Autofluorescence Images with Carl Zeiss versus Topcon Eye Fundus Camera: A Comparative Study

Purpose. To compare the autofluorescence images of the Zeiss versus Topcon eye fundus cameras and design an objective way to quantify it. Procedures. The IMAGEJ software was used to determine the gray level corresponding to the darkest veins and the peripapillary ring (thresholds), the level of white of the brightest perifoveal area, their difference (contrast level), and the suprathreshold area for each photograph. Results. Carl Zeiss has higher contrast values than Topcon. The Topcon contrast presented a crest with further decline as the suprathreshold area continued to increase. On the contrary, the Zeiss profile did not decline in contrast. Conclusions and Message. The Carl Zeiss camera showed superior contrast ability over the Topcon when performing autofluorescence imaging. We set objective parameters to compare fundus cameras FAF images. These parameters could be the base to objectively measure and determine changes and realize followup to areas of hyper- or hypofluorescence

Respuesta inmune post vacunación para la hepatitis B y tuberculosis en niños de 10 años. Consolación del Sur / Immune response after vaccination for hepatitis B and tuberculosis in children under 10, Consolación del Sur

En Cuba, el control de las enfermedades infecciosas constituye una de las estrategias priorizadas del Ministerio de Salud Pública, y en aquellas que para su prevención y erradicación existen vacunas con eficacia y calidad probada, de manera sistemática se orienta conocer su inmunogenicidad mediante estudios longitudinales e intervencionales. En este estudio se incluyeron la antihepatitis B y el BCG; ambas vacunas forman parte del Programa Nacional de Inmunización. Se evaluó la respuesta celular mediante método Inmunoenzimático (ELISA) para la antihepatitis B y observación de la huella para el BCG, a 498 niños de 10 años nacidos en el año 1994, pertenecientes al municipio Consolación del Sur, en la provincia de Pinar del Río, que habían recibido el esquema propuesto para ambas vacunas en la infancia. Se determinó que existió asociación en la respuesta inmune para ambas vacunas pasados 10 años de aplicadas. El normo peso al nacer tuvo un efecto protector para la respuesta inmune del BCG; sin embargo, para la antihepatitis B y el bajo peso al nacer se observó una alta significación estadística en aquellos que no alcanzaron valores de Seroprotección. No obstante, se comprobó la calidad de las vacunas estudiadas, evidenciado por la ausencia de marcadores de infección para ambas enfermedades. Palabras Clave: Enfermedades infecciosas/ epidemiología; bcg y antihepatitis b/ vacunas; respuesta inmune/ inmunología; programa nacional de inmunización/ prevención y control ABSTRACT Controlling infectious deseases constitutes one of the top priorities of the Ministry of Public Health in Cuba, and in those diseases that there is an efficient vaccine for prevention and complete elimination, knowing its immunogenicity is oriented by means of interventionist and lifetime research. In this study both, antihepatitis B and BCG were included, constituting also part of the National Program of Immunization. In this study, the cell response was evaluated by means of the inmunoenzimatic method (ELISA) for antihepatitis B, and the observation of scar or trace for BCG in 498 children born in 1994 and living in Consolación del Sur, Pinar del Río province, that had previously received a scheme for both vaccines during their chilhood. Associations in immune responses for both vaccines were determined after 10 years. Newborn with normal weight had a protection effect for BCG immune response, however, for antihepatitis B and low weight newborn, a high statistical significance was observed in those that did not get Seroprotection levels. Despite of this, the quality of the vaccines was proved, evidenced by the absence of infection markers for both diseases.Key Words: Infectious deseases/ epidemiology; bcg and antihepatitis b/ vaccines; immune response/ immunology; national program of immunization/ prevention and control

Respuesta inmune post vacunación para la hepatitis B y tuberculosis en niños de 10 años. Consolación del Sur / Immune response after vaccination for hepatitis B and tuberculosis in children under 10, Consolación del Sur

En Cuba, el control de las enfermedades infecciosas constituye una de las estrategias priorizadas del Ministerio de Salud Pública, y en aquellas que para su prevención y erradicación existen vacunas con eficacia y calidad probada, de manera sistemática se orienta conocer su inmunogenicidad mediante estudios longitudinales e intervencionales. En este estudio se incluyeron la antihepatitis B y el BCG; ambas vacunas forman parte del Programa Nacional de Inmunización. Se evaluó la respuesta celular mediante método Inmunoenzimático (ELISA) para la antihepatitis B y observación de la huella para el BCG, a 498 niños de 10 años nacidos en el año 1994, pertenecientes al municipio Consolación del Sur, en la provincia de Pinar del Río, que habían recibido el esquema propuesto para ambas vacunas en la infancia. Se determinó que existió asociación en la respuesta inmune para ambas vacunas pasados 10 años de aplicadas. El normo peso al nacer tuvo un efecto protector para la respuesta inmune del BCG; sin embargo, para la antihepatitis B y el bajo peso al nacer se observó una alta significación estadística en aquellos que no alcanzaron valores de Seroprotección. No obstante, se comprobó la calidad de las vacunas estudiadas, evidenciado por la ausencia de marcadores de infección para ambas enfermedades. Palabras Clave: Enfermedades infecciosas/ epidemiología; bcg y antihepatitis b/ vacunas; respuesta inmune/ inmunología; programa nacional de inmunización/ prevención y control ABSTRACT Controlling infectious deseases constitutes one of the top priorities of the Ministry of Public Health in Cuba, and in those diseases that there is an efficient vaccine for prevention and complete elimination, knowing its immunogenicity is oriented by means of interventionist and lifetime research. In this study both, antihepatitis B and BCG were included, constituting also part of the National Program of Immunization. In this study, the cell response was evaluated by means of the inmunoenzimatic method (ELISA) for antihepatitis B, and the observation of scar or trace for BCG in 498 children born in 1994 and living in Consolación del Sur, Pinar del Río province, that had previously received a scheme for both vaccines during their chilhood. Associations in immune responses for both vaccines were determined after 10 years. Newborn with normal weight had a protection effect for BCG immune response, however, for antihepatitis B and low weight newborn, a high statistical significance was observed in those that did not get Seroprotection levels. Despite of this, the quality of the vaccines was proved, evidenced by the absence of infection markers for both diseases.Key Words: Infectious deseases/ epidemiology; bcg and antihepatitis b/ vaccines; immune response/ immunology; national program of immunization/ prevention and control

Durabilidad de la respuesta inmune contra el VHB en niños y madres portadoras, Consolación del Sur / Duration of immune response against VHB in carrier children and mothers, Consolación del Sur

El Ministerio de Salud Pública de Cuba se ha propuesto la eliminación de la hepatitis viral tipo B para cumplir con este objetivo se lleva a cabo un Programa Nacional que comenzó en 1991 con la vacunación de los niños nacidos de madres portadoras de hepatitis B, y posteriormente se amplió a todos los recién nacidos a partir de 1992. Uno de los parámetros para evaluar la inmunogenicidad de una vacuna es la durabilidad de la respuesta post vacunal, que permite demostrar además la necesidad o no de una dosis de refuerzo. Tomando en consideración este tipo de estudio, se realizó la cuantificación de los niveles de títulos de anticuerpos contra el VHB (Anti-HBsAg) en niños de 10 años nacidos en el año 1994 pertenecientes a Centros Escolares del Municipio Consolación el Sur en la provincia de Pinar el Río, así como madres portadoras del VHB y sus hijos cuyos nacimientos ocurrieron en igual período. Las muestras serológicas se evaluaron mediante el método inmunoenzimático ( ELISA ) para el sistema HBsAg- anti HBsAg obtenido en el Departamento de Inmunología del Instituto Superior de Ciencias Médicas y utilizado en el Centro Nacional de Genética Médica. En aquellos individuos que resultaron negativos para el HBsAg y con títulos de Anti-HBsAg < 10 UI/L se les aplicó una dosis refuerzo evidenciándose respuesta secundaria de memoria en el 100% de los estudiados. Palabras clave: Salud pública, hepatitis b/prevención y control/inmunología / patología, Programas nacionales de salud, Anticuerpos / inmunología, Vacunas, Sangre. ABSTRACT The Ministry of Public Health in Cuba has set as one of its goals the total elimination of Hepatitis B, and to fulfill this objective, a national program is carried out which started with the vaccination program of children born from hepatitis B carrier mothers back in 1991, covering later all newborn babies in 1992. One of the parameters to evaluate immunogenicity in a vaccine is its post vaccine everlasting response that shows the need or not of a back up dose. Taking into consideration this research, a quantitation of antibody levels against Hepatitis B was done (Anti-HBsAg) in 10 year old children born in 1994, belonging to school centers in Consolacion del Sur, Pinar del Río province, as well as Hepatitis B carrier mothers and their children whose births occured in the same period. The serological samples were evaluated by means of the immunoenzimatic method (ELISA), obtained in the Higher Institute of Medical Sciences and used in the Department of Hepatitis B of the National Center of Medical Genetics. In those individuals who tested negative for HBsAg and with titles of Anti-HBsAg< 10UI/L, a booster was applied and the immunological memory response was evidenced in a 100% of the researched children. Key words: Public health, hepatitis b/prevention and control/immunology/pathology, national health programs, antibodies/immunology, vaccines, blood

Identificación de especies de candida aisladas de pacientes ambulatorios, hospitalizados, e inmunocomprometidos en Paraguay

Objetivo: Identificar las especies de candida aisladas de varias muestras clínicas. Métodos: Se aislaron 310 cepas de Candida spp de pacientes internados (n=133), ambulatorios (n=134) e inmunocomprometidos (n=43) que concurrieron a cuatro centros médicos en Asunción, desde enero del 2004 a octubre del 2005. Para la identificación de especies, las colonias fueron cultivadas en placas de CHROMagar Candida® e incubadas a 35º por 18-24 horas. Aquellas colonias que nopudieron ser identificadas por el método cromogénico fueron identificadas con el microsistema de identificación API candida (Biomérieux). Resultados: De las 310 cepas estudiadas, 188 (60,6%) correspondió a C. albicans, 79 (25,5%) a C. tropicalis, 33 (10,6%) a C. glabrata, 8 (2,6%) a C. krusei, y 2 (0,7%) a C. parapsilosis. C. albicans fue la especie más frecuentemente aislada tanto en las muestras de origen comunitario como en los pacientes inmunocomprometidos, 81% y 58%, respectivamente. Sin embargo, en las muestras hospitalarias especies de C. tropicalis fueron más frecuente que C. albicans (47% y 41%, respectivamente). Conclusión: Las especies de candida noalbicans predominaron en las muestras hospitalarias por lo que su tipificación rutinaria debería hacerse en forma rutinaria

Frecuencia y sensibilidad antimicrobiana de agentes etiológicos de dacriocistitis

La dacriocistitis representa la infección más frecuente del sistema lagrimal. El estudio microbiológico de las dacriocistitis es importante para la adecuada selección de los antibióticos. El objetivo del estudio es determinar la frecuencia y sensibilidad antimicrobiana de los agentes causantes de dacriocistitis en pacientes que acudieron a laCátedra de Oftalmología del Hospital de Clínicas de mayo de 1998 a abril de 2007. Los pacientes no recibieron antibióticos por lo menos por una semana antes de la toma de muestra, que fueron tomadas por aspiración del contenido del saco lagrimal por el canalículo inferior o punción directa del saco lagrimal, y cultivadas en aerobiosis y anaerobiosis siguiendo métodos convencionales. De 41 pacientes (23 adultos y 18 niños), 30 (73,1%) presentaron cultivos positivos; 16 (53.4%) monomicrobianos y 14 (46,6%) polimicrobianos. Se aislaron 51 microorganismos, 37 en adultos y 14 en niños. El 54% de los microorganismos aislados en muestras de adultos correspondió a bacilos gramnegativos (enterobacterias, Haemophilus sp, anaerobios, y bacilos gramnegativos no fermentadores); 41% a cocos grampositivos (Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus viridans, y estafilococo coagulasa negativo); el 72% de los micro-organismos aislados en niños correspondió a cocos grampositivos (Staphylococcus aureus y Streptococcus pneumoniae), y en una muestra se aisló Candida sp. La sensibilidad del Streptococcus pneumoniae a la penicilina y la del Staphylococcus aureus a la meticilina fue de 100%. Los microorganismos aislados presentaron buena sensibilidad a los antimicrobianos, pero por la gran variedad de microorganismos y la naturaleza polimicrobiana de los cultivos se debería ampliar el esquema inicial de tratamiento y de la profilaxis de la dacriocistorrinostomía y otros procedimientos intraoculares. Una opción es el uso de aminopenicilinas con un inhibidor de betalactamasa; asociado con colirio de tobramicina en niños y ciprofloxacina en adultos

Study protocol for a three-arm randomized controlled trial investigating the effectiveness, cost-utility, and physiological effects of a fully self-guided digital Acceptance and Commitment Therapy for Spanish patients with fibromyalgia

Objective Fibromyalgia (FM) is a prevalent pain syndrome with significant healthcare and societal costs. The aim of the SMART-FM-SP study is to determine the effectiveness, cost-utility, and physiological effects in patients with FM of a digital intervention (STANZA®) currently marketed in the United States, which delivers smartphone-based, fully self-guided Acceptance and Commitment Therapy (Digital ACT) for treating FM-related symptoms. Methods A single-site, parallel-group, superiority, randomized controlled trial (RCT) will be conducted, including a total of 360 adults diagnosed with FM. Individuals will be randomly allocated (1:1:1) to treatment as usual (TAU), to TAU plus 12 weeks of treatment with Digital ACT, or to TAU plus 12 weeks of treatment with digital symptom tracking (i.e. FibroST). Participants will be assessed at baseline, post-treatment, and 6-month follow-up. An intention-to-treat analysis using linear mixed models will be computed to analyze the effects of Digital ACT on functional impairment (primary outcome), as measured by the Fibromyalgia Impact Questionnaire Revised at 6 months from the inception of the treatment. Secondary outcomes include impression of change, symptoms of distress, pain catastrophising, quality of life, cost-utility, and selected biomarkers (cortisol and cortisone, immune-inflammatory markers, and FKBP5 gene polymorphisms). The role of ACT-related processes of change will be tested with path analyses. Conclusions This study is the first RCT that tests Digital ACT for Spanish patients with FM. Results will be important not only for patients and clinicians, but also for policy makers by examining the cost-utility of the app in a public healthcare context

Toxicity of wine effluents and assessment of a depuration system for their control: assay with tadpoles of Rhinella arenarum (BUFONIDAE)

We evaluated the toxicity of the winery effluent and the efficiency of a symbiotic depuration system by means an experiment with Rhinella arenarum tadpoles. The studied effluent was taken from warehouses during the cleaning season. These effluents subsequently subjected to the purification treatment under evaluation. The effluent samples differentiated into two treatment levels: “raw” where the effluent was evaluated with field conditions and “treated” where the effluent was previously filtered with the symbiotic depuration system. The results of the bioassays compared with the physicochemical parameters determined in the effluent samples. The lethal response had a clear-cut correspondence with the effluent quality assessed utilizing physicochemical parameters. In all cases, dilution of the samples resulted in a significant reduction of their toxicity. It concluded that (a) winery effluents could be harmful to tadpoles of R. arenarum, (b) the symbiotic purification system used to treat wine effluents it would produce a significant reduction in the contaminant levels of the effluent. However, this reduction in contaminant levels does not provide sufficient safety for the release of the effluents into the environment.Fil: Navas Romero, Ana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Herrera Moratta, Mario Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Rodríguez, María Rosa. Universidad Nacional de San Juan. Facultad de Ingeniería; ArgentinaFil: Quiroga, Lorena Beatriz. Universidad Nacional de San Juan. Facultad de Filosofía, Humanidades y Artes. Instituto de Ciencias Básicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Echegaray, Marcelo Eduardo. Universidad Nacional de San Juan. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Sanabria, Eduardo Alfredo. Universidad Nacional de San Juan. Facultad de Filosofía, Humanidades y Artes. Instituto de Ciencias Básicas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentin

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe