Poder mecánico en pacientes con infección por SARS-COV2 y ventilados por otras causas y su relación días de ventilación mecánica, estancia en UCI y mortalidad

La lesión pulmonar inducida por la ventilación mecánica o VILI por sus siglas en inglés, depende de la cantidad de energía por minuto transferida por el ventilador al pulmón medida en julios, la cual se denomina poder mecánico. La ecuación de poder mecánico que permite su aplicabilidad en la práctica clínica se deriva de la ecuación del movimiento respiratorio más el valor de la presión positiva al final de la espiración o PEEP por sus siglas en inglés, multiplicado por la frecuencia respiratoria y el volumen corriente. Esta ecuación tiene en cuenta tres componentes importantes: la elastancia del sistema respiratorio, la resistencia de la vía aérea y el tercer componente es la energía necesaria para superar la tensión de las fibras. El poder mecánico es una variable en desarrollo al igual que su relación con desenlaces en los pacientes críticamente enfermos..

Granulocyte to monocyte ratio: leucokinetics in hematic biometry for appendicitis screening

Background: Acute appendicitis diagnosis is still challenging and is established with clinical history, physical exam, laboratory tests, and imaging studies. It´s crucial to analyze the blood biometry with physiopathological asses and not with a statistical approach for establishing diagnostic items. The interaction between neutrophils with monocytes is noticeable in the blood biometry, so its relationship could be explained as directly proportional to the neutrophils count because of cellular recruitment and inversely proportional to the monocyte count because of cellular migration. Methods: A retrospective, transversal and analytic study was conducted, admission blood biometry of all patients (n=160) that went through appendectomy in Pemex´s North Central Hospital between 2014 and 2019 were dissected. Statistical correlation between sensibility and likelihood ratio of granulocyte/monocyte ratio (GMR), leucocyte elevation, and left shift of neutrophil count were contrasted. IBM® SPSS© statistical software performed the statistical analysis. Results: GMR (1.00) sensitivity showed to be superior to leukocytosis (0.785) and percentage neutrophils (0.846). the same for the negative likelihood ratios (LR-) calculated for GMR (0.00), leukocytosis (0.59) and percentage of neutrophils (0.579). Conclusions:  GMR showed higher sensibility for detecting immune response in a patient with suspected acute appendicitis compared to leucocyte elevation and left shift of neutrophil count or both

Nivel de adherencia a la guía de atención de neumonía adquirida en la comunidad en el Hospital Universitario San Jorge de Pereira, Colombia

Objetivos: Determinar las variables que se asocian con la falta de adherencia a la guía de atención de Neumonía Adquirida en la Comunidad (NAC) en el Hospital Universitario San Jorge de Pereira (HUSJ). Materiales y métodos: Estudio de corte transversal sobre todos los pacientes mayores de 18 años de cualquier sexo con diagnóstico de ingreso o egreso de NAC entre el 1 de enero de 2010 y 30 de marzo de 2012. La información se tomó de las historias clínicas considerando variables socio-demográficas, clínicas (diagnóstico, síntomas, comorbilidades), paraclínicas (leucograma, Rayos-X, hemocultivos) y terapéuticas (tiempo de hospitalización, costos y medicamentos). Se determinó la adherencia a la guía según cumplimiento de ésta. Se aplicaron pruebas de X2 y regresión logística. Resultados: se hallaron 297 casos de NAC, con ligero predominio masculino (159 hombres vs 138 mujeres) y edad promedio 56,3±22,4 años. La adherencia a la guía fue de 14,1% de casos. Los antibióticos más empleados fueron Ampicilina+Sulbactam en 180 pacientes (60,6% de los casos), Ceftriaxona en 53 (17,8%) y Claritromicina en 31 (10,4%). Se realizaron 92 hemocultivos y el 8,6% reportó cocos gram positivos.  El costo bajo de hospitalización (p=0,03, OR:2,07; IC95%: 1,02-4,14) y reporte de radiografía de tórax (p<0,001, OR:16,7; IC95%:2,26-124,11) se asociaron de manera estadísticamente significativa con adherencia a la guía. La falta de adherencia se asoció al desconocimiento de la guía por parte de los médicos. Discusión: El HUSJ debe difundir su guía de atención de NAC, socializarla entre los médicos y hacerle seguimiento a la implementación con el fin de reducir la estancia hospitalaria, las complicaciones y costos

El papel de los antimicrobianos en la estructura de las comunidades microbianas en la naturaleza

Los microambientes son estructuras complejas, en donde se encuentran en equilibrio una gran cantidad de organismos microscópicos, tanto eucariotes como procariotes, que interaccionan entre ellos y con los factores abióticos del medio. Para lograr el equilibrio entre los miembros de una comunidad microbiana, se establecen interacciones que resultan benéficas o perjudiciales para una de las especies que interaccionan, o para ambas. Entre estas interacciones, se encuentran: comensalismo, simbiosis, y parasitismo, entre otras. Estas interacciones les facilita a los microorganismos la obtención de compuestos que pueden ser utilizados como substratos o como complementos, asegurando así su sobrevivencia y mantenimiento en un ecosistema. Para sobrevivir, algunos microorganismos deben producir compuestos capaces de inhibir el desarrollo de microorganismos competidores. Estos compuestos, conocidos como antimicrobianos, pueden causar daño a la célula bacteriana competidora a través de diversos mecanismos de acción, pero el fin es cumplir con el mismo objetivo, la eliminación de la competencia microbiana. La producción industrial de algunos de estos antimicrobianos, han revolucionado nuestra forma de vida, al proporcionarnos herramientas para el control de enfermedades infecciosas. Abstract Microenvironments are natural complex structures, where microscopic organisms (both, eukaryotic and prokaryotic organisms) are in balance, by way of interactions among them and with the abiotic factors present in the environment. In order to achieve equilibrium between the members of a microbial community, different interactions are established, that are either beneficial or prejudicial to one or both interaction species. Among those interactions are commensalism, symbiosis and parasitism. The interactions support the acquirement of compounds that can be used as substrates or complements for microbial growth, assuring in this way, its survival and maintenance in the ecosystem. To survive, some microorganisms produce compounds capable of inhibiting the development of competitive microbiota. Those compounds, known as antimicrobials, can cause damage to the competitive microbial cell through different mechanisms of action, but the final goal is the same: to eliminate the competitive microbiota. Industrial production of some of those antimicrobials, have revolutionized our society, since they can be used to control infectious diseases. Keywords: microbial interactions, symbiosis, parasitism, competition, bacteria

Analysis of a new begomovirus unveils a composite element conserved in the CP gene promoters of several Geminiviridae genera: Clues to comprehend the complex regulation of late genes

"A novel bipartite begomovirus, Blechum interveinal chlorosis virus (BleICV), was characterized at the genome level. Comparative analyses revealed that BleICV coat protein (CP) gene promoter is highly divergent from the equivalent region of other begomoviruses (BGVs), with the single exception of Tomato chino La Paz virus (ToChLPV) with which it shares a 23-bp phylogenetic footprint exhibiting dyad symmetry. Systematic examination of the homologous CP promoter segment of 132 New World BGVs revealed the existence of a quasi-palindromic DNA segment displaying a strongly conserved ACTT-(N7)-AAGT core. The spacer sequence between the palindromic motifs is constant in length, but its sequence is highly variable among viral species, presenting a relaxed consensus (TT)GGKCCCY, which is similar to the Conserved Late Element or CLE (GTGGTCCC), a putative TrAP-responsive element. The homologous CP promoter region of Old World BGVs exhibited a distinct organization, with the putative TATA-box overlapping the left half of the ACTT-N7 composite element. Similar CP promoter sequences, dubbed “TATA-associated composite element” or TACE, were found in viruses belonging to different Geminiviridae genera, hence hinting unsuspected evolutionary relationships among those lineages. To get cues about the TACE function, the regulatory function of the CLE was explored in distinct experimental systems. Transgenic tobacco plants harboring a GUS reporter gene driven by a promoter composed by CLE multimers expressed high beta-glucuronidase activity in absence of viral factors, and that expression was increased by begomovirus infection. On the other hand, the TrAP-responsiveness of a truncated CP promoter of Tomato golden mosaic virus (TGMV) was abolished by site-directed mutation of the only CLE present in it, whereas the artificial addition of one CLE to the -125 truncated promoter strongly enhanced the transactivation level in tobacco protoplasts. These results indicate that the CLE is a TrAP-responsive element, hence providing valuable clues to interpret the recurrent association of the CLE with the TACE. On the basis of the aforesaid direct evidences and the insights afforded by the extensive comparative analysis of BleICV CP promoter, we propose that the TACE might be involved in the TrAP-mediated derepression of CP gene in vascular tissues.

COVID-19 anxiety, psychological well-being and preventive behaviors during the COVID-19 pandemic in Latin America and the Caribbean: relationships and explanatory model

This study assesses the relationship between COVID-19 anxiety and subjective well-being in terms of the mediating role of COVID-19 preventive behaviors. Additionally, the contribution of sociodemographic factors (sex and age) and risk perception on COVID-19 anxiety and its potential measurement invariance was tested in 5655 participants from 12 countries in Latin America and the Caribbean. A mixture of both latent and observable variables were analyzed using a system of structural equations. The Coronavirus Anxiety Scale (CAS), Preventive COVID-19 Infection Behaviors Scale (PCIBS) and single-item measures were used to assess the perceived probability of death, perceived severity and concern about transmitting COVID-19. The results indicated that there is a significant and relevant direct effect of COVID-19 anxiety on participants' well-being. Furthermore, COVID-19 anxiety significantly predicted both preventive behavior (β = .29, p < .01) and well-being (β = –.32, p < .01). The effects of COVID anxiety and preventive behavior explained 9.8% of the variance in well-being (R-square = .098); whereas, 8.4% of the variance in preventive behavior was associated with COVID anxiety (R-square = .084). Likewise, perceived likelihood of death from COVID, perceived severity of COVID, and concerns about COVID transmission were positively related to anxiety. Age was negatively related to anxiety, with men being less anxious than women. The results are invariant by country, i.e., the broad relationships found in the combined sample are also present in each individual country. The findings indicate that, although the exact relationships between variables may vary between countries, there are enough similarities to provide useful information about the impact of the COVID-19 pandemic in each of the countries included in the study

Is the meaning of subjective well-being similar in Latin American countries? A cross-cultural measurement invariance study of the WHO-5 well-being index during the COVID-19 pandemic

"Background: There is an urgent need to assess changes in well-being on a multinational scale during the COVID-19 pandemic, thus culturally valid scales must be available. Methods: With this in mind, this study examined the invariance of the WHO well-being index (WHO-5) among a sample of 5183 people from 12 Latin Americans countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, and Uruguay). Results: The results of the present study indicate that the WHO-5 is strictly invariant across samples from different Latin American countries. Furthermore, the results of the IRT analysis indicate that all items of the WHO-5 were highly discriminative and that the difficulty required to respond to each of the five items is ascending. Additionally, the results indicated the presence of moderate and small size differences in subjective well-being among most countries. Conclusion: The WHO-5 is useful for assessing subjective well-being in 12 Latin American countries during the COVID-19 pandemic, since the differences between scores can be attributed to differences in well-being and not in other characteristics of the scale.

What Is the Support for Conspiracy Beliefs About COVID-19 Vaccines in Latin America? A Prospective Exploratory Study in 13 Countries

Conspiracy theories about COVID-19 began to emerge immediately after the first news about the disease and threaten to prolong the negative impact of the COVID-19 pandemic by limiting people’s willingness of receiving a life-saving vaccine. In this context, this study aimed to explore the variation of conspiracy beliefs regarding COVID-19 and the vaccine against it in 5779 people living in 13 Latin American countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela) according to sociodemographic variables such as gender, age, educational level and source of information about COVID-19. The study was conducted during the COVID-19 pandemic between September 15 and October 25, 2021. The Spanish-language COVID-19 Vaccine Conspiracy Beliefs Scale (ECCV-COVID) and a sociodemographic survey were used. The results indicate that, in most countries, women, people with a lower educational level and those who receive information about the vaccine and COVID-19 from family/friends are more supportive of conspiracy ideas regarding the COVID-19 vaccine. In the case of age, the results vary by country. The analysis of the responses to each of the questions of the ECCV-COVID reveals that, in general, the countries evaluated are mostly in some degree of disagreement or indecision regarding conspiratorial beliefs about COVID-19 vaccines. The findings could help open further study which could support prevention and treatment efforts during the COVID-19 pandemic

Design and Cross-Cultural Invariance of the COVID-19 Vaccine Conspiracy Beliefs Scale (COVID-VCBS) in 13 Latin American Countries

"Aims: Over the past 2 years, the vaccine conspiracy beliefs construct has been used in a number of different studies. These publications have assessed the determinants and outcomes of vaccine conspiracy beliefs using, in some cases, pooled data from different countries, and compared the results across these contexts. However, studies often do not consider measurement invariance as a necessary requirement for comparative analyses. Therefore, the aim of this study was to develop and evaluate the crosscultural MI of the COVID-19 Vaccine Conspiracy Beliefs Scale (COVID-VCBS) in 12 Latin American countries. Methods: Confirmatory factor analysis, item response theory analysis and alignment method were applied to test measurement invariance in a large number of groups. Results: The COVID-VCBS showed robust psychometric properties and measurement invariance for both factor loadings and crosstabs. Also, a higher level of acceptance of conspiracy beliefs about vaccines is necessary to respond to higher response categories. Similarly, greater acceptance of conspiracy beliefs about COVID-19 vaccines was related to a lower intention to be vaccinated. Conclusion: The results allow for improved understanding of conspiracy beliefs about COVID-19 vaccines in the countries assessed; furthermore, they provide researchers and practitioners with an invariant measure that they can use in cross-cultural studies in Latin America. However, further studies are needed to test invariance in other countries, with the goal of developing a truly international measure of conspiracy beliefs about COVID-19 vaccines.

Network analysis of the relationships between conspiracy beliefs towards COVID-19 vaccine and symptoms of fear of COVID-19 in a sample of latin american countries

The present study examined how conspiracy beliefs about COVID-19 vaccines specifically relate to symptoms of fear of COVID-19 in a sample of four South American countries. A total of 1785 people from Bolivia, Colombia, Ecuador, and Peru participated, responding to a sociodemographic survey, the Fear of COVID-19 scale (FCV-19 S) and the Vaccine Conspiracy Beliefs Scale-COVID-19 (VCBS-COVID-19). Network analysis identified the most important symptoms of fear and conspiracy beliefs about COVID-19 vaccines (nodes) and the associations between them (edges). In addition, the robustness of the network of these indicators of centrality and the possible differences in the structure and connectivity of the networks between the four countries were evaluated. The results suggest that the nodes with the highest centrality were items 2 and 5 of the FCV-19 S and item 2 of the VCBS-COVID-19. Likewise, item 6 is the belief that most predicts conspiracy beliefs about vaccines against COVID-19; while item 6 was the symptom that most predicts fear of COVID-19. The findings strongly support cross-cultural similarities in the networks across the four countries rather than differences. Although it was expected that a higher presence of symptoms of fear of COVID-19 may lead people to compensate for their fear by believing in conspiratorial ideas about vaccines and, consequently, rejecting the COVID-19 vaccine, the results do not clearly show this relationship. This could lead other researchers to generate evidence to explain the differences between Latin American countries and countries in other contexts in terms of vaccination rates. This evidence could be useful to develop policies favoring vaccination against COVID-19 that are more contextualized to the Latin American region, characterized by social instability and economic recession during the pandemic