Trypanosoma cruzi DTU II coinfection with bacteria producing prolonged cutaneous lesion in a healthy young male

Chagas disease (CD) is a neglected tropical disease caused by Trypanosoma cruzi and is genetically classified in six discrete typing units (DTUs). The isolates reported in Mexico are generally associated with DTU I. We presented a case of a prolonged cutaneous lesion in a Mexican man, caused by DTU II in coinfection with Bacillus velezensis and Corynebacterium sp. The patient assessment included a complete clinical history, physical exam, laboratory tests, and a skin biopsy. In the facial tissues, intracellular parasites were revealed. The PCR tests were positive for T. cruzi in tissue and blood samples. DNA satellite sequencing was correlated with the DTU II. The initial serological tests reported negative results. However, four months later, two serological tests reported positive results. These exams were performed in different health centers. Mexico is considered an endemic area for CD; nevertheless, this is just the second cutaneous case associated with a DTU different from DTU-I noted in this country. From an ecological point of view, this fact suggests a geographical expansion of DTU II and an association with atypical skin manifestations. Further studies should be conducted to understand this exciting association between DTU-II and prolonged cutaneous expression in humans

Surveys on prevention of breast cancer in a population of uruguayan women

Natalia Camejo Martínez: Asistente del Servicio de Oncología Clínica, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Cecilia Castillo: Prof. Adj. del Servicio de Oncología Clínica, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Nora Artagaveytia: Prof. Adj. del Departamento Básico de Medicina, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Ana Laura Hernández: Prof. Adj. del Departamento de Psicología Medica, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Andrea Schiavone: Asistente del Servicio de Oncología Clínica, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Soledad Milans: Prof. Adj. con Orientación en Imagenología Mamaria del Departamento de Imagenología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Guillermo Laviña: Ex Prof. Adj. Clínica Quirúrgica 1, Facultad de Medicina, Universidad de la República, Uruguay.-- Lucía Delgado: Prof. Directora del Servicio de Oncología Clínica, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Uruguay.-- Contacto: [email protected] cáncer de mama ocupa el primer lugar en incidencia y mortalidad en el Uruguay. El conocimiento de la distribución de los factores de riesgo relacionados con el desarrollo de la enfermedad facilita la incorporación de estrategias de prevención en la práctica clínica habitual, lo que podría contribuir a disminuir los índices de morbimortalidad. Objetivos: conocer el perfil epidemiológico para el cáncer de mama y la frecuencia del control mamográfico en la población encuestada. Material y Métodos: Se aplicó una encuesta a mujeres uruguayas, luego de realizada, se les brindó información sobre los factores de riesgo y protectores y sobre la importancia de realizar el control mamográfico. Resultados: Se incluyeron 182 encuestadas, la mediana de edad fue 34 años (18-75 años). Excluyendo el sexo femenino (factor de riesgo presente en todas las encuestadas), 73 encuestadas (48%) presentaban uno o más factores de riego. La mayoría de las mujeres mayores de 50 años (58; 87,8%), realizaban control mamográfico al menos en forma bianual. Conclusiones: Concordantemente con lo reportado por el Programa Nacional de Cáncer de Mama, 40% de las encuestadas tuvieron algún factor de riesgo. La mayoría de las encuestadas mayores de 50 años realizaban control mamográfico y clínico al menos en forma bianual. Si bien, debido a las características del trabajo, solamente podemos obtener conclusiones sobre las mujeres incluidas, los datos recogidos nos permiten conocer mejor el perfil epidemiológico de la población uruguaya, lo que puede contribuir a las prácticas de prevención.Breast cancer ranks fi rst in incidence and mortality in Uruguay. The knowledge of the distribution of risk factors related to the development of the disease facilitates the incorporation of prevention strategies in routine clinical practice, which could contribute to lower morbidity and mortality rates. Objectives: to know the epidemiological profi le for breast cancer and the frequency of mam mographic control in the surveyed population. Material and Methods: A survey was applied to Uruguayan women. After the same, they were given information about the risk and protective factors and the importance of performing mammographic control. Results: 182 respondents were included; the median age was 34 years (18-75 years). Excluding the female sex (risk factor present in all respondents), 73 respondents (48%) had one or more risk factors. The majority of women older than 50 years (58; 87.8%), performed mammographic control at least biannually. Conclusions: Consistent with what was reported by the National Breast Cancer Program, 40% of the respondents had some risk factor. The majority of respondents over 50 years of age performed mammographic and clinical control at least bi-annually. Although, due to the characteristics of the work, we can only draw conclusions about the women included, the data collected allow us to better understand the epidemiological profi le of the Uruguayan population, which can contribute to prevention practices.O câncer de mama ocupa o primeiro lugar em incidência e mortalidade no Uruguai. O conhecimento da distribuição dos fatores de risco relacionados ao desenvolvimento da doença facilita a incorporação de estratégias de prevenção na prática clínica de rotina, o que poderia contribuir para menores taxas de morbidade e mortalidade. Objetivos: Conhecer o perfi l epidemiológico do câncer de mama e frequência de controle da população mamográfi ca encuestada. Material e Métodos: A pesquisa foi aplicada mulheres uruguaias. Após o mesmo, foram dadas in formações sobre os fatores de risco e proteção e a importância da realização do controle mamográfico. Resultados: 182 respondentes foram incluídos, a mediana de idade foi de 34 anos (18-75 anos). Excluindo o sexo feminino (fator de risco presente em todos os entrevistados), 73 entrevistados (48%) apresentavam um ou mais fatores de risco. A maioria das mulheres com idade superior a 50 anos (58; 87,8%) realizaram o controle mamográfico pelo menos semestralmente. Conclusões: Consistente com o que foi relatado pelo National Breast Cancer Program, 40% dos respondentes tinham algum fator de risco. A maioria dos entrevistados com mais de 50 anos de idade realizou controle mamográfi co e clínico pelo menos bianualmente. Embora, devido às características do trabalho, só podemos tirar conclusões sobre mulheres incluídas, os dados coletados nos permitem compreender melhor o perfi l epidemiológico da população uruguaia, que pode contribuir para práticas de prevenção

Association of candidate genetic variants and circulating levels of ApoE/ApoJ with common neuroimaging features of cerebral amyloid angiopathy

IntroductionCerebral amyloid angiopathy (CAA) is characterized by the accumulation of amyloid-beta (A beta) in brain vessels and is a main cause of lobar intracerebral hemorrhage (ICH) in the elderly. CAA is associated with magnetic resonance imaging (MRI) markers of small vessel disease (SVD). Since A beta is also accumulated in Alzheimer's disease (AD) in the brain parenchyma, we aimed to study if several single nucleotide polymorphisms (SNPs) previously associated with AD were also associated with CAA pathology. Furthermore, we also studied the influence of APOE and CLU genetic variants in apolipoprotein E (ApoE) and clusterin/apolipoprotein J (ApoJ) circulating levels and their distribution among lipoproteins. MethodsThe study was carried out in a multicentric cohort of 126 patients with lobar ICH and clinical suspicion of CAA. ResultsWe observed several SNPs associated with CAA neuroimaging MRI markers [cortical superficial siderosis (cSS), enlarged perivascular spaces in the centrum semiovale (CSO-EPVS), lobar cerebral microbleeds (CMB), white matter hyperintensities (WMH), corticosubcortical atrophy and CAA-SVD burden score]. Concretely, ABCA7 (rs3764650), CLU (rs9331896 and rs933188), EPHA1 (rs11767557), and TREML2 (rs3747742) were significantly associated with a CAA-SVD burden score. Regarding circulating levels of apolipoproteins, protective AD SNPs of CLU [rs11136000 (T) and rs9331896 (C)] were significantly associated with higher HDL ApoJ content in the lobar ICH cohort. APOE epsilon 2 carriers presented higher plasma and LDL-associated ApoE levels whereas APOE epsilon 4 carriers presented lower plasma ApoE levels. Additionally, we observed that lower circulating ApoJ and ApoE levels were significantly associated with CAA-related MRI markers. More specifically, lower LDL-associated ApoJ and plasma and HDL-associated ApoE levels were significantly associated with CSO-EPVS, lower ApoJ content in HDL with brain atrophy and lower ApoE content in LDL with the extent of cSS. DiscussionThis study reinforces the relevance of lipid metabolism in CAA and cerebrovascular functionality. We propose that ApoJ and ApoE distribution among lipoproteins may be associated with pathological features related to CAA with higher ApoE and ApoJ levels in HDL possibly enhancing atheroprotective, antioxidative, and anti-inflammatory responses in cerebral beta-amyloidosis

Good practice regarding smoking cessation management in Spain: Challenges and opportunities for primary care physicians and nurses

INTRODUCTION We analyze the activities carried out by primary care (PC) physicians and nurses with respect to smoking cessation and evaluate their self-reported training, knowledge, and behavior. METHODS A cross-sectional study was conducted including 1514 PC physicians and nurses from June 2016 to March 2017, in Spain. The main variable was Good Practice (GP) in attention to smokers. To identify associated factors, a multilevel logistic regression model was used adjusted for sex, age, type of center, contract, years of employment, tobacco consumption, and self-reported training/knowledge. RESULTS Of the 792 physicians and 722 nurses, 48.6% referred to GP in smoking cessation management. The finding related to: being a non-smoker (OR=1.8; 95% CI: 1.2-2.5) or ex-smoker (OR= 1.4; 95% CI: 1.02-2.1), having a good level of knowledge (OR=1.8; 95% CI: 1.3-2.4) and training (OR=2.4; 95% CI: 1.8-3.2), and, to a lesser extent, being female (OR=1.3; 95% CI: 1.03-1.7), and work experience >10 years (OR=1.4; 95% CI: 1.03-1.9). The main GP barriers were: lack of time (45.5%), organizational problems (48.4%), and 35.4% lack of training. CONCLUSIONS The GP of PC physicians and nurses regarding smoking cessation management is related to being non-smokers or ex-smokers, and having sufficient training and knowledge. Lack of time and organizational problems were considered to be the main barriers. The promotion of training activities in the Spanish National Health Service with the support of scientific societies is required

Observar per comprendre. Recull d’anàlisis d’usos i artefactes

Facultat de Belles Arts, Universitat de Barcelona. Assignatura: Artefactes i usos: disseny inclusiu, Curs: 2016-2017, Coordinador: Miquel Mallol Esquef

Polymorphisms within the TNFSF4 and MAPKAPK2 Loci influence the risk of developing invasive aspergillosis: A two-stage case control study in the context of the aspBIOmics consortium

Here, we assessed whether 36 single nucleotide polymorphisms (SNPs) within the TNFSF4 and MAPKAPK2 loci influence the risk of developing invasive aspergillosis (IA). We conducted a two-stage case control study including 911 high-risk patients diagnosed with hematological malignancies that were ascertained through the aspBIOmics consortium. The meta-analysis of the discovery and replication populations revealed that carriers of the TNFSF4rs7526628T/T genotype had a significantly increased risk of developing IA (p = 0.00022). We also found that carriers of the TNFSF4rs7526628T allele showed decreased serum levels of TNFSF14 protein (p = 0.0027), and that their macrophages had a decreased fungicidal activity (p = 0.048). In addition, we observed that each copy of the MAPKAPK2rs12137965G allele increased the risk of IA by 60% (p = 0.0017), whereas each copy of the MAPKAPK2rs17013271T allele was estimated to decrease the risk of developing the disease (p = 0.0029). Mechanistically, we found that carriers of the risk MAPKAPK2rs12137965G allele showed increased numbers of CD38+IgM-IgD- plasmablasts in blood (p = 0.00086), whereas those harboring two copies of the allele had decreased serum concentrations of thymic stromal lymphopoietin (p = 0.00097). Finally, we also found that carriers of the protective MAPKAPK2rs17013271T allele had decreased numbers of CD27-IgM-IgD- B cells (p = 0.00087) and significantly lower numbers of CD14+ and CD14+CD16- cells (p = 0.00018 and 0.00023). Altogether, these results suggest a role of the TNFSF4 and MAPKAPK2 genes in determining IA risk.This study was supported by grants PI20/01845, PI12/02688, and ISCIII-FEDER PI17/02276 from Fondo de Investigaciones Sanitarias (Madrid, Spain), PIM2010EPA-00756 from the ERA-NET PathoGenoMics (0315900A), the Collaborative Research Center/Transregio 124 FungiNet, the Fundacao para a Ciencia e Tecnologia (FCT) (PTDC/SAU-SER/29635/2017, PTDC/MED-GEN/28778/2017, CEECIND/03628/2017, and CEECIND/04058/2018), the European Union's Horizon 2020 research and innovation programme under grant agreement no. 847507, and the "la Caixa" Foundation (ID 100010434) and FCT under the agreement LCF/PR/HP17/52190003)

Protocolos de estandarización de los datos socioeconómicos y bioculturales, articulados con el programa de evaluación y monitoreo

Este documento define métodos, herramientas y procedimientos para que los investigadores del Instituto Humboldt orienten sus estrategias de trabajo e integren los datos socioeconómicos en el marco de la Infraestructura Institucional de Datos e Información (I2DBogotáCiencias sociales y saberes de la Biodiversida

Estado actual y propuesta de mejoramiento para los sistemas de control en el subsector del transporte público de pasajeros intermunicipal en la zona centro occidente de Colombia durante los años 2016-2017

El presente trabajo de investigación se direccionó en dos propósitos fundamentales que constituyen la naturaleza misma del fenómeno y orientan el ejercicio académico. En primer lugar, se llevó a cabo un análisis sobre el estado actual de los sistemas de control en el subsector del transporte público de pasajeros intermunicipal en la zona Centro Occidente de Colombia durante los años 2016-2017. A partir del anterior análisis, se estableció de manera general un plan de mejoramiento continuo para las organizaciones y empresas vinculadas en el estudio, a fin de posibilitar un avance en la prestación y calidad del servicio de transporte público intermunicipal entre los departamentos de Caldas, Chocó, Quindío, Valle y Risaralda, vinculados al ejercicio investigativo.The present research work was directed in two fundamental purposes that constitute the very nature of the phenomenon and guide the academic exercise. First, an analysis was carried out on the current status of control systems in the sub-sector of public intermunicipal passenger transport in the Central West of Colombia during the years 2016-2017. Based on the previous analysis, a continuous improvement plan was established in general for organizations and companies linked to the study, in order to enable progress in the provision and quality of intermunicipal public transport service between the departments of Caldas, Chocó , Quindío, Valle and Risaralda, linked to the research exercise.Universidad Libre Seccional Pereira - Facultad de Ciencias Economicas, Administrativas y Contables - Especialización en Revisoría fisca

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

XXV Curso Monográfico de Psiquiatría Infantil y la Adolescencia: Tópicos de Psicofarmacología Infantil - 2023

El XXV Curso Monográfico de Psiquiatría Infantil y de la Adolescencia, titulado "Tópicos de Psicofarmacología Infantil," fue un evento destacado en el campo de la salud mental infantil y adolescente. Durante tres días en septiembre de 2023, expertos líderes en la materia se reunieron para explorar a fondo la psicofarmacología en este grupo de edad. El evento, dedicado a la memoria del Dr. Francisco Javier Valencia Granados, comenzó con una ceremonia de inauguración en la que participaron autoridades institucionales. Luego, se sucedieron conferencias magistrales que abordaron una amplia variedad de temas cruciales. Estos incluyeron aspectos fundamentales como la neurobioquímica farmacológica y una introducción a la psicofarmacología. El programa se adentró en cuestiones específicas, como el uso de antipsicóticos en paidopsiquiatría, el abordaje de trastornos del aprendizaje, el tratamiento del suicidio desde una perspectiva psicofarmacológica, y la gestión farmacológica del insomnio en niños. Se exploraron temas especializados, como el tratamiento de la esquizofrenia en pacientes infantiles. El segundo día se centró en trastornos emocionales en niños y adolescentes, destacando el tratamiento del trastorno depresivo, los trastornos ansiosos y el espectro autista. Se presentaron enfoques vanguardistas, como el uso de psicodélicos en adolescentes y las novedades en psicofarmacología, como el dextrometorfano y el bupropión. También se discutió el manejo de la epilepsia y la adicción a los videojuegos. El tercer día se enfocó en el tratamiento farmacológico de trastornos pediátricos específicos, como el trastorno bipolar, el déficit de atención e hiperactividad, la enuresis y encopresis, parasomnias, y el abordaje neuropsiquiátrico en pacientes pediátricos con VIH. Se exploraron también trastornos de la conducta alimentaria y la disforia de género. El evento culminó con una reflexión sobre la salud mental en niños y un emotivo tributo al Dr. Francisco Javier