Clima organizacional del personal de salud y satisfacción de usuarios atendidos por Servicio de Atención Móvil de Urgencia (SAMU) en el contexto COVID-19, Piura 2021

Objetivo: Conocer la relación entre el clima organizacional del personal de salud y la satisfacción de los usuarios atendidos por el Servicio de Atención Móvil de Urgencias (SAMU) en el contexto COVID-19, Piura. Materiales y métodos: Se aplicó una encuesta a 80 trabajadores de salud para evaluar el clima organizacional y a 110 usuarios del SAMU para evaluar su nivel de satisfacción y si cumplían con los criterios de selección. La encuesta tuvo dos secciones: una dirigida a los trabajadores del SAMU y otra, al usuario. Se evaluaron con escala tipo Likert. Resultados: El 51,3 % del personal de salud fueron hombres, de una edad promedio de 32,65 ± 6,8 % años y hubo más licenciados en enfermería (32,50 %), seguido de médicos (31,30 %). El 54,5 % de usuarios fueron hombres, de una edad promedio de 58,78 ± 20,97 años, el 57,3 % no presentaron ninguna comorbilidad y el 84,5 % utilizaron el servicio una vez. El clima organizacional del personal y sus dimensiones fueron saludables (96,58 ± 3,21). La mayoría (51,60 %) de los usuarios del SAMU se encontraron satisfechos (57/110), mientras que el 38,2 % (42/110) manifestaron estar medianamente satisfechos y el 10,20 % (11/110) mostraron su insatisfacción. Se comprueba la hipótesis principal que existe asociación entre el clima organizacional y la satisfacción de los usuarios atendidos por el SAMU (p < 0,005) y existe asociación entre las cinco dimensiones con la satisfacción de los usuarios. Conclusiones: Existe relación entre el clima organizacional de los trabajadores de salud del Servicio de Atención Móvil de Urgencias y la satisfacción de usuarios atendidos por este servicio en Piura. El clima organizacional y sus dimensiones, comparados con el instrumento elaborado por el Minsa, se encuentran saludables, la mayoría de los pacientes atendidos se mostraron satisfechos con la atención recibida y las comorbilidades más frecuentes fueron la hipertensión y la diabetes mellitus tipo 2.

Objective: To determine the relationship between the organizational climate among healthcare personnel and the satisfaction of users assisted by the Mobile Emergency Care Service (SAMU) in the context of COVID-19, Piura. Materials and methods: A Likert-scale survey was administered to 80 healthcare workers to assess the organizational climate and 110 SAMU users to assess their satisfaction level and whether they met the selection criteria. The survey had one section addressed to SAMU workers and another one to SAMU users. Results: Out of all healthcare personnel, 51.3 % were men with an average age of 32.65 ± 6.8 % years, and there were more registered nurses (32.50 %) than doctors (31.30 %). Out of all users, 54.5 % were men with an average age of 58.78 ± 20.97 years, 57.3 % had no comorbidities and 84.5 % used the service once. The organizational climate and its dimensions showed healthy outcomes (96.58 ± 3.21). Most SAMU users (51.60 %) were satisfied (57/110) while 38.20 % (42/110) were moderately satisfied and 10.20 % (11/110) showed dissatisfaction. The main hypothesis concerning the relationship between the organizational climate and the satisfaction of SAMU users (p < 0.005) was confirmed. Moreover, there was a relationship between the five dimensions and the satisfaction of users. Conclusions: There is a relationship between the organizational climate among SAMU healthcare workers and the satisfaction of SAMU users in Piura. The organizational climate and its dimensions, compared to the instrument developed by MINSA, showed healthy outcomes. Most patients were satisfied with the care received and the most frequent comorbidities were hypertension and type 2 diabetes mellitus.

Evaluation of the durability and use of long-lasting insecticidal nets in Nicaragua.

BACKGROUND: Vector control for malaria prevention relies most often on the use of insecticide-treated bed net (ITNs) and indoor residual spraying. Little is known about the longevity of long-lasting insecticidal nets (LLINs) in the Americas. The physical integrity and insecticide retention of LLINs over time were monitored after a bed net distribution campaign to assess community practices around LLIN care and use in Waspam, northeastern Nicaragua. METHODS: At least 30 nets were collected at 6, 12, 24, and 36 months post distribution. Physical integrity was measured by counting holes and classifying nets into categories (good, damaged, and too torn) depending on a proportionate hole index (pHI). Insecticide bioefficacy was assessed using cone bioassays, and insecticide content measured using a cyanopyrethroid field test (CFT). RESULTS: At 6 months, 87.3 % of LLINs were in good physical condition, while by 36 months this decreased to 20.6 %, with 38.2 % considered 'too torn.' The median pHI increased from 7 at the 6-month time point to 480.5 by 36 months. After 36 months of use, median mortality in cone bioassays was 2 % (range: 0-6 %) compared to 16 % (range: 2-70 %) at 6 months. There was a decrease in the level of deltamethrin detected on the surface of the LLINs with 100 % of tested LLINs tested at 12 months and 24 months crossing the threshold for being considered a failed net by CFT. CONCLUSIONS: This first comprehensive analysis of LLIN durability in Central America revealed rapid loss of chemical bioefficacy and progressive physical damage over a 36-month period. Use of these findings to guide future LLIN interventions in malaria elimination settings in Nicaragua, and potentially elsewhere in the Americas, could help optimize the successful implementation of vector control strategies.

Central Role of Bicarbonate Anions in Charging Water/Hydrophobic Interfaces.

Aqueous interfaces are ubiquitous in Nature and play a fundamental role in environmental or biological processes or modern nanotechnologies. These interfaces are negatively charged, and despite several decades of research, the rationale behind this phenomenon is still under debate. Two main controversial schools of thought argue on this issue; the first relies on the adsorption of hydroxide anions on hydrophobic surfaces, whereas the second one supports a self-rearrangement of water molecules at the interface bearing hydronium ions. Here, we report on two series of independent experimental studies (nanoprecipitation and interfacial tension measurements) that demonstrate that in the pH 5-10 range the negative interfacial charge of the colloids mostly stems from bicarbonate ions, whereas at lower and higher pH, protons and hydroxide ions contribute, with bicarbonate ions, to the interfacial charging. This new interpretation complies with previous studies and opens new perspectives to this striking physical chemical issue.

Amlodipino y choque vasodilatado en una unidad de cuidados intensivos de un hospital general: Reporte de caso / Amlodipine and vasodilated shock in an intensive care unit of a general hospital: Case report

Los calcio antagonistas son fármacos usados para diferentes patologías médicas; sin embargo la intoxicación puede ser grave. Presentamos el caso de una mujer joven intoxicada por amlodipino quien cursó con choque vasodilatado y disfunción multiorgánica, en quien se usó vasopresores múltiples a dosis por encima de las habituales para estabilizarla. (AU)

Calcium antagonists are used in a number of medical conditions, but intoxication with these drugs may be lethal.We present the case of a young women intoxicated with amlodipine who presented with vasodilated shock and multi organ disfunction in whom multiple vasopressors at maximum allowed doses were used to estabilize the patient. (AU)

Fiebre amarilla y disfunción multiorgánica: Reporte de tres casos / Yellow fever and multi organ dysfunction: Report of three cases

Fiebre amarilla es una enfermedad viral aguda causada por un virus de la familia Flaviviridae transmitida por vectores, caracterizada por síndrome ictérico febril hemorrágica y que puede cursar con disfunción multiorgánica, con alta mortalidad. Se reportan tres casos de pacientes que viajaron a La Merced, Chanchamayo, que cursaron con síndrome ictérico febril hemorrágico con disfunción multiorgánica, con diagnóstico serológico de fiebre amarilla; uno sobrevivió y dos fallecieron. (AU)

Yellow fever is a vector-borne disease caused by a virus of the Flaviviridae family that is characterized by fever and jaundice that may progressed to multi organ failure with high associated mortality. We report three cases of patients who had travelled to La Merced, Chanchamayo who presented with multi organ failure with confirmed serology for yellow fever, one survived and the other two died. (AU)

Acidosis láctica y choque distributivo por sobredosis de metformina: Reporte de caso / Lactic acidosis and distributive shock due to metformin overdose: Case report

Metformina es una biguanida usada como agente antihiperglicemiante, que promueve la euglicemia; su principal toxicidad es acidosis láctica. Se reporta el caso de un varón, adulto mayor, diabético e hipertenso quien se automedicó con 10 tabletas de metformina 850 mg; presentando acidosis láctica severa y choque distributivo requiriendo soporte y manejo en la Unidad de Cuidados Intensivos. (AU)

Metformin is a biguanide drug used as an oral antidiabetic medication whose main toxicity is lactic acidosis. We report the case of an old adult male diabetic and hypertensive patient who self prescribed 10 tablets of metformin 850mg presenting lactic acidosis and distributive shock requiring treatment in the intensive care unit. (AU)

A Catalyst Platform for Unique Cationic (Co)Polymerization in Aqueous Emulsion.

Sodium dodecyl benzene sulfonate (DBSNa) surfactants, with a polydisperse and hyperbranched structure, combined with different rare earth metal salts generate highly water-dispersible Lewis acid surfactant combined catalysts (LASCs). This platform of new complexes promotes fast, efficient cationic polymerization of industrially relevant monomers in direct emulsion at moderate temperature. The process described here does not require high shearing, long polymerization time, or large catalyst content. It allows the reproducible generation of high-molar-mass homopolymers of pMOS, styrene, and isoprene, as well as random or multiblock copolymers of the latter two, in a simple and straightforward one-pot reaction.

Simple but precise engineering of functional nanocapsules through nanoprecipitation.

A general, rapid, and undemanding method to generate at will functional oil-filled nanocapsules through nanoprecipitation is reported. On the basis of polymer and hexadecane/water/acetone phase diagrams, the composition can be set so that polymer chains preferentially stick at the interface of the oil droplets to create nanocapsules. The nanocapsules can be decorated with biorelevant molecules (biotin, fluorescent tags, metal nanoparticles) within the shell and loaded with hydrophobic molecules in a simple one-pot procedure.

Vitamin D receptor BsmI polymorphism modulates soy intake and 25-hydroxyvitamin D supplementation benefits in cardiovascular disease risk factors profile.

Vitamin D receptor polymorphisms may predispose that not all individuals could have benefits from the nutritional supplementation of 25-hydroxyvitamin D. Furthermore, vitamin D-related cardiovascular effects may also be influenced by soy isoflavones considered endocrine regulators of cardiovascular homeostasis. To find possible gene-diet interactions by evaluating individualized lipid metabolism benefits from an increase in soy and 25-hydroxyvitamin D intake, 106 healthy individuals, genotyped for vitamin D receptor (VDR) gene polymorphism rs1544410 (BsmI) were randomly assigned to either no intake, to daily 250 mL or 500 mL of a 25-hydroxyvitamin D supplemented SB for 2 months. The soybean beverage induced differences in cardiovascular risk factors (lipid profile, blood pressure, TNFα and MCP-1), as well as vitamin D metabolites in a dose-gene-dependent relation. Thus, VDR BsmI polymorphism affected individual response being the GG genotype the ones that showed dose-dependent manner responsiveness in the reduction in total cholesterol, LDL and triglycerides in comparison with the AA/AG genotype. These differences were associated with increased plasma levels of 1α,25-dyhydroxyvitamin D3 in the carriers of the GG genotype. It was concluded that metabolic response to 25-hydroxyvitamin D and soybean supplementation is dependent on VDR BsmI GG genotype due to a higher conversion rate from vitamin D precursors.

Dietary intake of green tea polyphenols regulates insulin sensitivity with an increase in AMP-activated protein kinase α content and changes in mitochondrial respiratory complexes.

SCOPE: The intake of food rich in polyphenols is related to a lower incidence in almost all chronic degenerative diseases. However, relatively little is known about the molecular mechanisms involved in its antioxidant properties. The aim of this study was to determine whether the mechanism of action of polyphenols could be related to a modulation in energy uptake and metabolism, and further induced mitochondrial changes. METHODS AND RESULTS: For this purpose, male C57BL6 mice were fed during 3 months with a tea-based beverage rich in polyphenols. Insulin sensitivity, tissue oxidative damage biomarkers, as well as energy-related signaling pathways were determined to evaluate its mechanism of action. As a result, a tissue- and protein-specific subtle reduction in oxidative damage was observed. Skeletal muscle showed mitochondrial changes in respiratory complexes and an increase in AMP-activated protein kinase α levels, suggesting reduced energy availability. These changes were also associated with adipose tissue cellular metabolism. This was confirmed by a decline in the potential of energy uptake, evidenced by a diminished intestinal and systemic absorption of carbohydrates together with an inhibition of insulin sensitivity. CONCLUSIONS: Our results suggest that the mechanisms of action of green tea polyphenols may be related to their ability to modulate energy uptake leading to mitochondrial adaptations possibly responsible for the changes in protein oxidative damage.

Polyphenol-rich foods exhibit DNA antioxidative properties and protect the glutathione system in healthy subjects.

SCOPE: Polyphenols (ingested via food items) can decrease DNA, and oxidative damage of proteins and lipids. However, polyphenol effects in healthy populations have not been well defined. The aim of this study was to assess the relationship between urinary total polyphenol excretion (TPE), a biomarker of total polyphenol intake (TPI), polyphenol-rich foods, and oxidative stress biomarkers in healthy adults of different ages participating in the cross-sectional PAScual MEDicina study. METHODS AND RESULTS: Urinary TPE was determined by Folin-Ciocalteau method in spot urine samples of 81 participants (46 women), classified into three age groups: 18 to 39, 40 to 54, and 55 to 72 years of age. TPI was quantified from 3-day dietary records using the Phenol-Explorer database. Urinary TPE increased with age (p < 0.001). Urinary TPE was inversely associated with urinary 8-hydroxydeoxyguanosine (8-OHdG; p<0.001) and erythrocyte-oxidized glutathione concentrations (p < 0.05). A negative association between urinary 8-OHdG and daily intake of polyphenols from vegetables and fermented beverages such as red wine was observed. CONCLUSION: Urinary TPE increased with age and may reflect attenuation of oxidative damage. These results could explain the beneficial effects in healthy individuals of a diet rich in vegetables and moderate red wine; food items typical of the Mediterranean diet.

Efficacy of a microencapsulated iron pyrophosphate-fortified fruit juice: a randomised, double-blind, placebo-controlled study in Spanish iron-deficient women.

Fe-deficiency anaemia is a worldwide health problem. We studied the influence of consuming an Fe-fortified fruit juice on Fe status in menstruating women. A randomised, double-blind, placebo-controlled study of 16 weeks of duration was performed. Subjects were randomised into two groups: the P group (n 58) or the F group (n 64), and consumed, as a supplement to their usual diet, 500 ml/d of a placebo fruit juice or an Fe-fortified fruit juice, respectively. The Fe-fortified fruit juice, containing microencapsulated iron pyrophosphate, provided 18 mg Fe/d (100 % of the RDA). At baseline and monthly, dietary intake, body weight and Fe parameters were determined: total erythrocytes, haematocrit, mean corpuscular volume (MCV), red blood cell distribution width (RDW), Hb, serum Fe, serum ferritin, serum transferrin, transferrin saturation, soluble transferrin receptor (sTfR) and zinc protoporphyrin (ZnPP). The fruit juice consumption involved increased intake of carbohydrates and vitamin C, and increased BMI within normal limits. Ferritin was higher in the F group after week 4 (P < 0·05) and became 80 % higher than in the P group after week 16 (P < 0·001), and transferrin decreased in the F group compared with the P group after week 4 (P < 0·001). RDW was higher at weeks 4 and 8 in the F group compared with the P group (P < 0·05). Transferrin saturation increased after week 8, and haematocrit, MCV and Hb increased after week 12, in the F group compared with the P group. Serum Fe did not change. sTfR and ZnPP decreased in the F group at week 16 (P < 0·05). Iron pyrophosphate-fortified fruit juice improves Fe status and may be used to prevent Fe-deficiency anaemia.

Evaluación de cobertura y del nivel de información en la campaña de vacunación contra la fiebre amarilla, Cusco,Perú, 2005 / Evaluation of Coverage and Knowledge Levels during a Vaccination Campaign against Yellow Fever, Cusco-Perú, 2005

Introducción: la fiebre amarilla (FA) es enzootica en Cusco, siendo un serio problema social de salud pública. Para enfrentar el problema se elaboro el Plan Nacional de Prevención y Control de la FA, cuyo objetivo fue vacunar a toda la población del país mayor de 1 año, en 4 etapas (2004-2007); habiéndose previsto vacunar en la ciudad del Cusco a 306 160 personas entre noviembre 2004-febrero 2005. La cobertura final oficial reportada fue del 83.5%. Objetivo del estudio fue evaluar la cobertura de vacunación y el nivel de información y comunicación de la campaña. Material y método: estudio descriptivo, transversal y prospectivo realizado en la ciudad del Cusco, marzo 2005; por muestreo aleatorio estratificado; 954 personas fueron consideradas para evaluar la cobertura vacunal (CV); y 386 personas para evaluar los demás objetivos. Resultados: se evidenció que la CV contra la FA en Cusco fue del 64,04%. Las personas vacunadas, no tienen un conocimiento adecuado acerca de: que es FA (76,7%), el tiempo en que hace efecto la vacuna (84,9%), tiempo de protección de la vacuna (92,2%), contraindicaciones para la vacunación (65,2%). 58% de las personas vacunadas se informaron de la campaña de vacunación por la radio y 25% por la televisión. Solo 0,27% de los vacunados recuerda por lo menos uno de los mensajes principales de la campaña.Conclusiones: la evaluación de la CV evidenció que no se alcanzaron las metas establecidas para la campaña de vacunación, existiendo discrepancias entre lo reportado oficialmente (83,5%) y los resultados del estudio (64,04%). La población vacunada no fue debidamente informada acerca de la vacuna y la campaña de vacunación contra la FA, lo que pone en cuestión si es posible seguir implementando campañas sanitarias que afecten ciertos principios bioéticos básicos.

IIntroduction: Yellow Fever (YF) is enzootic in Cusco, and it is a serious public health problem. A National Plan for Control and Prevention of YF was implemented, aiming at vaccinating the whole Peruvian population above 1 year of age in four stages (2004–2007); and it was expected to vaccinate all of Cusco city inhabitants (306,160 persons in this age group) between November 2004 and February 2005. The final coverage reported was 83.5%. The objective of the study was to assess vaccination coverage and knowledge and communication levels of this campaign. Methods: A descriptive, cross-sectional, and prospective study was performed in Cusco in March 2005, using a stratified and randomized sampling technique. 954 people were interviewed in order to assess vaccination coverage and 386 for other objective measures. Results: Vaccination coverage against yellow fever in Cusco was 64.04%. Vaccinated people did not have good knowledge of: what yellow fever is (76.7%), how is it transmitted (50.9%), time in which the vaccine starts to exert its effect (84.9%), duration of the protective effect of the vaccine (92.2%), and contraindications for vaccination (65.2%). Only 0.27% remembered at least one of key messages of the campaign. Conclusions: This assessment showed that the goals for coverage in this vaccination campaign were not achieved; there were large differences between official reports (83.5%) and the results form our survey (64.04%). Immunized population was not adequately informed about the yellow fever vaccine and its vaccination campaign, which leads to question the benefits of performing campaigns affecting some basic bioethical principles.

Antioxidantes, atividade física e estresse oxidativo em mulheres idosas / Antioxidants, physical activity and oxidative stress in older women

OBJETIVO: Verificar a influência da suplementação de vitaminas antioxidantes na dieta de mulheres idosas que praticam exercícios físicos regulares, sobre o estresse oxidativo, indicadores da saúde física e risco de enfermidades cardiovasculares (ECV). MÉTODO: Foram observados dois grupos (S e C) de mulheres com idades entre 60 e 80 anos participantes de um programa de atividades físicas durante 58 semanas, com freqüência de três vezes por semana e duração de 50 a 55 minutos cada sessão. A dieta habitual do Grupo S (n=36) foi suplementada diariamente com 330 ml de uma bebida antioxidante (FuncionaTM); o Grupo C (n=32) ingeriu água e se caracterizou como controle. Como indicadores do estresse oxidativo foram determinadas as concentrações plasmáticas de glutationa reduzida (GSH) e oxidada (GSSG), calculada a relação molar GSH/GSSG, e identificado o dano oxidativo em lipídios e proteínas. As condições físicas e cardiovasculares foram avaliadas por meio dos parâmetros antropométricos habituais (peso, altura e índice de massa corporal) e da pressão arterial. RESULTADOS: O Grupo C apresentou aumentos significativos do estresse oxidativo, redução da pressão arterial e dos valores médios de indicadores de risco de ECV. O Grupo S teve o estresse oxidativo reduzido significativamente e apresentou incremento dos ganhos cardiovasculares. Não foram identificadas significâncias em relação aos efeitos ergogênicos. CONCLUSÃO: Os dados indicam que mulheres idosas que realizam exercícios físicos freqüentes melhoram suas condições físicas e cardiovasculares e que o suplemento dietético continuado de alimentos funcionais antioxidantes podem minimizar os efeitos danosos das espécies reativas de oxigênio.

OBJECTIVE: To verify the influence of dietary antioxidant supplementation in older women who regularly practice physical activities, on the occurrence of oxidative stress, physical health and risk of cardiovascular diseases (CVD). METHOD: Two groups (S and C) of women, with age ranging from 60 to 80 years old, were observed. Both groups took part in a physical activity program for 58 weeks, three times a week, for about 50 to 55 minutes each session. The diet of group S (n=36) was daily supplemented with 330 ml of a functional antioxidant beverage, FuncionaTM; Group C (n=32) ingested water and was used as Control. As oxidative stress indicators, the plasmatic concentrations of reduced (GSH) and oxidized (GSSG) glutathione were determined; the molar GSH/GSSG ratio was calculated, and the oxidative damage in lipids and proteins was evaluated. The physical and cardiovascular conditions were evaluated through routine anthropometric parameters (weight, stature and BMI) and blood pressure. RESULTS: Group C presented significant increases of oxidative stress, reduction in the blood pressure and in the indicators of cardiovascular risks. Group S presented significant reduction of the oxidative stress and increment of the cardiovascular gains. Significance concerning the ergogenic effects has not been identified. CONCLUSION: Our data suggest that regular exercise in older women can improve physical and cardiovascular conditions. Moreover, daily intake of functional antioxidant supplement can minimize harmful effects of the reactive oxygen species.

Characterization of Aedes aegypti (Diptera: Culcidae) production sites in urban Nicaragua.

To characterize the production patterns of the dengue virus vector Aedes aegypti (L.) (Diptera: Culcidae), pupal surveys were conducted in selected neighborhoods of two major cities in Nicaragua. In León, 833 houses were visited in July and September 2003, corresponding to the beginning and middle of the dengue season; in Managua, 1,365 homes were visited in July 2003. In total, 7,607 containers were characterized, of which 11% were positive for Ae. aegypti larvae and 4% for pupae. In addition to barrels, potted plants and superficial water on tarps and in puddles were identified as highly productive sites. Univariate and multivariate analysis revealed frequency of container use, use of a lid, and rainwater filling as key variables affecting pupal positivity. Importantly, this survey demonstrated the risk associated with the presence of lids, the limited temporal efficacy of temephos, and the lack of association of water availability with risky water storage practices. Finally, we introduce the concept of an efficiency value and an accompanying graphical display system that can facilitate development of targeted pupal control strategies. These data underscore the importance of entomological surveillance of pupal productivity to gather information from which to derive streamlined, efficient, and effective vector control measures to reduce the density of Aedes mosquito larvae and pupae and thus the risk for dengue.

Exercise, oxidative stress and risk of cardiovascular disease in the elderly. Protective role of antioxidant functional foods.

Free radicals and oxidative stress are involved in the pathogenic mechanisms of cardiovascular disease (CVD), diabetes and cancer. Exercise is a useful strategy for preventing CVD but in elderly persons it can enhance oxidative stress, which is why some studies recommend antioxidant supplementation for exercising elderly subjects. This intervention study was performed on 320 elderly subjects following a Geriatric Revitalization Program (GEREPRO) to maintain physical health and reduce CVD risk. GEREPRO was based on regular exercise concurrent with a nutritional antioxidant treatment based on daily intake of a functional antioxidant food, Biofrutas. Sustained exercise (10 months, 3 sessions/week) significantly increased cardiorespiratory fitness and plasma HDL-cholesterol; it reduced some predictors of cardiovascular risk (arterial pressure, LDL-cholesterol, total cholesterol/LDL-C, LDL-C/HDL-C), but significantly enhanced some biomarkers of oxidative stress. Concurrent antioxidant supplementation did not produce any ergogenic effects but, meaningfully, enhanced some positive effects of exercise on physical health and the CDV risk index, and it totally prevented the exercise-induced oxidative stress. Our results show that regular and moderate exercise improves cardiorespiratory function and reduces CVD risk in elderly people, while concurrent antioxidant supplementation modulates oxidative insult during exercise in the elderly and enhances the beneficial effects of exercise.

Identification of Aedes albopictus in urban Nicaragua.

Larvae of Aedes albopictus, a mosquito known for transmitting dengue virus, were identified in the city of León, Nicaragua, in 2003. Mosquito larvae were collected from a total of 2,225 residences in the 2 largest cities in Nicaragua during the period from June to September of 2003, and larval Ae. albopictus were identified in 4 homes in León. This represents the 1st detection of Ae. albopictus in a major Nicaraguan urban center, and increased control efforts appear to have eliminated the mosquito subsequently from León. The presence of Ae. albopictus in urban Nicaragua highlights the need for surveillance of areas thought to be free of the mosquito so that early detection and control activities can prevent its spread.