Incidence of Histoplasmosis in a Cohort of People with HIV: From Estimations to Reality

Among people with HIV, histoplasmosis represents an important cause of mortality. Previous studies provided estimates of the disease incidence. Here, we compared those estimates with the results obtained from a screening program implemented in Guatemala, which included histoplasmosis detection for people with HIV. To compare the results of this program with previous estimations, a literature search was performed and reports concerning histoplasmosis incidence were analyzed. The screening program enrolled 6366 patients. The overall histoplasmosis incidence in the screening program was 7.4%, which was almost double that estimated in previous studies. From 2017 to 2019, the screening program showed an upward trend in histoplasmosis cases from 6.5% to 8.8%. Histoplasmosis overall mortality among those who were newly HIV diagnosed showed a decrease at 180 days from 32.8% in 2017 to 21.2% in 2019. The screening approach using rapid diagnostic assays detects histoplasmosis cases more quickly, allowing a specific treatment to be administered, which decreases the mortality of the disease. Therefore, the use of these new techniques, especially in endemic areas of histoplasmosis, must be implemented.This work was supported by Global Action Fund for Fungal Infections and JYLAG, a charity Foundation based in Switzerland (E.A. received this funding under the proposal: “Minimising HIV deaths through rapid fungal diagnosis and better care in Guatemala”). Other contributions came from Intrahealth International and the Ministry of health in Guatemala (MSPAS).S

Social times, reproduction and social inequality at work : contrasts and comparative perspectives between countries

Production of INCASI Project H2020-MSCA-RISE-2015 GA 691004If the focus is placed specifically on the problem of work and family, the daily life of people and their use of time are a main problem. This time is expressed in both freely available time, which is related to activities, and time of the productive and reproductive sphere. This chapter considers work in a broad sense and takes into account the sexual division of labour. Specifically, this chapter will explore transformations in time use and social inequality in unpaid work. For this purpose, a comparative analysis of time-use surveys will be used, analysing the time spent, and the time dedicated to household chores in Chile, Argentina, Uruguay and Spain. From an analytical viewpoint, the analysis will place social reproduction at the centre of the socio-economic system, showing that the economic crisis has affected women and men differently, and that in both Europe and Latin America the family pattern is being replaced by a dominant family model of a male provider and a double presence of women. The large-scale incorporation of women into the labour market has emphasised the role that women assume in the domestic sphere perpetuating gender segregation in employment and in domestic and care work

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Efectos de la toxina botulínica A (Botox®) intraarticular en la artrosis de rodilla avanzada

Objective: osteoarthritis is the most common joint disease and it is among the most disabling health problems for middle aged and older people. Purpose: to test the effects of a single intraarticular injection of Botulinum Toxin A (BTA) on refractory knee osteoarthritis. Material and method: twelve women (mean age: 72) with refractory knee osteoarthritis who had failed other treatments and without possibilities of arthroplasty were injected with 100 units of BTA (Botox®-Allergan). Patients were followed-up for 16 weeks. They were assessed by means of VAS, WOMAC questionnaire, daily analgesic consumption, and a verbal relief scale. Side effects were also evaluated. Results: a peak of pain relief was evident 2 weeks after BTA injection and lasted typically for 16 weeks. The median change in WOMAC total score and VAS were -7.5 and -1.9 respectively, with a statistically significant pain decrease over 16 weeks. Five out of 12 do not found any decrease in total Womac score; 3 patients described at least 20% of relief and the remaining 4 found more than 40% of reduction in that scale. Those cases who responded to the BTA injection noted improved function in activities of daily living. Daily analgesic necessity droped from 3.6 to 2 doses. No side effects were noted. Conclusion: beneficial effects lasted for at least 12 weeks and gave pain relief. Based on the positive findings of this study, we believe that further, randomized, controlled trials for the use of BTA in knee osteoarthritic pain would be warranted.Objetivos: la osteoartritis es la enfermedad articular más común y una de los problemas de salud más frecuentes y sintomáticos en la madurez y senectud. Este trabajo describe nuestra experiencia clínica con inyecciones intraarticulares de toxina botulínica tipo A (TBA) en dolor de rodilla artrósico y refractario. Materiales y métodos: doce mujeres con gonartrosis avanzada y refractaria, acudieron a consulta para el manejo del dolor de rodilla de moderado a severo. Las pacientes estuvieron en seguimiento 16 semanas, durante las que la mejoría de su estado fue valorado comparando el dolor basal respecto al dolor en el momento de la visita mediante diferentes escalas estandarizadas. Simultáneamente, se evaluaron la funcionalidad, la cantidad de medicación analgésica diaria y los efectos secundarios. Resultados: el consumo de medicación decreció de 3,6 a 2 tomas/día. No se observaron efectos secundarios. Conclusión: se evidenció un alivio del dolor que se inició en la semana 2 y se mantuvo hasta 12 semanas tras la inyección de TBA. La mediana del cambio de la escala total de WOMAC y de la EVA fue de -7,5 y -1,9 respectivamente, con una disminución significativa del dolor a las 16 semanas. No se registraron cambios en la escala WOMAC en 5 pacientes, mientras que 3 casos mostraron un descenso en dicha escala mayor del 20% y los en los 4 restantes fue superior al 40%. Las que respondieron a la infiltración notaron una mejora en las actividades de la vida diaria gracias a este alivio. El consumo de medicación decreció de 3,6 a 2 tomas/día. No se observaron efectos secundarios

Facies analysis, foraminiferal record and chronostratigraphy of Holocene sequences from Saltés Island (Tinto-Odiel estuary, SW Spain): The origin of high-energy deposits

A multidisciplinary analysis of Holocene sediments from La Cascajera (Tinto-Odiel estuary, SW Spain) has al lowed to differentiate five sedimentary facies (sandy tidal flat, clayey tidal flat, washover fan, salt marsh, edaphic horizon), according to their granulometric characteristics, internal structure, mineralogical composi tion, clay mineral assemblage and paleontological record. These data, coupled to 14C AMS dating, suggest an evolution from a sandy tidal plain to a chenier before 2100 cal yr BP. This initial chenier was partially eroded later by regional storms between 2100 cal yr BP and 1900 cal yr BP, leading to the deposition of two washover fans. These facies have been eroded in the last centuries by the action of an ebb-tide channelJunta de Andalucía CORPVS VRBIVM BAETICARVM (I) (CUB)Ministerio de Economía, Industria y Competitividad DEATLANTIR II - HAR2017-89154-