Instrument-based screening for amblyopia risk factors in a primary care setting in children aged 18 to 30 months.

Amblyopia is the leading cause of vision impairment in children, and its early detection can avoid irreversible consequences for a child's visual ability. In this prospective study, to detect amblyopia risk factors, we examined patients aged 18 to 30 months in primary care settings. Patients were referred to an ophthalmologist for confirmation. The main aims were to detect amblyogenic risk factors and to assess the usefulness of a photoscreener in such settings. Out of 453 patients, 42 (9.3%) presented visual alterations according to the photoscreener, with astigmatism being the most common. The instrument had good sensitivity (89%) and specificity (91%), with a positive predictive value of 76% and a negative predictive value of 96%. Overall, 38% of the patients required follow-up, and 47% needed glasses. The automated screening device allowed these children to be diagnosed at an early stage.Conclusions: The use of a photoscreener to screen 2-year-old children in primary care settings was helpful and accurate. What is Known: • Early detection of amblyopic risk factors is important to avoid vision defects. However, it is very difficult to measure visual acuity using visual charts in children younger than 4 years old. What is New: • Instrument-based screening in children aged 18 to 30 months allows excellent detection of early amblyopia risk factors in primary care settings.

Production, Extraction, and Solubilization of Exopolysaccharides Using Submerged Cultures of Agaricomycetes.

Macrofungi, also known as mushrooms, can produce various bioactive compounds, including exopolysaccharides (EPS) with distinct biological properties and subsequent industrial applications in the preparation of cosmetics, pharmaceuticals, and food products. EPS are extracellular polymers with diverse chemical compositions and physical properties secreted by macrofungi in the form of capsules or biofilms into the cellular medium. Submerged cultivation is an industrially implemented biotechnological technique used to produce a wide variety of fungal metabolites, which are of economic and social importance due to their food, pharmaceutical, and agronomic applications. It is a favorable technique for cultivating fungi because it requires little space, minimal labor, and low production costs. Moreover, it allows for control over environmental variables and nutrient supply, essential for the growth of the fungus. Although this technique has been widely applied to yeasts, there is limited knowledge regarding optimal growth conditions for filamentous fungi. Filamentous fungi exhibit different behavior compared to yeast, primarily due to differences in cell morphology, reproductive forms, and the type of aggregates generated during submerged fermentation. Furthermore, various growing conditions can affect the production yield of metabolites, necessitating the development of new knowledge to scale up metabolite production from filamentous fungi. This protocol implements the following culture conditions: an inoculum of three agar discs with mycelium, agitation at 150 rpm, a temperature of 28 °C, an incubation time of 72 h, and a carbon source concentration of 40 g/L. These EPS are precipitated using polar solvents such as water, ethanol, and isopropanol and solubilized using water or alkaline solutions. This protocol details the production procedure of EPS using submerged culture; the conditions and culture medium used are described. A detailed description of the extraction is performed, from neutralization to lyophilization. The concentrations and conditions necessary for solubilization are also described. Key features • Production and extraction of EPS from submerged cultures of mycelial forms of macrofungi. • Modification of the method described by Fariña et al. (2001), extending its application to submerged cultures of mycelial forms of the macrofungi. • Determination of EPS production parameters in submerged cultures of mycelial forms of macrofungi. • EPS solubilization using NaOH (0.1 N). Graphical overview.

First evidence of the Hepatitis E virus in environmental waters in Colombia.

Hepatitis E virus (HEV) is one of the main causes of acute viral hepatitis of enteric transmission. HEV has been detected in environmental samples in several countries from Europe and Asia, constituting a risk factor for waterborne infection. In Colombia, HEV has been identified in samples obtained from patients as well as from swine, but no environmental studies have been carried out. To determine if HEV is present in environmental waters, samples from the main source of drinking water plant and of wastewater system of eight municipalities and two villages of Antioquia state (North West Colombia), were collected between December 2012 and April 2014. The HEV genome was detected by RT-PCR in 23.3% (7/30) of the samples from the main source of drinking water plants and in 16.7% (5/30) from sewage. Viral concentrates obtained from three positive sewage samples were used to inoculate HepG2 cell cultures that were followed for one month; however, the viral genome was not detected in any cell culture. This study demonstrates the circulation of HEV in both source of drinking water plants and wastewater in Antioquia state, Colombia. The presence of HEV in environmental waters could be a risk for waterborne transmission in this population. The findings of the present study, together with the evidence of HEV circulation in human and swine in Colombia, should be consider by public health authorities for the development of surveillance programs and the inclusion of HEV infection diagnosis in the guidelines of viral hepatitis in the country. This is the first report of HEV in environmental samples in Colombia and the second one in Latin America.

Evidence of the circulation of hepatitis A virus, subgenotype IA, in environmental samples from Antioquia, Colombia.

INTRODUCTION: Hepatitis A virus (HAV) is an important pathogen, typically transmitted via the faecal-oral route. The epidemiology of the infection is directly related to drinking water access and adequate disposal of sewage water.  OBJECTIVE: To determine the presence and identify the genotype of HAV in environmental samples from eight municipalities and two villages in Antioquia, northwestern Colombia.  MATERIALS AND METHODS: Three serial samplings were done between December, 2012, and April, 2014. Water samples were obtained from drinking water plants prior to treatment, as well as from the main reserve of wastewater in each municipality included in the study. Viral concentrations for the two types of sample sources were determined by filtration/tangential ultrafiltration and polyethyleneglycol plus flocculation with skimmed milk, respectively. Total ARN was subsequently obtained from each sample and the VP3-VP1 region amplified for detection of the viral genome. The genotype was determined by amplification of the VP1-2B region.  RESULTS: The HAV genome was detected in samples from drinking water plants at Puerto Berrío, Frontino and Nutibara, and in wastewater samples from the municipalities of Arboletes, Zaragoza and Venecia. HAV subgenotype IA was identified using phylogenetic analysis.  CONCLUSION: In this study, HAV was identified in 6.6% of the samples from drinking water plants and 13.3% of wastewater samples. This is the first report of HAV subgenotype IA circulating in environmental samples from Antioquia.

Consumo de tabaco, alcohol y marihuana según autodeclaración en mujeres que tuvieron su parto en el Centro Hospitalario Pereira Rosell (mayo 2013-abril 2014) / Smoking, alcohol and marijuana consumption in a self-report by women who delivered their babies at the Pereira Rossell Hospital Center (May 2013- April 2014)

Introducción: la prevalencia del consumo de drogas entre las mujeres que quedan embarazadas es probable que sea similar al de la población general, lo que puede resultar en una alta exposición fetal durante el primer trimestre, etapa más vulnerable con respecto al neurodesarrollo y organogénesis(¹).Objetivo: conocer la prevalencia de consumo de tabaco, alcohol, marihuana y derivados de cocaína durante el embarazo, según el autorreporte en mujeres que tuvieron su parto en el Centro Hospitalario Pereira Rossell.Material y método: se realizó un estudio descriptivo de tipo transversal, analítico, durante el período de un año. Los datos fueron recabados a partir de una encuesta protocolizada realizada a mujeres durante el puerperio inmediato y se recolectaron datos de la historia clínica.Resultados: se entrevistaron 319 mujeres. La mayoría eran mayores de 18 años (83,65%) con una media de 24,67 años; el embarazo no había sido planificado en 182 casos (57%). Declararon haber fumado tabaco alguna vez durante el embarazo 136 mujeres (42,63%), la mayor parte de las que abandonaron el hábito lo hicieron en el primer trimestre. Declararon consumo de alcohol en el embarazo 76 mujeres (23,82%), 5 (1,5%) reportaron consumo de marihuana durante el embarazo. Declararon consumir cocaína y pasta base de cocaína 3 (0,94%) y 3 (0,94%), respectivamente.Conclusiones: la sustancia que se consume con mayor frecuencia en el embarazo es el tabaco seguido en frecuencia por el alcohol. Un elevado porcentaje de embarazos no planificados puede determinar una mayor exposición a hábitos previos durante el primer trimestre de gestación, período de máxima vulnerabilidad para el desarrollo fetal.

Abstract Introduction: prevalence of drug use in women who get pregnant is likely to be similar to that of the general population, what may result in a high exposure of fetus during the first trimester, the most vulnerable stage with regards to neurodevelopment and organogenesis. Objective: to learn about the prevalence of smoking, alcohol, marijuana and cocaine derivatives during pregnancy, according to a self report by women who delivered their babies at the Pereira Rossell Hospital Center. Methods: we conducted a descriptive study,The data transversal and analytical during one year. The data were collected by means of a protocolized survey to women during the immediate puerperium and data was taken from the medical record. Results: 319 women were surveyed. Most women were older than 18 years old (83.65%) with an average of 24.67 years old; pregnancy had not been planned in 182 cases (57%). 136 women declared to have smoked during pregnancy (42.63%), most of those who quit the habit did it in the first trimester. 76 women declared to have drunk alcohol during pregnancy (23.825), 5 (1.5%) reported marijuana consumption during pregnancy. Three women declared they had consumed cocaine and 3 to have consumed coca paste (0.94 and 0.94 respectively). Conclusions: the substance that is more widely used during pregnancy is tobacco, followed by alcohol. A high percentage of unwanted pregnancies may determine a higher exposure to previous habit during the first trimester of pregnancy, when fetus are most vulnerable.

Resumo Introdução: a prevalência do consumo de drogas entre as mulheres que ficam grávidas provavelmente é similar ao da população em geral, o que pode causar uma alta exposição fetal durante o primer trimestre, etapa em que o feto é mais vulnerável com relação ao neurodesenvolvimento e a organogênese(¹). Objetivo: conhecer a prevalência do consumo de tabaco, álcool, maconha e derivados da cocaína durante a gravidez, de acordo com a auto declaração de mulheres cujos partos foram realizados no Centro Hospitalario Pereira Rossell. Material e método: foi realizado um estudo descritivo de tipo transversal, analítico, durante o período de um ano. Os dados foram coletados em entrevistas protocolizadas realizadas a mulheres durante o puerpério imediato e também foram coletados dados do prontuário das pacientes. Resultados: foram entrevistadas 319 mulheres. A maioria tinha mais de 18 anos (83,65%) com una media de 24,67 anos; a gravidez não havia sido planejada em 182 casos (57%). Declararam haver fumado tabaco alguma vez durante a gestação 136 mulheres (42,63%) sendo que a maior parte das que abandonaram o hábito o fez durante o primeiro trimestre. 76 mulheres (23,82%) declararam consumo de álcool durante a gravidez e 5 (1,5%) de maconha. 3 (0,94%) informaram consumir cocaína e 3 (0,94%) seus derivados (crack). Conclusões: a substância consumida com maior frequência durante a gravidez é o tabaco seguido pelo álcool. Uma porcentagem alta de gestações não planejadas pode determinar uma maior exposição a hábitos prévios durante o primeiro trimestre de gestação, período de máxima vulnerabilidade para o desenvolvimento fetal.

Evidencia de circulación del virus de la hepatitis A, subgenotipo IA, en muestras ambientales en Antioquia, Colombia / Evidence of the circulation of hepatitis A virus, subgenotype IA, in environmental samples from Antioquia, Colombia

Introducción. El virus de la hepatitis A (HAV) es un importante patógeno que se transmite por vía fecal-oral. La epidemiología de la infección está directamente relacionada con el acceso de la población al agua potable y con la infraestructura de alcantarillado. Objetivo. Determinar la presencia del HAV e identificar el genotipo en muestras de agua de abastecimiento y agua residual en ocho municipios, un corregimiento y una vereda del departamento de Antioquia, noroccidente de Colombia. Materiales y métodos. Se hicieron tres muestreos seriados de diciembre de 2012 a abril de 2014 en la fuente principal de abastecimiento de los acueductos y en el principal vertimiento de aguas residuales de cada municipio. Las muestras se concentraron por filtración y ultrafiltración tangencial, y por las técnicas de polietilenglicol y floculación con leche descremada, respectivamente. A partir del ARN total de cada muestra, se amplificaron la región VP3-VP1 para la detección del genoma viral y la región VP1-2B para la genotipificación. Resultados. El genoma del HAV se detectó en las fuentes de agua de abastecimiento de Puerto Berrío, Frontino y Nutibara, y en las muestras de aguas residuales provenientes de los municipios de Arboletes, Zaragoza y Venecia. Mediante el análisis de las secuencias se identificó el subgenotipo IA del virus. Conclusión. Este estudio permitió detectar la presencia del HAV en 6,6 % de las muestras de agua de abastecimiento y en 13,3 % de las muestras de agua residual de los municipios en estudio. Se reporta por primera vez la circulación del subgenotipo IA en muestras ambientales en Antioquia.

Introduction: Hepatitis A virus (HAV) is an important pathogen, typically transmitted via the faecal-oral route. The epidemiology of the infection is directly related to drinking water access and adequate disposal of sewage water. Objective: To determine the presence and identify the genotype of HAV in environmental samples from eight municipalities and two villages in Antioquia, northwestern Colombia. Materials and methods: Three serial samplings were done between December, 2012, and April, 2014. Water samples were obtained from drinking water plants prior to treatment, as well as from the main reserve of wastewater in each municipality included in the study. Viral concentrations for the two types of sample sources were determined by filtration/tangential ultrafiltration and polyethyleneglycol plus flocculation with skimmed milk, respectively. Total ARN was subsequently obtained from each sample and the VP3-VP1 region amplified for detection of the viral genome. The genotype was determined by amplification of the VP1-2B region. Results: The HAV genome was detected in samples from drinking water plants at Puerto Berrío, Frontino and Nutibara, and in wastewater samples from the municipalities of Arboletes, Zaragoza and Venecia. HAV subgenotype IA was identified using phylogenetic analysis. Conclusion: In this study, HAV was identified in 6.6% of the samples from drinking water plants and 13.3% of wastewater samples. This is the first report of HAV subgenotype IA circulating in environmental samples from Antioquia.

Características de la población expuesta a cocaína y pasta base de cocaína durante la gestación en el Centro Hospitalario Pereira Rossell / Characteristics of the population exposed to cocaine and cocaine base paste during gestation in the Centro Hospitalario Pereira Rossell

Introducción: para identificar el consumo de cocaína durante la gestación se utiliza frecuentemente el autorreporte; dado que esta conducta puede generar procesos judiciales y comprometer la tenencia de su hijo hay un porcentaje significativo de negación de consumo. El meconio del recién nacido puede identificar el consumo de sustancia desde la semana 20 de gestación.Objetivos: determinar la prevalencia del consumo de cocaína y pasta base de cocaína durante la gestación,describir sus características y evaluar el valor del autorreporte en referencia a la determinación en meconio.Metodología: se realizó un estudio observacional analítico de corte transversal en el Centro Hospitalario Pereira Rossell entre noviembre de 2010 y marzo del 2011. Se realizó una encuesta protocolizada sobre los hábitos de consumo y se obtuvo una muestra de meconio para su análisis por ELISA con una sensibilidad de 5 ng/g. Resultados: se obtuvieron 227 muestras de meconio,fueron positivos para el consumo de clorhidrato de cocaína y PBC con un corte de 5 ng/g el 9,25%. Se destaca que en las consumidoras de cocaína/PBC se observa una diferencia estadísticamente significativa(p=0,006) en la edad con una media de 28,04 años(DE=5,99) con respecto a la ausencia de consumo con una media de 24.66 (DE=5,42). Se observó una diferencia significativa en la población consumidora en la presencia de cuadros infecciosos(vulvovaginitis/sífilis) p=0,001. Los ingresos declarados en el núcleo familiar en la población consumidora de PBC estuvieron por debajo de la línea de pobreza. Se encontró una asociación importante entre el consumo de cocaína-PBC y marihuana. La especificidad de la autodeclaración fue muy alta pero la sensibilidad fue de 14,3...

Introduction: consumption of cocaine base pulp (PBC) in Uruguay was identified as a Public Health problem from the economic crisis that hit the country in 2002. To identify consumption of this substance in pregnant women in clinical practice is frequently used the self-report. Since the maternal cocaine consumption can generate law suits and may jeopardize the custody of the child there is a significant percentage of under reporting. Newborn`s meconium can identify cocain-PBC use from the 20th week of gestation. Objectives: determine the prevalence during pregnancy in a hospital population, describe their characteristics and assess the value of self-report in reference to the determination in meconium. Methodology: the methodology used in this ptoject was a observational analytic cross-sectional study of the population assisted in the Hospital Center Pereira Rossell between November 2010 and March 2011. A protocolized survey about consumption habits was conducted after an informed agreeing consent and a meconium sample obtained for analysis. By ELISA screening of NEOGEN brand the presence of cocaine and its metabolites in meconium was determined with a sensitivity of 5 ng/gy 20 ng/g.Results: 227 Meconium valid samples were obtained for analysis. 9,5% were positive for the consumption of cocaine hydrochloride and PBC with a cutoff of 5 ng/g. It is emphasized that in cocaine users / PBC a statistically significant difference (p = 0,006) was observed in the average age 28,04 years (SD = 5,99) compared to the absence of consumption with an average of 24,66 (SD 5,42). Pregnant women consumers Cocaine / PBC during pregnancy are over 19 years. A significant difference was observed in the consumer population regarding to the presence of infectious types (vulvovaginitis / syphilis) p = 0,001. Reported income in the household in the PBC consuming population was below the poverty line. Also was found a significant association between cocaine consumes and ...