Smartphone swabs as an emerging tool for toxicology testing: a proof-of-concept study in a nightclub.

OBJECTIVES: Smartphones have become everyday objects on which the accumulation of fingerprints is significant. In addition, a large proportion of the population regularly uses a smartphone, especially younger people. The objective of this study was to evaluate smartphones as a new matrix for toxico-epidemiology. METHODS: This study was conducted during two separate events (techno and trance) at an electronic music nightclub in Grenoble, France. Data on reported drug use and whether drugs were snorted directly from the surface of the smartphone were collected using an anonymous questionnaire completed voluntarily by drug users. Then, a dry swab was rubbed for 20 s on all sides of the smartphone. The extract was analyzed by liquid chromatography coupled to tandem mass spectrometry on a Xevo TQ-XS system (Waters). RESULTS: In total, 122 swabs from 122 drug users were collected. The three main drugs identified were MDMA (n=83), cocaine (n=59), and THC (n=51). Based on declarative data, sensitivity ranged from 73 to 97.2 % and specificity from 71.8 to 88.1 % for MDMA, cocaine, and THC. Other substances were identified such as cocaine adulterants, ketamine, amphetamine, LSD, methamphetamine, CBD, DMT, heroin, mescaline, and several NPS. Numerous medications were also identified, such as antidepressants, anxiolytics, hypnotics, and painkillers. Different use patterns were identified between the two events. CONCLUSIONS: This proof-of-concept study on 122 subjects shows that smartphone swab analysis could provide a useful and complementary tool for drug testing, especially for harm-reduction programs and toxico-epidemiolgy studies, with acceptable test performance, despite declarative data.

El arte gráfico como medio de comunicación y cuidados en personas con demencia temprana y Alzhéimer / A arte gráfica como meio de comunicação e cuidado em pessoas com demência precoce e Alzheimer / Graphic art as a means of communication and care in people with early dementia and Alzheimer’s

El presente trabajo analiza la repercusión de la técnica de grabadono tóxica Collagraph, en personas con Demencia tempranatipo Alzhéimer, en el programa de educación artística “Retalesde una vida”. El objetivo es conectar a los participantes conprogramas de carácter cultural para fomentar la comunicacióne interacción entre participantes. La experiencia se llevó a caboen el Centro de Referencia Estatal para personas con Alzheimery otras Demencias de Salamanca (CREA). Una vez adaptadala metodología del taller a las características personales y desalud de las personas enfermas de Alzheimer, se considera lautilización del grabado genera importantes beneficios en losparticipantes, relacionados con el incremento de la inteligenciacristalizada, la conducta prosocial y la valoración positiva desí mismos, favoreciendo la inclusión social y familiar.Asimismo, el empleo del grabado puede ofrecer un soporte deayuda terapéutica individual y cooperativa a los participantes,desarrollar habilidades funcionales, sociales y cognitivas, ampliandosus recursos emocionales y disfrutar de la experiencia. A suvez fortalecen su autoestima y seguridad ante su capacidady valía. Por último, planteamos una serie de pautas para laplanificación e implementación de este proceso artístico paraque sirva de referente a profesionales de la salud.(AU)

The present work analyzes the repercussion of the non-toxic engraving technique Collagraph, in people with EarlyAlzheimer’s Dementia, in the artistic education program “Retalesde una vida”. The objective is to connect the participants withprograms of a cultural nature to encourage communication and interaction between participants. The experience wascarried out at the State Reference Center for people withAlzheimer’s and other Dementias of Salamanca (CREA). Oncethe methodology of the workshop has been adapted to thepersonal and health characteristics of people with Alzheimer'sdisease, it is considered that the use of engraving generatesimportant benefits in the participants, related to the increasein crystallized intelligence, prosocial behavior and positiveassessment. of themselves, favoring social and family inclusion.Likewise, the use of engraving can offer support for individualand cooperative therapeutic help to the participants, developfunctional, social and cognitive skills, expanding theiremotional resources and enjoying the experience. In turn,they strengthen their self-esteem and security in the faceof their ability and worth. Finally, we propose a series ofguidelines for the planning and implementation of this artisticprocess so that it serves as a reference for health professionals.(AU)

O presente trabalho analisa a repercussão da técnica degravura atóxica Collagraph, em pessoas com DemênciaInicial de Alzheimer, no programa de educação artística“Retales de una vida”. O objetivo é conectar os participantes aprogramas de cunho cultural para estimular a comunicação ea interação entre os participantes. A experiência foi realizadano Centro Estadual de Referência para Pessoas com Alzheimere outras Demências de Salamanca (CREA). Uma vez quea metodologia da oficina foi adaptada às característicaspessoais e de saúde das pessoas com doença de Alzheimer,considerase que o uso da gravura gera importantes benefíciosnos participantes, relacionados ao aumento da inteligênciacristalizada, comportamento prósocial e avaliação positivade si mesmos, favorecendo a inclusão social e familiar.Da mesma forma, o uso da gravura pode oferecer suporte paraajuda terapêutica individual e cooperativa aos participantes,desenvolver habilidades funcionais, sociais e cognitivas, ampliandoseus recursos emocionais e desfrutando da experiência. Porsua vez, fortalecem sua auto-estima e segurança diante de suacapacidade e valor. Por fim, propomos uma série de diretrizespara o planejamento e implementação desse processo artísticopara que sirva de referência para os profissionais de saúde.(AU)

Formes de presentació clínica de les infeccions causades per Streptococcus pyogenes / Formas de presentación clínica de las infecciones causadas por Streptococcus pyogenes / Clinical presenting features of infections caused by Streptococcus pyogenes

Fonament. L’Streptococcus pyogenes és un bacteri causantde diverses i freqüents infeccions en infants, en la majoriade casos lleus, si bé pot causar infeccions invasives quesuposen un risc vital. Des de setembre de 2022 s’ha detectat un increment important de la incidència d’infeccionsper aquest bacteri, i se n’han registrat diversos casos mortals en poc temps. Malgrat que pot causar patologia greu,és sensible a la penicil·lina i altres ß-lactàmics en el 100% dels casos. El diagnòstic precoç és essencial per establir-neel tractament adequat i millorar-ne el pronòstic. Objectiu. Fer una revisió de les formes de presentació clínica de la infecció per Streptococcus pyogenes, els factors de risc i els signes d’alarma d’infecció greu. Mètode. Revisió bibliogràfica. Resultats. Es descriuen les formes de presentació clínicamés importants de la infecció per Streptococcus pyogenes,tant invasives com no invasives. Es defineixen com a formes invasives les que presenten l’aïllament del bacteri en una localització estèril. Es descriuen els diferents factors de riscde presentar formes més greus i amb evolució més tòrpida. Conclusions. La situació epidemiològica actual posa de manifest la necessitat que el pediatre mantingui un nivell altde sospita clínica i conegui totes les formes de presentació de la infecció, així com els factors de risc que fan sospitar d’una evolució a malaltia greu. El tractament antibiòtic precoç i correcte és l’eina principal per al maneig d’aquestes infeccions. La possibilitat de presentacions d’evolució fulminant en infants sans requereix d’un sistema de vigilància epidemiològica que en permeti la identificació i la definició. (AU)

Fundamento. Streptococcus pyogenes es una bacteria causante dediversas y frecuentes infecciones en niños, leves en la mayoría decasos, si bien puede causar infecciones invasivas que suponen un riesgo vital. Desde septiembre de 2022 se ha detectado un incremento importante de la incidencia de infecciones por esta bacteria, y se han registrado varios casos mortales en poco tiempo. Aunque puede causar patología severa, es sensible a penicilina yotros ß-lactámicos en el 100% de los casos. El diagnóstico precozes esencial para establecer su tratamiento adecuado y mejorar supronóstico. Objetivo. Realizar una revisión de las formas de presentación clínica de la infección por Streptococcus pyogenes, los factores deriesgo y los signos de alarma de infección grave. Método. Revisión bibliográfica. Resultados. Se describen las formas de presentación clínica más importantes de la infección por Streptococcus pyogenes, tanto invasivas como no invasivas. Se definen como formas invasivas aquellas que presentan el aislamiento de la bacteria en una localización estéril. Se describen los distintos factores de riesgo depresentar formas más graves y con evolución más tórpida. Conclusiones. La situación epidemiológica actual pone de manifiesto la necesidad de que el pediatra mantenga un nivel alto desospecha clínica y conozca todas las formas de presentación de la infección, así como los factores de riesgo que hacen sospechar deuna evolución a enfermedad grave. El tratamiento antibiótico precoz y correcto es la principal herramienta para el manejo de estas infecciones. La posibilidad de presentaciones de evolución fulminante en niños sanos requiere de un sistema de vigilancia epidemiológica que permita su identificación y definición. (AU)

Background. Streptococcus pyogenes is a bacterium that causesfrequent and very diverse infections in children. Although they aremild in most cases, Streptococcus pyogenes can also cause lifethreatening invasive infections. A significant increase in the incidence of Streptococcus pyogenes infections has been seen sinceSeptember 2022, with several fatal cases being reported in a short period of time. Although this bacterium can cause severe pathology, it is sensitive to penicillin and other ß-lactam antibiotics in100% of the cases. Early diagnosis is essential to establish itsproper treatment and improve its prognosis. Objective. To review the different clinical presentations of the Streptococcus pyogenes infection, its risk factors, and the warning signs of severe infection. Method. Bibliographic review. Results. We describe the most important clinical presentations of Streptococcus pyogenes infection, both invasive and non-invasive. Invasive infections are defined by the isolation of Streptococcus pyogenes from a normally sterile site. The risk factors for presenting a more severe or torpid evolution are described. Conclusions. The current epidemiological situation highlights theneed for pediatricians to have a high index of clinical suspicionand to be aware of all the presenting forms of the infection, as wellas the risk factors related to bad prognosis or adverse evolution. Early and correct antibiotic treatment is the main tool for managing these infections. The possibility of a sudden and fatal presentation in previously healthy children requires an epidemiological surveillance system to identify and define these cases. (AU)

Megacolon tóxico: peritonitis fecaloidea por colitis amebiana. Reporte de un caso y revisión de literatura / Toxic megacolon: fecaloid peritonitis caused by amebic colitis. Report of a case and literature review

Introducción: La amebiasis es una enfermedad causada por el parásito Entamoeba histolytica, y condiciona importantes tasas de afectación a escala global. Una de las complicaciones de la colitis amebiana es el megacolon tóxico, el cual se caracteriza por la dilatación colónica y signos de toxicidad sistémica. Aunque poco frecuente, el megacolon tóxico es considerado letal.Caso clínico : se trata de paciente femenino de 26 años, quien consulta por presentar dolor abdominal generalizado, de fuerte intensidad, tipo cólico, acompañado de náuseas y múltiples episodios eméticos. Al examen físico se precisó hemodinámicamente estable, sin signos de irritación peritoneal, por lo que es ingresada con diagnóstico de colitis amebiana. Se instaura manejo médico y es egresada por mejoría clínica. Luego de 7 días, es readmitida por deterioro clínico y distensión abdominal, realizándose diagnóstico de megacolon tóxico. Mediante laparotomía de emergencia se observa peritonitis fecaloidea difusa y perforación del ciego, se realiza hemicolectomía derecha e ileostomía terminal. Posteriormente, presenta absceso intraabdominal que fue drenado por vía percutánea. Conclusión : el megacolon tóxico es una patología infrecuente que surge como complicación de entidades como la colitis amebiana. En la actualidad, a pesar de los avances tecnológicos que han desencadenado importantes progresos en el ámbito sanitario, el diagnóstico del megacolon tóxico continúa representando un desafío para el profesional médico, por lo que la sospecha clínica es ineludible y determinante en el diagnóstico acertado y oportuno, que permiten la instauración de la terapéutica apropiada y reducción de la morbilidad y mortalidad que de esta se derivan(AU)

Introduction: Amebiasis is a disease caused by the parasite Entamoeba histolytica, and causes significant rates of infection on a global scale. One of the complications of amoebic colitis is toxic megacolon, which is characterized by colonic dilation and signs of systemic toxicity. Although rare, toxic megacolon is considered lethal. Clinical case: this is a 26-year-old female patient, who consults due to generalized abdominal pain, of strong intensity, colic type, accompanied by nausea and multiple emetic episodes. On physical examination she was found to be hemodynamically stable, with no signs of peritoneal irritation, so she was admitted with a diagnosis of amoebic colitis. Medical management was established and she was discharged due to clinical improvement. After 7 days, she was readmitted due to clinical deterioration and abdominal distention, and a diagnosis of toxic megacolon was made. Through emergency laparotomy, diffuse fecaloid peritonitis and perforation of the cecum were observed; right hemicolectomy and terminal ileostomy were performed. Subsequently, she developed an intra-abdominal abscess that was drained percutaneously. Conclusion: toxic megacolon is a rare pathology that arises as a complication of entities such as amoebic colitis. Currently, despite the technological advances that have triggered important progress in the healthcare field, the diagnosis of toxic megacolon continues to represent a challenge for the medical professional, which is why clinical suspicion is unavoidable and decisive in an accurate and timely diagnosis, which allow the establishment of appropriate therapy and reduction of the morbidity and mortality that arise from it(AU)

Microplásticos, un problema de salud pública emergente

Introducción: Los productos plásticos han transformado la era moderna de tal manera que la vida sin plásticos sería irreconocible, a la par de este desarrollo la contaminación plástica es omnipresente convirtiéndose en uno de los problemas ambientales modernos más importantes. Objetivo: Compilar la información publicada en los últimos cinco años sobre la contaminación ambiental por microplásticos en Ecuador para reforzar el interés local sobre estos contaminantes. Desarrollo: Se realizó una revisión no estructurada de la literatura. Se utilizaron como bases de datos PubMed y Google Scholar. Los criterios de inclusión fueron: artículos publicados en los últimos 5 años, en idiomas inglés y español, se excluyeron otros idiomas; la selección de estudios fue de tipo a conveniencia. Se organizó y analizó cronológicamente la evidencia publicada en PubMed y Google Scholar en los últimos 5 años sobre microplásticos en Ecuador. Consideraciones finales: La información recopilada muestra cronológicamente el avance de la contaminación por microplásticos tanto a nivel mundial como en Ecuador, además, se evidencia la presencia de microplásticos en océanos, agua dulce, ecosistemas terrestres, aire, alimentos y dentro del cuerpo humano. Por lo cual la contaminación por microplásticos es un tema de gran relevancia actual, que requiere acciones de control inmediatas.

Introduction: Commercial plastic products has transformed the modern era in such a way that current life without plastic would not be possible, so at the same time with this development, plastics contamination is present, becoming one of the most urgent environmental problems nowadays. Objective: To gather available information published on the last five years concerning the microplastics as a source of environmental contamination in Ecuador and in order to reinforce the local interest on plastic pollution. Development: An unstructured review of the literature was performed. Databases used, PubMed and Google Scholar. The inclusion criteria used were as follow: articles in English and Spanish published on the last 5 years, no other language; study selections have been done by convenience. It was chronologically organized and analyzed the evidence published in PubMed and Google Scholar on the last five years concerning the microplastics behavior in Ecuador. Final considerations: The information collected chronologically shows the advancing pollution caused by microplastics both globally and in Ecuador, in addition, the presence of microplastics in oceans, fresh water, terrestrial ecosystems, air, foods and even in the human body is evident. Therefore, contamination caused by microplastics is a topic of a great importance today, which requires a speedy control action.

Introdução: Os produtos plásticos transformaram a era moderna de tal forma que a vida sem plásticos seria irreconhecível, junto com esse desenvolvimento, a poluição plástica é onipresente, tornando-se um dos mais importantes problemas ambientais modernos. Objetivo: Compilar as informações publicadas nos últimos 5 anos sobre a contaminação ambiental por microplásticos no Equador para reforçar o interesse local por esses contaminantes. Desenvolvimento: Foi realizada uma revisão não estruturada da literatura. Foram utilizadas as bases de dados PubMed e Google Scholar. Os critérios de inclusão foram: artigos publicados nos últimos 5 anos, nos idiomas inglês e espanhol, foram excluídos outros idiomas; a seleção dos estudos foi do tipo conveniência. As evidências publicadas no PubMed e Google Scholar nos últimos 5 anos sobre microplásticos no Equador foram organizadas e analisadas cronologicamente. Considerações finais: As informações coletadas cronologicamente mostram o progresso da contaminação por microplásticos tanto no mundo quanto no Equador, além disso, é evidente a presença de microplásticos nos oceanos, água doce, ecossistemas terrestres, ar, alimentos e dentro do corpo humano. Portanto, a contaminação por microplásticos é um tema de grande relevância atual, que requer ações imediatas de controle.

Toxic stress on a pediatric population during the COVID-19 pandemic / Estresse tóxico em uma população pediátrica durante a pandemia de COVID-19

Abstract Objective: The aim of this study was to analyze the impact of social isolation as a result of the coronavirus-19 disease (COVID-19) pandemic in children and adolescents aged 0-17 years in Southern Brazil. Methods: This is a cross-sectional study in which 542 questionnaires answered by parents or legal guardians of children and adolescents aged 0-17 years residing in the Brazilian South region, through Google Forms®. Questionnaires answered incompletely or from children outside the stipulated age group and from other regions of the country were excluded from the research. The collected data were organized into descriptive and association tables containing absolute and relative frequencies, medians, averages, standard deviations, quartile deviations, average, and proportion estimates in the form of 95% confidence intervals and the result of the chi-square test of independence. Data analysis was fulfilled with the application aid of Microsoft Excel 2016 and Epi Info version 7.2.1.0 of 01/27/2017. Statistically significant associations were considered when p<0.05. Results: There was an increase in the perception of nervousness (62.7%), anxiety (67.7%), and sadness (51.3%) in children and adolescents during the pandemic period. This study evidenced a high prevalence of screens overuse (50.9%) and sedentary lifestyle (39.1%) in this age group during the period. Furthermore, the occurrence of regressive behaviors occurred more frequently in the age group of 3-6 years (57.1%) and between 7 and 10 years (44.6%). Conclusions: It is inferred from this study that one of the implications resulting from the pandemic period is the increase of toxic stress in the pediatric population.

RESUMO Objetivo: Analisar o impacto do isolamento social em decorrência da pandemia associada ao coronavírus 2019 (COVID-19), em crianças e adolescentes de zero a 17 anos da Região Sul do Brasil. Métodos: Trata-se de um estudo de corte transversal em que foram obtidos 542 questionários, respondidos por pais ou responsáveis legais de crianças e adolescentes de zero a 17 anos residentes da Região Sul brasileira, por meio do Google Forms®. Questionários respondidos de maneira incompleta ou de crianças fora da faixa etária estipulada e de outras regiões do país foram excluídos da pesquisa. Os dados colhidos foram organizados em tabelas descritivas e de associação contendo frequências absolutas, relativas, médias, medianas, desvios padrão, desvios quartílicos, estimativas de média e de proporção em forma de intervalos com 95% de confiança e resultado do teste do qui-quadrado de independência. A análise dos dados foi realizada com o auxílio dos aplicativos Microsoft Excel 2016 e Epi Info versão 7.2.1.0, de 27 de janeiro de 2017. Foram consideradas associações estatisticamente significativas quando p<0,05. Resultados: Houve aumento da percepção de nervosismo (62,7%), ansiedade (67,7%) e tristeza (51,3%) em crianças e adolescentes no período da pandemia. O estudo evidenciou alta prevalência de uso excessivo de telas (48,2%) e de sedentarismo (39,1%) nessa faixa etária durante o período. Ademais, a ocorrência de comportamentos regressivos ocorreu de maneira mais frequente nas faixas etárias de 3-6 anos (57,1%) e de 7-10 anos (44,6%). Conclusões: Infere-se deste estudo que uma das implicações do período da pandemia é o aumento do estresse tóxico na população pediátrica.

The wire. Una iluminación profana / The wire. A profane illumination

Introducción: Considerada la mejor serie de televisión del siglo XXI, The wire pone en escena la ciudad de Baltimore, una de las más violentas del mundo, tomando como eje central la industria de las drogas baratas. Las dinámicas a las que da lugar esta economía ilegal sirve de matriz en la ficción para entender las instituciones de las ciudades contemporáneas y el actual contexto del lazo social. Metodología: Tomando como referencia los textos sociales de Sigmund Freud y la revisión crítica efectuada por Jacques-Alain Miller a partir de la obra de Jacques Lacan, el presente artículo aborda la función del tóxico en esta serie desde discusiones actuales del campo psicoanalítico. Resultados: Es posible corroborar que la cultura de las drogas a la que se refiere David Simon en diversas ocasiones implica un empuje a la obtención de un plus como principal horizonte de sus personajes e instituciones de las que forman parte. La lectura propuesta en el presente artículo plantea que esta mutación cultural puede ser analizada desde la noción de objeto plus de goce propuesto por Jacques Lacan. (AU)

Introduction: Considered the best television series of the 21st century, The Wire stages the city of Baltimore, one of the most violent in the world, taking the cheap drug industry as its central axis. The dynamics to which this illegal economy gives rise serves as a matrix in fiction to understand the institutions of contemporary cities and the current context of the social bond. Methodology: Taking as reference the social texts of Sigmund Freud and the critical review carried out by Jacques-Alain Miller based on the work of Jacques Lacan, this article addresses the function of the toxic in this series from current discussions in the psychoanalytic field. Results: It is possible to corroborate that the drug culture to which David Simon refers on several occasions implies a push to obtain a plus as the main horizon of his characters and institutions of which they are a part. The reading proposed in this article suggests that this cultural mutation can be analyzed from the notion of object plus jouissance proposed by Jacques Lacan. (AU)

The wire. A profane illumination / The wire. Una iluminación profana

Introduction: Considered the best television series of the 21st century, The Wire stages the city of Baltimore, one of the most violent in the world, taking the cheap drug industry as its central axis. The dynamics to which this illegal economy gives rise serves as a matrix in fiction to understand the institutions of contemporary cities and the current context of the social bond. Methodology: Taking as reference the social texts of Sigmund Freud and the critical review carried out by Jacques-Alain Miller based on the work of Jacques Lacan, this article addresses the function of the toxic in this series from current discussions in the psychoanalytic field. Results: It is possible to corroborate that the drug culture to which David Simon refers on several occasions implies a push to obtain a plus as the main horizon of his characters and institutions of which they are a part. The reading proposed in this article suggests that this cultural mutation can be analyzed from the notion of object plus jouissance proposed by Jacques Lacan. (AU)

Introducción: Considerada la mejor serie de televisión del siglo XXI, The wire pone en escena la ciudad de Baltimore, una de las más violentas del mundo, tomando como eje central la industria de las drogas baratas. Las dinámicas a las que da lugar esta economía ilegal sirve de matriz en la ficción para entender las instituciones de las ciudades contemporáneas y el actual contexto del lazo social. Metodología: Tomando como referencia los textos sociales de Sigmund Freud y la revisión crítica efectuada por Jacques-Alain Miller a partir de la obra de Jacques Lacan, el presente artículo aborda la función del tóxico en esta serie desde discusiones actuales del campo psicoanalítico. Resultados: Es posible corroborar que la cultura de las drogas a la que se refiere David Simon en diversas ocasiones implica un empuje a la obtención de un plus como principal horizonte de sus personajes e instituciones de las que forman parte. La lectura propuesta en el presente artículo plantea que esta mutación cultural puede ser analizada desde la noción de objeto plus de goce propuesto por Jacques Lacan. (AU)

Pobreza, traumas tempranos, déficit atencional y deserción educacional: un círculo de daño. Lecciones aprendidas en el Programa Soymás, La Pintana / Poverty, early trauma, attention deficit and educational dropout: a circle of harm. Lessons learned in the Soymás Program, La Pintana

El antecedente de maltrato infantil y el Trastorno por Déficit de Atención e Hiperactividad (TDAH), son condiciones que tienen una alta prevalencia en los jóvenes de sectores vulnerables. Analizamos su relación con deserción escolar, que también es mayor en tales contextos. La deserción es un fenómeno multifactorial, influenciado por factores propios del estudiante, de la institución, del contexto familiar y del entorno social. Presentamos hallazgos en la Fundación Soymás, institución de formación para madres adolescentes, localizada en La Pintana, una de las comunas con mayor pobreza en Chile, donde la deserción en 2022 fue 45%. De acuerdo a la encuesta ACES de 10 eventos traumáticos en la niñez, 50% de las estudiantes sufrió 3 o más, y 21% 7 o más. Al menos un 40% de la población cumplía criterios de TDAH y un 30% adicional manifestaba síntomas sugerentes (versus 4,5% de TDAH reportado en adolescentes del país). Constatamos una asociación directa entre las tres variables: Maltrato, TDAH y Deserción. Estos hallazgos deberían ser considerados en políticas públicas, reforzando la necesidad de colaboración entre Salud y Educación.

A history of child abuse and Attention Deficit Hyperactivity Disorder (ADHD) are conditions that have a high prevalence in young people from vulnerable sectors. We analyze its relationship with school dropout, which is also higher in such contexts. Dropout is a multifactorial phenomenon, influenced by factors specific to the student, the institution, the family context, and the social environment. We present findings at the Soymás Foundation, a training institution for adolescent mothers, located in La Pintana, one of the counties with the highest poverty in Chile, where dropout in 2022 was 45%. According to the ACES survey of 10 traumatic events in childhood, 50% of the students suffered 3 or more, and 21% 7 or more. At least 40% of the population met the criteria for ADHD and an additional 30% manifested suggestive symptoms (versus 4.5% of ADHD reported in adolescents in the country). We found a direct association between the three variables: Abuse, ADHD and Desertion. These findings should be considered in public policies, reinforcing the need for collaboration between Health and Education.

Polineuropatía por cadmio: una causa infrecuente, pero no menos importante, de neuropatía periférica / Cadmium polyneuropathy: a rare, but not less important, cause of peripheral neuropathy

Introducción: El cadmio es un metal pesado importante en neurobiología, con potenciales efectos neurotóxicos, frecuentemente en forma de polineuropatía. Caso clínico: Presentamos un caso excepcional de polineuropatía por cadmio de origen tóxico-ocupacional, en concreto, un varón de 47 años, mecánico aeronáutico, con un cuadro de cinco años de evolución, consistente en sensación de hormigueo ‘en guante y calcetín’ y torpeza manipulativa bimanual. En la exploración destacaba una hiporreflexia aquílea bilateral, y una hipoestesia exteroceptiva protopático-térmico-algésica en las manos y los pies. Se solicitó analítica general completa con perfil tóxico-metabólico-infeccioso-vitamínico, resonancia magnética craneomedular completa, estudio electroneurográfico-electromiográfico de los miembros superiores e inferiores, tomografía por emisión de positrones-tomografía axial computarizada body y videoelectroencefalograma de 24 horas. Los resultados fueron compatibles con una polineuropatía sensitivomotora axonal, distal, simétrica, de intensidad moderada, de evolución crónica y desnervación activa, de origen tóxico-ocupacional por cadmio. El paciente prosiguió la baja laboral para cesar la exposición al cadmio, iniciando neurorrehabilitación intensiva multimodal, y determinaciones analíticas seriadas de tóxicos y nuevos estudios electroneurográficos-electromiográficos cada seis meses, con normalización de los valores alterados y restitución clínica ad integrum al año. Conclusiones: Este caso enfatiza la importancia de incluir la determinación toxicológica del cadmio ante la sospecha de una polineuropatía de origen tóxico-ocupacional, descartadas otras etiologías, para interrumpir precozmente dicha exposición laboral, al ser una causa potencialmente reversible de neuropatía periférica. Actualmente no existe un tratamiento farmacológico específico frente al cadmio demostrado en seres humanos.(AU)

Introduction: Cadmium is an important heavy metal in neurobiology, with potential neurotoxic effects, often in the form of polyneuropathy (PNP). Case report: We present an exceptional case of PNP due to cadmium of toxic-occupational origin, specifically a 47-year-old man, aeronautical mechanic, with a 5-year clinical picture, consisting of a tingling sensation having a ‘glove and stocking’ distribution of symptoms and bimanual manipulative clumsiness. The neurological examination revealed bilateral achilles hyporeflexia and protopathic-thermal-algesic exteroceptive hypoesthesia in hands and feet. The following complementary rests were requested: toxic-metabolic-infectious-vitamin profile, full craniospinal MRI, electroneurographic-electromyographic study (ENG-EMG) of the upper and lower limbs, PET-CT body and 24-hour video-electroencephalogram. The results were consistent with an axonal, distal, symmetric sensory-motor PNP, of moderate intensity, chronic evolution, with active denervation, of toxic-occupational origin due to cadmium. The patient continued on sick leave to cease exposure to cadmium, initiating intensive multimodal neurorehabilitation program, with serial analytical determinations of toxins and new ENG-EMG studies every 6 months. With normalization of the altered values ​​and complete clinical restitution at one-year follow-up. Conclusions: This case highlights the importance of including the toxicological determination of cadmium in case of suspicion of a PNP of toxic-occupational origin, once ruled out other etiologies, in order to early interrupt occupational exposure, as it is a potentially reversible cause of peripheral neuropathy. Currently there is no specific pharmacological treatment against cadmium tested in humans. Randomized clinical trials carried out in these patients are warranted to develop an anti-cadmium drug in refractory cases despite the end of exposure.(AU)

Un plaguicida en el franquismo: comunicación de riesgos tóxicos en España, 1945-1975 / A pesticide in Franco's regime: communicating toxic risks in Spain, 1945-1975

Resumen En este trabajo se analizan las representaciones de los riesgos tóxicos del hexaclorociclohexano, un ingrediente activo de plaguicidas de uso común en los campos españoles durante el franquismo. Se hace énfasis en las prácticas que visibilizaron e invisibilizaron dichos riesgos en España entre 1945 y 1975, buscando establecer los actores que las fomentaron y los medios que emplearon. Desde la perspectiva de la agnotología, se analizan los procesos de creación de ignorancia e incertidumbre relacionadas con este compuesto. Asimismo, se examinan las estrategias retóricas utilizadas para abordarlos. Para ello se utilizan tres fuentes primarias principales: la revista de agronomía dirigida a expertos Boletín de patología vegetal y entomología agrícola, la revista dirigida a agricultores Agricultura y el periódico ABC.

Abstract This work analyzes the representations of the toxic risks of hexachlorocyclohexane, an active ingredient of many pesticides commonly used in Spanish fields during Franco's regime. Emphasis is placed on the practices that visibilized and invisibilized these risks, seeking to establish the actors that promoted them and the mechanisms they used. From the perspective of agnotology, I analyze the generation of ignorance and uncertainty related to this compound. Likewise, I examine the most prevalent rhetorical strategies used in print sources. To do so, I consulted three main primary sources: Boletín de patología vegetal y entomología agrícola, an agronomy journal for experts; Agricultura, a magazine for farmers, and ABC, a newspaper.

Preliminary study to investigate the distribution and effects of certain metals after inhalation of welding fumes in mice.

The most important welding processes used are the gas metal arc (GMA) welding, the tungsten inert gas (TIG) welding, and the manual metal arc (MMA) welding processes. The goal of our investigation was to monitor the distribution of iron (Fe), manganese (Mn), calcium (Ca), and magnesium (Mg) in the lung, spleen, liver, and kidney of mice after inhalation exposure of different welding methods using different steel base materials. The treatment groups were the following: MMA-mild steel, MMA-molybdenum-manganese (MoMn) alloy, TIG-mild steel, and TIG-stainless steel. The samples were taken 24 and 96 h after the treatments. Most importantly, it was found that the Mn concentration in the lung' samples of the MMA-mild steel and the MMA-MoMn groups was increased extremely at both sampling times and in the spleen' samples also. In the TIG groups, the rise of the Mn concentration was only considerable in the lungs and spleens at 24 h, and emerged concentration was found in the liver in 96 h samples. Histopathology demonstrated emerged siderin content in the spleens of the treated animals and in siderin filled macrophages in the lungs mostly in all treated groups. Traces of high-level glycogen retention was found in the MMA groups at both sampling times. Similar glycogen retention in TIG-Ms and TIG stainless group's liver samples and emerged number of vacuoles, especially in the hepatocytes of the TIG-stainless steel 96 h group were also found. The mentioned results raise the consequence that there is a considerable difference in the kinetics of the Mn distribution between the MMA- and the TIG-fume-treated groups. Hence, the result suggests that manganese has a particle-size-dependent toxico-kinetics property. The anomaly of the glycogen metabolism indicates the systemic effect of the welding fumes. Also, the numerous vacuoles mentioned above show a possible liver-specific adverse effect of some components of the TIG-stainless steel welding fumes.

Descripcion Fisiopatológica de la Descamacion Cutanea por Toxinas Exfoliativas Estafilococicas, Nuevo Enfoque de Diagnostico Diferencial

Resumen El síndrome de piel escaldada estafilocócica, la escarlatina estafilocócica y el impétigo ampollar son patologías que tienen en común el mecanismo de lesión de la piel por toxinas exfoliativas producidas por estafilococos, su presentación y manifestaciones clínicas son difíciles de diferenciar de otras patologías sistémicas como la enfermedad de Kawasaki, el síndrome de Steven Johnson y diferentes farmacodermias. En los últimos años se ha podido explicar el mecanismo molecular de lesión cutánea, lo que ayudo de manera importante a interpretar y poder realizar un adecuado diagnóstico diferencial entre estas patologías. Los pediatras necesitan múltiples herramientas para llegar a un diagnóstico certero de las noxas que producen lesiones en piel y manifestaciones sistémicas. Una buena anamnesis y el conocimiento de un abanico de diagnósticos diferenciales son importantes para el tratamiento médico.

Abstract Staphylococcal scalded skin syndrome, staphylococcal scarlet fever and bullous impetigo are pathologies that have in common the mechanism of skin injury by exfoliative toxins produced by staphylococci, their presentation and clinical manifestations are difficult to differentiate from other systemic pathologies such as Kawasaki disease, the syndrome of Steven Johnson and drug induced skin diseases. In recent years, it has been possible to explain the molecular mechanism of skin injury, which has helped in an important way to interpret and be able to make an adequate differential diagnosis between these pathologies. Pediatricians need multiple tools to reach an accurate diagnosis of the disease that produce skin lesions and systemic manifestations. A good history and knowledge of a range of differential diagnoses are important for medical management.

Anilinas vs. organofosforados: la implicación de la empresa Bayer en las polémicas en torno al Síndrome del Aceite Tóxico / Anilines vs. organophosphates: the involvement of the Bayer company in the controversies surrounding the Toxic Oil Syndrome

La aparición de la intoxicación alimentaria en España en el año 1981, causante del Síndrome del Aceite Tóxico, unido a la imposibilidad de encontrar la toxina responsable de la enfermedad, potenció la posibilidad de señalar otros agentes causales, en particular un pesticida organofosforado de la casa Bayer, Nemacur. Se desarrolló así una línea alternativa a la decisión oficial, liderada por los médicos Antonio Muro y Luís Frontela, particularmente defendida, en España, por la empresa editorial Grupo 16. La polémica traspasó las fronteras españolas y se difundió a través de los medios de comunicación alemanes; los miembros del grupo político Los Verdes/Die Grünen tuvieron especial interés en servir de amplificador a estas suposiciones. La llegada de esta ola de acusaciones a Alemania, a principios de febrero de 1985, fue el detonante que alarmó a la empresa Bayer y le obligó a dar explicaciones para evitar poner en peligro la imagen corporativa de la multinacional química de Leverkusen. La documentación conservada en los archivos de la empresa alemana aporta nueva luz sobre esta polémica (AU)

Colitis ulcerosa en paciente con enfermedad celiaca silente

RESUMEN Se presenta caso de mujer con enfermedad celiaca que presentó colitis ulcerosa complicada con megacolon tóxico. El cuadro revirtió con inmunosupresores y tratamiento médico. Se sugiere a los médicos la búsqueda activa de enfermedades autoinmunes asociadas, además del diagnóstico precoz y tratamiento oportuno de la enfermedad celiaca para evitar complicaciones.

ABSTRACT We present case of a woman with celiac disease who presented ulcerative colitis complicated with toxic megacolon. The condition reversed with immunosuppressants and medical treatment. Physicians are advised to actively search for associated autoimmune diseases, as well as early diagnosis and timely treatment of celiac disease to avoid complications.

RESUMO Apresentamos o caso de uma mulher com doença celíaca que apresentou colite ulcerosa complicada com megacolo tóxico. A condição foi revertida com imunossupressores e tratamento médico. Os médicos são aconselhados a pesquisar ativamente as doenças autoimunes associadas, além do diagnóstico precoce e do tratamento oportuno da doença celíaca para evitar complicações.

El tratamiento paciente específico del hipertiroidismo con radioyodo: una oportunidad a la mejora / Radioiodine treatment of hyperthyroidism with patient-specific techniques: an improvement opportunity

Introducción: La aplicación de actividades fijas en el tratamiento del hipertiroidismo con I131 (yoduro de sodio, conocido también como radioyodo), es el método más usado en nuestro país, a pesar de la individualidad morfo-funcional que caracteriza esta afección. Sin embargo, no existe aún, un consenso internacional sobre la dosis más conveniente para cada caso, y por ende, los resultados no siempre son los deseados. Objetivo: Evaluar la aplicabilidad de varios métodos de cálculo de dosis paciente-específica para el tratamiento de hipertiroidismo con yoduro de sodio. Métodos: Se realizó un análisis de los resultados de varios métodos de cálculo de dosis recomendados internacionalmente a partir de la actividad fija prescrita en 10 pacientes, con el empleo de tecnologías y herramientas ya desarrolladas y disponibles en el país. Se evaluó la variabilidad inter-especialista y su impacto en la dosis planificada para el tratamiento. Resultados: El uso de la información incompleta de la biodistribución y farmacocinética del paciente produjo diferencias entre -42 por ciento y 37 por ciento de las dosis para el mismo paciente. El resultado de la comparación del método de cálculo recomendado por la Sociedad Europea de Medicina Nuclear, manejando la masa por gammagrafía-2D / 3D y por ultrasonido, arrojó diferencias no significativas entre sí. La variabilidad inter-especialista de las actividades prescrita mostró diferencias significativas, que arrojan sobre el mismo paciente, discrepancias entre 44Gy y 243Gy de las dosis terapéuticas a recibir, situación que puede comprometer el éxito del tratamiento y producir efectos secundarios no deseados. Conclusiones: Las técnicas dosimétricas paciente-específicas se pueden implementar satisfactoriamente en nuestro país. Las diferencias numéricas encontradas, especialmente la variabilidad inter-especialista, demuestran la no estandarización terapéutica, lo que apoya el uso de la farmacocinética paciente-específica pre terapéutica y la masa por gammagrafía-3D para planificar el tratamiento siempre que sean posible(AU)

Introduction: Despite of its typical morpho-functional individuality, fixed activities remain as the most used method in Cuba for hyperthyroidism treatment with I (sodium iodide, also known as radioiodine). However, there is not yet an international consensus on the most convenient doses for each case, so, the results are not always the desired ones. Objective: To evaluate the applicability of various patient-specific dose calculation methods for the treatment of hyperthyroidism with sodium iodide. Methods: It was carried out an analysis in 10 patients of the results of some methods for dose calculation from the prescribed fixed activity recommended internationally, with the use of technologies and tools already developed and available in the country. The inter-specialist variability and its impact in the planned dose for the treatment were assessed. Results: The use of uncompleted biodistribution and pharmacokinetics information of the patient showed differences between -42 percent and 37 percent in the doses for the same patient. The outcome of the comparison of the calculation method recommended by the European Society of Nuclear Medicine managing the mass by 3D/2D gammagraphy and ultrasound, presented no significant discrepancies among them. The inter-specialist variability of prescribed activity was statistically significant, and it can produce in the same patient differences between 44Gy and 243Gy of the therapeutic doses, which could affect the treatment success and lead to unnecessary side effects. Conclusions: The patient´s personalized calculation methods can be satisfactorily applied in Cuba. The numeric differences found, especially inter-specialist variability, show the lack of therapeutic standardization, which supports the use of pre-therapeutic patient-specific pharmacokinetics and the mass by 3D-gammagraphy to plan the treatment when possible(AU)

One and multi-compartments toxico-kinetic modeling to understand metals' organotropism and fate in Gammarus fossarum.

The use of freshwater invertebrates for biomonitoring has been increasing for several decades, but little is known about relations between external exposure concentration of metals and their biodistribution among different tissues. One and multi-compartments toxicokinetic (TK) models are powerful tools to formalize and predict how a contaminant is bioaccumulated. The aim of this study is to develop modeling approaches to improve knowledge on dynamic of accumulation and fate of Cd and Hg in gammarid's organs. Gammarids were exposed to dissolved metals (11.1 ± 1.2 µg.L-1 of Cd or 0.27 ± 0.13 µg.L-1 of Hg) before a depuration phase. At each sampling days, their organs (caeca, cephalon, intestine and remaining tissues) were separated by dissection before analyses. Results allowed us to determine that i) G.fossarum takes up Cd as efficiently as the mussel M.galloprovincialis, but eliminates it more rapidly, ii) organs which accumulate and depurate the most, in terms of concentrations, are caeca and intestine for both metals; iii) the one-compartment TK models is the most relevant for Hg, while the multi-compartments TK model allows a better fit to Cd data, demonstrating dynamic transfer of Cd among organs.

Plants and zootoxins: Toxico-epidemiological investigation in domestic animals.

An epidemiological study on animal poisoning due to plants and zootoxins has been carried out by the Poison Control Centre of Milan (CAV) in collaboration with the University of Milan (Italy). During the period January 2015-March 2019, the CAV received 932 calls on animal poisonings, 12.66% (n = 118) of which were related to plants and zootoxins. Among these, 95 enquiries (80.51%) concerned exposures to plants and 23 (19.49%) to zootoxins. The dog was the species most frequently involved (67.80% of the calls, n = 80), followed by the cat (26.27%, n = 31). As for the plants, several poisoning episodes were related to glycoside-, alkaloid-, oxalate- and diterpenoid-containing species. Cycas revoluta, Euphorbia pulcherrima and Hydrangea macrophylla were the most often reported plants. The outcome has been reported for half of the episodes (51.58%, n = 49) and it was fatal for 3 animals (6.12%). Regarding the zootoxins, the majority of the enquiries were related to asp viper (Vipera aspis), but exposures to pine processionary moth (Thaumetopoea pityocampa), common toad (Bufo), fire salamander (Salamandra), and jellyfish (phylum Cnidaria) were also reported. The outcome was known in 65.22% of the cases with just one fatal episode. This epidemiological investigation depicts an interesting overview on the issue of plant and zootoxin exposures in domestic animals, highlighting the relevance of these agents as causes of animal poisoning and providing useful information for prevention and diagnosis.

Physiological effects of the interaction between Nosema ceranae and sequential and overlapping exposure to glyphosate and difenoconazole in the honey bee Apis mellifera.

Pathogens and pollutants, such as pesticides, are potential stressors to all living organisms, including honey bees. Herbicides and fungicides are among the most prevalent pesticides in beehive matrices, and their interaction with Nosema ceranae is not well understood. In this study, the interactions between N. ceranae, the herbicide glyphosate and the fungicide difenoconazole were studied under combined sequential and overlapping exposure to the pesticides at a concentration of 0.1 µg/L in food. In the sequential exposure experiment, newly emerged bees were exposed to the herbicide from day 3 to day 13 after emerging and to the fungicide from day 13 to day 23. In the overlapping exposure experiment, bees were exposed to the herbicide from day 3 to day 13 and to the fungicide from day 7 to day 17. Infection by Nosema in early adult life stages (a few hours post emergence) greatly affected the survival of honey bees and elicited much higher mortality than was induced by pesticides either alone or in combination. Overlapping exposure to both pesticides induced higher mortality than was caused by sequential or individual exposure. Overlapping, but not sequential, exposure to pesticides synergistically increased the adverse effect of N. ceranae on honey bee longevity. The combination of Nosema and pesticides had a strong impact on physiological markers of the nervous system, detoxification, antioxidant defenses and social immunity of honey bees.