Treatment of imported severe malaria with artesunate instead of quinine--more evidence needed?

Rapid and fast acting anti-malarials are essential to treat severe malaria. Quinine has been the only option for parenteral therapy until recently. While current evidence shows that intravenous artesunate is more effective than quinine in treating severe malaria in endemic countries, some questions remain regarding safety profiles and drug resistance. For imported severe malaria, additional unanswered questions are related to generalizability of the findings from endemic countries and to legal aspects, as there is no Good Manufacturing Practice-conform drug available yet. Here, the implications of existing evidence for the treatment of imported severe malaria are discussed

Numerical study of efficiencies for box type solar cooker with internal reflectors

En este trabajo se muestran los resultados del estudio de las eficiencias termodinámicas de 1.a y 2.a ley aplicadas a 4 arreglos diferentes de estufas solares de tipo caja con reflectores internos. La estufa solar tiene 2 vidrios en su cubierta para disminuir la pérdida de calor por radiación y convección, y crear así el efecto invernadero. El interior de la estufa tiene espejos colocados a diferentes ángulos para dirigir la radiación solar hacia un recipiente con agua que se encuentra también dentro de la estufa. Los resultados obtenidos están basados en las temperaturas de calentamiento del agua, las cuales fueron obtenidas por medio de una simulación numérica que permite comparar los 4 arreglos de estufas solares bajo condiciones idénticas. El tratamiento de los resultados revela que la cantidad de energía que impacta en las estufas solares no es aprovechada de manera adecuada para los fines de calentamiento de agua. La mayor parte de la energía aprovechable se almacena en los vidrios de la tapa, lo que evidencia la necesidad de trabajar en el desarrollo de mejores materiales para mejorar tal situación.In this work, results of efficiencies for first and second law of thermodynamics applied to four box-type solar cookers with internal reflectors are shown. The solar cooker has two glasses on its cover to diminish the losses of heat for radiation and convection, besides creating the effect hothouse inside the cooker. The interior of the cooker has flat mirrors placed at different angles to reflect the solar radiation toward a recipient with water inside the cooker. The obtained results are based on heating water temperatures which were obtained by means of numeric simulation, allowing comparison under identical conditions of four solar cookers. The treatment of the results revealed that the quantity of energy that impacts on the solar cookers is not used in right way for the heating water ends. Most of the profitable energy is stored in the glasses of the cover, what evidences the necessity to work in the development of better materials to diminish such situation.Peer Reviewe

Surveillance of imported malaria in Spain: The useful tool of the Semi-Nested Multiplex PCR

The use of a new PCR-based method for the diagnosis of malaria in the Spanish Malaria Reference Laboratory has promoted an increase in confirmed cases of malaria. From August 1997 to July 1998, a total of 192 whole-blood samples and 71 serum samples from 168 patients were received from the hospitals of the Spanish National Health System. Most of the patients came from west-central African countries (85%). This molecular method showed more sensitivity and specificity than microscopy, detecting 12.4% more positive samples than microscopy and 13% of mixed infections undetectable by Giemsa stain. Plasmodium falciparum was the main species detected, with 68% of the total positive malaria cases, followed by Plasmodium malariae (29%), Plasmodium vivax (14%), and Plasmodium ovale (7%), including mixed infections in all cases. This report consists of the first wide, centralized survey of malaria surveillance in Spain. The reference laboratory conducted the analysis of all imported cases in order to detect trends in acquisition. The use of a seminested multiplex PCR permitted confirmation of the origins of the infections and the Plasmodium species involved and confirmation of the effectiveness of drug treatments. This PCR also allowed the detection of the presence in Spain of primaquine-tolerant P. vivax strains from west-central Africa, as well as the detection of a P. falciparum infection induced by transfusion.This work was supported by the Fondo de Investigaciones Sanitarias (FIS) (contract number 96/0216) and the Spanish Agency of International Cooperation (AECI). J. M. Rubio was granted a postdoctoral fellowship from the Comunidad Autónoma de Madrid, Madrid, Spain. J. Alvar was supported by a B.A.E. from the FIS (contract number 99/5038) and by the Christ’s College, University of Cambridge, Cambridge, United Kingdo

Las alternativas ciudadanas para otros mundos posibles: pensamiento y experiencias

El documento está conformado por tres partes: la primera define algunos conceptos y expone ciertas teorías sobre el desarrollo y las alternativas (los artículos que componen este apartado son: "Diversidad y dinamismo de las alternativas ciudadanas", "¿Desarrollo alternativo o alternativas al desarrollo? repensando el concepto desde el territorio y el sur global"); la segunda, hace referencia a la construcción de algunas experiencias concretas relacionadas con las alternativas ciudadanas ("La gestión compleja del agua", "La alternativa educativa intercultural wixárika"; "Los procesos sociales en la construcción de alternativas a conflictos ambientales en la cuenca alta del río Santiago"). La tercera parte consiste en una propuesta de investigación sobre las alternativas ciudadanas ("Las alternativas ciudadanas: una propuesta de análisis").ITESO, A.C

Chagas disease in Latin American migrants: a Spanish challenge

AbstractChagas’ disease affects millions in Latin America and is the leading cause of cardiomyopathy and death due to cardiovascular disease in patients aged 30–50 years. As a consequence of immigration it has settled in several European countries, where besides imported cases, autochthonous infections arise through vertical transmission and blood/organ donation. All Latin American immigrants who attended our Unit were screened for T. cruzi infection (ELISA and IFAT ± PCR). An ECG and echocardiogram were requested for all positive patients, and oesophageal manometry, barium swallow and barium enema were requested according to patient symptoms. All patients under 50 years without severe cardiac involvement and who had not received correct treatment previously were treated with benznidazole 5 mg/kg/day for 60 days. Patients were followed-up with serology and PCR 1 month after treatment ended and every 6 months thereafter. A total of 1146 Latin Americans were screened for T. cruzi (357 positive serology results). The typical patient profile was a Bolivian female, of rural origin, in her fourth decade of life, without evidence of visceral involvement. Treatment tolerance was poor, with 29.7% discontinuing treatment due to adverse reactions. Among those with adverse reactions (52%), the most frequent were cutaneous hypersensitivity (68.7%), gastrointestinal upset (20%) and nervous system disturbances (16.2%). T. cruzi infection is no longer limited to Latin America. Poor treatment tolerance can limit current treatment options. More epidemiological data are necessary to estimate the magnitude of a problem of great relevance for public health and health resource planning

Utility of a Short Neuropsychological Protocol for Detecting HIV-Associated Neurocognitive Disorders in Patients with Asymptomatic HIV-1 Infection

Human Immunodeficiency Virus type 1 (HIV-1) infection is a chronic disease that affects ~40 million people worldwide. HIV-associated neurocognitive disorders (HAND) are common in individuals with HIV-1 Infection, and represent a recent public health problem. Here we evaluate the performance of a recently proposed short protocol for detecting HAND by studying 60 individuals with HIV-1-Infection and 60 seronegative controls from a Caribbean community in Barranquilla, Colombia. The short evaluation protocol used significant neuropsychological tests from a previous study of asymptomatic HIV-1 infected patients and a group of seronegative controls. Brief screening instruments, i.e., the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS), were also applied. Using machine-learning techniques, we derived predictive models of HAND status, and evaluated their performance with the ROC curves. The proposed short protocol performs exceptionally well yielding sensitivity, specificity, and overall prediction values >90%, and better predictive capacity than that of the MMSE and IHDS. Community-specific cut-off values for HAND diagnosis, based on the MMSE and IHDS, make this protocol suitable for HAND screening in individuals from this Caribbean community. This study shows the effectivity of a recently proposed short protocol to detect HAND in individuals with asymptomatic HIV-1-Infection. The application of community-specific cut-off values for HAND diagnosis in the clinical setting may improve HAND screening accuracy and facilitate patients’ treatment and follow-up. Further studies are needed to assess the performance of this protocol in other Latin American populations

Topologically protected superconducting ratchet effect generated by spin-ice nanomagnets

We have designed, fabricated and tested a robust superconducting ratchet device based on topologically frustrated spin ice nanomagnets. The device is made of a magnetic Co honeycomb array embedded in a superconducting Nb film. This device is based on three simple mechanisms: (i) the topology of the Co honeycomb array frustrates in-plane magnetic configurations in the array yielding a distribution of magnetic charges which can be ordered or disordered with in-plane magnetic fields, following spin ice rules; (ii) the local vertex magnetization, which consists of a magnetic half vortex with two charged magnetic Neel walls; (iii) the interaction between superconducting vortices and the asymmetric potentials provided by the Neel walls. The combination of these elements leads to a superconducting ratchet effect. Thus, superconducting vortices driven by alternating forces and moving on magnetic half vortices generate a unidirectional net vortex flow. This ratchet effect is independent of the distribution of magnetic charges in the array

Healthy lifestyle behaviors and their association with self-regulation in chilean children

Indexación: Scopus.Background: Self-regulation comprises a series of important competencies, such as the ability to control inner states or responses toward thoughts, attention, emotions, or even performance. The relationship between self-regulation and different healthy lifestyle behaviors among children has not been examined in depth to date. The aim of this study was to explore the association between physical activity, screen time levels, and/or Mediterranean Diet adherence and self-regulation in Chilean children. Methods: A total of 1561 children aged 8–12 years from eight public schools with low socioeconomic status were included. Physical activity, screen time, Mediterranean Diet, and self-regulation were assessed with validated questionnaires. Results: Children who were classified as active or those who reported less than 2 h per day of screen time had higher self-regulation than those who were classified as inactive or counterparts with 2 h per day or more of screen time, respectively. Using joint categories, active children both with low and high screen time showed higher self-regulation compared to inactive/high screen time peers. Additionally, active groups with adherence or non-adherence to the Mediterranean Diet had higher self-regulation compared to inactive and non-adherence peers. Conclusion: Having a greater number of healthy habits, mainly regular physical activity, was associated with higher self-regulation, which might be one potential strategy to promote child social-emotional development. © 2020 by the authors.https://www.mdpi.com/1660-4601/17/16/567