Detection of organochlorine pesticides in infertile eggs of crocodylus acutus from sinaloa.

Environmental contaminants endanger human health and non-target organisms such as crocodiles (Crocodylus acutus) that live in aquatic bodies surrounding agricultural areas. Due to their intrinsic characteristics, these organisms could be bioaccumulating and transmitting organochlorine pesticides (OCs) to their eggs. The objectives of this study were to determine the OCs in infertile eggs of C. acutus from Sinaloa and their correlation with the morphometric characteristics (MC), and to perform a preliminary estimate of the ecological risk due to the presence of pesticides using the PERPEST model. In June 2022, 76 infertile eggs (Ie) were collected: 57 from wild areas (Wa) and 19 from a crocodile farm (CSMf). Determination of OC in Ie was performed according to the USEPA method 8081b, modified. The observed percentages of Ie in Wa were 31.48% and 21.33% in CSMf. Twenty OCs were detected in the Ie, where dieldrin recorded the highest average concentration in Wa (6542.6 ng/g), and endosulfan-II in the CSMf (2172.8 ng/g). Bad negative and positive correlations were observed between OCs and MC, standing out the correlations between endosulfan-II and %Ie (-0.688) in the Wa, Cedritos drain, and between endrin and the weight of Ie (0.786) of the CSMf. The evaluation of the ecological risks of the aquatic environment due to the presence of OCs follow the sequence cyclodienes > aromatic > alicyclic hydrocarbons. A potential risk to the endocrine health of the species C. acutus was observed. Crocodiles are excellent biological models for monitoring the effects of OCs.

[Prevalence and factors associated with subjective cognitive complaints in Latin American health workers during the COVID-19 pandemic]. / Prevalencia y factores asociados con las quejas cognitivas subjetivas del personal sanitario latinoamericano durante la pandemia de COVID-19.

Background and objectives: An increase in emotional disturbances and complaints about cognitive performance has been observed in Latin American healthcare workers during the SARS-CoV-2 pandemic, which can affect attention capacity and increase the levels of stress and burnout of these professionals. The objective was to analyse subjective cognitive complaints (SCC) and associated factors in health personnel during the COVID-19 pandemic in five Latin American countries.Methods: Multicentre cross-sectional study, which included 3,738 professionals from Colombia, Chile, Argentina, Ecuador, Bolivia, and Peru. The Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Mini-Z to assess Burnout. For the SCC, an item on cognitive concerns in attention and memory was used.Results: The prevalence of cognitive complaints was 69.2%. The factors associated with a higher risk of SCC were the scores in the GAD-7, PHQ and Mini-Z, in addition to being part of the Ecuadorian health personnel.Conclusions: There is a high prevalence of SCC in health personnel, which is modulated by emotional states and stress.

Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection.

BACKGROUND: Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion in the medial longitudinal fasciculus (MLF) located in the midbrain. Adduction paralysis of both eyes and bilateral abduction nystagmus are the main features of INO[1]. CASE PRESENTATION: A 29-year-old Hispanic woman was admitted to the emergency department complaining of an intense holocranial headache lasting 9 days, associated with nausea and vomiting. She was discharged home with resolution of the headache but persistence of symptoms. However, she subsequently developed horizontal diplopia and gait abnormalities. She was readmitted to hospital because of anomalous eye movements and conjugate gaze palsy, manifested as bilateral INO. Magnetic resonance angiography (MRA) findings were consistent with dissection of the left V4 vertebral artery with multiple brain infarcts in the superior cerebellar artery territory, comprising both MLF tracts. CONCLUSIONS: In young adults, bilateral INO is normally caused by demyelinating disease. In other patients, common causes include trauma, infections and autoimmune diseases with neurological symptoms. Vascular disease is implicated in over a third of cases. LEARNING POINTS: A vascular aetiology should be suspected when internuclear ophthalmoplegia (INO) presents with an intense headache.Almost a third of patients with bilateral INO have an identified vascular cause.Magnetic resonance imaging is the gold standard for investigating INO.

Impact of a national specialty e-consultation implementation project on access.

OBJECTIVES: To assess the early impact of implementation of the electronic consults (e-consults) initiative by the Veterans Health Administration (VHA), designed to improve specialty care access. STUDY DESIGN: Observational cohort study exploiting a natural experiment begun in May 2011 at 12 VHA medical centers and expanded to 122 medical centers by December 2013. METHODS: The following were assessed: 1) growth of e-consults by VHA regional networks, medical centers, and specialty; 2) location of patient's primary care provider (medical center vs community-based outpatient clinic [CBOC]); 3) potential patient miles needed to travel for a specialty care face-to-face consult in place of the observed e-consults using estimated geodesic distance; 4) use of specialty care subsequent to the e-consult. RESULTS: Of 11,270,638 consults completed in 13 clinics of interest, 217,014 were e-consults (adjusted rate, 1.93 e-consults per 100 consults). The e-consult rate was highest in endocrinology (5.0 per 100), hematology (3.0 per 100), and gastroenterology (3.0 per 100). The percentage of e-consult patients with CBOC-based primary care grew from 28.5% to 44.4% in the first year of implementation and to 45.6% at year 3. Of those e-consult patients from community clinics, the average potential miles needed to travel was 72.1 miles per patient (SD = 72.6; median = 54.6; interquartile range = 17.1-108), translating to a potential savings of 6,875,631 total miles and travel reimbursement costs of $2,853,387. CONCLUSIONS: E-consult volume increased significantly since inception within many medical and surgical specialties. For patients receiving primary care at one of more than 800 CBOCs, e-consults may decrease travel burden and direct travel costs for patients.

Efecto del contraste endovenoso iónico sobre los marcadores séricos y clínicos en la pancreatitis aguda experimental / Effects of the endovenous ionic contrast on seric and clinical markers in experimental acute pancreatitis

Determinar el efecto del contraste endovenoso iónico utilizando para la realización de la tomografía axial computarizada como agravante del cuadro clínico y su correlación con las concentraciones de marcadores séricos, en una pancreatitis aguda experimental en caninos. Universidad de Carabobo Núcleo Aragua. Estudio experimental, cuantitativo, prospectivo, longitudinal y comparativo, donde se utilizó una muestra de 8 caninos con características similares en cuanto a peso y edad, divididos de la siguiente manera: 2 caninos para la prueba piloto de pancreatitis aguda y 6 caninos divididos aleatoriamente en un grupo de 3 caninos al cual no se administró contraste endovenoso posterior a la pancreatitis aguda y otro grupo de 3 caninos al cual se le administró contraste endovenoso posterior a la inducción de pancreatitis. Se tomó muestras sanguíneas en ambos grupos para la determinación de amilasa, lipasa y leucocitos y se midió la frecuencia cardíaca, frecuencia respiratoria y temperatura 30 minutos pre-operatorio, 6, 24, 48, 72 y 96 horas postoperatorio. Los datos fueron recopilados en fichas, llevadas a una base de datos, tabulados, se utilizaron indicadores de variables cuantitativas y se realizó prueba estadística no paramétrico (Kurskall Wallis). Las concentraciones promedio de amilasa, lipasa y leucocitos a las 48 y 96 horas fueron mayores en el grupo que recibió contraste endovenoso (p<0,05). El grupo que recibió contraste endovenoso, presentó evolución mas tórpida, tanto clínica como paraclinicamente, en comparación con el grupo que no lo recibió (p<0,05). El contraste endovenoso iónico mantiene por más tiempo elevadas las concentraciones de enzimas pancreáticas, niveles de leucocitos séricos, de manera que puede prolongar un cuadro clínico de pancreatitis aguda experimental en caninos