A west African ancestry-associated SNP on 8q24 predicts a positive biopsy in African American men with suspected prostate cancer following PSA screening.

BACKGROUND: African American (AA) men have the highest incidence and mortality rates of prostate cancer (PCa) among all racial groups in the United States. While race is a social construct, for AA men, this overlaps with west African ancestry. Many of the PCa susceptibility variants exhibit distinct allele frequencies and risk estimates across different races and contribute substantially to the large disparities of PCa incidence among races. We previously reported that a single-nucleotide polymorphism (SNP) in 8q24, rs7824364, was strongly associated with west African ancestry and increased risks of PCa in both AA and Puerto Rican men. In this study, we determined whether this SNP can predict biopsy positivity and detection of clinically significant disease (Gleason score [GS] ≥ 7) in a cohort of AA men with suspected PCa. METHODS: SNP rs7824364 was genotyped in 199 AA men with elevated total prostate-specific antigen (PSA) (>2.5 ng/mL) or abnormal digital rectal exam (DRE) and the associations of different genotypes with biopsy positivity and clinically significant disease were analyzed. RESULTS: The variant allele carriers were significantly over-represented in the biopsy-positive group compared to the biopsy-negative group (44% vs. 25.7%, p = 0.011). In the multivariate logistic regression analyses, variant allele carriers were at a more than a twofold increased risk of a positive biopsy (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.06-4.32). Moreover, the variant allele was a predictor (OR = 2.26, 95% CI = 1.06-4.84) of a positive biopsy in the subgroup of patients with PSA < 10 ng/mL and normal DRE. The variant allele carriers were also more prevalent in cases with GS ≥ 7 compared to cases with GS < 7 and benign biopsy. CONCLUSIONS: This study demonstrated that the west African ancestry-specific SNP rs7824364 on 8q24 independently predicted a positive prostate biopsy in AA men who were candidates for prostate biopsy subsequent to PCa screening.

Trans people perceptions of care received from healthcare professionals - A phenomenological study.

Introduction: Trans people have unique health needs and turn to the public health system to meet them. Offering them a more inclusive assistance requires health professionals to know these needs and work on cultural competence. Understanding trans people perceptions of service received will improve therapeutic relationships and the assistance provided to them. Objective: To understand trans patients experiences with health care and their perception of care rendered by the Andalusian Public Health System. Design: A qualitative phenomenological study according to Ricoeur's hermeneutic approach. Methodology: 18 in-depth interviews were conducted between January and April 2022 with trans adult users of the Andalusian Public Health System. These interviews were audio recorded, transcribed and analyzed following the steps proposed by Tan. The Consolidated Criteria for Reporting Qualitative Research was used for writing the study report. Results: Three themes were generated from trans patients experiences in the Andalusian Public Health System related to the assistance provided to them: 1) Positive and negative feelings during their pass through the public health system, 2) The importance of being able to receive the care they need, and 3) Having the chosen identity in official documents in order to utterly complete their transition. Conclusion: Care rendered by healthcare professionals to trans people was received as positive in mostly cases. However, trans people think these professionals need more training in order to avoid some behaviors they perceive as discriminatory and which they believe tends to pathologize gender identity. They also require more information about the treatments in particular they are about to receive and they demand to end drug shortages. Administrative procedures to change identity are also problematic. So the healthcare system must undergo some modifications in order to become more inclusive.

Intense craving for eat: standardization of the Food Cravings Questionnaire-State in Mexico.

BACKGROUND: Food craving is an intense-compulsive response to eating highly appetizing foods. The Food Cravings Questionnaire-State (FCQ-S) is the most used instrument for its diagnosis. It is a multidimensional instrument, sensitive and adaptable to contextual and cultural changes. OBJECTIVE: To standardize the FCQ-S in the adult population of Mexico City. METHOD: Non-experimental, cross-sectional, at convenience design, with 1059 adults of both sexes, aged 18-84 years. It is highlighted that 71.9% of the participants were women. RESULTS: A reliability coefficient of 0.95 was obtained, the correlations between the items were from r = 0.598 to r = 0.793. With the exploratory factorial analysis, an MKO of sampling adequacy of 0.943 was obtained, and with the Bartlett sphericity test a p = 0.000. The factors explain 78.61% of the total variation of the data. The RMSEA was 0.068, which indicates an acceptable fit. The CFI was 0.974, considered good, and NNFI was 0.969, good fit. The correlations ranged from p < 0.05 to p < 0.01, showing a connection between the different dimensions. CONCLUSIONS: The FCQ-S is valid and adaptable in the Mexican population.

ANTECEDENTES: El food craving es un deseo intenso y compulsivo de comer alimentos altamente apetecibles. El Food Cravings Questionnaire-State (FCQ-S) es el instrumento más utilizado para su diagnóstico. Es un instrumento multidimensional, sensible y adaptable a cambios contextuales y culturales. OBJETIVO: estandarizar el FCQ-S en población adulta de la Ciudad de México. MÉTODO: Diseño no experimental, transversal y a conveniencia por método de bola de nieve, con 1059 adultos ambos sexos y de 18-84 años. Se destaca que el 71.9% de los participantes fueron mujeres. RESULTADOS: Se obtuvo un coeficiente de fiabilidad de 0.95 y las correlaciones entre los ítems fueron de r = 0.598 a r = 0.793. Con el análisis factorial exploratorio se obtuvo una MKO de adecuación de muestreo de 0.943, y con la prueba de esfericidad de Bartlett una p = 0.000. Los factores explican el 78.61% de la variación total de los datos. La RMSEA fue 0.068, lo cual indica ajuste aceptable. El CFI fue 0.974, considerado bueno, y el NNFI fue 0.969 (buen ajuste). Las correlaciones fueron de p < 0.05 a p < 0.01, lo que muestra una conexión entre las diferentes dimensiones. CONCLUSIONES: El FCQ-S es válido y adaptable en población mexicana.

Comparison of the Fecal Bacteriome of HIV-Positive and HIV-Negative Older Adults.

HIV infection is considered a scenario of accelerated aging. Previous studies have suggested a link between aging, frailty, and gut dysbiosis, but there is a knowledge gap regarding the HIV population. Our objective was to compare the fecal bacteriome of older people with HIV (PWH) and non-HIV controls, and to assess potential links between gut dysbiosis and frailty. A total of 36 fecal samples (24 from PWH and 12 from non-HIV controls) were submitted to a metataxonomic analysis targeting the V3-V4 hypervariable region of the 16S rRNA gene. High-quality reads were assembled and classified into operational taxonomic units. Alpha diversity, assessed using the Shannon index, was higher in the control group than in the HIV group (p < 0.05). The relative abundance of the genus Blautia was higher in the HIV group (p < 0.001). The presence of Blautia was also higher in PWH with depression (p = 0.004), whereas the opposite was observed for the genus Bifidobacterium (p = 0.004). Our study shows shifts in the composition of the PWH bacteriome when compared to that of healthy controls. To our knowledge, this is the first study suggesting a potential link between depression and gut dysbiosis in the HIV population.

Time from symptoms onset to remdesivir is associated with the risk of ICU admission: a multicentric analyses.

BACKGROUND: Shorter duration of symptoms before remdesivir has been associated with better outcomes. Our goal was to evaluate variables associated with the need of ICU admission in a cohort of hospitalized patients for COVID-19 under remdesivir including the period from symptoms onset to remdesivir. METHODS: We conducted a retrospective multicentric study analysing all patients admitted with COVID-19 in 9 Spanish hospitals who received treatment with remdesivir in October 2020. The main outcome was the need of ICU admission after 24 h of the first dose of remdesivir. RESULTS: In our cohort of 497 patients, the median of days from symptom onset to remdesivir was 5 days, and 70 of them (14.1%) were later admitted into ICU. The clinical outcomes associated with ICU admission were days from symptoms onset (5 vs. 6; p = 0.023), clinical signs of severe disease (respiratory rate, neutrophil count, ferritin levels and very-high mortality rate in SEIMC-Score) and the use of corticosteroids and anti-inflammatory drugs before ICU. The only variable significatively associated with risk reduction in the Cox-regression analyses was ≤ 5 days from symptoms onset to RDV (HR: 0.54, CI95%: 0.31-0.92; p = 0.024). CONCLUSION: For patients admitted to the hospital with COVID-19, the prescription of remdesivir within 5 days from symptoms onset diminishes the need of ICU admission.

Clinical atrophy patterns of filiform papillae of the tongue and their relationship with the serum levels of iron, vitamin B12 and folic acid in patients with systemic diseases.

BACKGROUND: The purpose of the study was to evaluate the clinical patterns of atrophy of the filiform papillae (FP) of the tongue and their relationship with the serum levels of iron and vitamin B12 among patients with systemic diseases, in a tertiary care center. METHODS: A cross-sectional, analytical, research study was designed. A systematic tongue examination was performed to evaluate the presence and clinical patterns of FP atrophy. We collected epidemiologic, clinical, and laboratory data. Statistical analysis included χ2 test, Fisher's exact test, Kruskal-Wallis test, and a logistic regression analysis. RESULTS: A total of 87 patients (83.9% females) were included [median age = 55 (range 20-89) years]. Endocrinopathy (60.9%) was the most frequent comorbidity. We found atrophy of the FP in 90.8% of the patients; the atrophy was mild in 83.5% of the cases, and severe in 16.5%. The most common atrophic patterns were as follows: focalized in 64 (73.6%) cases, "U"-shaped pattern in 60 (69%), and generalized in 30 (34.5%). Geographic tongue and median rhomboid glossitis were observed in 12 (13.8%) and 11 (12.6%) subjects, respectively. Lower titers of serum iron were detected in cases with focal (median = 71 vs. 110 mcg/dl) and generalized (median = 55 vs. 78 mcg/dl) FP atrophy (P = 0.03 and P = 0.009, respectively), than their counterparts. The presence of symptomatology was related to the focal pattern of atrophy (P = 0.038). CONCLUSIONS: A high frequency of filiform papillary atrophy of the tongue was observed in patients with comorbidities. Some atrophic patterns of the tongue were significantly associated with certain medical conditions.

An exploratory prospective study of the factors associated with adverse health outcomes in older adults living with HIV. / Estudio exploratorio prospectivo de los factores asociados a eventos adversos en salud en personas mayores que viven con VIH.

Objective: This study examines the clinical and sociodemographic factors associated with adverse health outcomes (falls, emergency room visits, hospital admissions and death) in a cohort of patients older than 55 years with HIV infection. Methods: It is an exploratory prospective study with four years follow-up. People with HIV infection followed in the infectious diseases consultation unit of two hospitals in Madrid were included. Sociodemographic data and clinical variables were collected. The functional, mental, and social situations of the participants were assessed. Patient clinical histories were reviewed to gather data on the number of falls, visits to emergency departments and hospital admissions during the period studied. Results: One hundred seventeen patients with a mean age of 61,4 (SD 6,6) years and a median follow-up of 47 months(35 to 50) were included. Of these subjects, 25% had depressive symptoms, and 10% had some degree of cognitive impairment at the baseline visit. The recorded frequencies were: falls 7,7%, visits to the emergency room 53%, hospital admission 33,3% and deaths 2,6%. Depressive symptoms were associated with falls and emergency room visits in the univariate analysis. The factors associated with hospital admission were having acquired the infection through intravenous drug use, frailty and being under 65 years of age. Multivariate analysis was conducted for the hospital admissions outcome, with the variables showing p < 0,07 in the univariate analysis, none of which reached statistical significance. Conclusions: Depression screening and cognitive evaluation should be done systematically in this population group. More studies with more patients and longer follow-up times are necessary.

Introducción: Gracias al tratamiento antirretroviral en Occidente, la infección por el virus de la inmunodeficiencia humana (VIH) se ha convertido en una enfermedad crónica. Hoy, el 50% de las personas que viven con VIH son mayores de 50 años y en torno al 20% de los nuevos casos de esta infección se dan en ese mismo grupo etario. Este trabajo tiene por objeto el analizar los factores clínicos y sociodemográficos asociados a eventos adversos en salud (caídas, visitas a urgencias, ingresos hospitalarios y muerte) en una cohorte de personas mayores de 55 años con infección por VIH. Métodos: Estudio exploratorio prospectivo con cuatro años de seguimiento. Se incluyeron personas con infección por VIH seguidas en las consultas de enfermedades infecciosas de dos hospitales de Madrid. Se recogieron datos sociodemográficos y variables clínicas. Se evaluó la situación funcional, mental y social de los participantes. Se revisaron en las historias clínicas de los pacientes número de caídas, visitas a los servicios de urgencias, ingresos hospitalarios y muertes producidas durante el periodo estudiado. Resultados: Se incluyeron 117 pacientes con una edad media de 61,4 (desviación estándar 6,6) años y una mediana de seguimiento de 47 meses (35 a 50). De estos sujetos, el 25% tenía síntomas depresivos y el 10% tenía algún grado de deterioro cognitivo en la visita inicial. Las frecuencias de eventos adversos en salud registradas fueron: caídas del 7,7%, visitas a urgencias del 53%, ingresos hospitalarios del 33,3% y muertes del 2,6%. Los síntomas de depresión se asociaron con caídas y visitas a urgencias en el análisis bivariado. Los factores asociados a ingreso hospitalario fueron haber adquirido la infección por consumo de drogas por vía parenteral, ser frágil y ser menor de 65 años. Se realizó análisis multivariado para el resultado de ingresos hospitalarios con las variables que mostraron p < 0,05 en el análisis bivariado y ninguna de ellas alcanzó significación estadística. Conclusiones: Los síntomas de depresión y el deterioro cognitivo se presentan con una alta frecuencia en estos pacientes, por lo que debería realizarse tamizaje de ambos de forma sistemática en este grupo poblacional. Son necesarios estudios con más pacientes y mayor tiempo de seguimiento que permitan identificar los factores de riesgo asociados a eventos adversos en las personas mayores que viven con VIH.

Estudio exploratorio prospectivo de los factores asociados a eventos adversos en salud en personas mayores que viven con VIH / An exploratory prospective study of the factors associated with adverse health outcomes in older adults living with HIV

Introducción Gracias al tratamiento antirretroviral en Occidente, la infección por el virus de la inmunodeficiencia humana (VIH) se ha convertido en una enfermedad crónica. Hoy, el 50% de las personas que viven con VIH son mayores de 50 años y en torno al 20% de los nuevos casos de esta infección se dan en ese mismo grupo etario. Este trabajo tiene por objeto el analizar los factores clínicos y sociodemográficos asociados a eventos adversos en salud (caídas, visitas a urgencias, ingresos hospitalarios y muerte) en una cohorte de personas mayores de 55 años con infección por VIH. Métodos Estudio exploratorio prospectivo con cuatro años de seguimiento. Se incluyeron personas con infección por VIH seguidas en las consultas de enfermedades infecciosas de dos hospitales de Madrid. Se recogieron datos sociodemográficos y variables clínicas. Se evaluó la situación funcional, mental y social de los participantes. Se revisaron en las historias clínicas de los pacientes número de caídas, visitas a los servicios de urgencias, ingresos hospitalarios y muertes producidas durante el periodo estudiado. Resultados Se incluyeron 117 pacientes con una edad media de 61,4 (desviación estándar 6,6) años y una mediana de seguimiento de 47 meses (35 a 50). De estos sujetos, el 25% tenía síntomas depresivos y el 10% tenía algún grado de deterioro cognitivo en la visita inicial. Las frecuencias de eventos adversos en salud registradas fueron: caídas del 7,7%, visitas a urgencias del 53%, ingresos hospitalarios del 33,3% y muertes del 2,6%. Los síntomas de depresión se asociaron con caídas y visitas a urgencias en el análisis bivariado. Los factores asociados a ingreso hospitalario fueron haber adquirido la infección por consumo de drogas por vía parenteral, ser frágil y ser menor de 65 años. Se realizó análisis multivariado para el resultado de ingresos hospitalarios con las variables que mostraron p < 0,05 en el análisis bivariado y ninguna de ellas alcanzó significación estadística. Conclusiones Los síntomas de depresión y el deterioro cognitivo se presentan con una alta frecuencia en estos pacientes, por lo que debería realizarse tamizaje de ambos de forma sistemática en este grupo poblacional. Son necesarios estudios con más pacientes y mayor tiempo de seguimiento que permitan identificar los factores de riesgo asociados a eventos adversos en las personas mayores que viven con VIH.

Introducción Gracias al tratamiento antirretroviral en Occidente, la infección por el virus de la inmunodeficiencia humana (VIH) se ha convertido en una enfermedad crónica. Hoy, el 50% de las personas que viven con VIH son mayores de 50 años y en torno al 20% de los nuevos casos de esta infección se dan en ese mismo grupo etario. Este trabajo tiene por objeto el analizar los factores clínicos y sociodemográficos asociados a eventos adversos en salud (caídas, visitas a urgencias, ingresos hospitalarios y muerte) en una cohorte de personas mayores de 55 años con infección por VIH. Métodos Estudio exploratorio prospectivo con cuatro años de seguimiento. Se incluyeron personas con infección por VIH seguidas en las consultas de enfermedades infecciosas de dos hospitales de Madrid. Se recogieron datos sociodemográficos y variables clínicas. Se evaluó la situación funcional, mental y social de los participantes. Se revisaron en las historias clínicas de los pacientes número de caídas, visitas a los servicios de urgencias, ingresos hospitalarios y muertes producidas durante el periodo estudiado. Resultados Se incluyeron 117 pacientes con una edad media de 61,4 (desviación estándar 6,6) años y una mediana de seguimiento de 47 meses (35 a 50). De estos sujetos, el 25% tenía síntomas depresivos y el 10% tenía algún grado de deterioro cognitivo en la visita inicial. Las frecuencias de eventos adversos en salud registradas fueron: caídas del 7,7%, visitas a urgencias del 53%, ingresos hospitalarios del 33,3% y muertes del 2,6%. Los síntomas de depresión se asociaron con caídas y visitas a urgencias en el análisis bivariado. Los factores asociados a ingreso hospitalario fueron haber adquirido la infección por consumo de drogas por vía parenteral, ser frágil y ser menor de 65 años. Se realizó análisis multivariado para el resultado de ingresos hospitalarios con las variables que mostraron p < 0,05 en el análisis bivariado y ninguna de ellas alcanzó significación estadística. Conclusiones Los síntomas de depresión y el deterioro cognitivo se presentan con una alta frecuencia en estos pacientes, por lo que debería realizarse tamizaje de ambos de forma sistemática en este grupo poblacional. Son necesarios estudios con más pacientes y mayor tiempo de seguimiento que permitan identificar los factores de riesgo asociados a eventos adversos en las personas mayores que viven con VIH.

Effects of frailty, geriatric syndromes, and comorbidity on mortality and quality of life in older adults with HIV.

BACKGROUND: To understand the effects of frailty, geriatric syndromes, and comorbidity on quality of life and mortality in older adults with HIV (OAWH). METHODS: Cross-sectional study of the FUNCFRAIL multicenter cohort. The setting was outpatient HIV-Clinic. OAWH, 50 year or over were included. We recorded sociodemographic data, HIV infection-related data, comorbidity, frailty, geriatric syndromes (depression, cognitive impairment, falls and malnutrition), quality of life (QOL) and the estimated risk of all-cause 5-year mortality by VACS Index. Association of frailty with geriatric syndromes and comorbidity was evaluated using the Cochran-Mantel-Haenszel test. RESULTS: Seven hundred ninety six patients were included. 24.7% were women, mean age was 58.2 (6.3). 14.7% were 65 or over. 517 (65%) patients had ≥3 comorbidities, ≥ 1 geriatric syndrome and/or frailty. There were significant differences in the estimated risk of mortality [(frailty 10.8%) vs. (≥ 3 comorbidities 8.2%) vs. (≥ 1 geriatric syndrome 8.2%) vs. (nothing 6.2%); p = 0.01] and in the prevalence of fair or poor QOL [(frailty 71.7%) vs. (≥ 3 comorbidities 52%) vs. (≥ 1 geriatric syndrome 58.4%) vs. (nothing 51%); p = 0.01]. Cognitive impairment was significantly associated to mortality (8.7% vs. 6.2%; p = 0.02) and depression to poor QOL [76.5% vs. 50%; p = 0.01]. CONCLUSIONS: Frailty, geriatric syndromes, and comorbidity had negative effects on mortality and QOL, but frailty had the greatest negative effect out of the three factors. Our results should be a wake-up call to standardize the screening for frailty and geriatric syndromes in OAWH in the clinical practice. TRIAL REGISTRATION: NCT03558438.

Building Programs to Eradicate Toxoplasmosis Part I: Introduction and Overview.

Purpose of Review: Review building of programs to eliminate Toxoplasma infections. Recent Findings: Morbidity and mortality from toxoplasmosis led to programs in USA, Panama, and Colombia to facilitate understanding, treatment, prevention, and regional resources, incorporating student work. Summary: Studies foundational for building recent, regional approaches/programs are reviewed. Introduction provides an overview/review of programs in Panamá, the United States, and other countries. High prevalence/risk of exposure led to laws mandating testing in gestation, reporting, and development of broad-based teaching materials about Toxoplasma. These were tested for efficacy as learning tools for high-school students, pregnant women, medical students, physicians, scientists, public health officials and general public. Digitized, free, smart phone application effectively taught pregnant women about toxoplasmosis prevention. Perinatal infection care programs, identifying true regional risk factors, and point-of-care gestational screening facilitate prevention and care. When implemented fully across all demographics, such programs present opportunities to save lives, sight, and cognition with considerable spillover benefits for individuals and societies. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00269-w.

Scalability of an ACT-Based strategy for improving well-being in health care providers: A mix-method and preliminary evaluation of efficacy.

The burden of the COVID-19 pandemic has been mainly carried by health care providers. Technology-Mediated Interventions (TMI) seem to be a feasible alternative to increase access to behavioral health resources in this population. However, scaling-up treatments into TMI requires developing user-friendly, accepted, and accessible formats. A two-stage study was conducted to assess scalability of an Acceptance and Commitment Therapy (ACT) based strategy (named FACE COVID) delivered using technology. First, a mix-method design connected qualitative and quantitative data from health providers and ACT experts by which changes were performed to enhance scalability. Second, a pretest-posttest study was conducted to preliminary evaluate the efficacy of FACE COVID intervention on well-being, psychological distress, and psychological flexibility. Results showed a positive impact on well-being, but not distress and psychological flexibility. While this intervention has promising results, changes in dose intensity, social support, and mental health literacy could improve retention as well as increase opportunities to target distress and psychological flexibility in future studies.

Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances "Take a Village".

Purpose of Review: Review international efforts to build a global public health initiative focused on toxoplasmosis with spillover benefits to save lives, sight, cognition and motor function benefiting maternal and child health. Recent Findings: Multiple countries' efforts to eliminate toxoplasmosis demonstrate progress and context for this review and new work. Summary: Problems with potential solutions proposed include accessibility of accurate, inexpensive diagnostic testing, pre-natal screening and facilitating tools, missed and delayed neonatal diagnosis, restricted access, high costs, delays in obtaining medicines emergently, delayed insurance pre-approvals and high medicare copays taking considerable physician time and effort, harmful shortcuts being taken in methods to prepare medicines in settings where access is restricted, reluctance to perform ventriculoperitoneal shunts promptly when needed without recognition of potential benefit, access to resources for care, especially for marginalized populations, and limited use of recent advances in management of neurologic and retinal disease which can lead to good outcomes. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00268-x.

Cistitis hemorrágica por adenovirus en trasplante renal: revisión epidemiológica y resultados clínicos

Contexto la infección de vías urinarias (IVU), causada por adenovirus (ADV) posterior al trasplante renal, tiene el potencial de causar disfunción o pérdida del injerto. La presentación clínica es variable y el tratamiento difiere según la disponibilidad de medicamentos en el medio y la experiencia clínica. Objetivo el estudio describe las características clínicas, de laboratorio y la respuesta al tratamiento de una serie de casos de pacientes trasplantados renales con IVU por ADV en un hospital de Cali, Colombia. Metodología estudio retrospectivo que incluye a todos los pacientes adultos trasplantados con diagnóstico de IVU por ADV entre enero del 2015 hasta enero del 2021. El diagnóstico se realizó basado en la clínica, el resultado positivo de la prueba de reacción de cadena de polimerasa (PCR) y la carga viral del ADV. Resultados de 256 pacientes trasplantados, ocho presentaron diagnóstico de cistitis hemorrágica o nefritis intersticial secundaria a infección por ADV. Se presentó de forma temprana (≤ 3 meses) en el 62 % de los casos, quienes debutaron con macrohematuria asociada a piuria estéril y linfopenia. Por otra parte, se presentó alteración en la función renal en el 87,5 % de los casos y la reducción de la inmunosupresión fue el pilar fundamental en el manejo clínico. Conclusiones el reconocimiento de la infección por ADV en pacientes trasplantados renales ha ido en aumento. La sospecha clínica es clave para el diagnóstico (macrohematuria, síntomas urinarios irritativos y falla renal) y la reducción de la dosis de inmunosupresión para restaurar la función inmune puede ser suficiente en la resolución de la infección y la reversión de la disfunción renal.

Introduction Urinary tract infection (UTI) caused by adenovirus (ADV) after kidney transplantation has the potential to cause graft dysfunction or loss. The clinical presentation is variable, from an asymptomatic course to a multisystemic compromise. Treatment varies based on the availability of different medications and clinical experience. Objective The study describe the clinical, laboratory characteristics and results of a series of cases of kidney transplant patients with hemorrhagic cystitis secondary to ADV infection in a hospital in Cali, Colombia. Methods Retrospective study based on the records of patients with a diagnosis of UTI caused by ADV between January 2015 to January 2021 were included. The diagnosis was made by clinical suspicion and polymerase chain reaction (PCR) - Adenovirus DNA viral load. Results Of 256 transplant patients, eight patients had a diagnosis of hemorrhagic cystitis or interstitial nephritis secondary to ADV infection. It presented early (≤ 3 months) in 62%, who presented with macrohematuria, associated with sterile pyuria and lymphopenia. Alterations in renal function were presented in 87.5%. The reduction of immunosuppression was the fundamental pillar in the management. Conclusions The recognition of ADV infection in kidney transplant patients has been increasing. Clinical suspicion is the key for the diagnosis, with a predominance of macrohematuria, irritative urinary symptoms and kidney graft dysfunction. Reducing the dose of immunosuppression by restoring immune function may be sufficient in resolving the infection and reversing renal dysfunction.

Different profiles among older adults with HIV according to their chronological age and the year of HIV diagnosis: The FUNCFRAIL cohort study (GeSIDA 9817).

BACKGROUND: People in their fifties with HIV are considered older adults, but they appear not to be a homogeneous group. OBJECTIVE: To evaluate the differences among older adults with HIV according to their chronological age and the year of HIV diagnosis. METHODS: Cross-sectional study of the FUNCFRAIL cohort. Patients 50 or over with HIV were included and were stratified by both chronological age and the year of HIV diagnosis: before 1996 (long-term HIV survivors [LTHS]) and after 1996. We recorded sociodemographic data, HIV-related factors, comorbidities, frailty, physical function, other geriatric syndromes, and quality of life (QOL). RESULTS: We evaluated 801 patients. Of these, 24.7% were women, 47.0% were LTHS, and 14.7% were 65 or over. Of the 65 or over patients, 73% were diagnosed after 1996. Higher rates of comorbidities among LTHS were found, being the more prevalent: COPD, history of cancer, osteoarthritis, depression, and other psychiatric disorders while the more prevalent among the 65 or over patients were: hypertension, diabetes, dyslipidemia, cancer, and osteoarthritis. LTHS showed a significantly worse QOL. There were no differences by the year of HIV diagnosis regarding frailty and functional impairment (SPPB <10) but they were more than twice as prevalent in the 65 or over patients compared to the other chronological age groups. CONCLUSIONS: A LTHS and a 65 or over person are both "older adults with HIV," but their characteristics and requirements differ markedly. It is mandatory to design specific approaches focused on the real needs of the different profiles.

Building Programs to Eradicate Toxoplasmosis Part III: Epidemiology and Risk Factors.

Purpose of Review: Review comprehensive data on rates of toxoplasmosis in Panama and Colombia. Recent Findings: Samples and data sets from Panama and Colombia, that facilitated estimates regarding seroprevalence of antibodies to Toxoplasma and risk factors, were reviewed. Summary: Screening maps, seroprevalence maps, and risk factor mathematical models were devised based on these data. Studies in Ciudad de Panamá estimated seroprevalence at between 22 and 44%. Consistent relationships were found between higher prevalence rates and factors such as poverty and proximity to water sources. Prenatal screening rates for anti-Toxoplasma antibodies were variable, despite existence of a screening law. Heat maps showed a correlation between proximity to bodies of water and overall Toxoplasma seroprevalence. Spatial epidemiological maps and mathematical models identify specific regions that could most benefit from comprehensive, preventive healthcare campaigns related to congenital toxoplasmosis and Toxoplasma infection.

Building Programs to Eradicate Toxoplasmosis Part II: Education.

Purpose of Review: Review work to create and evaluate educational materials that could serve as a primary prevention strategy to help both providers and patients in Panama, Colombia, and the USA reduce disease burden of Toxoplasma infections. Recent Findings: Educational programs had not been evaluated for efficacy in Panama, USA, or Colombia. Summary: Educational programs for high school students, pregnant women, medical students and professionals, scientists, and lay personnel were created. In most settings, short-term effects were evaluated. In Panama, Colombia, and USA, all materials showed short-term utility in transmitting information to learners. These educational materials can serve as a component of larger public health programs to lower disease burden from congenital toxoplasmosis. Future priorities include conducting robust longitudinal studies of whether education correlates with reduced adverse disease outcomes, modifying educational materials as new information regarding region-specific risk factors is discovered, and ensuring materials are widely accessible.

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort.

BACKGROUND: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). METHODS: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. RESULTS: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. CONCLUSIONS: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women.

Genome-wide mapping of brain phenotypes in extended pedigrees with strong genetic loading for bipolar disorder.

Bipolar disorder is a highly heritable illness, associated with alterations of brain structure. As such, identification of genes influencing inter-individual differences in brain morphology may help elucidate the underlying pathophysiology of bipolar disorder (BP). To identify quantitative trait loci (QTL) that contribute to phenotypic variance of brain structure, structural neuroimages were acquired from family members (n = 527) of extended pedigrees heavily loaded for bipolar disorder ascertained from genetically isolated populations in Latin America. Genome-wide linkage and association analysis were conducted on the subset of heritable brain traits that showed significant evidence of association with bipolar disorder (n = 24) to map QTL influencing regional measures of brain volume and cortical thickness. Two chromosomal regions showed significant evidence of linkage; a QTL on chromosome 1p influencing corpus callosum volume and a region on chromosome 7p linked to cortical volume. Association analysis within the two QTLs identified three SNPs correlated with the brain measures.

Corrigendum to "Effect of stressful conditions on the carotenogenic activity of a Colombian strain of Dunaliella salina". [Saudi J. Biol. Sci. 26(7) (2019) 1325-1330].

[This corrects the article DOI: 10.1016/j.sjbs.2019.07.010.].

A qualitative study of community perspectives surrounding cleaning practices in the context of Zika prevention in El Salvador: implications for community-based Aedes aegypti control.

BACKGROUND: In El Salvador, Aedes aegypti mosquitoes transmitting Zika and other arboviruses use water storage containers as important oviposition sites. Promotion of water storage container cleaning is a key element of prevention programs. We explored community perceptions surrounding cleaning practices among pregnant women, male partners of pregnant women, and women likely to become pregnant. METHODS: Researchers conducted 11 focus groups and 12 in-depth interviews which included individual elicitations of Zika prevention measures practiced in the community. Focus group participants rated 18 images depicting Zika-related behaviors according to effectiveness and feasibility in the community context, discussed influencing determinants, voted on community intentions to perform prevention behaviors, and performed washbasin cleaning simulations. In-depth interviews with male partners of pregnant women used projective techniques with images to explore their perceptions on a subset of Zika prevention behaviors. RESULTS: General cleaning of the home, to ensure a healthy environment, was a strong community norm. In this context, participants gave water storage container cleaning a high rating, for both its effectiveness and feasibility. Participants were convinced that they cleaned their water storage containers effectively against Zika, but their actual skills were inadequate to destroy Aedes aegypti eggs. A further constraint was the schedule of water availability. Even during pregnancy, male partners rarely cleaned water storage containers because water became available in homes when they were at work. Furthermore, prevailing gender norms did not foster male participation in domestic cleaning activities. Despite these factors, many men were willing to provide substantial support with cleaning when their partners were pregnant, in order to protect their family. CONCLUSIONS: Behavior change programs for the prevention of Zika and other arboviruses need to improve community members' mosquito egg destruction skills rather than perpetuate the promotion of non-specific cleaning in and around the home as effective. Egg elimination must be clearly identified as the objective of water storage container maintenance and programs should highlight the effective techniques to achieve this goal. In addition, programs must build the skills of family members who support pregnant women to maintain the frequency of effective egg destruction in all water storage containers of the home.