The UALE project : a cross-sectional approach for trends in HIV/STI prevalence among key populations attending STI clinics in Guatemala

To describe and compare trends in prevalence, sexual behaviour and HIV transmission knowledge data related to sexually transmitted infections (STI) and HIV in patients attending three STI clinics over an 8-year period in Escuintla Department, Guatemala. STI clinic attendees were classified into transmission groups as follows: female sex workers (FSW), men who have sex with men (MSM) and 'high-risk heterosexuals' (HRH). Annual cross-sectional analysis and multivariable Poisson regression adjusted for sociodemographic variables were used for prevalence comparisons and adjusted prevalence trends for HIV/STI outcomes and used for adjusted trends in proportions in sexual behaviour and HIV transmission knowledge outcomes. Endocervical swabs were obtained to detect trichomonas, chlamydia and neisseria infections. Serologies for syphilis and HIV were performed using rapid tests. For reactive HIV samples, positivity was confirmed by an ELISA. All reactive syphilis samples were further confirmed for diagnosis of active syphilis disease. From a total of 4027 clinic attendees, 3213 (79.78%) were FSW, 229 (5.69%) were MSM and 585 (14.53%) were HRH. The proportion of FSW, MSM and HRH who had a single visit was 56.42%, 57.23% and 91.10%, respectively. Overall, HIV prevalence was 2.10% in FSW, 8.17% in MSM and 4.12% in HRH. Prevalence trends in HIV and syphilis decreased in FSW. Prevalence trends in gonorrhoea did not decrease over time neither in FSW nor in HRH. Chlamydia and trichomonas infections in HRH showed an increase prevalence trend. In FSW, trends in condom use in last sexual intercourse with regular and occasional clients were above 93%. FSW show a decreasing trend in HIV, syphilis and chlamydia prevalence. Gonorrhoea prevalence in FSW and HRH did not decrease over time. HRH is a hard to engage population with low follow-up rates and high potential to act as a bridge population

Risk Factors for Ocular Infection with Chlamydia trachomatis in Children 6 Months following Mass Treatment in Tanzania

Trachoma control programs aim for high coverage of endemic communities with oral azithromycin to reduce the pool of infection with Chlamydia trachomatis. However, even with high coverage, infection is seen following treatment. In four communities in Tanzania, we followed every child aged under ten years from baseline through treatment to six months post-treatment. We determined who had infection at baseline and who still had or developed infection six months later. Coverage was over 95% in children in these communities, and infection in these children decreased by over 50% at six months. The study found that, at baseline, uninfected children who were treated had prevalence of infection at 6 months of 6%, but infected children who were treated had prevalence of infection of 22% at 6 months. Other risk factors for infection at 6 months included living in a household with other infected children, and living in a household with untreated children. Our data suggest that households with untreated children might be targeted for more intensive follow up to increase coverage and reduce subsequent infection in the community

Efectos de la suplementación con microminerales en indicadores de producción y su residualidad en sangre, heces y orina de alpacas (Lama lama) en pastoreo.

Con el objetivo de analizar el efecto del nivel de suplemento de microminerales adicionales a la dieta sobre las variables alzada peso y diámetro de la fibra de alpacas, se evaluó la aplicación de tres dosis de selenio y zinc (0,0; 1,0 y 1,5 cc), bajo un (DCA) en arreglo factorial (3 x 2) + (3 x 2). Los resultados mostraron diferencias estadísticas para tratamientos: dosis de selenio, edades, dosis de zinc, edades y para la interacción zinc por edades (Se1E2 con 74,33 kg a los 90 días para alzada a la cruz, Zn1E2 con un promedio de 91,33 cm). La longitud de la fibra los tratamientos Se1E1 y Se1E2 con promedio de 3 cm. Para el diámetro de la fibra los tratamientos 1 (Se0E1) y tratamiento Se1E1 del grupo 1 y los tratamientos Zn0E2 y Zn1E1 del grupo 2 mostraron mejor calidad de la fibra (P < 0,05), con promedios de 28 micras. Se confirmó un efecto beneficioso en el peso vivo, calidad de la fibra en animales maduros de la suplementación con los microelementos Se y Zn, que mejoró las características fenotípicas de producción como el peso vivo, aunque manifestó residualidad en la orina de los animales de 3 a 5 años de edad.Effects of Supplementation with Microminerals on Production Indicators and Blood, Feces, and Urine Traces of Grazing alpaca (Lama lama) ABSTRACTIn this area was applied three doses of selenium and zinc (0.0; 1.0 and 1.5 cc), under a (DCA) in factorial arrangement (3 x 2) + (3 x 2) in order to analyze the effect of the level of additional mineral supplement micro (Selenium, Zinc) to the diet on the raised variables, weight and fiber diameter of alpacas. Results revealed statistical differences for treatment: selenium doses, age, Zinc doses, Zinc interaction for ages. For this, the treatment 4 (Se1E2) with 74.33 kg to 90 days to cross height (Zn1E2) with 91.33 cm average. The length fiber into treatments 3 (Se1E1) and 4 (Se1E2) with 3 cm average. For fiber diameter on treatments 1 (Se0E1) Treatment 3 (Se1E1) of group 1, treatments 8 (Zn0E2) and 9 (Zn1E1) which group 2 charged better fiber quality with 28 microns average. It was confirmed an beneficial effect on live weight and fiber quality in mature animals for mineral supply with Se and Zn con los microelements, that improved the production phenotypical characteristics like weight, but it was manifested minerals urine residuality in 3-5 years old animals

Síncope y escalas de riesgo: ¿Qué evidencia se tiene?

Objetivo: hacer una revisión de las escalas de riesgo existentes para predecir eventos adversos relacionados con síncope. Metodología: se realizó una búsqueda de artículos en MEDLINE, EMBASE y Cochrane Database of Systematic Reviews con el uso de las palabras clave relacionadas con reglas de predicción clínica (algoritmos, análisis multivariado, guías de predicción clínica, escalas, modelos logísticos, valoración de riesgo) y síncope. Adicionalmente, se buscó literatura con el uso de la estrategia de bola de nieve. Resultados: se encontraron nueve escalas que relacionaron el síncope con predicción de eventos adversos. Se hallaron diferencias en los criterios para definir riesgo, las variables de desenlace, la población estudiada, el uso de una estrategia prospectiva o retrospectiva y el tiempo de seguimiento. Conclusiones: aunque existen varias escalas para la definición de riesgo con el paciente que ingresa por síncope a urgencias, no hay evidencia de que alguna sea superior a otra, tienen poca validez externa y no se han aplicado en nuestro medio

Síncope y escalas de riesgo ¿Qué evidencia se tiene?

hacer una revisión de las escalas de riesgo existentes para predecir eventos adversos relacionados con síncope. Metodología: se realizó una búsqueda de artículos en MEDLINE, EMBASE y Cochrane Database of Systematic Reviews con el uso de las palabras clave relacionadas con reglas de predicción clínica (algoritmos, análisis multivariado, guías de predicción clínica, escalas, modelos logísticos, valoración de riesgo) y síncope. Adicionalmente, se buscó literatura con el uso de la estrategia de bola de nieve. Resultados: se encontraron nueve escalas que relacionaron el síncope con predicción de eventos adversos. Se hallaron diferencias en los criterios para definir riesgo, las variables de desenlace, la población estudiada, el uso de una estrategia prospectiva o retrospectiva y el tiempo de seguimiento. Conclusiones: aunque existen varias escalas para la definición de riesgo con el paciente que ingresa por síncope a urgencias, no hay evidencia de que alguna sea superior a otra, tienen poca validez externa y no se han aplicado en nuestro medio

Advances in improving tolerance to waterlogging in Brachiaria grasses

An inter-institutional and multi-disciplinary project to identify Brachiaria genotypes, which combine waterlogging tolerance with high forage yield and quality, for use in agricultural land in Latin America with poor drainage, is underway. The aim is to improve meat and milk production and mitigate the impacts of climate change in the humid areas of Latin America. Researchers at the International Center for Tropical Agriculture (CIAT) have developed a screening method to evaluate waterlogging in grasses. Using this method, 71 promising hybrids derived from the species, Brachiaria ruziziensis, B. brizantha and B. decumbens, were evaluated. Four hybrids with superior waterlogging tolerance were identified. Their superiority was based on greater: green-leaf biomass production, proportion of green leaf to total leaf biomass, green-leaf area, leaf chlorophyll content and photosynthetic efficiency; and reduced dead-leaf biomass. These hybrids, together with previously selected hybrids and germplasm accessions, are being field-tested for waterlogging tolerance in collaboration with National Agricultural Research Institutions and farmers from Colombia, Nicaragua and Panama

Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study

Background: Patients with primary systemic vasculitis or polymyalgia rheumatica might be at a high risk for poor COVID-19 outcomes due to the treatments used, the potential organ damage cause by primary systemic vasculitis, and the demographic factors associated with these conditions. We therefore aimed to investigate factors associated with COVID-19 outcomes in patients with primary systemic vasculitis or polymyalgia rheumatica. Methods: In this retrospective cohort study, adult patients (aged ≥18 years) diagnosed with COVID-19 between March 12, 2020, and April 12, 2021, who had a history of primary systemic vasculitis (antineutrophil cytoplasmic antibody [ANCA]-associated vasculitis, giant cell arteritis, Behçet's syndrome, or other vasculitis) or polymyalgia rheumatica, and were reported to the COVID-19 Global Rheumatology Alliance registry were included. To assess COVID-19 outcomes in patients, we used an ordinal COVID-19 severity scale, defined as: (1) no hospitalisation; (2) hospitalisation without supplemental oxygen; (3) hospitalisation with any supplemental oxygen or ventilation; or (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs), adjusting for age, sex, time period, number of comorbidities, smoking status, obesity, glucocorticoid use, disease activity, region, and medication category. Analyses were also stratified by type of rheumatic disease. Findings: Of 1202 eligible patients identified in the registry, 733 (61·0%) were women and 469 (39·0%) were men, and their mean age was 63·8 years (SD 17·1). A total of 374 (31·1%) patients had polymyalgia rheumatica, 353 (29·4%) had ANCA-associated vasculitis, 183 (15·2%) had giant cell arteritis, 112 (9·3%) had Behçet's syndrome, and 180 (15·0%) had other vasculitis. Of 1020 (84·9%) patients with outcome data, 512 (50·2%) were not hospitalised, 114 (11·2%) were hospitalised and did not receive supplemental oxygen, 239 (23·4%) were hospitalised and received ventilation or supplemental oxygen, and 155 (15·2%) died. A higher odds of poor COVID-19 outcomes were observed in patients who were older (per each additional decade of life OR 1·44 [95% CI 1·31–1·57]), were male compared with female (1·38 [1·05–1·80]), had more comorbidities (per each additional comorbidity 1·39 [1·23–1·58]), were taking 10 mg/day or more of prednisolone compared with none (2·14 [1·50–3·04]), or had moderate, or high or severe disease activity compared with those who had disease remission or low disease activity (2·12 [1·49–3·02]). Risk factors varied among different disease subtypes. Interpretation: Among patients with primary systemic vasculitis and polymyalgia rheumatica, severe COVID-19 outcomes were associated with variable and largely unmodifiable risk factors, such as age, sex, and number of comorbidities, as well as treatments, including high-dose glucocorticoids. Our results could be used to inform mitigation strategies for patients with these diseases. Funding: American College of Rheumatology and the European Alliance of Associations for Rheumatology