Escenario prospectivo del entramado cárnico de la Región Sur de Río Negro : ¿Oportunidad para fortalecer la soberanía alimentaria y generar trabajo genuino?

Esta Plataforma de Innovación Territorial (PIT) se desarrolla en el vasto territorio semiárido de la Región Sur de la Provincia de Rio Negro, abarcando una superficie de 114.913 km2. El recorte territorial, si bien presenta gradientes ambientales importantes, presenta muchas características homogéneas en aspectos socio-económico y productivos. La ganadería ovina, caprina y en menor grado bovina, de manera extensiva, sobre pastizales naturales es la principal actividad productiva en todo este territorio. Comunidades originarias del pueblo mapuche (más de 11), pequeños productores nucleados, o no, en cooperativas (más de 12), empresas familiares y un reducido número de grandes empresas (algunas nucleadas en sociedades rurales), son los protagonistas de esta actividad. Condiciones de fragilidad ambiental, deficiencias estructurales en servicios básicos y la vulnerabilidad ante el escenario de cambio climático son comunes a gran parte de este recorte territorial. El objetivo de la PIT es fortalecer este sistema para contribuir al desarrollo sustentable de la región sur de Río Negro, aportando soluciones a los siguientes problemas y oportunidades identificados: • Problema Organizacional: Debilidad organizativa en la red de actores, Organizaciones de Productores, Empresas Agropecuarias e Instituciones. • Problema Ambiental: Baja productividad primaria, alta fragilidad ambiental y escasa adaptación al Cambio Climático. • Problema Productivo: Bajos índices productivos por deficiente infraestructura, manejo ganadero y acceso al agua, sumado a las pérdidas por depredación. • Oportunidad Comercial: Consolidación de los canales comerciales, acceso a mercados formales y valor agregado.Estación Experimental Agropecuaria BarilocheFil: Bidinost, Franca. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Agencia de Extensión Rural Bariloche; ArgentinaFil: Gaetano, Andres Marcelo. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Agencia de Extensión Rural Ingeniero Jacobacci; ArgentinaFil: Alvarez, Hilda Rocio. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Oficina Técnica Los Menucos; ArgentinaFil: Reuque, Raul Esteban. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Agencia de Extensión Rural El Bolsón; ArgentinaFil: Ojeda, Julio César. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Agencia de Extensión Rural Bariloche; ArgentinaFil: Claps, Leonardo Luis. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área de Desarrollo Rural; ArgentinaFil: Villagra, Edgar Sebastian. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Desarrollo Rural; ArgentinaFil: Stiglauer, Marcela Alejandra. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Valle Inferior; ArgentinaFil: Mora Jara, Gloria Ines. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Valle Inferior; ArgentinaFil: Cortes, María Victoria. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Valle Inferior. Agencia de Extensión Rural Valcheta; ArgentinaFil: Molina, Roberto Ángel. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Valle Inferior. Agencia de Extensión Rural Valcheta; ArgentinaFil: Llampa, Julio Argentino. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estación Experimental Agropecuaria Valle Inferior. Agencia de Extensión Rural Valcheta; ArgentinaFil: Conti, Santiago. Universidad Nacional de Rio Negro; ArgentinaFil: López, M. Programa Ganadero Ente de desarrollo de la Región Sur de Río Negro; ArgentinaFil: Machiñena, Graciela. UFINPRO Río Negro; ArgentinaFil: Fornasa, Alejandro. Ministerio de Agricultura, Ganadería y Pesca. Secretaria de Agricultura Familiar, Campesina e Indígena

FGFR1 and PROKR2 rare variants found in patients with combined pituitary hormone deficiencies

The genetic aetiology of congenital hypopituitarism (CH) is not entirely elucidated. FGFR1 and PROKR2 loss-of-function mutations are classically involved in hypogonadotrophic hypogonadism (HH), however, due to the clinical and genetic overlap of HH and CH; these genes may also be involved in the pathogenesis of CH. Using a candidate gene approach, we screened 156 Brazilian patients with combined pituitary hormone deficiencies (CPHD) for loss-of-function mutations in FGFR1 and PROKR2. We identified three FGFR1 variants (p.Arg448Trp, p.Ser107Leu and p.Pro772Ser) in four unrelated patients (two males) and two PROKR2 variants (p.Arg85Cys and p.Arg248Glu) in two unrelated female patients. Five of the six patients harbouring the variants had a first-degree relative that was an unaffected carrier of it. Results of functional studies indicated that the new FGFR1 variant p.Arg448Trp is a loss-of-function variant, while p.Ser107Leu and p.Pro772Ser present signalling activity similar to the wild-type form. Regarding PROKR2 variants, results from previous functional studies indicated that p.Arg85Cys moderately compromises receptor signalling through both MAPK and Ca2 + pathways while p.Arg248Glu decreases calcium mobilization but has normal MAPK activity. The presence of loss-of-function variants of FGFR1 and PROKR2 in our patients with CPHD is indicative of an adjuvant and/or modifier effect of these rare variants on the phenotype. The presence of the same variants in unaffected relatives implies that they cannot solely cause the phenotype. Other associated genetic and/or environmental modifiers may play a role in the aetiology of this condition

Vigilancia epidemiológica de parasitosis zoonóticas en un área centinela desde la perspectiva de Una Salud

El abordaje de las enfermedades zoonóticas debe realizarse desde un enfoque multisectorial. Desde el concepto de Una Salud, las acciones realizadas por un solo sector no resultan eficaces para controlar este tipo de infecciones. En ese sentido, los distintos agentes de enfermedades transmisibles zoonóticas, afectan tanto a animales como a humanos y habitualmente el ecosistema actúa como reservorio o transmisor directo o indirecto, en la interfaz hombre-animal-ambiente. Los caninos pueden diseminar con sus heces enteroparásitos transmisibles a humanos y como animales centinela, pueden utilizarse para realizar vigilancia de la circulación de patógenos. Algunas helmintiasis, varias protozoosis y el alga parásita Blastocystis sp., son comunes en caninos y humanos. Nematodes del género Toxocara spp., enteroparásito de animales, ocasionan en personas toxocarosis, enfermedad de elevada seroprevalencia en la ciudad de La Plata y otras regiones. Sus formas neurológica y ocular tienen generalmente serias consecuencias. Su presencia en humanos se ve influenciada favorablemente por el lugar de residencia y su tejido suburbano. Giardia lamblia, enteroparásito zoonótico, ocasiona síndrome de malabsorción y modificación de moléculas de fármacos, también se correlaciona giardiasis con enfermedad de Whipple y otros disturbios gastroentéricos. El enfoque "Una salud" tiene en su estructura elementos esenciales, ellos son voluntad política (compromiso con las normas internacionales y los Objetivos de Desarrollo Sostenible), planes de financiación sostenibles; comunicación (entre sectores y disciplinas a nivel internacional, regional, nacional y subnacional). Los aprendizajes socialmente productivos y significativos “resignifica el papel social, cultural y económico social del conocimiento” y son aquellos “modifican a los sujetos enseñándoles a transformar su naturaleza y su cultura, enriqueciendo el capital cultural de la sociedad y de las comunidades” (Orozco B, 2009: 88). Los objetivos de este trabajo fueron: Realizar vigilancia y alertas tempranas en cuanto a parasitosis humanas animales y zoonóticas. Ejecutar acciones tendientes a su control. Implementar aprendizajes socialmente significativos.Facultad de Ciencias Veterinaria

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Nuevos guardianes. Perros protectores y luces anti-depredación

DOSSIERLos carnívoros provocan daños económicos importantes cuando en sus dietas incorporan a los herbívoros domésticos. El conflicto carnívoro-humano plantea un desafío urgente en todo el mundo debido a que los distintos abordajes y perspectivas generan un enfrentamiento entre diversos sectores de la sociedad. El control de depredadores constituye la estrategia de mitigación más empleada a nivel global pero, si bien ha reducido significativamente las poblaciones de carnívoros, ha demostrado ser ineficiente en la reducción del nivel de daño para el ganado. Dos nuevas herramientas, amigables con la fauna silvestre, contribuyen a reducir las pérdidas por depredación. El conflicto ganadería-depredación requiere la intervención de múltiples actores y miradas

Predictors of Bothrops jararaca venom allergy in snake handlers and snake venom handlers

Since allergic sensitization to snake venom has been reported, anaphylactic reactions to snake venom might be an underestimated factor contributing to fatal snakebites, independently from the toxicity of the venom itself. However, little information is available on the determinants of such reaction. Hence, we studied a group of workers exposed to Bothrops jararaca venom (BJV), in order to clarify the factors related with snake venom allergy. The aim of this work was to investigate the prevalence and predictors of venom allergy among workers exposed to BJV and to confirm the involvement of IgE-mediated mechanisms in this condition. Workers exposed to BJV were assessed for venom allergy using questionnaires and immunological tests. The presence of BJV sensitization was determined through quantification of specific IgE. Allergens were studied using the Western blots and inhibition assays. Of the 67 workers evaluated, 7 (10.4%) presented specific IgE antibodies to BJV. Of those, 6 presented typical symptoms of an IgE-mediated allergic reaction when exposed to BJV. Venom sensitization was associated with length of employment (P = 0.042), high levels of total IgE (P = 0.034), atopy (P = 0.051), and specific tasks, primarily the handling of dried venom (P = 0.014). Our observations suggest that exposure to BJV can result in allergic sensitization in snake handlers through IgE-mediated mechanisms. The prevalence rate of this condition appears to be high among these workers, and the handling of dried venom, total IgE level above 100 kU/L, length of employment, and probably history of atopy were predictors of its occurrence. (C) 2008 Elsevier Ltd. All rights reserved

Absence of GH-Releasing Hormone (GHRH) Mutations in Selected Patients with Isolated GH Deficiency

Context: Although numerous reports of mutations in GH1 and GHRHR (GHRH receptor) causing isolated GH deficiency (IGHD) have been published, mutations in GHRH itself have not been hitherto reported but are obvious candidates for GH deficiency. Objective: The aim of this study was to identify mutations in GHRH in a large cohort of patients with IGHD. Patients and Methods: DNA was isolated from 151 patients diagnosed with IGHD at national and international centers. Seventy-two patients fulfilled all the following criteria: severe short stature (height SD score <= -2.5), low peakGHafter stimulation (peak <= 5 ng/ml), eutopic posterior pituitary lobe, and absence of mutations in GH1 and GHRHR and therefore were strong candidates for GHRH mutations. The coding sequence and splice sites of GHRH were amplified by PCR with intronic primers and sequenced. Results: In five of 151 patients (four of 42 from Brazil), the GHRH c. 223 C>T, p. L75F change was identified in heterozygosity. This variant has been previously reported as a polymorphism and is more frequent in African than European and Asian populations. Six allelic variants (five novel) that do not predict change of amino acids or splice sites were identified in five patients: c. 147 C>T, p.S49S, IVS1 -70 G>A, IVS1 -74 T>C, IVS3 -47 del1, and IVS3 +7 G>A/IVS3 + 41 G>A. No functional mutations were found in this cohort. Conclusions: GHRH mutations were not identified in a selected cohort of patients with IGHD, suggesting that, if they exist, they may be an extremely rare cause of IGHD. Other, as-yet-unidentified genetic factors may be implicated in the genetic etiology of IGHD in our cohort. (J Clin Endocrinol Metab 96: E1457-E1460, 2011)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo-FAPESP[05/04726-0]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo-FAPESP[07/56490-5]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq[301477/2009-4]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq[301339/2008-9]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq[300982/2009-7

Novel Heterozygous Nonsense GLI2 Mutations in Patients with Hypopituitarism and Ectopic Posterior Pituitary Lobe without Holoprosencephaly

Context: GLI2 is a transcription factor downstream in Sonic Hedgehog signaling, acting early in ventral forebrain and pituitary development. GLI2 mutations were reported in patients with holoprosencephaly (HPE) and pituitary abnormalities. Objective: The aim was to report three novel frameshift/nonsense GLI2 mutations and the phenotypic variability in the three families. Setting: The study was conducted at a university hospital. Patients and Methods: The GLI2 coding region of patients with isolated GH deficiency (IGHD) or combined pituitary hormone deficiency was amplified by PCR using intronic primers and sequenced. Results: Three novel heterozygous GLI2 mutations were identified: c. 2362_2368del p. L788fsX794 (family 1), c. 2081_2084del p. L694fsX722 (family 2), and c. 1138 G > T p. E380X (family 3). All predict a truncated protein with loss of the C-terminal activator domain. The index case of family 1 had polydactyly, hypoglycemia, and seizures, and GH, TSH, prolactin, ACTH, LH, and FSH deficiencies. Her mother and seven relatives harboring the same mutation had polydactyly, including two uncles with IGHD and one cousin with GH, TSH, LH, and FSH deficiencies. In family 2, a boy had cryptorchidism, cleft lip and palate, and GH deficiency. In family 3, a girl had hypoglycemia, seizures, excessive thirst and polyuria, and GH, ACTH, TSH, and antidiuretic hormone deficiencies. Magnetic resonance imaging of four patients with GLI2 mutations and hypopituitarism showed a hypoplastic anterior pituitary and an ectopic posterior pituitary lobe without HPE. Conclusion: We describe three novel heterozygous frameshift or nonsense GLI2 mutations, predicting truncated proteins lacking the activator domain, associated with IGHD or combined pituitary hormone deficiency and ectopic posterior pituitary lobe without HPE. These phenotypes support partial penetrance, variable polydactyly, midline facial defects, and pituitary hormone deficiencies, including diabetes insipidus, conferred by heterozygous frameshift or nonsense GLI2 mutations. (J Clin Endocrinol Metab 95: E384-E391, 2010)FAPESP Fundacao de Amparo a Pesquisa do Estado de Sao Paulo[05/04726-0]FAPESP Fundacao de Amparo a Pesquisa do Estado de Sao Paulo[07/56490-5]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq[301477/2009-4]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq[301339/2008-9]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq[300982/2009-7