Estudio exploratorio sobre la situación de los comités de ética frente a emergencias sanitarias y brotes de enfermedades en Latinoaméricay Caribe / Estudi exploratori sobre la situació dels comitès d'ètica davant d'emergències sanitàries i brots de malalties a Llatinoamèrica i Carib / Ethics committee’ssituation facing health emergencies and disease outbreaks, an exploratory study in LatinAmericaand the Caribbean

Se realizó un estudio exploratorio a través de una encuesta a Comités de Ética en países de América Latina y el Caribede habla hispana, con el fin de relevar su situación frente a emergencias sanitarias y consultar los dilemas éticos enfrentados en las investigaciones para COVID-19. Se obtuvieron respuestas de 106 comités, pertenecientes a 14 países.Solamente el 24% respondió que existía una red de comunicación eficiente y efectiva entre comités, previa a la pandemia. El 45% respondió queno existían en su región comités específicos para evaluar proyectos vinculados a emergencias sanitarias con anterioridad a la pandemia. El porcentaje de CEI que disponía de procedimientos previos para evaluar investigaciones en situaciones de emergencias sanitarias, fue sólo de 7%, si bien el 52% estaba en proceso de elaboración a raíz de la pandemia.El porcentaje de CEI que consideró razonable un tiempo inferior a 5 días para la evaluación de proyectos de investigación, varió en virtud del diseño: 32% para los estudios observacionales y 12% para los ensayos clínicos con drogas o con vacunas.Los tres problemas éticos principales identificados en los estudios para COVID estuvieron relacionados con el consentimiento informado, los aspectos metodológicos y la poca información previa o falta de evidencia para los productos de investigación.Consideramos que debemos reformular la manera de pensar los problemas éticos de las emergencias hacia un abordaje global, con un enfoque preventivo, donde las redes de colaboración entre los CEI deberían convertirse en regla.(AU)

Es va realitzar un estudi exploratori a través d'una enquesta a Comitès d'Ètica a països d'Amèrica Llatina i el Carib de parla hispana, per rellevar la seva situació davant d'emergències sanitàries i consultar els dilemes ètics enfrontats a les investigacions per a COVID-19. S'obtingueren respostes de 106 comitès, pertanyents a 14 països. Només el 24% va respondre que existia una xarxa de comunicació eficient i efectiva entre comitès, prèvia a la pandèmia. El 45% va respondre que no existien a la seva regió comitès específics per avaluar projectes vinculats a emergències sanitàries amb anterioritat a la pandèmia. El percentatge de CEI que disposava de procediments previs per avaluar investigacions en situacions d'emergències sanitàries va ser només de 7%, si bé el 52% estava en procés d'elaboració arran de la pandèmia. El percentatge de CEI que va considerar raonable un temps inferior a 5 dies per a l'avaluació de projectes de recerca va variar en virtut del disseny: 32% per als estudis observacionals i 12% per als assaigs clínics ambdrogues o amb vacunes.Els tres problemes ètics principals identificats als estudis per a COVID van estar relacionats amb el consentiment informat, els aspectes metodològics i la poca informació prèvia o manca d'evidència per als productes de recerca. Considerem que cal reformular la manera de pensar els problemes ètics de les emergències cap a un abordatge global, amb un enfocament preventiu, on les xarxes de col·laboració entre els CEI haurien de convertir-se en regla.(AU)

An exploratory study was carried out through a survey of Ethics Committees in Spanish-speaking Latin American and Caribbean countries, to assess their situation in the face of health emergencies and consult the ethical dilemmas faced in research for COVID-19. Responses were obtained from 106 committees, belonging to 14 countries.Only 24% responded that there was an efficient and effective communication network between committees, before the pandemic. 45% responded that there were no specific committees in their regions to evaluate projects linked to health emergencies before the pandemic. The percentage of RECs that had prior procedures to evaluate research in health emergencies was only 7%, although 52% were in the process of being prepared as a result of the pandemic.The percentage of RECs that reasonably expected less than 5 days to evaluate research projects varied by design: 32% for observational studies and 12% for clinical drug or vaccine trials.The three main ethical problems identified in the studies for COVID were related to informed consent, methodological aspects, and little prior information or lack of evidence for investigational products.We believe that we must reformulate the way of thinking about the ethical problems of emergencies towards a global approach, with a preventive approach, where collaboration networks between the RECs will not become the rule.(AU)

Omicron SARS-CoV-2 antiviral on poly(lactic acid) with nanostructured copper coating: Wear effects.

Surface modification corresponds to a set of viable technological approaches to introduce antimicrobial properties in materials that do not have such characteristics. Antimicrobial materials are important to prevent the proliferation of microorganisms and minimize the transmission of diseases caused by pathogens. Herein, poly(lactic acid) (PLA) was decorated with nanocones through copper sputtering followed by a plasma etching. Antiviral assays by Quantitative Reverse Transcription-Polymerase Chain Reaction (RT-qPCR) show that nanostructured Cu-coated PLA has high antiviral activity against Omicron SARS-CoV-2, showing a relative reduction in the amplified RNA (78.8 ± 3.9 %). Atomic Force Microscopy (AFM), X-ray Photoelectron Spectroscopy (XPS), and wear-resistance tests show that 20 wear cycles disrupt the surface nanocone patterns and significantly reduce the Cu content at the surface of the nanostructured Cu-coated PLA, leading to total loss of the antiviral properties of nanostructured PLA against Omicron SARS-CoV-2.

Bioinspired Antimicrobial PLA with Nanocones on the Surface for Rapid Deactivation of Omicron SARS-CoV-2.

Bioinspired bactericidal surfaces are artificial surfaces that mimic the nanotopography of insect wings and are capable of inhibiting microbial growth by a physicomechanical mechanism. The scientific community has considered them an alternative method to design polymers with surfaces that inhibit bacterial biofilm formation, suitable for self-disinfectant medical devices. In this contribution, poly(lactic acid) (PLA) with nanocone patterns was successfully produced by a novel two-step procedure involving copper plasma deposition followed by argon plasma etching. According to reverse transcription-quantitative polymerase chain reaction tests, the bioinspired PLA nanostructures display antiviral performance to inactivate infectious Omicron severe acute respiratory syndrome coronavirus 2 particles, reducing the amount of the viral genome to less than 4% in just 15 min due to a possible combined effect of mechanical and oxidative stress. The bioinspired antiviral PLA can be suitable for designing personal protection equipment to prevent the transmission of contagious viral diseases, such as Coronavirus Disease 2019.

Questioning ZnO, Ag, and Ag/ZnO nanoparticles as antimicrobial agents for textiles: Do they guarantee total protection against bacteria and SARS-CoV-2?

Coronavirus Disease 2019 (COVID-19) occasioned global economic and health systems collapse. Also, it raised several concerns about using conventional cotton fabrics for manufacturing personal protective equipment without the antimicrobial capacity to inactivate viruses, such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its variants. Therefore, developing antimicrobial cotton fibers is crucial to avoid new global pandemics or the transmission of dangerous pathogens that remain on surfaces for long periods, especially in hospitals and medical clinics. Herein, we developed antimicrobial cotton fabrics with Ag, ZnO, and Ag/ZnO nanoparticles and evaluated their bactericidal activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), photocatalytic activity, and antiviral activity against Delta SARS-CoV-2. Although the antimicrobial fabrics are effective against these bacteria, they only reduce part of the SARS-CoV-2 virions during the first 15 min of direct contact via damage only to biological structures on the viral surface particle while the viral RNA remains intact.

Delta SARS-CoV-2 inactivation and bactericidal performance of cotton wipes decorated with TiO2/Ag nanoparticles like Brazilian heavy-fruited Myrciaria cauliflora.

The current pandemic of Coronavirus Disease 2019 (COVID-19) raised several concerns about using conventional textiles for manufacturing personal protective equipment without self-disinfecting properties since the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is transmitted mainly by aerosols that can transpose cotton masks. Therefore, developing new cotton fibers with high self-disinfecting ability is essential to avoid a new pandemic due to new SARS-CoV-2 variants. Herein, we developed cotton wipes (CFs) with fibers coated by Ag, TiO2, and Ag/TiO2 hybrid nanoparticles like Brazilian heavy-fruited Myrciaria cauliflora by a sonochemical approach. Moreover, the coated CFs present high antimicrobial performance against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), being able to inactivate infectious SARS-CoV-2 (Delta variant) by the destruction of the spike, membrane, and nucleocapsid proteins while the viral RNA is not significantly affected, according to the molecular biological findings.

Wastewater-based epidemiology: A Brazilian SARS-COV-2 surveillance experience.

Since 2020, developed countries have rapidly shared both publicly and academically relevant wastewater surveillance information. Data on SARS-CoV-2 circulation is pivotal for guiding public health policies and improving the COVID-19 pandemic response. Conversely, low- and middle-income countries, such as Latin America and the Caribbean, showed timid activities in the Wastewater-Based Epidemiology (WBE) context. In these countries, isolated groups perform viral wastewater monitoring, and the data are unevenly shared or accessible to health agencies and the scientific community. This manuscript aims to highlight the relevance of a multiparty effort involving research, public health, and governmental agencies to support usage of WBE methodology to its full potential during the COVID-19 pandemic as part of a joint One Health surveillance approach. Thus, in this study, we explored the results obtained from wastewater surveillance in different regions of Brazil as a part of the COVID-19 Wastewater Monitoring Network ANA (National Water Agency), MCTI (Ministry of Science, Technology, and Innovations) and MS (Ministry of Health). Over the epidemiological weeks of 2021 and early 2022, viral RNA concentrations in wastewater followed epidemiological trends and variations. The highest viral loads in wastewater samples were detected during the second Brazilian wave of COVID-19. Corroborating international reports, our experience demonstrated usefulness of the WBE approach in viral surveillance. Wastewater surveillance allows hotspot identification, and therefore, early public health interventions. In addition, this methodology allows tracking of asymptomatic and oligosymptomatic individuals, who are generally underreported, especially in emerging countries with limited clinical testing capacity. Therefore, WBE undoubtedly contributes to improving public health responses in the context of this pandemic, as well as other sanitary emergencies.

Sampling strategies for wastewater surveillance: Evaluating the variability of SARS-COV-2 RNA concentration in composite and grab samples.

The shedding of SARS-CoV-2 RNA titers by infected individuals, even asymptomatic and oligosymptomatic ones, allows the use of wastewater monitoring to track the COVID-19 spread in a community. This approach is interesting especially for emerging countries with limited clinical testing capabilities. However, there are still important methodological aspects that need validation so that wastewater monitoring data become more representative and useful for public health. This study evaluated the between-day and within-day variability of SARS-CoV-2 RNA concentrations in 24-hour composite and grab samples from three different sampling points, including two wastewater treatment plants (WTTP) and a sewer manhole. In the between-day evaluation (17 weeks of monitoring), a good agreement between the SARS-CoV-2 RNA concentration of each sampling method was observed. There were no significant differences between the mean concentrations of the grab and composite samples (p-value > 0.05), considering N1 and N2 gene assays. The strong relationship between composite and grab samples was proven by correlation coefficients: Pearson's r of 0.83 and Spearman's rho of 0.78 (p-value < 0.05). In within-day evaluation, 24-hour cycles were analyzed and low variability in hourly viral concentrations was observed for three sampling points. The coefficient of variation (CV) values ranged from 3.0% to 11.5%. Overall, 24-hour profiles showed that viral RNA concentrations had less variability and greater agreement with the mean values between 8 a.m. and 10 a.m, the recommended time for grab sampling. Therefore, this study provides important information on wastewater sampling techniques for COVID-19 surveillance. Wastewater monitoring information will only be useful to public health and decision-makers if we ensure data quality through best practices.

First case of SARS-CoV-2 RNA detection in municipal solid waste leachate from Brazil.

This work presents the first case of SARS-CoV-2 RNA detection in leachate collected from a transfer station in the city of São Paulo, Brazil. After calibration of the viral detection method already used for wastewater samples with a pilot leachate sample and virus fragments in laboratory, twelve polyethylene glycol concentrated leachates samples were tested by RT-qPCR. The results confirmed the presence of N1 gene in 9 of the 12 analyzed samples between epidemiological weeks 33 and 38 of the year 2021 (08/15/2021 to 09/19/2021). The occurrence of the N2 gene was only observed in 5 of the 12 samples. The concentration values for N1 and N2 genes varied between 3.1 and 4.6 log10.GC·L-1, which are values close to those measured in sanitary wastewater. This method showed to be a promising procedure to verify the presence of viral RNA in municipal solid waste leachate, being especially useful where there is no treatment system and sanitation infrastructure, which makes the conventional wastewater surveillance unfeasible.

Alternative SARS-CoV-2 detection protocol from self-collected saliva for mass diagnosis and epidemiological studies in low-incoming regions.

Until mass vaccination befalls, control of the new betacoronavirus-associated severe acute respiratory syndrome pandemic (SARS-CoV-2) is based on decreasing virus circulation by social distancing and blocking transmission foci after diagnosis. Globally adopted SARS-CoV-2 diagnostic criteria embrace viral RNA detection by quantitative reverse-transcription polymerase chain reaction (qRT-PCR) on nasopharynx secretions, which requires healthcare facilities and specialized personnel for sample collection. To develop an alternative protocol, hydrophilic cotton as the material and saliva as the source for biological sample collection in qRT-PCR/RT-endpoint-PCR SARS-CoV-2 diagnostic methods prepared with local consumables were evaluated using 99 archived nasopharynx samples previously diagnosed as positive for SARS-CoV-2 and 111 prospective saliva samples pared with nasopharynx samples from patients attending the local reference ABC Medical School diagnostic laboratory. The kappa agreement coefficient between the SARS-CoV-2 qRT-PCR and RT-endpoint-PCR was k = 0.97 (95 % CI 0.92-1.00) and k = 0.90 (95 % CI 0.81-0.99), respectively, on SARS-CoV-2-positive archived samples, with the initial qRT-PCR CT under 25. The agreement coefficient of the SARS-CoV-2 alternative saliva diagnostic protocol, when used to test the paired nasopharynx samples, was k = 0.79 (95 % CI 0.56-1,00). These data support that the SARS-CoV-2 diagnostic assay based on self-collected saliva on cotton represents an alternative protocol for mass diagnosis and epidemiological studies in low-income regions.

Long-term monitoring of SARS-COV-2 RNA in wastewater in Brazil: A more responsive and economical approach.

SARS-CoV-2, the novel Coronavirus, was first detected in Wuhan, China, in December 2019, and has since spread rapidly, causing millions of deaths worldwide. As in most countries of the world, in Brazil, the consequences of the COVID-19 pandemic have been catastrophic. Several studies have reported the fecal shedding of SARS-CoV-2 RNA titers from infected symptomatic and asymptomatic individuals. Therefore, the quantification of SARS-CoV-2 in wastewater can be used to track the virus spread in a population. In this study, samples of untreated wastewater were collected for 44 weeks at five sampling sites in the ABC Region (São Paulo, Brazil), in order to evaluate the SARS-CoV-2 occurrence in the sewerage system. SARS-CoV-2 RNA titers were detected throughout the period, and the concentration ranged from 2.7 to 7.7 log10 genome copies.L-1, with peaks in the last weeks of monitoring. Furthermore, we observed a positive correlation between the viral load in wastewater and the epidemiological/clinical data, with the former preceding the latter by approximately two weeks. The COVID-19 prevalence for each sampling site was estimated via Monte-Carlo simulation using the wastewater viral load. The mean predicted prevalence ranged 0.05 to 0.38%, slightly higher than reported (0.016 ± 0.005%) in the ABC Region for the same period. These results highlight the viability of the wastewater surveillance for COVID-19 infection monitoring in the largest urban agglomeration in South America. This approach can be especially useful for health agencies and public decision-makers in predicting SARS-CoV-2 outbreaks, as well as in local tracing of infection clusters.

Cotton Fabrics Decorated with Antimicrobial Ag-Coated TiO2 Nanoparticles Are Unable to Fully and Rapidly Eradicate SARS-CoV-2.

The successful development of multifunctional cotton fabrics with antimicrobial and antiviral activities is essential to prevent the proliferation of microorganisms and transmission of coronavirus virions today, especially with the emergence of new variants of SARS-CoV-2. In this work, we developed antimicrobial cotton fabrics with Ag/TiO2 nanoparticles synthesized via sonochemistry. Here, we show that more than 50% of infectious SARS-CoV-2 remain active after prolonged direct contact self-disinfecting materials capable of inhibiting the proliferation of Escherichia coli and Staphylococcus aureus. The findings bring several epidemiologic worries about using silver and TiO2 as self-disinfecting nanostructured agents to prevent coronavirus transmission.

Structural modelling and thermostability of a serine protease inhibitor belonging to the Kunitz-BPTI family from the Rhipicephalus microplus tick.

rBmTI-A is a recombinant serine protease inhibitor that belongs to the Kunitz-BPTI family and that was cloned from Rhipicephalus microplus tick. rBmTI-A has inhibitory activities on bovine trypsin, human plasma kallikrein, human neutrophil elastase and plasmin with dissociation constants in nM range. It is characterized by two inhibitory domains and each domain presents six cysteines that form three disulfide bonds, which contribute to the high stability of its structure. Previous studies suggest that serine protease inhibitor rBmTI-A has a protective potential against pulmonary emphysema in mice and anti-inflammatory potential. Besides that, rBmTI-A presented a potent inhibitory activity against in vitro vessel formation. In this study, the tertiary structure of rBmTI-A was modeled. The structure stabilization was evaluated by molecular dynamics analysis. Circular dichroism spectroscopy data corroborated the secondary structure found by the homology modelling. Also, in circular dichroism data it was shown a thermostability of rBmTI-A until approximately 70 °C, corroborated by inhibitory assays toward trypsin.

Evaluación del impacto de la cuarentena por la pandemia de COVID-19 en la transmisión perinatal del VIH en Buenos Aires, Argentina / Assessment of the impact of the COVID-19 pandemic lockdown on perinatal HIV transmission in Buenos Aires, Argentina

Objetivos: Describir variables epidemiológicas clave durante el año 2020 (pandemia de COVID-19) con respecto a la prevención de la transmisión perinatal (TP) del VIH en Ciudad de Buenos Aires (CABA), comparando con períodos previos.Métodos: Análisis retrospectivo de los datos agregados de TP de las principales maternidades de CABA. El año pandémico (2020) se comparó con los años no pandémicos 2018 y 2019.Resultados: Se observó una reducción del total de nacimientos en 2020 en comparación con 2019 y 2018 (11.640 vs. 14.031 y 15,978, respectivamente). La proporción de nacidos vivos en madres VIH+ (MEV) fue 0,88% en 2020, sin diferencia con 2019 y 2018 (0,94% y 0,93%), p> 0,05 para todas las comparaciones. Entre las MEV, el diagnóstico intraparto fue del 2,9% para 2020, sin diferencias con 2019 (2,25%) y 2018 (9,3%), p> 0,05 (todas las comparaciones); el 8,8% comenzó el tratamiento antirretroviral con > 28 semanas de edad gestacional en 2020 frente al 16% y el 18,05% en 2018 y 2019 (p> 0,05, todas las comparaciones). La prevalencia de la carga viral indetectable en el momento del parto fue del 67% en 2020 frente al 64% en 2018 y del 65,4% en 2019 (p> 0,05, todas las comparaciones). La transmisión perinatal fue 0% en 2020 vs. 1,33% en 2018 y 2,25% 2019 (p> 0,05, todas las comparaciones).Conclusiones: En la primera ola de la pandemia de COVID-19 no se observaron cambios en la proporción de MEV asistidas, diagnóstico intraparto de VIH, inicio tardío del TARV y TP en CABA

Background: To describe key epidemiological variables in 2020 (COVID-19 pandemic) regarding prevention of mother-to-child transmission (MTCT) in Buenos Aires city (CABA) in comparison with previous periods. Methods: Retrospective analysis of aggregated MTCT data was gathered from six principal maternity hospitals in Buenos Aires city. Pandemic year (2020) was compared to non-pandemic years 2018-19 individually considering key epidemiological variables. Results: A reduction of total births was observed in 2020 compared to 2019 and 2018 (11640 vs. 14031 and 15978, respectively). Proportion of live births in HIV-infected women (HPW) was 0.88% in 2020 without difference with 2019 and 2018 (0.94% and 0.93%), p> 0.05 for all comparisons. Among HPW, intrapartum diagnosis was 2.9% for 2020, with no difference between 2019 (2.25%) and 2018 (9.3%), p>0.05 (all comparisons); 8.8% had antiretroviral therapy (ART) started > 28 weeks of gestational age in 2020 vs. 16% and 18.05% in 2018 and 2019 (p> 0.05, all comparisons). Prevalence of undetectable viral load at delivery was 67% in 2020 vs 64% in 2018 and 65.4% in 2019 (p> 0.05, all comparisons). Perinatal transmission was 0% in 2020 vs 1.33% in 2018 and 2.25% 2019 (p> 0.05, all comparisons) Conclusions: In first wave of COVID 19 pandemic no changes in the proportion of HPW assisted, HIV intrapartum diagnosis, late ART initiation and MTCT-rate was observed in CABA

Género y juventudes Argentinas: ¿de qué estamos hablando cuando hablamos de "el problema del embarazo adolescente"? / Gender and Argentine youth: what are we talking about when we speak of "the problem of adolescent pregnancy"? / Gênero e juventudes Argentinas: do que estamos falando quando falamos sobre "o problema da gravidez na adolescência"?

Resumen Este artículo buscará echar luz acerca del embarazo adolescente como problema. A través de un recorrido histórico por fuentes bibliográficas, periodísticas y de un corpus de le- yes, se intentará dar cuenta de la naturalización propia del enfoque habitual en esta temática. Un punto central en la pregunta que nos orientará, concierne a la inclusión de la voz de lxs involucradxs, con el fin de pensar estrategias para acompañarlxs en ese momento (entendién- dose como una necesidad imperiosa para lxs mismxs).

Abstract This article examines the issue of adolescent pregnancy as a problem. Through a historical journey across journalistic sources and a legal corpus, the authors show the current naturalization when this topic is addressed. A guiding issue is the inclusion of the voices of those involved, to think about strategies that keep them company (which is understood as an important demand from the adolescents).

Resumo Este artigo examina o "problema da gravidez na adolescência". Por meio de um per- curso histórico por fontes bibliográficas, jornalísticas e um corpus de leis, tentaremos mostrar a naturalização da abordagem tradicional sobre o tema da gravidez ocorrida na adolescência. A questão que nos orienta levará em consideração a inclusão da voz dos envolvidos/as no que se refere a pensar estratégias para acompanhá-los/as (entendendo isso como uma necessidade imperiosa para os/as mesmos/as).

Author Correction: Effects of the serine protease inhibitor rBmTI-A in an experimental mouse model of chronic allergic pulmonary inflammation.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Neutrophil elastase inhibitor purification strategy from cowpea seeds.

Serine proteases and its inhibitors are involved in physiological process and its deregulation lead to various diseases like Chronic Obstructive Pulmonary Disease (COPD), pulmonary emphysema, skin diseases, atherosclerosis, coagulation diseases, cancer, inflammatory diseases, neuronal disorders and other diseases. Serine protease inhibitors have been described in many species, as well as in plants, including cowpea beans (Vigna unguiculata (L.) Walp). Here, we purified and characterized a protease inhibitor, named VuEI (Vigna unguiculata elastase inhibitor), from Vigna unguiculata, with inhibitory activity against HNE (human neutrophil elastase) and chymotrypsin but has no inhibitory activity against trypsin and thrombin. VuEI was obtained by alkaline protein extraction followed by three different chromatographic steps in sequence. First, an ion exchange chromatography using Hitrap Q column was employed, followed by two reversed-phase chromatography using Source15RPC and ACE18 columns. The molecular mass of VuEI was estimated in 10.99 kDa by MALDI-TOF mass spectrometry. The dissociation constant (Ki) to HNE was 9 pM. These data indicate that VuEI is a potent inhibitor of human neutrophil elastase, besides to inhibit chymotrypsin.

Effects of the serine protease inhibitor rBmTI-A in an experimental mouse model of chronic allergic pulmonary inflammation.

To evaluate whether a recombinant serine protease inhibitor (rBmTI-A) modulates inflammation in an experimental model of chronic allergic lung inflammation. Balb/c mice were divided into four groups: SAL (saline), OVA (sensitized with ovalbumin), SAL + rBmTI-A (control treated with rBmTI-A) and OVA + rBmTI-A (sensitized with ovalbumin and treated with rBmTI-A). The animals received an intraperitoneal injection of saline or ovalbumin, according to the group. The groups received inhalation with saline or ovalbumin and were treated with rBmTI-A or saline by nasal instillation. After 29 days, we evaluated the respiratory mechanics; bronchoalveolar lavage fluid (BALF); cytokines; MMP-9, TIMP-1; eosinophils; collagen and elastic fibre expression in the airways; and the trypsin-like, MMP-1, and MMP-9 lung tissue proteolytic activity. Treatment with rBmTI-A reduced the trypsin-like proteolytic activity, the elastance and resistance maximum response, the polymorphonuclear cells, IL-5, IL-10, IL-13 and IL-17A in the BALF, the expression of IL-5, IL-13, IL-17, CD4+, MMP-9, TIMP-1, eosinophils, collagen and elastic fibres in the airways of the OVA + rBmTI-A group compared to the OVA group (p < 0.05). rBmTI-A attenuated bronchial hyperresponsiveness, inflammation and remodelling in this experimental model of chronic allergic pulmonary inflammation. This inhibitor may serve as a potential therapeutic tool for asthma treatment.

Situación epidemiológica y estado de la respuesta al VIH en la ciudad autónoma de Buenos Aires 2003-2017 / Epidemiological situation and response to HIV in Ciudad Autónoma de Buenos Aires, 2003-2017

El monitoreo de indicadores epidemiológicos es un elemento clave en el fortalecimiento de la respuesta al VIH. OBJETIVO: Se presenta un análisis epidemiológico de las tendencias en indicadores seleccionados en base a las notificaciones de infección reportadas a la Coordinación Salud Sexual, Sida e Infecciones de Transmisión Sexual, dependiente del Ministerio de Salud de la Ciudad Autónoma de Buenos Aires entre 2003 y 2017. MÉTODOS: En dicho análisis se incluyen datos sobre la distribución por sexo e índice de masculinidad, el acceso al diagnóstico de VIH, la distribución por edad al momento del diagnóstico, la cobertura de salud, las vías de transmisión, la tasa de mortalidad por sida, la vigilancia de la transmisión perinatal del VIH y la situación de niños, niñas y adolescentes con VIH. RESULTADOS: Los datos presentados reflejan un perfil metropolitano en el que predomina la transmisión sexual tanto en mujeres como en varones y ponen en evidencia algunas situaciones que precisan un abordaje específico y avalan la importancia de implementar estrategias de prevención diferenciadas de acuerdo a las necesidades de cada grupo poblacional. DISCUSIÓN: La forma en la que se presenta la información muestra una clara intencionalidad de fomentar la interacción entre la epidemiología y la toma de decisiones en salud, a sabiendas de que esa información constituye una herramienta fundamental para la definición y puesta en práctica de políticas públicas. Palabras clave: Epidemiología; VIH; Ciudad de Buenos Aires

Implementación del test rápido para VIH en la ciudad autónoma de Buenos Aires una estrategia para facilitar el acceso al diagnostico oportuno / Implementation of Rapid Test for HIV in Buenos Aires City: A Strategy to Facilitate Access to Timely Diagnosis

INTRODUCCIÓN: El diagnóstico oportuno de la infección por VIH es una estrategia clave en el control de la epidemia. El uso de las pruebas rápidas facilita el acceso al diagnóstico en el primer nivel de atención y en espacios por fuera del sistema de salud. MÉTODOS: Se describió el proceso de implementación del test rápido para VIH en la Ciudad Autónoma de Buenos Aires (CABA), analizando indicadores epidemiológicos para evaluar el impacto sanitario. RESULTADOS: Desde el inicio de esta estrategia en 2012 y hasta 2018, el test rápido se implementó en 36 centros de la ciudad, tanto en el sistema de salud como en organizaciones de la sociedad civil. En 2014 se inició una campaña de promoción con testeos mensuales en el espacio público de distintos barrios. El número de personas sometidas a la prueba se duplicó en los centros de testeo y aumentó progresivamente en los laboratorios de los hospitales públicos, con un descenso en la proporción de diagnósticos en estadios sintomáticos. CONCLUSIONES: La implementación de la prueba rápida para el diagnóstico de VIH en CABA muestra un modelo exitoso de oferta de prestación en los puntos de atención, que facilita el acceso al tamizaje y que puede extenderse para el diagnóstico y tratamiento de otras infecciones de transmisión sexual.

rBmTI-6 attenuates pathophysiological and inflammatory parameters of induced emphysema in mice.

Protease/anti-protease imbalance is the main pathogenic mechanism of emphysema and protease inhibitors have been recognized as potential molecules to treat the disease conditions. In this work the rBmTI-6 first domain (rBmTI-6-D1), a recombinant Kunitz-type serine proteinase inhibitor, was used to verify its effect in prevention or minimization of PPE-induced emphysema in mice. C57BL/6 mice were submitted to a PPE-induced emphysema model and treated with rBmTI-6-D1 before the emphysema development. We showed that the rBmTI-6-D1 treatment was sufficient to avoid the loss of elastic recoil, an effective decrease in alveolar enlargement and in the number of macrophages and lymphocytes in bronchoalveolar lavage fluid. Proteolytic analysis showed a significant increase in elastase activity in PPE-VE (induced emphysema) group that is controlled by rBmTI-6-D1. Kallikrein activity was decreased in the PPE-rBmTI6 (induced emphysema and inhibitor treated) group when compared to PPE-VE group. Although rBmTI-6-D1, did not present a neutrophil elastase (NE) inhibitory activity, the results show that the inhibitor interfered in the pathway of NE secretion in PPE-emphysema mice model. The role of rBmTI-6-D1 in the prevention of emphysema development in the mice model, apparently, is related with a control of inflammatory response due the trypsin/kallikrein inhibitory activity of rBmTI-6-D1.