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1.
Rev Colomb Psiquiatr ; 2021 Oct 08.
Artículo en Español | MEDLINE | ID: mdl-34642505

RESUMEN

INTRODUCTION: The new COVID-19 disease is worldwide. During the pandemic, attacks on healthcare staff have increased. The objective of the study was to know the incidence of aggression towards nursing staff and to evaluate the main emotional and psychological symptoms experienced during the COVID-19 pandemic in Latin America. METHOD: A cross-sectional survey was applied to nursing staff of Spanish-speaking Latin American countries. Sociodemographic information was obtained concerning aggression, psychological symptoms, and emotional state. Descriptive statistics were applied in frequencies and percentages, means and standard deviation. RESULTS: 310 people from Mexico (65.2%), Argentina (5.8%), Colombia (5.2%), Honduras (5.2%), Costa Rica (4.5%) and other Latin American countries (14.1%) participated. 78.1% were women, with an average age of 35.2 years. 79.6% of the sample reported being attacked or discriminated against. The most common emotions were fear of getting sick (73.7%), sleep disturbances (33.4%), fear of infecting their relatives (33.4%). The mental health disorders reported were anxiety (29.2%), sadness (10.4%) and increased appetite (8.8%). The most frequent locations of aggression were the street and public transport. Our results suggest a high incidence of aggression against nursing staff during the pandemic; in any case, the staff present emotional and mental disturbances. It is necessary to develop safety and security policies for nursing staff and provide mental health care to staff who are on the first line of defence against COVID-19.

2.
J Ethnopharmacol ; 283: 114710, 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34626780

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: Snakebite envenoming is a public health problem of high impact in Central America. Bothrops asper, known as barba amarilla, terciopelo, and equis, is the snake species responsible for most snakebites in Central America. In this region, there is a long-standing tradition on the use of plants in the management of snakebites, especially in indigenous communities. Ethnomedical use of Eryngium foetidum L., Neurolaena lobata (L.) Cass. and Pimenta dioica (L.) Merr. to treat snakebite envenoming has been reported in Belice, Guatemala, Nicaragua, and Costa Rica. Extracts of the leaves of these plants have shown anti-venom activities in in vitro assays in previous studies. AIM OF THE STUDY: To assess the ability of organic fractions from these three plants to inhibit enzymatic activities associated with toxicity of the venom of B. asper, and to study, by docking analysis, the interaction of metalloproteinase and phospholipases A2 (PLA2) from B. asper venom with secondary metabolites previously described in these plants. MATERIALS AND METHODS: Organic fractions were obtained from these three plant species and their ability to neutralize proteolytic, PLA2 and in vitro coagulant activities of B. asper venom was assessed. A phytochemical analysis was carried out in these fractions. The interaction of secondary metabolites previously described in these plants with three toxins from B. asper venom (a metalloproteinase, a PLA2 and a PLA2 homologue) was investigated by docking analysis. RESULTS: The inhibitory activity of plants was mainly concentrated in their polar fractions. Acetonic fraction from P. dioica was the most active against PLA2 activity, while the acetonic fraction of E. foetidum completely inhibited the proteolytic activity of the venom. Coagulant activity was partially inhibited only by the acetone and ethyl acetate fractions of P. dioica. Phytochemical analysis of the most bioactive fractions identified flavonoids, saponins, essential oils, coumarins, alkaloids, tannins and sesquiterpene lactones. Docking analysis revealed high affinity interactions of several secondary metabolites of these plants with residues in the vicinity of the catalytic site of these enzymes and, in the case of PLA2 homologue myotoxin II, in the hydrophobic channel. CONCLUSIONS: Various fractions from these plants have inhibitory activity against enzymatic actions of B. asper venom which are directly associated with toxicological effects. Docking analysis showed structural evidence of the interaction of secondary metabolites with three toxins. These observations provide support to the potential of these plants to inhibit relevant toxic components of this snake venom.

3.
Biotechniques ; 2021 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-34636654

RESUMEN

The lack of knowledge about biological communities residing in soils, especially those in tropical regions, represents a constraint to management practices to take advantage of the ecological services provided by soil microbiota to agroecosystems. One of the complexities derived from describing biological diversity in such tropical conditions comes from the methods used to isolate microorganisms without altering the composition of the sample. The goal of this study was to establish a protocol for adequate soil sampling and environmental DNA extraction from a tropical region in Costa Rica. We present an up-to-date protocol optimized for tropical soils which improves sevenfold the amount of DNA extracted without significantly affecting the 260/280 and 260/230 ratios compared with commercially available kits and standard protocols.

4.
J Appl Clin Med Phys ; 2021 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-34623023

RESUMEN

Radiography remains the most widely used imaging modality throughout the world. Additionally, while it has been demonstrated that a quality control (QC) program, especially in mammography, improves image quality, weekly technologist QC testing might be lacking even where there is clinical qualified medical physicist (CQMP) support. Therefore, the International Atomic Energy Agency (IAEA) developed simple QC phantoms that can easily be used on a regular basis (daily/weekly) for radiography and mammography. These are simple in design and use materials that are easily accessible in most parts of the world. A software application is also developed that automatically analyzes images and Digital Imaging and Communications in Medicine (DICOM) header information. It exports data to a comma-separated values (CSV) file that is read by a Microsoft Excel® spreadsheet for documentation and graphical analysis. The phantom and the software were tested in four institutions (in Costa Rica and the United States of America) both on computed radiography and direct digital mammography and radiography systems. Data were collected over a 3-year period. No corrective actions were taken on the data, but service was performed on two of the units. Results demonstrated noise that could be attributed to suboptimal placement of the phantom and incorrect data being put into the DICOM header. Preliminary evaluation of the IAEA methodology has demonstrated that it can provide meaningful QC data that are sensitive to changes in the imaging systems. Care must be taken at implementation to properly train personnel and ensure that the image data, including the DICOM header, are being correctly transmitted. The methodology gives the opportunity for a single CQMP to provide QC services even to remote sites where travel is prohibitive, and it is feasible and easy to implement.

5.
Microbiol Resour Announc ; 10(41): e0055321, 2021 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-34647804

RESUMEN

We report the draft genome sequences of Leptolyngbya sp. strain 7M and Leptolyngbya sp. strain 15MV, isolated from Miravalles Thermal Spring, Costa Rica. The thermophilic cyanobacteria exhibit unique diversity features that provide insight into the adaptation and evolution of phototrophic microorganisms in geothermal habitats.

6.
Oecologia ; 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34613464

RESUMEN

Humans are transforming the ecology of the Earth through rapid changes in land use and climate. These changes can affect tropical forest structure, dynamics and diversity. While numerous studies have focused on diversity metrics, other aspects of forest function, such as long-term biomass dynamics, are often less considered. We evaluated plant community structure change (i.e., abundance, diversity, composition, and aboveground biomass) in a 2.25 ha forest dynamics plot located within a ~ 365 ha reserve in southern Costa Rica. We censused, mapped and identified to species all plants ≥ 5 cm diameter at breast height (DBH) in three surveys spanning 2010-2020. While there were no changes in late-successional species diversity, there were marked changes in overall species composition and biomass. Abundance of large (≥ 40 cm DBH) old-growth dense-wooded trees (e.g., Lauraceae, Rosaceae) decreased dramatically (27%), leading to major biomass decline over time, possibly driven by recent and recurrent drought events. Gaps created by large trees were colonized by early-successional species, but these recruits did not make up for the biomass lost. Finally, stem abundance increased by 20%, driven by increasing dominance of Hampea appendiculata. While results suggest this reserve may effectively conserve overall plant diversity, this may mask other key shifts such as large aboveground biomass loss. If this pattern is pervasive across tropical forest reserves, it could hamper efforts to preserve forest structure and ecosystem services (e.g., carbon storage). Monitoring programs could better assess carbon trends in reserves over time simply by tracking large tree dynamics.

7.
Artículo en Español | PAHO-IRIS | ID: phr-54951

RESUMEN

[RESUMEN]. Objetivo. Evaluar las diferencias de costos y prevalencia de las terapias de remplazo renal (TRR) como el trasplante, la diálisis peritoneal y la hemodiálisis en Argentina, Costa Rica y Uruguay, mediante estrategias costo-efectivas de difusión. Métodos. Costos y prevalencia de principales financiadores y prestadores por país, y análisis de costo- efectividad mediante modelo de Markov a 5 años, evaluando estrategias de asignación de recursos expresa-das por razón incremental de costo-efectividad en costo por año de vida ajustado por calidad. Resultados. Se observa dispersión entre los países en el acceso y los valores prestacionales de TRR, que afectan su prevalencia y el punto de equilibrio monetario. Desde el punto de vista de los costos, es más eficiente promover la realización de trasplantes y de diálisis peritoneal, y desalentar la indicación de hemodiálisis, aunque la disponibilidad de cada TRR por país requirió evaluaciones particulares. Conclusiones. Promover la realización de trasplantes ahorra costos, aunque los puntos de equilibrio variables requieren determinar diferentes umbrales de costo-efectividad por país. En Argentina y Uruguay, la administración de TRR mejoraría su eficiencia si se aumentan la cantidad de pacientes en diálisis peritoneal y las tasas de donación para trasplantes. En Costa Rica (donde hay tasas elevadas de trasplantes y margen presupuestario), la incorporación de técnicas dialíticas se ajusta por demanda e incidencia de pacientes con ERCT.


[ABSTRACT]. Objective. Evaluate differences in the cost and prevalence of renal replacement therapies (RRTs) such as transplants, peritoneal dialysis, and hemodialysis in Argentina, Costa Rica, and Uruguay, based on cost-effective dissemination strategies. Methods. Costs and prevalence obtained from the main financers and providers in each country; analysis of cost-effectiveness using a Markov model with a five-year horizon, evaluating resource allocation strategies for their incremental cost-effectiveness ratio expressed as quality-adjusted years of life. Results. There is observed dispersion among countries in terms of access to and beneficial value of RRTs, affecting their prevalence and monetary breakeven point. From the cost standpoint, it is more efficient to promote transplants and peritoneal dialysis, and to discourage hemodialysis, although the availability of each RRT in each country required a specific evaluation. Conclusions. Promoting transplants saves costs, but the variable breakeven points make it necessary to determine different cost-effectiveness thresholds for each country. In Argentina and Uruguay, RRTs would be more cost-effective with an increase in the number of patients in peritoneal dialysis and higher donation rates for transplants. In Costa Rica (where there is a high transplant rate and large budgetary margin), the use of dialysis is aligned with demand and with the incidence of patients with terminal chronic kidney disease.


[RESUMO]. Objetivo. Avaliar as diferenças de custos e prevalência das terapias de substituição renal (TSR) como o transplante, a diálise peritoneal e a hemodiálise na Argentina, na Costa Rica e no Uruguai, mediante estratégias de difusão custo-efetivas. Métodos. Foram avaliados custos e prevalência dos principais financiadores e prestadores por país, e realizada análise de custo-efetividade mediante modelo de Markov para 5 anos, avaliando estratégias de alocação de recursos expressas pela razão de custo-efetividade incremental por ano de vida ajustado por qualidade. Resultados. Foi observada, entre os países, dispersão no acesso e nos valores prestacionais de TSR, afetando sua prevalência e o ponto de equilíbrio monetário. Do ponto de vista dos custos, é mais eficiente promover a realização de transplantes e de diálise peritoneal e desestimular a indicação de hemodiálise, embora a disponibilidade de cada TSR por país tenha exigido avaliações específicas. Conclusões. Promover a realização de transplantes economiza custos, embora os pontos de equilíbrio variáveis requeiram a determinação de diferentes limiares de custo-efetividade por país. Na Argentina e no Uruguai, a administração de TSR melhoraria sua eficiência se a quantidade de pacientes em diálise peritoneal e as taxas de doação para transplantes aumentassem. Na Costa Rica (onde há taxas elevadas de transplantes e margem orçamentária), a incorporação de técnicas dialíticas é ajustada por demanda e incidência de pacientes com DRCT.


Asunto(s)
Fallo Renal Crónico , Factores Epidemiológicos , Trasplante de Riñón , Diálisis , Análisis Costo-Beneficio , Argentina , Costa Rica , Uruguay , Fallo Renal Crónico , Factores Epidemiológicos , Trasplante de Riñón , Diálisis , Análisis Costo-Beneficio , Fallo Renal Crónico , Factores Epidemiológicos , Trasplante de Riñón , Diálisis , Análisis Costo-Beneficio , Uruguay
8.
Primates ; 62(6): 1037-1043, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34626294

RESUMEN

On 5 February 2021, we observed the first instance of female-committed infanticide followed by cannibalism in a long-studied (> 35 years) population of wild white-faced capuchins (Cebus imitator) in the Santa Rosa Sector of the Área de Conservación Guanacaste, Costa Rica. The events leading up to and including the infanticide and cannibalism were observed and documented ad libitum, with segments digitally recorded, and a post-mortem necropsy performed. Here we detail our observations and evaluate the events within the framework of leading adaptive explanations. The infanticide may have been proximately motivated by resource competition or group instability. The circumstances of the observed infanticide provided support for the resource competition, adoption avoidance, and social status hypotheses of infanticide, but not for the exploitation hypothesis, as neither the perpetrator nor her kin consumed the deceased infant. The subsequent cannibalism was performed by juveniles who observed the infanticide and may have been stimulated by social facilitation and their prior experience of meat consumption as omnivores. To our knowledge, cannibalism has been documented only once before in C. imitator, in an adjacent study group, with the two cases sharing key similarities in the context of occurrence and manner of consumption. These observations add to our growing knowledge of the evolutionary significance of infanticide and its importance as a reproductive strategy in nonhuman primates.

9.
Artículo en Inglés | MEDLINE | ID: mdl-34501611

RESUMEN

Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May-August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.

10.
Phytopathology ; 2021 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-34495679

RESUMEN

Ditylenchus gallaeformans is a plant parasitic nematode that induces galls on aboveground parts of Melastomataceae plants. It differs from most gall-inducing nematodes in that it is not an endoparasite, and has been considered as a possible biological control agent against invasive species of Miconia . Little is known about D. gallaeformans biology, genetic differences among populations and host preferences. This study examined the genetic differences among D. gallaeformans populations from different locations and host species and the phylogenetic relationships among them. Nematodes were collected from galls in plants from Costa Rica, Dominica, and Trinidad. The Cytochrome c oxidase 1 (cox1) region was sequenced from a total of 33 individual nematodes isolated from 33 different plant individuals, representing 21 species of Melastomataceae. Phylogenetic reconstructions, haplotype networks, and analysis of molecular variance showed that the species is monophyletic and has three major clades, which were mostly consistent with geographic location but not with host species. The first clade was composed by two subclades, one with individuals from Costa Rica and one with individuals from Dominica. The second and third clades comprised nematodes only from Trinidad. Overall, there is no evidence of host-species specialization in D. gallaeformans . Biocontrol efforts using the nematode against invasive Miconia could focus on geographical location matching but likely will not need to match host species.

11.
Int J Life Cycle Assess ; : 1-16, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34522069

RESUMEN

Purpose: Several frameworks coincide in the importance of addressing social impacts to ensure sustainability. However, the agri-food sector, regarded as key in sustainable production, still neglects to identify potential social impacts when applying life cycle approaches. This work contributes to understanding the social performance of three agricultural products from a Latin American and Caribbean developing country as Costa Rica while recognising the challenges of Social-Life Cycle Assessment (S-LCA) application in this context. Methods: S-LCA represents a powerful technique to evaluate the potential social impacts of a product. Three case studies were analysed through S-LCA, using the subcategory assessment method (SAM) to characterise the social impacts and detect hotspots in the production of green coffee, raw milk and leafy vegetables. Primary data was collected through questionnaires to relevant informants and observations. In addition to secondary information, these data and information were used to assess eight impact subcategories for the farmer and worker stakeholder groups and nine subcategories for the local community. Results and discussion: The main results suggest that the Costa Rican institutional and market frameworks provide an enabling environment for a generally positive social performance in the studied cases. The assessed stakeholders can fulfil basic needs through access to inputs and services and achieve fair-trading conditions. Child labour, forced labour and evidence of environmental or health risks for the surrounding communities were absent. Important efforts to address the delocalisation, migration and child labour were observed, suggesting the potential development of social handprints in further studies. However, the farm production phase, related to farmers and workers, entails hotspots regarding social security and women's empowerment. Moreover, farmers appear as the most vulnerable group because of their overall social performance. Conclusions: S-LCA helped identify relevant areas of intervention in the context of these particular case studies; however, further research and capacity building are recommended to tackle the detected challenges, both in the agri-food chains and in the use of S-LCA. Furthermore, these findings can aid in future decision and policy-making to improve and safeguard the positive social performance observed in the studied products. Supplementary information: The online version contains supplementary material available at 10.1007/s11367-021-01964-4.

12.
Int. j. med. surg. sci. (Print) ; 8(3): 1-11, sept. 2021. graf
Artículo en Español | LILACS | ID: biblio-1292523

RESUMEN

El objetivo del presente manuscrito fue describir los incidentes clínicos que fueron enviados al sistema de reporte voluntario durante el año 2020, que funciona en el Hospital Nacional de Niños de Costa Rica, perteneciente a la Caja Costarricense de Seguro Social. Se realizó un estudio observacional descriptivo de los datos consolidados que se enviaron durante los meses de enero a diciembre del año 2020. Durante el año 2020 el 1,6% de los pacientes atendidos en el hospital experimentó algún tipo de incidente clínico. El total de egresos disminuyó un 38,4% en comparación con los egresos del año 2019, sin embargo, los incidentes clínicos reportados aumentaron en el año 2020 un 37,6%, especialmente a partir del mes de agosto. No se reportaron eventos centinela en este año. Los servicios que realizaron mayor cantidad de reportes fueron Cuidados Intensivos (14,3%), Cirugía General (12%), Neonatología (9,8%) e Infectología (9%). El día en el cual se reportaron más incidentes fue el miércoles (27,8%), en el primer turno hospitalario se reportaron la mayoría de los casos (48,1%) y estos incidentes ocurrieron predominantemente a individuos masculinos (66%). Respecto de la edad de los pacientes, la mayoría estuvo en el rango de edad de 1 año a menos de 5 años (36,1%), seguido por el rango de edad de mayores de 29 días a menores de 1 año (24,1%). La mayor parte de los casos estuvieron relacionados con el cuidado que se brindaba al paciente (63,9%). El 41,4% de los incidentes requirieron medidas clínicas pero las secuelas fueron transitorias. El 51,1% de los casos ameritó algún tipo de cuidado médico adicional a su esquema terapéutico al ingreso. El 96% de los incidentes clínicos fueron reportados por personal de enfermería. La mayoría de los incidentes clínicos (35,3 %) en este período fueron errores relacionados con notas en el expediente digital.


The objective of this manuscript was to describe the clinical incidents that were sent to the voluntary reporting system during 2020 at the National Children's Hospital of Costa Rica, belonging to the Costa Rican Social Security Fund.A descriptive observational study of the consolidated data that was sent during the months of January to December of the year 2020 was carried out.During 2020, 1.6% of the patients treated in the hospital experienced some type of clinical incident. The total discharges decreased by 38.4% compared to the discharges of the year 2019, however, the reported clinical incidents increased in the year 2020 by 37.6%, especially from the month of August. Sentinel events were not reported this year. The services that made the highest number of reports were Intensive Care (14.3%), General Surgery (12%), Neonatology (9.8%) and Infectiology (9%). The day on which the most incidents were reported was Wednesday (27.8%), in the first hospital shift most of the cases were reported (48.1%) and these incidents occurred predominantly to male individuals (66%). Regarding the age of the patients, the majority were in the age range from 1 year to less than 5 years (36.1%), followed by the age range from over 29 days to under 1 year (24, 1%). Most of the cases were related to the care provided to the patient (63.9%). 41.4% of the incidents required clinical measures but the sequelae were transitory. 51.1% of the cases merited some type of additional medical care to their therapeutic scheme upon admission. 96% of clinical incidents were reported by nursing staff. Most of the clinical incidents (35.3%) in this period were errors related to notes in the digital file.


Asunto(s)
Humanos , Errores Médicos , Seguridad del Paciente , Pediatría , Costa Rica , Estudio Observacional
13.
Parasit Vectors ; 14(1): 468, 2021 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-34521453

RESUMEN

Canine babesiosis is a disease caused by a parasite of the genus Babesia which destroys red blood cells. Previous studies have shown the presence of Babesia vogeli in rural areas in Costa Rica using molecular techniques. The objective of the present study was to determine the seroprevalence and prevalence of B. vogeli in clinically healthy dogs and their ticks at the national level, both within and outside the Central Valley. Blood samples and ticks from 482 dogs were collected between June 2011 and May 2014, and analyzed by immunofluorescence assay (IFA) and real-time polymerase chain reaction (qPCR); two protocols of endpoint PCR and sequencing were used to confirm qPCR-positive samples. Seroprevalence of canine babesiosis of 5.3% (24/453) was determined at the national level, specifically 2.0% (5/253) within and 9.5% (19/200) outside the Central Valley, respectively. Real-time PCR determined a global prevalence of B. vogeli of 31.3% (125/400): 21.4% (47/220) within the Central Valley and 43.3% (78/180) outside the Central Valley. The endpoint PCR amplified only 10 of the 125 blood samples identified as positive in qPCR. One sample amplified by endpoint PCR was sequenced and identified as B. vogeli. Twelve canines were identified with past infections, seven canines with active infection, and 111 canines with early infection. Two species of ticks were found with B. vogeli: Rhipicephalus sanguineus sensu lato (n = 40) and Amblyomma ovale (n = 1). The prevalence of canine babesiosis at the national level, both within and outside the Central Valley, is reported here for the first time, determining the presence of the piroplasmid throughout the country, with a higher circulation of the agent outside the Central Valley. Only one species, B. vogeli, was detected in the blood of dogs and their ticks. Therefore, veterinarians should consider using qPCR to determine the presence of the parasite in blood donors and before starting treatment of vector-borne disease in dogs.

14.
J Proteomics ; 249: 104379, 2021 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-34534714

RESUMEN

We report the first proteomics analyses of the venoms of two poorly studied snakes, the Manabi hognosed pitviper Porthidium arcosae endemic to the western coastal province of Manabí (Ecuador), and the Costa Rican hognosed pitviper P. volcanicum with distribution restricted to South Pacific Costa Rica and western Panamá. These venom proteomes share a conserved compositional pattern reported in four other congeneric species within the clade of South American Porthidium species, P. nasutum, P. lansbergii, P. ophryomegas, and P. porrasi. The paraspecific immunorecognition profile of antivenoms produced in Costa Rica (ICP polyvalent), Perú (Instituto Nacional de Salud) and Brazil (soro antibotrópico pentavalente, SAB, from Instituto Butantan) against the venom of P. arcosae was investigated through a third-generation antivenomics approach. The maximal venom-binding capacities of the investigated antivenoms were 97.1 mg, 21.8 mg, and 25.7 mg of P. arcosae venom proteins per gram of SAB, ICP, and INS-PERU antibody molecules, respectively, which translate into 28.4 mg, 13.1 mg, and 15.2 mg of total venom proteins bound per vial of SAB, ICP, and INS-PERU AV. The antivenomics results suggest that 21.8%, 7.8% and 6.1% of the SAB, ICP, and INS-PERU antibody molecules recognized P. arcosae venom toxins. The SAB antivenom neutralized P. arcosae venom's lethality in mice with an ED50 of 31.3 mgV/g SAB AV. This preclinical neutralization paraspecificity points to Brazilian SAB as a promising candidate for the treatment of envenomings by Ecuadorian P. arcosae. BIOLOGICAL SIGNIFICANCE: Assessing the preclinical efficacy profile of antivenoms against homologous and heterologous medically relevant snake venoms represents an important goal towards defining the biogeographic range of their clinical utility. This is particularly relevant in regions, such as Mesoamerica, where a small number of pharmaceutical companies produce antivenoms against the venoms of a small number of species of maximum medical relevance among the local rich herpetofauna, leaving a wide range of snakes of secondary medical relevance, but also causing life-threatening human envenomings without nominal clinical coverage. This work is part of a larger project aiming at mapping the immunological characteristics of antivenoms generated in Latin American countries towards venoms of such poorly studied snakes of the local and neighboring countries' herpetofauna. Here we report the proteomics characterization of the Manabi hognosed pitviper Porthidium arcosae endemic to the western coastal province of Manabí (Ecuador), and the Costa Rican hognosed pitviper P. volcanicum with distribution restricted to southwestern Costa Rica, the antivenomics assessment of three bothropoid commercial antivenoms produced in Costa Rica, Perú, and Brazil against the venom components of P. arcosae, and the in vivo capacity of the Brazilian soro antibotrópico pentavalente (SAB) from Instituto Butantan to neutralize the murine lethality of P. arcosae venom. The preclinical paraspecific ED50 of 31.3 mg of P. arcosae venom per gram of antivenom points to Brazilian SAB as a promising candidate for the treatment of envenomings by the Manabi hognosed pitviper P. arcosae.

15.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34465442

RESUMEN

BACKGROUND AND OBJECTIVE: Vestibular disorders are linked to a group of pathologies that can affect the vestibular part, the auditory part, or both parts of the inner ear. The problem in this study is the little information that exists about the audiological profile of people suffering from vestibular disorders in Costa Rica. There are international research studies on this topic, but there are no records of studies conducted in the Costa Rican population. This is why there is interest in developing this research which aims to characterize the audiological profile and the levels of handicap in people with vestibular disorders under Centro Equilibra, Vertigo and Equilibrio consultation during the months of September to November 2019. PATIENTS AND METHODS: A descriptive, cross-sectional, quantitative, and observational analytical study with patients over 18years old who attended Centro Equilibra. The main variables analysed were sex, age, personal pathological history, medical diagnosis, main vestibular symptoms, auditory manifestations, and levels of handicap. RESULTS: The data was obtained from 177 people; vestibular disorders occurred more in the female sex (ratio 2.6:1). The mean age was 56years. Fifty-three point seven percent presented slight sensorineural hearing loss, gradually decreasing. Of the population, 33.9% presented tinnitus, mostly at high frequencies. In the adult population, 52% presented some level of hearing handicap, unlike older adults, where the majority (77%) did not present any level of handicap. People with vestibular disorders perceive greater physical handicap (83%). CONCLUSIONS: Hearing loss was the most common hearing manifestation and although statistical analysis shows that it is not directly related to vestibular disorders, it is related to concomitant metabolic diseases. For this reason, it is necessary to promote the prevention of metabolic diseases as one of the measures to improve hearing health, even from an early age.

16.
Washington, D.C.; PAHO; 2021-09-16.
en Inglés | PAHO-IRIS | ID: phr-54847

RESUMEN

A debate on public goods is urgently needed in health care. Care must be recognized as a social function, as an occupation and, at the same time, as a human right—which imposes binding obligations to comply with precise standards of quality, quantity, suitability, adaptability, and accessibility, among others. It is a complex and invisible task, that may be done as part of a medical treatment, post-surgical recovery process, or permanent support in cases of chronic illness, disability, or mental health conditions. And it tends to be provided mainly in the home, by women, without remuneration. In Latin America, care has not been included in a coordinated and specific public health policy agenda but has been advanced through isolated actions—in many cases highly fragmented and heterogeneous—without a clear awareness of the public nature of care and the associated responsibility of the State. Accordingly, this document takes a gender and rights-based approach. It starts with an analysis of the main definitions of unpaid work in the health sector, and then focuses on initiatives in three Latin American countries (Colombia, Costa Rica, and Uruguay) with regard to measurement, valuation, integration, and recognition in national health systems or policies, in care models, and in time-use surveys. The conclusions propose recommendations aimed at addressing unpaid care as an essential element of social policies in general, and health policies in particular, from a gender and rights-based perspective.


Asunto(s)
Sistema de Costos en Instituciones de Salud , Acceso Universal a los Servicios de Salud , Américas
17.
Toxicon ; 202: 20-26, 2021 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-34562491

RESUMEN

Snake venoms are mixtures of proteins whose physicochemical features confer them toxicity and immunogenicity. Animals (e.g., horses or sheep) immunized with snake venoms produce antibodies towards the venom proteins. Since these antibodies can neutralize the venom toxicity, they have been used to formulate snake antivenoms. The efficacy of the antivenoms is widely accepted, and standard venoms are expected to be representative of the snake's population that inhabit in the region where the antivenom is intended to be used. The representativeness of a single venom collected from a Crotalus simus snake, and its usefulness as standard venom to produce an antivenom is evaluated. The use of an "average venom" might be as representative of the population intended to be used, as the standard venom composed by many venom samples. Variations in the relative abundance concentration of crotoxin in the C. simus leads to different clinical manifestations, as well as differences in the neutralization efficacy of the antivenoms. A monovalent anti-Cs antivenom was produced from a single venom C. simus specimen, and its efficacy in neutralizing the lethal activity of 30 C. simus snakes was tested. Despite the variations in the relative abundance content of crotoxin found in the proteomes, the monovalent anti-Cs antivenom was successful in neutralize the toxicity caused by the variations on the venom composition of three different snake population used. Interestingly, it seems that the sex is not a key factor in the lethality of the venoms tested. The concept of representative venom mixtures for immunization should be revised for the case of C. simus on the populations found in Costa Rica, since it might use as less as one representative individual whose venom covers the mainly toxic enzymes.


Asunto(s)
Venenos de Crotálidos , Crotoxina , Animales , Antivenenos , Costa Rica , Venenos de Crotálidos/toxicidad , Crotalus , Caballos , Ovinos
18.
Toxicon ; 202: 75-81, 2021 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-34562498

RESUMEN

Instituto Butantan (São Paulo, Brazil) and Instituto Clodomiro Picado (San José, Costa Rica) are public institutions devoted to scientific and technological research, production of antivenoms and other immunobiologicals, and a variety of public health interventions aimed at confronting the problem of snakebite envenoming in their countries and elsewhere. In the context of the 120th anniversary of Instituto Butantan, this work describes the historical developments in the relationship between these institutions, which has evolved into a solid cooperation platform in science, technology, and public health. The relationship between Instituto Butantan and Costa Rica started early in the 20th century, with the provision of Brazilian antivenoms to Costa Rica through the coordination of Instituto Butantan and the health system of Costa Rica, with the leadership of Clodomiro Picado Twight. After the decade of 1980, a prolific collaborative network has been established between Instituto Butantan and Instituto Clodomiro Picado (founded in 1970) in the areas of scientific and technological research in pharmacology, biochemistry, experimental pathology, immunology, and public health, as well as in antivenom development, production, preclinical evaluation, and quality control. In addition, both institutions have played a key role in the integration of regional efforts in Latin America to create a network of public institutions devoted to antivenom production and quality control, in close coordination with the Pan American Health Organization (PAHO). This long-standing partnership is an example of a highly productive south-south cooperation under a frame of solidarity and public well-being.


Asunto(s)
Salud Pública , Mordeduras de Serpientes , Antivenenos , Brasil , Humanos , Tecnología
19.
J Int Bioethique Ethique Sci ; Vol. 32(1): 61-74, 2021 May 24.
Artículo en Español | MEDLINE | ID: mdl-34378885

RESUMEN

The Artavia Murillo v. Costa Rica judgement wants to make the Convention say the opposite of what it clearly states: that one is a person from the moment of conception. Contrary to what the Inter-American Court maintains, conduct cannot be ethical if it is not based on criteria of justice, and the concept of justice is based on reality.In order to know how to treat something, it is first necessary to know what the thing – in reality – is. Then it is necessary to treat it as it is in reality: to treat each thing as it should be treated, according to its being.Human life cannot be treated like animal or vegetable life. Human life is superior. The capacity to will and to understand give it an exclusive nobility characterized by freedom. It must therefore be treated in accordance with its dignity.For treatment to be dignified, it must first prevent the destruction of its object (abortion). The principle of preservation applies. Once its reality, its being, has been preserved, its integrity must be respected. The violation of integrity is the removal of part of the being. Then we must respect its nature, which presupposes the idea of an end according to the operations that are proper to it. If we maintain that human life is an end in itself, it cannot be instrumentalized. This rule is universally accepted in the Western world from the ethical point of view, and it is the application of the golden rule of Kantian ethics: “treat the human being as an end in itself”; “treat others as I would like to be treated myself”.The concept of personhood is not fundamental to assigning special dignity to human life. It is its consequence. Personhood is an essential attribute of human life. It is the attribute that best corresponds to it. However, recent legal systems have not granted personal status to unborn life because they are old norms. They come from times when science was not able to prove its existence. Their evolution is hindered by scientific hesitations created by the dispute between different criteria. But this discussion does not make sense, it should not exist. If there is any doubt, whatever it may be, one must pronounce oneself in favour of life. This must be an essential principle of today’s bioethics – derived from the primum non nocere – and therefore, of the law based on it, and in particular that provided for in the Inter-American Convention.


Asunto(s)
Bioética , Personeidad , Costa Rica , Femenino , Humanos , Principios Morales , Embarazo , Estados Unidos
20.
PLoS One ; 16(8): e0254604, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34383779

RESUMEN

The major histocompatibility complex (MHC) is an important gene complex contributing to adaptive immunity. Studies of platyrrhine MHC have focused on identifying experimental models of immune system function in the equivalent Human Leukocyte Antigen (HLA). These genes have thus been explored primarily in captive platyrrhine individuals from research colonies. However, investigations of standing MHC variation and evolution in wild populations are essential to understanding its role in immunity, sociality and ecology. Capuchins are a promising model group exhibiting the greatest habitat diversity, widest diet breadth and arguably the most social complexity among platyrrhines, together likely resulting in varied immunological challenges. We use high-throughput sequencing to characterize polymorphism in four Class II DR and DQ exons for the first time in seven capuchin species. We find evidence for at least three copies for DQ genes and at least five for DRB, with possible additional unrecovered diversity. Our data also reveal common genotypes that are inherited across our most widely sampled population, Cebus imitator in Sector Santa Rosa, Costa Rica. Notably, phylogenetic analyses reveal that platyrrhine DQA sequences form a monophyletic group to the exclusion of all Catarrhini sequences examined. This result is inconsistent with the trans-species hypothesis for MHC evolution across infraorders in Primates and provides further evidence for the independent origin of current MHC genetic diversity in Platyrrhini. Identical allele sharing across cebid species, and more rarely genera, however, does underscore the complexity of MHC gene evolution and the need for more comprehensive assessments of allelic diversity and genome structure.

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