Institutional outbreaks of influenza-like illnesses in the state of São Paulo: an analysis of the epidemiological profile during the COVID-19 pandemic.

OBJECTIVES: This study aimed to spatiotemporally analyze the profile of influenza-like illness (ILI) outbreaks in the state of São Paulo, Brazil, between 2020 and 2022. STUDY DESIGN: This was a cross-sectional retrospective study. METHODS: Outbreaks of ILI with final diagnoses of COVID-19, influenza, or other respiratory viruses (ORVs) recorded between January 2020 and November 2022, obtained from the Notifiable Diseases Information System (SINAN NET) Outbreak module, were analyzed. Kernel density estimates and Getis-Ord Gi∗ statistics were performed to identify spatial clusters. RESULTS: A total of 13,314 ILI outbreaks were identified, involving 130,568 cases and 2649 deaths. Of these, 104,399 (80%) were confirmed as COVID-19, 15,861 (12%) were confirmed as ORV, and 10,308 (8%) were confirmed as influenza. The year 2021 had the highest number of outbreaks and cases. Schools recorded the most outbreaks and cases, followed by long-term care facilities for older adults (LTCs). The highest average number of cases per outbreak and the highest attack rates occurred at social gatherings and prisons. Prisoners were three times more likely to contract COVID-19 during outbreaks than people in other institutions. The highest hospitalization and mortality rates for all virus types occurred in the LTC group. The occurrence and intensity of outbreaks were highly heterogeneous among the different institutions after the introduction of new SARS-CoV-2 variants in the state. CONCLUSIONS: ILI outbreaks were not randomly distributed; they clustered in specific areas. Transmissibility varied among different institutions with different responses to the COVID-19 pandemic. These results can be used as a basis for prioritizing actions and allocating resources during future pandemics.

Dust events characterization from visibility, trends and Dust Adversity Index in the Canary Islands for the period 1980-2022.

Dust events in the Canary Islands have been documented since the late 19th century. However, during the past few years, several severe dust episodes have occurred in the Canary Islands, resulting in significant impacts on various sectors, such as aviation, air quality, and health, among others. These recent severe events have drawn the attention of both scientists and the general population, raising questions about whether these episodes are now more frequent and more severe. This study analyzes 483 dust events recorded in the Canary Islands over the last 40 years. Data analysis reveals that the average number of dust event days per year is approximately 24 days, and these events have an average duration of 1.8 days, both of which show a statistically significant decreasing trend over the series. Seasonal examination indicates that events occurring in the first and fourth quarters of the year have twice the duration of those in the other quarters. Furthermore, on an annual basis, events in the first quarter exhibit negative trends in both average and minimum visibilities. This suggests that dust events in the Canary Islands are becoming shorter in duration but more intense in terms of visibility. In this article, the Dust Adversity Index (DAI) is introduced to objectively compare the severity of events. Finally, anomalies in geopotential have been utilized to determine the prevailing synoptic patterns during dust events. It is evident that the dominant synoptic pattern during the first and fourth quarters of the year consists of a low cut-off system located to the west of the Canary Islands and a high-pressure system to the north of the Iberian Peninsula.

Structural elucidation of derivatives of polyfunctional metabolites after methyl chloroformate derivatization by high-resolution mass spectrometry gas chromatography. Application to microbiota metabolites.

Metabolomics has become an essential discipline in the study of microbiome, emerging gas chromatography coupled to mass spectrometry as the most mature, robust, and reproducible analytical technique. Silylation is the most widely used chemical derivatization strategy, although it has some limitations. In this regard, alkylation by alkyl chloroformate offers some advantages, such as a rapid reaction, milder conditions, better reproducibility, and the generation of more stable derivatives. However, commercial spectral libraries do not include many of the alkyl derivatives, mainly for polyfunctional metabolites, which can form multiple derivatives. That introduces a huge bias in untargeted metabolomics leading to common errors such as duplicates, unknowns, misidentifications, wrong assignations, and incomplete results from which non-reliable findings and conclusions will be retrieved. For this reason, the purpose of this study is to overcome these shortcomings and to expand the knowledge of metabolites in general and especially those closely related to the gut microbiota through the thorough study of the reactivity of the different functional groups in real matrix derivatized by methyl chloroformate, a common representative alkylation reagent. To this end, a systematic workflow has been developed based on exhaustive structural elucidation, along with computational simulation, and taking advantage of the high sensitivity and high-resolution gas chromatography-mass spectrometry. Several empirical rules have been established according to chemically different entities (free fatty acids, amino acids, polyols, sugars, amines, and polyfunctional groups, etc.) to predict the number of derivatives formed from a single metabolite, as well as their elution order and structure. In this work, some methyl chloroformate derivatives not previously reported as well as the mechanisms to explain them are given. Extremely important is the interconversion of E- and Z- geometric isomers of unsaturated dicarboxylic acids (case of fumaric-maleic and case of citraconic-mesaconic acids), or the formation of cycled derivatives for amino acids, as well as common metabolites, as in the case of serine and cysteine, and many others.

Covid-19 transmission, outcome and associated risk factors in cancer patients at the first month of the pandemic in a Spanish hospital in Madrid.

BACKGROUND: There are no large reported series determining the Covid-19 cancer patient's characteristics. We determine whether differences exist in cumulative incidence and mortality of Covid-19 infection between cancer patients and general population in Madrid. MATERIAL AND METHODS: We reviewed 1069 medical records of all cancer patients admitted at Oncology department between Feb 1 and April 7, 2020. We described Covid-19 cumulative incidence, treatment outcome, mortality, and associated risk factors. RESULTS: We detected 45/1069 Covid-19 diagnoses in cancer patients vs 42,450/6,662,000 in total population (p < 0.00001). Mortality rate: 19/45 cancer patients vs 5586/42,450 (p = 0.0001). Mortality was associated with older median age, adjusted by staging and histology (74 vs 63.5 years old, OR 1.06, p = 0.03). Patients who combined hydroxychloroquine and azithromycin presented 3/18 deaths, regardless of age, staging, histology, cancer treatment and comorbidities (OR 0.02, p = 0.03). CONCLUSION: Cancer patients are vulnerable to Covid-19 with an increase in complications. Combined hydroxychloroquine and azithromycin is presented as a good treatment option.

[Descriptive study of activity of the bone marrow donor registry and bank from the Murcia Region (southeast of Spain) (1994-2004)]. / Estudio descriptivo de actividad del banco y registro de donantes de médula ósea de la región de Murcia (sureste de España) (1994-2004).

OBJECTIVE: To perform a descriptive study of the activity of the Bank of marrow donors from Murcia Region. SUBJECTS AND METHODS: All donors in the Bank of bone marrow from 1994 until 2004 (n=3137). This study analysed the number of donors, their origin and, performed donor searches activity. Donors were typed by serological microlymphocytotoxicity and molecular PCR-SSO and PCR-SSP techniques. RESULTS: The Bank of bone marrow has 3,137 voluntary donors typed in low- and high-resolution. A total of 680 donor searches have been realized. The origin of the donors according to several Areas of Health in which the Autonomous Community of Murcia is divided, is the following one: Area I (28%), Area II (18 %), Area III (23 %), Area IV (6 %), Area VI (10 %) and other provinces (12%). CONCLUSIONS: An increase is observed in the number of annual donors as well as an increase very marked of donor searches that are realized every year, especially in 2004.

Manejo diagnóstico y terapéutico de un quiste de vallécula en un lactante

Resumen Los quistes laríngeos, y en particular los quistes de vallécula, son una entidad infrecuente en la práctica clínica habitual. Sin embargo, su localización y aparición en neonatos y lactantes, pueden suponer una causa reconocida de estridor y obstrucción de vía aérea superior que, si no es diagnosticada y tratada de forma precoz, puede tener consecuencias fatales. Presentamos el caso de un lactante que presenta estridor inspiratorio. Se realiza una nasofibrolaringoscopía observándose una formación quística en la vallécula, y una ecografía cervical que muestra dicha formación quística sugerente de un quiste del conducto tirogloso como primera posibilidad etiológica. Ante estos hallazgos, se solicitan pruebas tiroideas y una gammagrafía que son normales, por lo que se decide intervenir al paciente bajo laringoscopia en suspensión, realizando una marsupialización del quiste, sin complicaciones posteriores. El análisis histopatológico posterior confirmó el diagnóstico de un quiste de vallécula. Se debe considerar esta patología en los casos de estridor inspiratorio en lactantes ya que, aunque es infrecuente, su diagnóstico precoz y tratamiento adecuado son determinantes.

Abstract Laryngeal cysts, and especially vallecular cysts, are a rare entity in everyday clinical practice. Nevertheless, their location and the fact that they appear in newborns and infants, must be recognized as a cause of stridor and upper airway obstruction, since their misdiagnosis and late treatment can have fatal consequences. We present the case of an infant with inspiratory stridor. We performed a nasofibrolaryngoscopy where a vallecular cystic lesion was observed, and a neck ultrasound showed a cyst, described as a thyroglossal duct cyst, as the main etiology. Thyroid function tests and a gammagraphy, were both normal, hence the patient underwent a suspension microlaryngoscopy and marsupialization of the cyst, without further complications. The histopathology confirmed the diagnosis of a vallecular cyst. This entity must be considered in infants with inspiratory stridor. Although it is a rare lesion, its early diagnosis and adequate management is crucial.

Three-dimensional computed tomography-guided monotherapeutic pararectal brachytherapy of prostate cancer with seminal vesicle invasion.

PURPOSE: To treat patients with prostate cancer and seminal vesicle invasion with monotherapeutic three dimensional computed tomography (3-DCT)-guided posterior pararectal brachytherapy. METHODS AND MATERIALS: Three hundred and sixty two patients with clinical stage T1 a,b or T2 a,b of prostate cancer were referred for 3-DCT-guided brachytherapy. Each underwent ftirther staging with 3-D CT-guided pararectal biopsy of the seminal vesicles under local anesthesia during the pre-treatment CT-planning. Forty-three patients (12%) were upstaged to T3 cNoMo disease. In the set of 43 patients, Eight had Gleason's score< or =6, 24 Gleason's score=7, and 11 patients > or =8. Initial PSA was <10 ng/ml in 14 patients, 10-20 ng/ml in 11 patients, and >20 in 18 patients. Of the 43 patients, 37 patients were treated monotherapeutically with 3-D CT-guided brachytherapy. No patients received hormone therapy after the implant. The prescribed dosage to the seminal vesicles and prostate is 120 Gy with Pd-103 seeds and 144 Gy with 1-125 seeds. RESULTS: The prescribed dosage was achieved in all 37 patient's throughout the seminal vesicles whose range of target radiation extended 5-10 mm outside the target in the adjacent fat as calculated with post-implant CT-dosimetry with Varian Brachy Vision or MMS software. Prostate Specific Antigen (PSA) outcome data were available in 34 patients treated with monotherapy and follow up ranged from 12-56 months (median, 24 months). Decreased PSA levels were stratified into six groups based on the presenting Gleason's score and initial PSA. In the first group (with Gleason's score< or =6 and initial PSA <20 ng/ml), PSA levels decreased to less than 0.5 ng/ml in all seven patients (100%) after brachytherapy. In the second group (with Gleason's=7 and initial PSA<20 ng/ml), PSA levels decreased to less than 1 ng/ml in 11 of 13 patients (85%); additionally PSA levels decreased to less than 0.5 ng/ml in ten patients (77% in this group). In the third group (with Gleason's score=7 and initial PSA> 20 ng/ml), PSA decreased to less than 0.5 ng/ml in four out of eight patients (50%). All of the patients in the fourth group (with Gleason's score> or =8 and initial PSA<20 ng/ml) decreased their PSA levels to less than 0.5 ng/ml in three of three patients. PSA decreased less than 0.5 ng/ml in two out of three patients (67% in the last group with Gleason's score> or =8 and initial PSA> 20 ng/ml). There were no patients with Gleason's score of 1-6 and greater than 20 ng/ml initial PSA. Patients, irrespective of the Gleason's score and PSA, had an overall response of decreased PSA (less than 1 ng/ml) of 79%. CONCLUSION: 3-D CT-guided brachytherapy delivers adequate dosage to the seminal vesicles. Clinical and biochemical results are encouraging in patients with low initial PSA levels regardless of their Gleason's scores, but longer-term data in a greater number of patients is necessary.

Is Tourette syndrome a cause of sudden infant death syndrome and childhood obstructive sleep apnea?

The cause of sudden infant death syndrome (SIDS) is unknown. Sleep-related impairment of respiratory control and arousal are postulated; hyperdopaminergic and hyposerotonergic dysfunction may contribute to events leading to infant apnea and SIDS. Psychosocial adversity and impulsive and compulsive behaviors characterize some families of SIDS victims. Tourette syndrome (TS) is a common hereditary neurobehavioral disorder characterized by the frequent presence of impulsive and compulsive behaviors. Sleep disorders are common and include sleep apnea and abnormal arousal. Hyperdopaminergic and hyposerotonergic abnormalities are postulated to contribute to the pathophysiology of the disorder. The following is a report of the presence of incidents of infant apnea and SIDS in families in which TS was present. In an additional TS family, a child had obstructive sleep apnea syndrome (OSAS). Results of a preliminary survey suggest that TS gene carriers are at increased risk of life-threatening apneas of infancy and that the prevalence of SIDS in such families may be 2 to 5 times the prevalence in the general population. The presence in some pedigrees of sleep apnea in children and adults suggest that in some instances disorders of sleep-related ventilatory control and arousal occurring throughout the life-span share common pathophysiological mechanisms.

Renal vascular hypertension secondary to renal arterial aneurysm.

A case is reported of a ten-year-old boy with hypertension with a fusiform aneurysm and an intrarenal arterial malformation similar to a cirsoid aneurysm in the same kidney. Renal vein renin values were elevated. The cause, classification, pathologic anatomy, relationship between aneurysm and hypertension, and treatment are discussed. The patient was cured by nephrectomy.

[Risk factors for coronary heart disease in university students aged 17 to 19]. / Factores de riesgo de enfermedades de arteria coronaria en universitarios de 17 a 19 años de edad.

OBJECTIVE: To study the prevalence of risk factors for coronary heart disease (CHD) in university students between 17 an 19 years of age. METHODS: A sample of 289 first year students, 144 females and 145 males, of the University of Costa Rica were included for anthropometric, biochemical and physical studies. RESULTS: One in six (17% N = 48) had total cholesterol > 200 mg/dL and it was more frequent in females. High LDL-C > 130 mg/dL was found in 26% (N = 74) whereas low HDL-C was present in only 42% (N = 121). Nearly 10% (N = 28) smoked and 38% (N = 111) did not exercise. Obesity was seen in 7% (N = 20) when the Body Mass Index was used as a criterium but only 1.4% (N = 4) by body fat. The distribution of risk factors was: one factor in 36% (N = 105), two factors in 27% (N = 77) and three or more in 13% (N = 37). The most common were sedentarism, dislipedemias and smoking. CONCLUSIONS: CHD risk factors were present in many of our adolescents. Our finding suggests the need to promote healthier lifestyles to minimize the potential of these factors to cause CHD in adulthood.

[Obstetric and gynecologic anesthesia reported in the "Revista Española de Obstetricia y Ginecología" (1916-1936)]. / La anestesia en obstetricia y ginecología a través de la "Revista Española de Obstetricia y Ginecología" (1916-1936).

This study follows the evolution of anesthesia in gynecology and obstetrics in Spain between 1916 and 1936. Research included revising all articles and references concerning anesthesiology appearing in the Revista Española de Obstetricia y Ginecologia over the 20 years during which that journal was published. Eighty-three articles were found: 18 (21.6%) original research reports, 37 (44.6%) reviews of the Spanish professional literature and 28 (33.7%) summaries and descriptions of meetings of scientific organizations. Spanish references constituted 39.8% with the remaining 60.2% coming from European and Hispano-American sources. Twenty-four (34.9%) were related to spinal anesthesia, 15 (18%) covered various methods for analgesia during childbirth and 14 (16.8%) were on barbiturates. The remaining articles referred to rectally administered anesthesia, local anesthesia, inhalatory anesthesia and pain in gynecology. In conclusion, our review reveals the strong international contacts in Spanish gynecology during this period, as well as the interest of gynecologists and obstetricians in various anesthetic techniques and the rapid incorporation of new methods into their therapeutic arsenal.

[Diuretic effect of Cecropia obtusifolia (Moraceae) on albino rats]. / Actividad diurética de la Cecropia obtusifolia (Moraceae) en ratas albinas.

The possible diuretic effect of the leaf extract of Cecropia obtusifolia, Bertol; used in Costa Rican traditional medicine, was tested on five Sprague Dawley rats in individual metabolic cages. During the control week, distilled water was administered with an intragastric cannula. During the C.obtusifolia week, the rats were given the aqueous leaf extract in a daily dosage of 500 mg/kg, intragastricly. Although, the urinary flow was increased (p < 0.05) by a 20%, there was no statistically significant difference between the following parameters: excretion in urine of osmoles, sodium and potassium; daily ingestion of food and water. The animal weights decreased when C. obtusifolia was used, but only on the fourth day the decrease was significant (p < 0.05). In conclusion, the aqueous leaf extract of C. obtusifolia has a slight diuretic effect.

[Effects of acute and subacute administration of Pimenta dioica (Myrtaceae) extracts on normal and hypertensive albino rats]. / Efectos de la administración aguda y subaguda de extractos de Pimenta dioica (Myrtaceae) en ratas albinas normotensas e hipertensas.

The intraperitoneal administration of different extracts of Pimenta dioica (L.) Merrill (Myrtaceae) to conscious normotensive and hypertensive rats caused a depression of the central nervous system (CNS). The intensity of this depression depends on the dose. Analgesic and hypothermic effects were also observed. The total aqueous extract was more effective than the ethanolic extract and the final aqueous fraction was the most effective. The peritoneal irritation caused by the extract explains only partially the depressive effect over the CNS. When the final aqueous fraction was given orally to SDN and SHR rats during 14 days there was no observed change on the sistolic blood pressure, heart rate and weight of the animals.

Escombroidosis: causa frecuente de intoxicación alimentaria / Scombroid: frequent cause of food poisoning

No disponible

[Combined effect of intracerebroventricular injections of angiotensin II, met-enkephalin and acetylcholine on mean arterial pressure in albino rats]. / Efecto combinado de angiotensina II, met-encefalina y acetilcolina administradas intracerebroventricularmente sobre la presión arterial media en ratas albinas.

Single and combined effects of intracerebroventricular bolus injection of Ang. II (200 ng), ACh (6 micrograms) and met-enkephalin (50 micrograms) on mean arterial pressure (MAP), was tested in Sprague-Dawley albino rats. A metallic cannula was implanted in the third ventricle according to standard stereotaxic procedures under pentobarbital anesthesia (35 mg/kg). On the third day, the animal was anesthetized again, a carotid artery was cannulated and connected to a pressure transducer for recording of MAP. Ang. II increased MAP; ACh produced a significant increase in the initial 5 minutes after injection and met-enkephalin did not induce any significant changes in MAP. The combined effect showed interesting results. Instead of a potentiation of the rise in MAP, Ang. II and ACh, when given together, did not show any significant changes. Also, met-enkephalin blocked the hypertensive response due to Ang. II, if given combined. This is compatible with an inhibitory action of met-enkephalin on an angiotensinergic neuronal system. A simplified hypothetical model that explains the findings described above is proposed as a working hypothesis.

[The efficacy of Salmocumarín rodenticide in livestock-raising and urban sites]. / Efectividad del rodenticida Salmocumarín en objetivos pecuarios y urbano.

The activity in burrows at four different sites was calculated, and it went from 80 to 98% during pretreatment. For the first time in our country, average values of days/deaths of synanthropic rodents in natural conditions were obtained, and the reached values were between 16.50 and 19.06 after applying the biorodenticide. In the statistical analysis, a significant difference was found in the set of objectives related with days/deaths averages (H = 8.60*; p < 0.05). Moreover, no significant differences were found in percentages of residual activity in burrows (G = 8,27; p < 0.05). Results obtained show that Salmocumarín biorodenticide is much more effective in places where great populations of this species of cosmopolitan rodents exist.