Guía de Sífilis Gestacional y Congénita: perspectivas de profesionales de la salud en Bolívar (Colombia) / Guidelines on Gestational and Congenital Syphilis: insights of health professionals in Bolívar (Colombia)

Objetivos: Describir los conocimientos, la idoneidad y las prácticas respecto a la "Guía de práctica clínica (GPC) basada en la evidencia para la atención integral de la sífilis gestacional (SG) y congénita (SC)". Materiales y métodos: Estudio descriptivo de corte transversal. Incluyó médicos generales, especialistas y enfermeras que laboraban en 52 instituciones de salud en el departamento de Bolívar (Colombia) y realizan el control prenatal o la atención al neonato en el 2020. Muestreo por conveniencia. Se aplicó cuestionario digital que recolectó información sociodemográfica; evaluó conocimientos, idoneidad y prácticas sobre la "Guía de práctica clínica (GPC)" mencionada en los objetivos. Se hace análisis descriptivo. Resultados: Se incluyeron 101 trabajadores. Hay deficiencias relacionadas con la aplicación correcta del algoritmo inverso de diagnóstico (48 %) y seguimiento de SG (77 %), manejo de la paciente con antecedentes de alergias de manifestaciones sistémicas (31 %) y tratamiento de la SG (61 %) y SC (10 %). La recomendación de no aplicar prueba de penicilina en pacientes sin antecedentes de alergias sistémicas se considera poco útil (60 %). El 23 % de los trabajadores no emplea las pruebas rápidas y el 44 % de los especialistas da tratamiento para sífilis al compañero sexual. Conclusiones: Es importante intensificar las estrategias de capacitación en el personal de salud con énfasis en el personal de enfermería y, de manera urgente, empoderar a este personal en las actividades relacionadas con el control de la sífilis. Se requiere hacer nuevas y continúas evaluaciones a nivel nacional y regional de la implementación de esta guía que permitan evaluar los indicadores que contiene la estrategia de eliminación de esta enfermedad.

Objectives: To describe the knowledge, appropriateness and practices regarding the evidence-based "Clinical Practice Guidelines (CPG) for the comprehensive management of gestational syphilis (GS) and congenital syphilis (CS)". Material and methods: A descriptive, cross-sectional study including general practitioners, specialists and nurses working at 52 healthcare institutions in the Bolivar Department (Colombia) who provided prenatal control or neonatal care in 2020. Convenience sampling was used. A digital questionnaire was administered to collect sociodemographic information, assessed knowledge, appropriateness and practices in terms of the evidenced-based "Clinical Practice Guidelines (CPG)" mentioned in the objectives. A descriptive analysis followed. Results: A total of 101 workers were included. There are deficiencies associated with the correct use of the inverse algorithm of diagnosis (48 %) and GS follow-up (77 %), management of the patient with a history of systemic manifestation allergies (31 %) and treatment of GS (61 %) and CS (10 %). The recommendation of not using the penicillin test in patients with no history of systemic allergies is considered of little benefit (60 %). 23 % of the workers do not use rapid tests and 44 % of the specialists administer syphilis treatment to the sexual partner. Conclusions: It is important to intensify the training strategies for health personnel with emphasis on nurses and, as a matter of urgency, empower them in syphilis control activities. New and continuous national and regional evaluations of the implementation of these guidelines are needed to assess the indicators associated with the strategy for the elimination of this disease.

Effect of Micro-Nanobubbles on Arsenic Removal by Trichoderma atroviride for Bioscorodite Generation.

The global environmental issue of arsenic (As) contamination in drinking water is a significant problem that requires attention. Therefore, the aim of this research was to address the application of a sustainable methodology for arsenic removal through mycoremediation aerated with micro-nanobubbles (MNBs), leading to bioscorodite (FeAsO4·2H2O) generation. To achieve this, the fungus Trichoderma atroviride was cultivated in a medium amended with 1 g/L of As(III) and 8.5 g/L of Fe(II) salts at 28 °C for 5 days in a tubular reactor equipped with an air MNBs diffuser (TR-MNBs). A control was performed using shaking flasks (SF) at 120 rpm. A reaction was conducted at 92 °C for 32 h for bioscorodite synthesis, followed by further characterization of crystals through Fourier-Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and X-ray diffraction (XRD) analyses. At the end of the fungal growth in the TR-MNBs, the pH decreased to 2.7-3.0, and the oxidation-reduction potential (ORP) reached a value of 306 mV at 5 days. Arsenic decreased by 70%, attributed to possible adsorption through rapid complexation of oxidized As(V) with the exchangeable ferrihydrite ((Fe(III))4-5(OH,O)12), sites, and the fungal biomass. This mineral might be produced under oxidizing and acidic conditions, with a high iron concentration (As:Fe molar ratio = 0.14). The crystals produced in the reaction using the TR-MNBs culture broth and characterized by SEM, XRD, and FTIR revealed the morphology, pattern, and As-O-Fe vibration bands typical of bioscorodite and römerite (Fe(II)(Fe(III))2(SO4)4·14H2O). Arsenic reduction in SF was 30%, with slight characteristics of bioscorodite. Consequently, further research should include integrating the TR-MNBs system into a pilot plant for arsenic removal from contaminated water.

Barriers to adequate nutrition in pregnant adolescent Colombian females.

Pregnant adolescent females face nutritional challenges. The nutritional demands of a growing fetus, when added to the requirements for growing adolescent bodies, are risk factors for undernutrition. An adolescent expectant mother's nutritional status therefore affects both the mother's and the child's future growth, development, and potential development of diseases later in life. In Colombia, the rate of female adolescent pregnancies is higher than neighboring countries and the global average. The most recent data suggest that approximately 21 % of all pregnant adolescent females in Colombia are underweight, 27 % suffer from anemia, 20 % suffer from vitamin D deficiency, and 19 % suffer from vitamin B12 deficiency. Contributing factors to these nutritional deficiencies during pregnancy may be the region in which the female lives, the female's ethnicity, and the female's socioeconomic and educational status. In rural parts of Colombia, limitations regarding access to prenatal care and food choices that include animal source proteins may also contribute to nutritional deficiencies. To help remedy this, recommendations include encouraging nutrient dense food sources with higher protein content, eating one additional meal per day, and taking a prenatal vitamin throughout the pregnancy. Making healthy eating choices can be difficult for adolescent females with limited resources and education; therefore, it is recommended that discussions about nutrition begin at the first prenatal visit for optimum benefits. These factors should be considered for the development of future health policies and interventions in Colombia and other low-income and middle-income countries where pregnant adolescent females may be experiencing similar nutritional deficiencies.

Guidelines on Gestational and Congenital Syphilis: insights of health professionals in Bolívar (Colombia) / Guía de Sífilis Gestacional y Congénita: perspectivas de profesionales de la salud en Bolívar (Colombia)

Objectives: To describe the knowledge, appropriateness and practices regarding the evidence-based "Clinical Practice Guidelines (CPG) for the comprehensive management of gestational syphilis (GS) and congenital syphilis (CS)". Material and methods: A descriptive, cross-sectional study including general practitioners, specialists and nurses working at 52 healthcare institutions in the Bolivar Department (Colombia) who provided prenatal control or neonatal care in 2020. Convenience sampling was used. A digital questionnaire was administered to collect sociodemographic information, assessed knowledge, appropriateness and practices in terms of the evidenced-based "Clinical Practice Guidelines (CPG)" mentioned in the objectives. A descriptive analysis followed. Results: A total of 101 workers were included. There are deficiencies associated with the correct use of the inverse algorithm of diagnosis (48 %) and GS followup (77 %), management of the patient with a history of systemic manifestation allergies (31 %) and treatment of GS (61 %) and CS (10 %). The recommendation of not using the penicillin test in patients with no history of systemic allergies is considered of little benefit (60 %). 23 % of the workers do not use rapid tests and 44 % of the specialists administer syphilis treatment to the sexual partner. Conclusions: It is important to intensify the training strategies for health personnel with emphasis on nurses and, as a matter of urgency, empower them in syphilis control activities. New and continuous national and regional evaluations of the implementation of these guidelines are needed to assess the indicators associated with the strategy for the elimination of this disease.

Objetivos: describir los conocimientos, la idoneidad y las prácticas respecto a la "Guía de práctica clínica (GPC) basada en la evidencia para la atención integral de la sífilis gestacional (SG) y congénita (SC)". Materiales y métodos: estudio descriptivo de corte transversal. Incluyó médicos generales, especialistas y enfermeras que laboraban en 52 instituciones de salud en el departamento de Bolívar (Colombia) y realizan el control prenatal o la atención al neonato en el 2020. Muestreo por conveniencia. Se aplicó cuestionario digital que recolectó información sociodemográfica; evaluó conocimientos, idoneidad y prácticas sobre la "Guía de práctica clínica (GPC)" mencionada en los objetivos. Se hace análisis descriptivo. Resultados: se incluyeron 101 trabajadores. Hay deficiencias relacionadas con la aplicación correcta del algoritmo inverso de diagnóstico (48 %) y seguimiento de SG (77 %), manejo de la paciente con antecedentes de alergias de manifestaciones sistémicas (31 %) y tratamiento de la SG (61 %) y SC (10 %). La recomendación de no aplicar prueba de penicilina en pacientes sin antecedentes de alergias sistémicas se considera poco útil (60 %). El 23 % de los trabajadores no emplea las pruebas rápidas y el 44 % de los especialistas da tratamiento para sífilis al compañero sexual. Conclusiones: es importante intensificar las estrategias de capacitación en el personal de salud con énfasis en el personal de enfermería y, de manera urgente, empoderar a este personal en las actividades relacionadas con el control de la sífilis. Se requiere hacer nuevas y continúas evaluaciones a nivel nacional y regional de la implementación de esta guía que permitan evaluar los indicadores que contiene la estrategia de eliminación de esta enfermedad.

Effects of a Light Crude Oil Spill on a Tropical Coastal Phytoplankton Community.

Oiling scenarios following spills vary in concentration and usually can affect large coastal areas. Consequently, this research evaluated different crude oil concentrations (10, 40, and 80 mg L-1) on the nearshore phytoplanktonic community in the southern Gulf of Mexico. This experiment was carried out for ten days using eight units of 2500 L each; factors monitored included shifts in phytoplankton composition, physicochemical parameters and the culturable bacterial abundance of heterotrophic and hydrocarbonoclastic groups. The temperature, salinity, and nutrient concentrations measured were within the ranges previously reported for Yucatan Peninsula waters. The total hydrocarbon concentration (TPH) in the control at T0 indicated the presence of hydrocarbons (PAHs 0.80 µg L-1, aliphatics 7.83 µg L-1 and UCM 184.09 µg L-1). At T0, the phytoplankton community showed a similar assemblage structure and composition in all treatments. At T10, the community composition remained heterogeneous in the control, in agreement with previous reports for the area. However, for oiled treatments, Bacillariophyceae dominated at T10. Hydrocarbonoclastic bacteria were associated with oiled treatments throughout the experiment, while heterotrophic bacteria were associated with control conditions. Our results agreed with previous works at the taxonomic level showing the presence of Bacillariophyceae and Dinophyceae in oil-related treatments, where these groups showed the major interactions in co-occurrence networks. In contrast, Chlorophyceae showed the key node in the co-occurrence network for the control. This study aims to contribute to knowledge on phytoplankton community shifts during a crude oil spill in subtropical oligotrophic regions.

The Globalization Monster: Challenges and Alternatives of Jacques B. Gélinas / El monstruo de la globalización: desafíos y alternativas, de jacques b. gélinas

RESUMEN Este artículo describió la evolución histórica del término globalización, acompañada de diferentes acontecimientos económicos, políticos y sociales que dan cuenta del estado actual de concentración extrema de riqueza que ocasiona desigualdades y fracturas sociales en el mundo. En la obra El monstruo de la globalización: desafíos y alternativas, de Jacques Gélinas, traducida al español en 2006, Gélinas presenta una propuesta de desarrollo de un pensamiento único cultural que invita a comprender, criticar, resistir y construir alternativas de los fenómenos socioeconómicos y del sentido de la historia, para despertar consciencia planetaria y lograr un balance mundial entre las aspiraciones económicas, sociales, culturales y ambientales. Asimismo, se hace una reflexión sobre el caso colombiano, donde la discrepancia ideológica se presenta precisamente por la concepción conservadora de la sociedad colombiana, niveles salariales no tan elevados y cohesión local en función de los productos agrícolas y textiles; de la misma manera, el alto nivel de regionalismo, potenciado por la limitación geográfica y de vías de comunicación, ha ralentizado en Colombia el desarrollo de productos manufacturados, que se han enfocado como continuidad histórica en la dependencia de commodities como café, petróleo, minería y productos agrícolas.

ABSTRACT This text describes the historical evolution of the term globalization, accompanied by different economic, political, and social events that account for the current state of extreme concentration of wealth, which causes inequalities and social fractures in the world. In the work "The Globalization Monster: Challenges and Alternatives" by Jacques B. Gélinas, translated to Spanish in 2006, the author presents a proposal for the development of a unique cultural thought, one that invites us to understand, criticize, resist, and build alternatives to socioeconomic phenomena and the meaning of history, to awaken planetary consciousness, and to achieve a global balance between economic, social, cultural, and environmental aspirations. Likewise, a reflection is made on the Colombian case, where the ideological discrepancy is presented, precisely because of the conservative conception of Colombian society, not-so-high salary levels, and local cohesion based on agricultural and textile products; in the same way, the high level of regionalism, enhanced by geographical limitations and communication routes, have slowed down the development of manufactured products in Colombia, focusing as a historical continuity on dependence of commodities such as coffee, oil, mining, and agricultural products.

Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case-control study of suicide attempts in Catalonia, Spain.

INTRODUCTION: Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools. METHODS AND ANALYSIS: The CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case-control study of suicide attempts during the period 2014-2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study's sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools. ETHICS AND DISSEMINATION: This protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines. TRIAL REGISTRATION NUMBER: NCT04235127.

Taxocoenosis of epibenthic dinoflagellates in the coastal waters of the northern Yucatan Peninsula before and after the harmful algal bloom event in 2011-2012.

Eutrophication causes the major impact in the coastal waters of the state of Yucatan. In general, loss of water quality and biological communities and massive development of toxic microorganisms are some of the consequences of this phenomenon. To reveal changes in species composition and cell abundance of the taxocoenosis of epibenthic dinoflagellates before and after a harmful algal bloom event in the water column that lasted about 150days (August-December 2011) in the Dzilam - San Crisanto area (northern Yucatan Peninsula, southeastern Gulf of Mexico) were the main objectives of the present study. In August 2011 and September 2012, sampling along 20 transects perpendicular to the coastline along the entire northern Yucatan coast, starting from 20 sampling sites from El Cuyo in the east to Celestún in the west, at a distance of 50, 150 and 250m from the coast, was carried out. Physicochemical characteristics measured before and after the bloom were within the ranges previously reported in the study area. Salinity was the most stable characteristic, with mean values of 36.25 and 36.42 in 2011 and 2012, respectively. Phosphates were the only parameter that showed a wide range with higher values before the bloom (0.03-0.54µM/l). A total of 168 macrophyte (seaweeds and seagrasses), sponge and sediment samples (105 in 2011 and 63 in 2012) that included associated microphytobenthos were taken by snorkeling from 0.7 to 5m depth. Six substrate types were distinguished: Chlorophyta, Phaeophyceae, Rhodophyta, Angiospermae (seagrasses), Demospongiae (sponges) and sediment. Chlorophytes dominated the collected samples: 38 samples in 2011 and 23 in 2012. Avrainvillea longicaulis f. laxa predominated before the bloom and Udotea flabellum after it. In total, 25 epibenthic dinoflagellate species from 11 genera were found. The genus Prorocentrum was the most representative in terms of the number of species. The highest total dinoflagellate cell abundances were observed in the sites with different types of macrophytes (up to 2441cells/g substrate wet weight in 2011 and up to 1068cells/g in 2012). The lowest cell densities were observed in the areas with scarce or no macrophytes on sandy seafloor. Before the bloom, Prorocentrum rhathymum (up to 4995cells/g) and P. cf. sipadanensis (up to 5275cells/g) were the most abundant, and after the bloom the latter was dominant (up to 3559cells/g); in 2012, both variety of substrates and dinoflagellate cell abundance diminished. A canonical correspondence analysis revealed significant relationships between the physicochemical variables and epiphytic/benthic dinoflagellate species either before or after the bloom. The pelagic bloom resulted in the loss of substrate for epiphytic dinoflagellates, which caused replacement of the dominant species and a decrease in cell abundance of the whole taxocoenosis.

Nutrient content and nutrient availability of sorghum wet distiller's grain in comparison with the parental grain for ruminants.

BACKGROUND: The present study aimed to compare wet sorghum distiller's grain (WSDG) with sorghum grain (SG) in terms of: (i) chemical composition; (ii) in situ rumen degradation kinetics of organic matter (OM) and neutral detergent fiber (NDF); (iii) crude protein (CP) sub-fractions; (iv) in situ disappearance at 12 and 48 h; and (v) energy values. The WSDG intestinal digestibility (ID) of undegradable crude protein (UCP) was compared to soybean meal (SBM). RESULTS: Compared to SG, WSDG exhibited: (i) lower (P < 0.01) dry matter and non-fiber carbohydrate content, whereas the other chemical components were higher (P < 0.01); (ii) higher (P < 0.01) degradation rates of OM and NDF and lower (P < 0.01) degradable fraction of OM and NDF; (iii) lower (P < 0.05) contents of CP sub-fractions A, B1 and B2, and higher (P < 0.05) contents of B3 and C; (iv) lower (P < 0.05) protein disappearance at 12 and 48 h and higher UCP; and (v) lower (P < 0.05) energy content. The ID of UCP for WSDG was lower (P < 0.05) compared to SBM. CONCLUSION: The WSDG as a supplement provides a good source of energy. To enable its use as a protein supplement, further studies should be performed. © 2016 Society of Chemical Industry.

Linfoma primario del mediastino (tímico): Presentación de caso / Primary Mediastinal Lymphoma (Thymic): A Case Report

Los linfomas mediastinales anteriores pueden hacer parte del linfoma sistémico y comprenden aproximadamente el 50 % de los tumores mediastinales. El linfoma no Hodgkin primario del mediastino es un subtipo de menor prevalencia, representando un 10 % de los casos; este tiene dos subtipos histológicos que son el linfoma T linfoblástico y el linfoma B difuso de célula grande. Este último es agresivo y tiende a infiltrar la pleura, las estructuras óseas y el pulmón; se origina de las células B de la médula del timo. En este artículo se describe un caso de linfoma no Hodgkin primario del mediastino del subtipo B difuso de células grandes, sus hallazgos por imágenes, patología y una breve revisión de la literatura.

Anterior mediastinal lymphomas may be part of systemic lymphoma and they comprise approximately 50 % of mediastinal neoplasms. Primary non-Hodgkin's lymphoma of the mediastinum is a subtype with lower prevalence, representing 10 % of all cases; it has two histologic subtypes that include T-cell lymphoblastic lymphoma and diffuse large B-cell lymphoma. The latter is an aggressive neoplasm that tends to infiltrate the pleura, bone structures and the lung; it originates from thymic medullary B cells. This article presents a case of primary non-Hodgkin's lymphoma of the mediastinum with diffuse large B-cell subtype, its radiologic findings, pathology and a brief review of the literature.

Leiomyosarcoma of the Right Atrium Masked by a Covering Thrombus: Conflicting Results of Echocardiography and Transvenous Biopsy-In Favor of Echocardiography.

A 62-year-old woman was admitted for the evaluation of pedal edema and ascitis. Echocardiography revealed a right atrial (RA) mass invading the interatrial septum and extending into the inferior vena cava (IVC). Contrast enhanced computerized tomography scan excluded extravascular involvement. An organized thrombus was diagnosed by transvenous endomyocardial biopsy. The patient was treated with continuous intravenous heparin, and died soon after from hepatic failure. Postmortem histologic examination revealed a leiomyosarcoma surrounded by a thrombus involving RA, IVC, and hepatic veins. Endomyocardial biopsy played a misleading role that affected patient's management.