient. The term «vertebral destruction syndrome¼ proposes a notarized scheme aimed at improving the patients prognosis and his/her prompt treatment.

El término «síndrome de destrucción vertebral¼ engloba patologías que causan alteraciones estructurales en la columna en particular, en el cuerpo vertebral, produciendo deformidad con afectación neurológica y/o mecánica. Dentro de las patologías que se encuentran en esta definición están la infecciosa, tumoral y metabólica. La osteomielitis vertebral es una enfermedad que se da sobre todo en adultos > 50 años; se habla de espondilodiscitis cuando hay afección del disco y cuerpo vertebral. El más importante organismo en la osteomielitis vertebral es el Staphylococcus aureus, visto en más de 50% de los casos. Los tumores de la columna vertebral pueden iniciar desde lesiones locales o adyacentes a la columna o a distancia, diseminados por vía hematógena o linfática; las lesiones por metástasis abarcan cerca de 97% de todos los tumores de la columna. Los tumores primarios que con mayor frecuencia se diseminan a columna vertebral son pulmonar, de próstata, mama y riñón. Las enfermedades metabólicas óseas son un grupo de desórdenes que ocurren como resultado de cambios en el metabolismo del calcio. La columna vertebral contiene grandes cantidades de hueso esponjoso metabólicamente activo que debe resistir cargas axiales durante la postura. La osteoporosis es la enfermedad metabólica que con más frecuencia afecta la columna vertebral; se caracteriza por disminución en la masa ósea. El diagnóstico de estas entidades es importante para el tratamiento y pronóstico del paciente; el término «síndrome de destrucción vertebral¼ propone un esquema protocolizado encaminado a mejorar el pronóstico del paciente, así como su pronto tratamiento.

Molecular epidemiology of Shiga toxin-producing O113:H21 isolates from cattle and meat.

The serotype O113:H21 is considered one of the relevant non-O157 STEC serotypes associated with severe human infections. Due to the increased detection of O113 strains and their relationship with clinical cases, which emphasizes the importance of this serogroup as an emerging pathogen, our aim was to determine the characteristics of STEC O113:H21 strains circulating in bovine cattle and retail meat from Argentina. For this purpose, we determined the presence and combinations of various virulence genes (and their variants) related to adhesion and toxicity in a collection of 34 isolates. Their genetic relatedness using multiple-locus variable-number tandem repeat analysis (MLVA) was also studied. Subtyping of stx genes indicated that O113:H21 strains circulating in Argentina mainly present stx2a alone or together with stx2c or, less frequent, with stx2d , all of which are subtypes associated with human disease. We found plasmid markers, such as saa, ehxA and subA, in a higher proportion than previous studies, and five variants of saa, two of which were novel ones. In relation to MLVA subtyping, we detected a limited diversity among the isolates considering that several loci were not discriminative and, that in some farms, the same clone seemed to remain circulating throughout the year. The O113:H21 strains studied harbour several toxin and adhesion genes (saa, espP, fimCD, ehaA, iha, hcpA, elfA, lpfO113, ecpA, subA, cdt-V) and Stx subtypes associated with human disease. Results also highlighted that subtyping of stx and saa is useful to discriminate O113:H21 strains that share virulence genes. In conclusion, this study shows that a number of O113:H21 strains that occur in foods and bovines could be pathogenic for humans. This situation calls for further attention in the prevention and control of foodborne disease caused by these strains.

CCL23: a new CC chemokine involved in human brain damage.

BACKGROUND: CCL23 role in the inflammatory response after acute brain injuries remains elusive. Here, we evaluated whether CCL23 blood levels associate with acquired cerebral lesions and determined CCL23 predictive capacity for assessing stroke prognosis. We used preclinical models to study the CCL23 homologous chemokines in rodents, CCL9 and CCL6. METHODS: Baseline CCL23 blood levels were determined on 245 individuals, including ischaemic strokes (IS), stroke mimics and controls. Temporal profile of circulating CCL23 was explored from baseline to 24 h in 20 of the IS. In an independent cohort of 120 IS with a 3-month follow-up, CCL23 blood levels were included in logistic regression models to predict IS outcome. CCL9/CCL6 cerebral expression was evaluated in rodent models of brain damage. Both chemokines were also profiled in circulation and histologically located on brain following ischaemia. RESULTS: Baseline CCL23 blood levels did not discriminate IS, but permitted an accurate discrimination of patients presenting acute brain lesions (P = 0.003). IS exhibited a continuous increase from baseline to 24 h in circulating CCL23 (P < 0.001). Baseline CCL23 blood levels resulted an independent predictor of IS outcome at hospital discharge (ORadj : 19.702 [1.815-213.918], P = 0.014) and mortality after 3 months (ORadj : 21.47 [3.434-134.221], P = 0.001). In preclinics, expression of rodent chemokines in neurons following cerebral lesions was elevated. CCL9 circulating levels decreased early after ischaemia (P < 0.001), whereas CCL6 did not alter within the first 24 h after ischaemia. CONCLUSIONS: Although preclinical models do not seem suitable to characterize CCL23, it might be a novel promising biomarker for the early diagnosis of cerebral lesions and might facilitate the prediction of stroke patient outcome.

Resemblance in physical activity levels: The Portuguese sibling study on growth, fitness, lifestyle, and health.

OBJECTIVES: To investigate the relationships of biological, behavioral, familial, and environmental characteristics with siblings´ physical activity (PA) levels as well as the intrapair resemblance in PA. METHODS: The sample comprises 834 (390 females) biological siblings [brother-brother (BB), sister-sister (SS), brother-sister (BS)] aged 9 to 20 years. Total PA index (TPAI) was estimated by questionnaire. Information on potential behavioral, familial, and environmental correlates was obtained by self-report; body mass index (BMI), biological maturation, and physical fitness were measured. Multilevel models were used to analyze siblings´ clustered data, and sibling resemblance was estimated with the intraclass correlation (ρ). RESULTS: On average, younger sibs, those more physically fit, and those with more parental support had greater TPAI. Further, BB pairs had higher TPAI levels than SS or BS pairs, but also had greater within-pair variance. When adjusted for all covariates, SS pairs demonstrated greater resemblance in TPAI (ρ = 0.53, 95%CI = 0.38-0.68) than BS (ρ = 0.26, 95%CI = 0.14-0.43) or BB pairs (ρ = 0.18, 95%CI = 0.06-0.44). CONCLUSIONS: Age, physical fitness, and parental support were the best predictors of TPAI levels. A moderate level of resemblance in TPAI was observed in SS pairs, while lower resemblance was found for BS and BB pairs. These findings may be due to differences in the roles of shared genetic factors, familial, and environmental characteristics across different sibling types.