Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. / Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

An LC-MS based study of the metabolic profile of primaquine, an 8-aminoquinoline antiparasitic drug, with an in vitro primary human hepatocyte culture model.

The 8-aminoquinoline drug primaquine (PQ) is currently the only drug in use against the persistent malaria caused by the hypnozoite-forming strains P. vivax and P. ovale. However, despite decades of research, its complete metabolic profile is still poorly understood. In the present study, the metabolism of PQ was evaluated by incubating the drug with pooled human hepatocytes cultured in vitro as well as with recombinant cytochrome P450 (CYP) iso- enzymes, monoamine oxidases (MAO), and flavin-containing monooxygenases (FMO). Targeted LC-MS/MS analysis of hepatocyte incubations using chemical inhibitors indicated that PQ was predominantly metabolized by CYPs 3A4, 1A2 and 2D6, MAO-A, -B and FMO-3. Confirmation of these results was sought by incubation of PQ with the corresponding recombinant enzymes. Small amounts of carboxyprimaquine (CPQ), the major observed PQ metabolite in vivo, were detected in recombinant MAO-A incubations along with another peak at m/z 261, and no significant formation of CPQ with any other recombinant enzymes was observed. Incubations with all recombinant enzymes identified as potentially active towards PQ from the hepatocyte-based assay resulted in significant parent loss over the course of 1 h. These results suggest that several enzymes, including CYPs in combination with FMOs and MAOs, play a role in the overall metabolism of PQ and indicate a major role for MAO-A. Future studies to elucidate the potential role in cytotoxicity and/or efficacy of the PQ metabolite observed at m/z 261, as observed in MAO-A isoenzyme studies, are needed.

The evolution of entomopathogeny in nematodes.

Understanding how parasites evolved is crucial to understand the host and parasite interaction. The evolution of entomopathogenesis in rhabditid nematodes has traditionally been thought to have occurred twice within the phylum Nematoda: in Steinernematidae and Heterorhabditidae families, which are associated with the entomopathogenic bacteria Xenorhabdus and Photorhabdus, respectively. However, nematodes from other families that are associated with entomopathogenic bacteria have not been considered to meet the criteria for "entomopathogenic nematodes." The evolution of parasitism in nematodes suggests that ecological and evolutionary properties shared by families in the order Rhabditida favor the convergent evolution of the entomopathogenic trait in lineages with diverse lifestyles, such as saprotrophs, phoretic, and necromenic nematodes. For this reason, this paper proposes expanding the term "entomopathogenic nematode" considering the diverse modes of this attribute within Rhabditida. Despite studies are required to test the authenticity of the entomopathogenic trait in the reported species, they are valuable links that represent the early stages of specialized lineages to entomopathogenic lifestyle. An ecological and evolutionary exploration of these nematodes has the potential to deepen our comprehension of the evolution of entomopathogenesis as a convergent trait spanning across the Nematoda.

Sodium caseinate induces mouse granulopoiesis.

OBJECTIVE AND DESIGN: Sodium caseinate (CasNa) induces differentiation and M-CSF production in mouse band granulocytes in vitro; however, it is not yet known if this molecule can also induce the proliferation and activation of the granulocyte lineage in vivo. In this work we evaluated the induction in vivo of granulopoiesis and the activation of granulocytes in mice treated with CasNa. MATERIAL OR SUBJECTS: BALB/c male mice 8-12 weeks old were used. TREATMENT: The animals were inoculated intraperitoneally with 1 ml of CasNa (10% in PBS p/v) four times (every 48 h). METHODS: Granulocyte proliferation was evaluated by flow cytometry; activation was evaluated by phagocytic indices. The cytokine was measured using an ELISA assay. RESULTS: We show that CasNa increased bone marrow granulopoiesis percentage (38.35 ± 10.88 vs. 64.94 ± 34.14 BrdU+/Gr-1+ cells) and the granulocytes generated presented increased phagocytic indices (0.3 ± 0.1 vs. 0.6 ± 0.11, p < 0.05). We also show that G-CSF (974 ± 411 vs. 3189 ± 350 pg/ml, p < 0.05) and GM-CSF increased in serum, but only G-CSF in bone marrow plasma. CONCLUSIONS: CasNa induces granulopoiesis with functional granulocytes, suggesting that this molecule could be an innate immune system activator.

Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIALS AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n = 20419) was higher than among Spaniards (n = 131599): 8.81 and 6.51 and per 1000 inhabitants, respectively (p <  .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found in people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p =  .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p <  .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p <  .001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

[Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain]. / Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n = 20,419) was higher than among Spaniards (n = 131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p < .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p = .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p < .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p < .001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

Evaluation of two scopolamine and physostigmine pretreatment regimens against nerve agent poisoning in the dog.

Currently, there is no viable protection against chemical warfare agents for the working dog. Physostigmine (PHY) and scopolamine (SCO) have been shown to protect dogs against nerve agents with minimal side effects. The goal of this study was to investigate whether reported protective SCO/PHY plasma concentrations of 0.2 and 0.7 ng/mL, respectively, could be reached and maintained with minimal side-effects thereby identifying possible pretreatment regimens. Two continuous regimens of SCO/PHY were administered to beagle dogs. The first regimen consisted of administering transdermal SCO and intraocular PHY, the second consisted of transdermal SCO and rectal PHY. SCO/PHY plasma concentrations for each regimen were determined, individual protective times were calculated and a computerized pharmacokinetic analysis was performed. The results showed transdermal SCO and intraocular PHY routes of delivery achieved sustained protective drug concentrations with minimal side-effects and the rectal route of delivery did not. Group median protective times for the first regimen were 54.45 h for SCO and 64.35 h for PHY, and for the second regimen 63.75 h for SCO and 0 h for PHY. The combined transdermal patch and intraocular regimen may provide a safe and effective regimen against nerve agent poisoning in dogs.

Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad / Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain

Introducción y objetivo Existen pocos estudios sobre el potencial papel de los orígenes raciales/étnicos en el riesgo de infección de COVID-19, particularmente en Europa. Evaluamos el riesgo de COVID-19 entre los migrantes de diferentes zonas del mundo en un contexto de acceso universal gratuito a la atención médica. Material y métodos Realizamos un análisis de cohortes poblacional de la incidencia acumulada de COVID-19 confirmada mediante PCR entre los residentes adultos en Alcorcón (España) en la primera oleada de la enfermedad hasta el 25 de abril de 2020. Resultados La incidencia acumulada bruta entre los migrantes (n=20.419) fue mayor que entre los españoles (n=131.599): 8,81 y 6,51 por cada 1.000 habitantes, respectivamente (p<0,001), pero difería según la región de origen mundial. Mediante regresión binomial negativa, ajustada por edad y sexo, los riesgos relativos (RR) para COVID-19 no fueron significativamente diferentes de los españoles para los individuos provenientes de Europa, Asia o el norte de África. Por el contrario, hubo un marcado aumento del riesgo para los del África subsahariana (RR 3,66, intervalo de confianza del 95% [IC] 1,42-9,41, p=0,007), el Caribe (RR 6,35, IC 95% 3,83-10,55, p<0,001) y América Latina (RR 6,92, IC 95% 4,49-10,67, p<0,001). Conclusiones Los migrantes procedentes del África subsahariana, el Caribe y América Latina, a diferencia de los españoles o migrantes procedentes de Europa, el norte de África o Asia, presentaron un mayor riesgo de COVID-19. Nuestros datos sugieren un papel para el origen étnico en el riesgo de COVID-19. Los migrantes de algunas zonas del mundo pueden merecer una atención más cercana tanto por razones clínicas como epidemiológicas (AU)

Introduction and objectives Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. Material and methods We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. Results The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). Conclusions Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons (AU)

Determination of the antimalarial arteether and its deethylated metabolite dihydroartemisinin in plasma by high-performance liquid chromatography with reductive electrochemical detection.

A rapid, sensitive, and specific reversed-phase HPLC method using reductive electrochemical detection has been developed for the determination of arteether and its O-dealkylated metabolite dihydroartemisinin (DQHS) in plasma. The internal standard assay was validated between 25 and 1000 ng/mL, with a coefficient of variation of greater than 10% for both intra- and interday accuracy and precision. An assay for determination of arteether only, using the n-propyl ether of DQHS as internal standard, was also developed and validated from 5-500 ng/mL. A new automated sample deoxygenation and injection system is used to greatly increase sample throughput. These methods have been used to study the pharmacokinetics of arteether after intravenous and intramuscular administration.

[Explanatory models on the utilization of health services: a review and analysis]. / Modelos explicativos sobre la utilización de servicios de salud: revisión y análisis.

The present article begins with a conceptual review of the models which have been developed for the analysis of health services utilization. The models are: epidemiological, psychosocial, sociological and economic. The stages and/or determining factors in the procedure of health services use, are described and a cross study is made with each model by means of a contingency matrix. The starting point for the search of a model that enables (in a complete and unisolated way) the identification of the determinant factors in health service use is the cross analysis of the models under investigation. This cross analysis is also taken as a conceptual framework of reference in the unfolding investigation.

Study of a patient referral system in the Republic of Honduras.

The first nationwide study on a patient referral system was conducted in Honduras. It covered all 25 public hospitals (six National, five Regional and 14 Area Hospitals) and 24 major health centres. Based on 46,739 reviews of patient records, 226 'received referral' and 1072 'sent referral' cases were analyzed by age and sex of the patient, diagnosis on referral, institution from or to which the case was referred, use of proper referral form, and reception of reply for referrals. At the same time, the study team supervised the function of the registry and management of patient records at each institution. The average referral rate by the level of health facility was 15.8% at National, 4.0% at Regional, 2.8% at Area Hospitals, and 0.8% at health centres. The referral rate was observed to be higher when institutional managers emphasized the importance of the referral system. Only 1.4% of referrals received a reply from upper level institutions. The most common cases for referral were neurological at National, obstetric at Regional and respiratory cases at Area Hospitals. The use rate of the standard referral form was 70 to 80% at hospitals and 60% at health centres. There was no norm to duplicate referral letters for record keeping. The patient referral system has not developed satisfactorily in Honduras. The main problems were: 1) low referral rate at all levels of institution, 2) evident by-pass phenomenon at intermediate hospitals, 3) inadequate health information system for patient referral, and 4) misunderstanding of the terminology of referral by health personnel. The following recommendations were made: guarantee of essential health services at peripheral institutions, development of an effective information system for patient referral, facilitation of frequent reply for referrals, elaboration of referral case discussion between institutions, patient education on proper use of health facilities, and restructuring the health service network in the two major cities.

Analysis of the antimalarial, mefloquine, in blood and plasma using high-performance liquid chromatography.

An analytical method is described for the quantitation of mefloquine, a new antimalarial agent, in plasma and blood. A structurally similar quinolinemethanol compound, WR 184,806, is used as the internal standard. The method employs a three-step extraction procedure followed by reversed-phase high-performance liquid chromatography, and octanesulfonate is used as an ion-pairing reagent. Detection is achieved at 222 nm. The entire procedure is relatively simple and requires only 1 ml of sample. Good accuracy and precision are obtained over the wide concentration range tested.

Estudio de nueve casos de "Blastomicosis Sudamericana" Hospital Nacional Guillermo Almenara Irigoyen / Study of nine cases of \"Sudamerican blastomycosis\" at Hospital Guillermo Almenara Yrigoyen

Durante los años 1973 y 1985, se estudiaron nueve pacientes con diagnóstico presuntivo de Blastomicosis Sudamericana. Se realizó el presente estudio con la finalidad de llegar al diagnóstico etiológico. Se efectuó las investigaciones tomando muestras por raspado de las lesiones y el esputo. Se utilizó las coloraciones de Gram y Wrigh y se hizo inoculaciones en el testículo de cobayo. Encontramos el PARACOCCIDIOIDES BRASILIENSIS en los nueve casos; tres de ellos presentaron lesiones labio-pulmón; tres en pulmón; dos en labio; y uno en brazo. En los nueve casos se confirmó el diagnóstico etiológico.

Evaluación de la red de servicios del primer nivel de atención del SILAIS Carazo: I Semestre 2006 / Network assessment services first level of care SILAIS Carazo: I Semester 2006

Concluye que existe una red de servicios desorganizada, carente de criterios técnicos en su crecimiento, con inequidad en la distribución de recursos humanos, que se realiza sin tomar en cuenta asignación de población, ni accesibilidad geográfica. Son notorias las limitaciones en el sistema de información que inician desde el llenado de los formatos, registro de actividades, hasta el resguardo de la información. Existe desconocimiento y pocas habilidades en los procesos administrativos por los tomadores de decisiones, que ocasiona limitaciones en la agilidad de la ejecución de fondos. Las recomendaciones fueron dirigidas a los tres niveles de resolución: nivel municipal, SILAIS y nivel Central, en aspectos normativos, de evaluación y capacitación