Coancestría de apellidos y linajes del cromosoma Y en el noroeste de Colombia: una herramienta útil para establecer migración entre poblaciones

Using Y chromosome genetic markers we studied the lineage composition and distribution in the most common surnames in 471 males from the municipality of Marinilla and its zone of influence, the municipality of Aranzazu (department of Caldas) and a group of samples from the general population of Medellin (Antioquia). Despite a variable rate of coancestry between surnames and Y-chromosome markers, we found a high similarity in the pattern of distribution of haplogroups/haplotypes/surnames between Marinilla and its zone of influence and Aranzazu, reinforcing the historical migration between these two regions. This similarity would indicate that in both populations may be circulating common genetic variants linked to human diseases.Por medio del análisis de marcadores genéticos del cromosoma Y, se estudió la composición de los linajes y su distribución en los apellidos más comunes en una muestra de 471 hombres provenientes del municipio de Marinilla (Antioquia) y su zona de influencia y del municipio de Aranzazu (Caldas), y en un grupo de muestras de la población general de Medellín. Además de encontrar una tasa variable de coancestría entre apellidos y linajes del cromosoma Y, también se detectó una gran similitud en el patrón de distribución de haplogrupos/haplotipos/apellidos entre Marinilla y su zona de influencia y Aranzazu, hallazgo que refuerza la idea de la migración histórica entre estas dos regiones. Esta similitud indicaría además que en las dos poblaciones pueden circular variantes genéticas comunes vinculadas a enfermedades humanas

Variantes en los genes TNFA, IL6 e IFNG asociadas con la gravedad del dengue en una muestra de población colombiana

Introduction: The genetic makeup of the host contributes to the clinical profile of dengue. This could be due to the effect of variants in the genes encoding pro-inflammatory cytokines.Objective: To evaluate the association between the variants of three polymorphisms in TNFA, IL6 and IFNG candidate genes with dengue severity in a sample of Colombian population.Materials and methods: We evaluated the rs1800750, rs2069843, and rs2069705 polymorphisms in TNFA, IL6 and IFNG candidate genes, respectively, in 226 patients with dengue infection. The genotypes were typed using both polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). To determine the risk of different dengue phenotypes, we compared allele frequencies with chi-square and genotypes and haplotypes using logistic regression. Finally, these analyzes were adjusted with data from self-identification or the ancestral genetic component.Results: The A allele in the rs2069843 polymorphism, adjusted by self-identification, was associated with dengue hemorrhagic fever cases in Afro-Colombians. In the entire sample, this polymorphism, adjusted by the ancestral genetic component, was reproducible. In addition, there were significant associations between GGT and GAC allelic combinations of rs1800750, rs2069843, and rs2069705 in dengue hemorrhagic fever patients, with and without adjustment by ancestral genetic component. Additionally, the AGC allelic combination produced 58.03 pg/ml of interleukin-6 more than the GGC combination, regardless of European, Amerindian and African genetic components.Conclusions: The variants of GGT and GAC polymorphisms of rs1800750, rs2069843, and rs2069705 in the TNFA, IL6 and IFNG genes, respectively, were correlated with the susceptibility to dengue severity in a sample of Colombian population.Introducción. La composición genética del huésped determina, entre otros aspectos, el perfil clínico del dengue, lo cual se debería al efecto de variantes en los genes que codifican citocinas proinflamatorias.Objetivo. Evaluar la asociación entre las variantes de tres polimorfismos en los genes candidatos TNFA, IL6 e IFNG con la gravedad del dengue en una población colombiana.Materiales y métodos. Se evaluaron los polimorfismos rs1800750, rs2069843 y rs2069705 de los genes TNFA, IL6 e IFNG, respectivamente, en 226 pacientes con dengue. Los genotipos se tipificaron usando la reacción en cadena de la polimerasa (PCR) y los polimorfismos de la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism, RFLP). Para determinar el riesgo de diferentes fenotipos del dengue, se compararon las frecuencias alélicas con la prueba de ji al cuadrado, y los genotipos y los haplotipos, con regresión logística. Por último, los análisis se ajustaron utilizando datos de autoidentificación o del componente genético ancestral.Resultados. El alelo A del rs2069843, ajustado por autoidentificación, se asoció con casos de dengue hemorrágico en afrocolombianos. En la muestra completa, dicho polimorfismo, ajustado por componente genético ancestral, fue reproducible. Además, hubo asociaciones significativas entre las combinaciones alélicas GGT y GAC de los rs1800750, rs2069843 y rs2069705 en pacientes con dengue hemorrágico, con ajuste por componente genético ancestral y sin él. Además, la combinación alélica AGC produjo 58,03 pg/ml más de interleucina 6 que la GGC, independientemente de los componentes genéticos europeo, amerindio y africano.Conclusión. Las variantes de los polimorfismos GGT y GAC de los rs1800750, rs2069843 y rs2069705 en los genes TNFA, IL6 e IFNG, respectivamente, se correlacionaron con la gravedad del dengue en esta muestra de población colombiana

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Cambios genéticos temporales y microgeográficos de Aedes aegypti en Medellín, Colombia

Introducción. Las poblaciones de Aedes aegypti pueden experimentar cambios en cuanto a su abundancia y diversidad genética y, con ello, su potencial evolutivo para responder al control vectorial. El conocimiento de los cambios en la variación genética a escala espacio-temporal, permite entender mejor la epidemiología del dengue y contribuye al diseño adecuado y oportuno de estrategias antivectoriales. Objetivo. Evaluar los cambios genéticos, la diversidad y el flujo génico en seis poblaciones microgeográficas de Ae. aegypti en Medellín en diferentes periodos epidemiológicos del dengue Materiales y métodos. En 255 especímenes provenientes de seis barrios de Medellín, se evaluó la variación en la composición de los haplotipos mtDNA CO1, así como la diversidad y la diferenciación genética en un período epidémico (2010) y en otro endémico (2012) Resultados. Se detectaron dos grupos de haplotipos muy diferenciados entre sí en ambos periodos al igual que un haplotipo de alta frecuencia presente en todos los barrios. La mayor diversidad de haplotipos se refiere en el 2012, pero la mayor diversidad de nucleótidos se presenta en el 2010. No se trata de una correlación significativa entre las distancias genéticas y geográficas. Conclusión. La composición genética de Ae. Aogypti Varia, sin embargo, un patrón predecible. La presencia de un haplotipo de gran frecuencia en ambos periodos podría ser un indicio de una variación persistente adaptada al control vectorial. Sin embargo, la circulación simultánea de los haplotipos CO1 son muy diferentes y compatibles con múltiples introducciones, sugiere que diversos acervos genéticos serianos son aptos para la transmisión. Estos resultados son compatibles con la dispersión del mosquito por el efecto de las actividades antrópicas, lo que posibilita la diseminación rápida del virus durante las epidemias en Medellín.Introduction: Aedes aegypti populations may experience changes in abundance and genetic diversity in addition to changes in their evolutionary capability to respond to vector control. The knowledge on the changes in genetic variation on a spatial-temporal scale of the epidemiological understanding or dengue and supports the appropriate and timely design of vector control strategies. Objective: To assess the genetic changes, diversity and gene flow in six microgeographical populations of Ao. Aogypti in Medellin for different epidermiological periods of dengue. Materials and methods: A total of 255 specimens frörm six different neighborhoods in Medellin were used to assess variations in the CO1 mIDNA haplotype composition, diversity and genetic differentiation for an epidemic period (2010) and an endemic period (2012). Results: Two groups of highly differentiated haplotypes were present in both periods, and a high frequency was evaluated for all neighborhoods. The highest haplotype diversity was recorded in 2012, but the maximum nucleotide diversity was recorded in 2010. No significant correlation between genetic and geographic distances was observed. Conclusions: The genetic composition of Ao. aegypti varies over time without a predictable pattern In addition, the presence of a high-frequency haplotype in both periods could indicate a persistent ariatry adapted to vector control. However, the simultaneous movement of highly differentiated CO1Departamento Administrativo de Ciencia, Tecnología e Innovación [CO] Colciencias1115-569-34549n

Coancestría de apellidos y linajes del cromosoma Y en el noroeste de Colombia: una herramienta útil para establecer migración entre poblaciones

Por medio del análisis de marcadores genéticos del cromosoma Y, se estudió la composición de los linajes y su distribución en los apellidos más comunes en una muestra de 471 hombres provenientes del municipio de Marinilla (Antioquia) y su zona de influencia y del municipio de Aranzazu (Caldas), y en un grupo de muestras de la población general de Medellín. Además de encontrar una tasa variable de coancestría entre apellidos y linajes del cromosoma Y, también se detectó una gran similitud en el patrón de distribución de haplogrupos/haplotipos/apellidos entre Marinilla y su zona de influencia y Aranzazu, hallazgo que refuerza la idea de la migración histórica entre estas dos regiones. Esta similitud indicaría además que en las dos poblaciones pueden circular variantes genéticas comunes vinculadas a enfermedades humanas

¿Where do migratory fish spawn in a neotropical Andean basin regulated by dams?

Spawning sites play a key role in the reproduction of fish allowing populations to endure over time. The Nechí River is an important spawning area for potamodromous fish species where one of the threats is dam construction. In order to determine the importance of the Nechí River as a spawning site in the Magdalena River basin, sampling was conducted during the low-water-to-high-water season transition period between 2018 and 2019 at seven sampling sites. The average density of ichthyoplankton was 42.4 ind.10m-3 (SD = 7.1). Of the individuals in the post-larval stage, seven migratory species were identified, and two additional taxa were identified to genus; Prochilodus magdalenae, Megaleporinus muyscorum, and Pseudoplatystoma magdaleniatum presented the greatest density. At the temporal level, the greatest density of larvae of potamodromous species was observed in the first high-water season of 2019 with a total of 5.7 ind.10m-3(SD = 1.044), of which the most representative at the seasonal level were the Cauca River, Magdalena River, and Nechí River before it flows into the Cauca River. There were significant differences in the frequency of embryos and vitelline larvae of the potamodromous species in the interaction of the sampling sites and high-water seasons, as well as with the density of post-larvae. The average drift distance of the spawning areas is roughly 52.1 km. A positive association was found between the volume of turbined water and the presence of ichthyoplankton in the Porce River site, after discharge from the Porce III Hydroelectric Plant. The Nechí River is an important spawning site and there seems to be an association between the increase in ichthyoplankton densities and the distance to the dam (Porce III) as long as there are floodplains along the course of the river

Association of IL4R-rs1805016 and IL6R-rs8192284 polymorphisms with clinical dengue in children from Colombian populations

Background: Etiologic studies provide evidence that IL-4R and IL-6R receptors may play important roles in the regulatory mechanisms of the development of clinical dengue, especially in children which is a segment of the population with high severe dengue risk. Moreover, the allele frequencies and genetic associations may be influenced by the populational genetic background. Therefore, we performed a case-control study to evaluate possible associations between SNPs in IL4R and IL6R genes and clinical dengue in children from two Colombian populations. Methods: We genotyped the rs1805016 (IL4R) and rs8192284 (IL6R) by PCR-RFLP method, in 298 symptomatic children and 648 asymptomatic controls. Three individual genetic ancestral proportions (APs) (European, Amerindian, African) were inferred by genotyping 29 AIMs (Ancestry informative markers). The variables gender, APs, and the population of origin were used like confusion variables. Results: We found IL4R-rs1805016 GG genotype and G-allele carriers and IL6R-rs8192284 AA genotype associated with clinical dengue in the pooled and Huila samples. Nevertheless, we found no association of these polymorphisms in the sample of Antioquia. Conclusions: For the first time, we report SNPs in IL4R and IL6R genes associated with clinical dengue, which contributes to understanding the genetic susceptibility to dengue disease. Moreover, these results may be influenced by genetic background and must be evaluated through functional analysis. Keywords: SNPs, Dengue, IL4R, IL6R, Th2 respons