Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA)

OBJECTIVES: The aims of the Online Latin American Survey of Anaphylaxis (OLASA) were to identify the main clinical manifestations, triggers, and treatments of severe allergic reactions in patients who were seen by allergists from July 2008 to June 2010 in 15 Latin American countries and Portugal (n =634). RESULTS: Of all patients, 68.5% were older than 18 years, 41.6% were male, and 65.4% experienced the allergic reaction at home. The etiologic agent was identified in 87.4% of cases and predominantly consisted of drugs (31.2%), foods (23.3%), and insect stings (14.9%). The main symptom categories observed during the acute episodes were cutaneous (94.0%) and respiratory (79.0%). The majority of patients (71.6%) were treated initially by a physician (office/emergency room) within the first hour after the reaction occurred (60.2%), and 43.5% recovered in the first hour after treatment. Most patients were treated in an emergency setting, but only 37.3% received parenteral epinephrine alone or associated with other medication. However, 80.5% and 70.2% were treated with corticosteroids or antihistamines (alone or in association), respectively. A total of 12.9% of the patients underwent reanimation maneuvers, and 15.2% were hospitalized. Only 5.8% of the patients returned to the emergency room after discharge, with 21.7% returning in the first 6 hours after initial treatment. CONCLUSION: The main clinical manifestations of severe allergic reactions were cutaneous. The etiologic agents that were identified as causing these acute episodes differed according to age group. Following in order: drugs (31.2%), foods (23.3% and insect stings (14.9%) in adults with foods predominance in children. Treatment provided for acute anaphylactic reactions was not appropriate. It is necessary to improve educational programs in order to enhance the knowledge on this potentially fatal emergency.Federal University of São Paulo Clinical Immunology and Rheumatology Department of Pediatrics Division of AllergyUniversidad del Salvador Medical School ImmunologyClínica Santa Isabel Head of the Division of Allergy and ImmunologyCentro Médico-Docente La Trinidad Allergy and Clinical Immunology DepartmentClínica El Avila Head of Allergy and Immunology DepartmentUniversity of Montes ClarosFederal University of Paraná Department of PediatricsNational University of Rosario Faculty of Medical SciencesFederal Faculty Foundation of Medical Sciences of Porto Alegre Division of Immunology and ImmunopathologyUNIFESP, Clinical Immunology and Rheumatology Department of Pediatrics Division of AllergySciEL

Individual Tree Diameter and Height Growth Models for 30 Tree Species in Mixed-Species and Uneven-Aged Forests of Mexico

Lack of knowledge of individual tree growth in species-rich, mixed forest ecosystems impedes their sustainable management. In this study, species-specific models for predicting individual diameter at breast height (dbh) and total tree height (h) growth were developed for 30 tree species growing in mixed and uneven-aged forest stands in Durango, Mexico. Growth models were also developed for all pine, all oaks, and all other species of the genus Arbutus (strawberry trees). A database of 55,158 trees with remeasurements of dbh and h of a 5-year growth period was used to develop the models. The data were collected from 217 stem-mapped plots located in the Sierra Madre Occidental (Mexico). Weighted regression was used to remove heteroscedasticity from the species-specific dbh and h growth models using a power function of the tree size independent variables. The final models developed in the present study to predict dbh and total tree height growth included size variables, site factors, and competition variables in their formulation. The developed models fitted the data well and explained between 98 and 99% and of the observed variation of dbh, and between 77 and 98% of the observed variation of total tree height for the studied species and groups of species. The developed models can be used for estimating the individual dbh and h growth for the analyzed species and can be integrated in decision support tools for management planning in these mixed forest ecosystemsThis study was supported by the National Forestry Commission (CONAFOR) and the Mexican National Council for Science and Technology (CONACYT)S

Near Real-Time Automated Early Mapping of the Perimeter of Large Forest Fires from the Aggregation of VIIRS and MODIS Active Fires in Mexico

In contrast with current operational products of burned area, which are generally available one month after the fire, active fires are readily available, with potential application for early evaluation of approximate fire perimeters to support fire management decision making in near real time. While previous coarse-scale studies have focused on relating the number of active fires to a burned area, some local-scale studies have proposed the spatial aggregation of active fires to directly obtain early estimate perimeters from active fires. Nevertheless, further analysis of this latter technique, including the definition of aggregation distance and large-scale testing, is still required. There is a need for studies that evaluate the potential of active fire aggregation for rapid initial fire perimeter delineation, particularly taking advantage of the improved spatial resolution of the Visible Infrared Imaging Radiometer (VIIRS) 375 m, over large areas and long periods of study. The current study tested the use of convex hull algorithms for deriving coarse-scale perimeters from Moderate Resolution Imaging Spectroradiometer (MODIS) and Visible Infrared Imaging Radiometer Suite (VIIRS) active fire detections, compared against the mapped perimeter of the MODIS collection 6 (MCD64A1) burned area. We analyzed the effect of aggregation distance (750, 1000, 1125 and 1500 m) on the relationships of active fire perimeters with MCD64A1, for both individual fire perimeter prediction and total burned area estimation, for the period 2012–2108 in Mexico. The aggregation of active fire detections from MODIS and VIIRS demonstrated a potential to offer coarse-scale early estimates of the perimeters of large fires, which can be available to support fire monitoring and management in near real time. Total burned area predicted from aggregated active fires followed the same temporal behavior as the standard MCD64A1 burned area, with potential to also account for the role of smaller fires detected by the thermal anomalies. The proposed methodology, based on easily available algorithms of point aggregation, is susceptible to be utilized both for near real-time and historical fire perimeter evaluation elsewhere. Future studies might test active fires aggregation between regions or biomes with contrasting fuel characteristics and human activity patterns against medium resolution (e.g., Landsat and Sentinel) fire perimeters. Furthermore, coarse-scale active fire perimeters might be utilized to locate areas where such higher-resolution imagery can be downloaded to improve the evaluation of fire extent and impactFunding for this study was provided by CONAFOR/CONACYT Projects “CO2-2014-3-252620” and “CO-2018-2-A3-S-131553” for the development and enhancement of a Forest Fire Danger Prediction System for Mexico, funded by the Sectorial Fund for forest research, development and technological innovation “Fondo Sectorial para la investigación, el desarrollo y la innovación tecnológica forestal”S

Flow Diverter Treatment for Non-Ruptured Carotid Aneurysms: Efficacy and Safety

Purpose Internal carotid artery (ICA) aneurysm treatment with a flow diverter (FD) has shown an adequate efficacy and safety profile, presenting high complete occlusion or near occlusion rates with low complications during follow-up. The purpose of this study was to evaluate the efficacy and safety of FD treatment in non-ruptured internal carotid aneurysms. Materials and Methods This is a retrospective, single-center, observational study evaluating patients diagnosed with unruptured ICA aneurysms treated with an FD between January 1, 2014, and January 1, 2020. We analyzed an anonymized database. The primary effectiveness endpoint was complete occlusion (O’Kelly–Marotta D, OKM-D) of the target aneurysm through 1-year follow-up. The safety endpoint was the evaluation of modified Rankin Scale (mRS) 90 days after treatment, considering a favorable outcome an mRS 0-2. Results A total of 106 patients were treated with an FD, 91.5% were women; the mean follow- up was 427.2±144.8 days. Technical success was achieved in 105 cases (99.1%). All patients included had 1-year follow-up digital subtraction angiography control; 78 patients (73.6%) completed the primary efficacy endpoint by achieving total occlusion (OKM-D). Giant aneurysms had a higher risk of not achieving complete occlusion (risk ratio, 3.07; 95% confidence interval, 1.70 - 5.54]). The safety endpoint of mRS 0-2 at 90 days was accomplished in 103 patients (97.2%). Conclusion Treatment of unruptured ICA aneurysms with an FD showed high 1-year total occlusion results, with very low morbidity and mortality complications

Temporal patterns of active fire density and its relationship with a satellite fuel greenness index by vegetation type and region in Mexico during 2003-2014

Background: Understanding the temporal patterns of fire occurrence and their relationships with fuel dryness is key to sound fire management, especially under increasing global warming. At present, no system for prediction of fire occurrence risk based on fuel dryness conditions is available in Mexico. As part of an ongoing national-scale project, we developed an operational fire risk mapping tool based on satellite and weather information. Results: We demonstrated how differing monthly temporal trends in a fuel greenness index, dead ratio (DR), and fire density (FDI) can be clearly differentiated by vegetation type and region for the whole country, using MODIS satellite observations for the period 2003 to 2014. We tested linear and non-linear models, including temporal autocorrelation terms, for prediction of FDI from DR for a total of 28 combinations of vegetation types and regions. In addition, we developed seasonal autoregressive integrated moving average (ARIMA) models for forecasting DR values based on the last observed values. Most ARIMA models showed values of the adjusted coefficient of determination (R2 adj) above 0.7 to 0.8, suggesting potential to forecast fuel dryness and fire occurrence risk conditions. The best fitted models explained more than 70% of the observed FDI variation in the relation between monthly DR and fire density. Conclusion: These results suggest that there is potential for the DR index to be incorporated in future fire risk operational tools. However, some vegetation types and regions show lower correlations between DR and observed fire density, suggesting that other variables, such as distance and timing of agricultural burn, deserve attention in future studiesAntecedentes: Una adecuada planificación del manejo del fuego requiere de la comprensión de los patrones temporales de humedad del combustible y su influencia en el riesgo de incendio, particularmente bajo un escenario de calentamiento global. En la actualidad en México no existe ningún sistema operacional para la predicción del riesgo de incendio en base al grado de estrés hídrico de los combustibles. Un proyecto de investigación nacional actualmente en funcionamiento, tiene como objetivo el desarrollo de un sistema operacional de riesgo y peligro de incendio en base a información meteorológica y de satélite para México. Este estudio pertenece al citado proyecto Resultados: Se observaron en el país distintas tendencias temporales en un índice de estrés hídrico de los combustibles basado en imágenes MODIS, el índice “dead ratio” (DR), y en las tendencias temporales de un ìndice de densidad de incendios (FDI), en distintos tipos de vegetación y regiones del país. Se evaluaron varios modelos lineales y potenciales, incluyendo términos para la consideración de la autocorrelación temporal, para la predicción de la densidad de incendios a partir del índice DR para un total de 28 tipos de vegetación y regiones. Se desarrollaron además modelos estacionales autoregresivos de media móvil (ARIMA en inglés) para el pronóstico del índice DR a partir de los últimos valores observados. La mayoría de los modelos ARIMA desarrollados mostraron valores del coeficiente de determinación ajustado (R2 adj) por encima de 0.7 to 0.8, sugiriendo potencial para ser empleados para un pronóstico del estrés hídrico de los combustibles y las condiciones de riesgo de ocurrencia de incendio. Con respecto a los modelos que relacionan los valores mensuales de DR con FDI, la mayoría de ellos explicaron más del 70% de la variabilidad observada en FDI. Conclusiones: Los resultados sugirieron potencial del índice DR para ser incluido en futuras herramientas operacionales para determinar el riesgo de incendio. En algunos tipos de vegetación y regiones se obtuvieron correlaciones más reducidas entre el índice DR y los valores observados de densidad de incendios, sugiriendo que el papel de otras variables tales como la distancia y el patrón temporal de quemas agrícolas debería ser explorado en futuros estudiosFunding for this work was provided by CONAFOR-CONACYT Project 252620 “Development of a Fire Danger System for Mexico.” This work was also cofinanced by the Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria and European Social Fund (Dr. E. Jiménez grant)S

Izaña Atmospheric Research Center. Activity Report 2021-2022

Editors: Emilio Cuevas, Celia Milford and Oksana Tarasova.[EN]The Izaña Atmospheric Research Center (IARC), which is part of the State Meteorological Agency of Spain (AEMET), is a site of excellence in atmospheric science. It manages four observatories in Tenerife including the high altitude Izaña Atmospheric Observatory. The Izaña Atmospheric Observatory was inaugurated in 1916 and since that date has carried out uninterrupted meteorological and climatological observations, contributing towards a unique 100-year record in 2016. This reports are a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues.[ES]El Centro de Investigación Atmosférica de Izaña (CIAI), que forma parte de la Agencia Estatal de Meteorología de España (AEMET), representa un centro de excelencia en ciencias atmosféricas. Gestiona cuatro observatorios en Tenerife, incluido el Observatorio de Izaña de gran altitud, inaugurado en 1916 y que desde entonces ha realizado observaciones meteorológicas y climatológicas ininterrumpidas y se ha convertido en una estación centenaria de la OMM. Estos informes resumen las múltiples actividades llevadas a cabo por el Centro de Investigación Atmosférica de Izaña. El liderazgo del Centro en materia de investigación y desarrollo con respecto a las técnicas de medición, calibración y validación de última generación, así como la cooperación internacional, le han otorgado una reputación sobresaliente en lo que se refiere al tiempo, el clima, la hidrología y otros temas ambientales afines

Izaña Atmospheric Research Center. Activity Report 2019-2020

Editors: Emilio Cuevas, Celia Milford and Oksana Tarasova.[EN]The Izaña Atmospheric Research Center (IARC), which is part of the State Meteorological Agency of Spain (AEMET), is a site of excellence in atmospheric science. It manages four observatories in Tenerife including the high altitude Izaña Atmospheric Observatory. The Izaña Atmospheric Observatory was inaugurated in 1916 and since that date has carried out uninterrupted meteorological and climatological observations, contributing towards a unique 100-year record in 2016. This reports are a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues.[ES]El Centro de Investigación Atmosférica de Izaña (CIAI), que forma parte de la Agencia Estatal de Meteorología de España (AEMET), representa un centro de excelencia en ciencias atmosféricas. Gestiona cuatro observatorios en Tenerife, incluido el Observatorio de Izaña de gran altitud, inaugurado en 1916 y que desde entonces ha realizado observaciones meteorológicas y climatológicas ininterrumpidas y se ha convertido en una estación centenaria de la OMM. Estos informes resumen las múltiples actividades llevadas a cabo por el Centro de Investigación Atmosférica de Izaña. El liderazgo del Centro en materia de investigación y desarrollo con respecto a las técnicas de medición, calibración y validación de última generación, así como la cooperación internacional, le han otorgado una reputación sobresaliente en lo que se refiere al tiempo, el clima, la hidrología y otros temas ambientales afines

El desafío de la paz: Colombia, Guatemala, Ucrania y El Salvador a la luz de los Objetivos de Desarrollo Sostenible

Recoge las ponencias expuestas por treinta y una personalidades académicas y políticas de talla internacional además de las intervenciones de las autoridades académicas de la Universidad Carlos III de Madrid y del Ministerio de Derechos Sociales y Agenda 2030, presentadas en cuatro seminarios, que comenzaron con los relativos a los procesos de paz en Colombia y Guatemala, a fines de 2021, que continuaron el 30 de marzo de 2022 con la jornada dedicada a las herramientas para buscar una solución diplomática a la guerra en Ucrania (solo un mes después de la invasión rusa) y en junio del mismo año con el relativo a los acuerdos de 1992 en El Salvador. Dichos seminarios fueron: "Los Acuerdos de Paz en Colombia, cinco años después". (Madrid, 29 y 30 de noviembre de 2021); "Los Acuerdos de Paz en Guatemala, veinticinco años después". (Madrid, 13 de diciembre de 2021); "Ucrania: Solución negociada, seguridad compartida". (Madrid, 30 de marzo de 2022); "Los Acuerdos de Paz de El Salvador, treinta años después, en el marco de la Agenda 2030". (Madrid, 22 de junio de 2022)Presentación / Juan Daniel Oliva, Carlos R. Fernández Liesa (pp.12-14). -- Prólogo / Lilith Verstrynge Revuelta, (pp. 15-16). -- Primera parte: Los acuerdos de paz en Colombia, cinco años después (p. 18). -- Apertura / Juan Romo Uroz (pp. 18-20). -- [Apertura] / Ione Belarra (pp. 20-23). -- Hacer la paz es más difícil que hacer la guerra / Juan Manuel Santos Calderón (pp. 23-27). -- No hay un acuerdo de paz que tenga un calado de reformas como el colombiano / Josefina Echavarría Álvarez (pp. 28-34). -- Juramos que nuestra única arma sería la palabra / Rodrigo Londoño Echeverri (pp. 34-38). -- Tuvisteis que hacer frente a una coyuntura política dificilísima / José Luis Rodríguez Zapatero (pp. 38-42). -- Segunda mesa: Balance, implementación y Agenda 2030 / Enrique Santiago (pp. 43-46). -- Solicito la apertura del macrocaso de la responsabilidad del Estado / Álvaro Leyva Durán (pp. 47-53). -- En Colombia existen más de cien mil desaparecidos / Luz Marina Monzón Cifuentes (pp. 54-61). -- No hay contradicción entre la búsqueda de la paz y la de la justicia / Yesid Reyes Alvarado (pp. 62-67). -- Logramos el primer acuerdo de paz con enfoque de género / Gloria Inés Ramírez (pp. 68-74). -- Segunda parte. Los Acuerdos de Paz en Guatemala, veinticinco años después (p. 75). -- Apertura / J. Daniel Oliva Martínez (pp. 75-76) , Enrique Santiago Romero (pp. 77-78). -- Guatemala es hoy un Estado capturado por mafias / José Manuel Martín Medem (pp. 78-81). -- Se firmó la paz, pero falta la construcción de una cultura de paz / Olinda Salguero (pp. 81-85). -- Guatemala se halla en el peor escenario en materia de derechos humanos desde 1986 / Velia Muralles (pp. 85-90). -- Las comisiones de la verdad registraron unas doscientas mil personas desaparecidas y ejecutadas / Erik de León (pp. 90-94). -- El problema fundamental era y es la marginación de los grupos indígenas y la pobreza extrema / Vinicio Cerezo Arévalo (pp. 94-102). -- Guatemala está peor que cuando firmamos la paz / Pablo Monsanto (pp. 103-109). -- Guatemala es un barril de pólvora con la mecha prendida / Ana Isabel Prera (pp. 109-115). -- Clausura / Ione Belarra (pp. 115-120). -- Tercera parte. Ucrania: Solución negociada, seguridad compartida (p. 121). Apertura / María Luisa González Cuéllar Serrano, Ione Belarra (pp. 122-125). -- Debemos trabajar para exponer las amenazas de esta guerra. Es necesario para sobrevivir / Noam Chomsky (pp. 125-132). -- Primera Mesa - La negociación como herramienta de resolución de conflictos / Santiago Jiménez Martín (p. 133). -- Trabajar por la paz acarrea incomprensiones y entraña riesgos / Yago Pico de Coaña (pp. 134-139). -- La Unión Europea debe volver a un papel de potencia pacífica / Gianni Labella (pp. 140-145). -- Las armas no nos salvarán / Carmen Magallón Portoles (pp. 145-149). -- Segunda mesa: Construcción de paz y seguridad compartida en Europa / Cástor Díaz Barrado (pp. 149-150). -- Un mundo sin armas nucleares es necesario y posible / Carlos Umaña (pp. 151-154). -- Pedimos una solución diplomática negociada / Mariela Kohon (pp. 155-159). -- Hay que avanzar hacia una arquitectura de seguridad europea basada en la seguridad compartida / Vicenç Fisas Armengol (pp. 159-162). -- Que la guerra en Ucrania no nos lleve a olvidar los otros conflictos armados, que también requieren nuestro apoyo / Mabel González Bustelo (pp. 163-168). -- Clausura / Carlos Fernández Liesa, Enrique Santiago (pp. 168-173). -- Cuarta parte. Los Acuerdos de Paz de El Salvador, treinta años después, en el marco de la Agenda 2030 (p. 174). -- Apertura / Montserrat Huguet Santos, Enrique Santiago (pp. 175-178). -- Hicimos la paz a través del diálogo político en medio de la guerra / Óscar Santamaría (pp. 178-182). -- Agradecemos el acompañamiento y la solidaridad de la comunidad internacional / Nidia Díaz (pp. 183-190). -- El proceso de paz no fue una confrontación ideológica / Álvaro de Soto (pp. 190-196). -- Fue el momento más importante desde la independencia nacional / Rubén Zamora (pp. 196-201). -- Segunda mesa: Los Acuerdos de Paz treinta años después: Balance, implementación y Agenda 2030 / Daniel Oliva (pp. 202-203). -- El presidente Bukele se burla de los acuerdos de paz / David Morales (pp. 203-209). -- Están en riesgo los derechos conquistados por las mujeres / Lorena Peña (pp. 209-212). -- Necesitamos una alianza en defensa de los derechos humanos / José María Tojeira (pp. 213-216). -- Tenemos que construir la unidad opositora para desplazar a esta dictadura de nuevo tipo / Maricela Ramírez (pp. 217-222). -- Clausura / Matilde Sánchez, Ione Belarra (pp. 222-224). -- Epílogo / Federico Mayor Zaragoza (pp. 225-228)

The Caldera. No. 23

La pandemia, sin lugar a dudas, nos ha cambiado la vida a todos; un viernes nos fuimos para nuestros hogares, en el marco de una educación presencial; al lunes siguiente, después de dos días, estábamos iniciando el camino hacia una educación remota, una educación virtual, que se ha convertido en una gran alternativa para seguir contribuyendo con la formación de nuestros niños y jóvenes caldistas y al mejoramiento de nuestra calidad de vida que halla, en la educación, nuevamente la respuesta; han sido meses de cambios drásticos, inimaginables pero, cambios positivos que nos han permitido crecer como individuos, como familia, como escuela y como sociedad.Especial pandemia. Una generación Resiliente por promoción DINASTIA…06 VII Concurso Intercolegiado departamental de Oratoria. Ulibro 2020…51 Deporte en el Caldas…64 Expresiones Caldistas…71 Celebremos la palabra…93 Nuestros Maestros…102 Galería de Imágenes…107The pandemic, without a doubt, has changed the lives of all of us; One Friday we went to our homes, as part of a face-to-face education; The following Monday, after two days, we were starting the path towards a remote education, a virtual education, which has become a great alternative to continue contributing to the training of our children and young Caldistas and to the improvement of our quality of life. that finds, in education, the answer again; They have been months of drastic changes, unimaginable but positive changes that have allowed us to grow as individuals, as a family, as a school and as a society

Association of Candidate Gene Polymorphisms With Chronic Kidney Disease: Results of a Case-Control Analysis in the Nefrona Cohort

Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2, 445 CKD cases and 559 controls. Genotyping was performed with matrix assisted laser desorption ionizationtime of flight mass spectrometry. We used logistic regression models considering different genetic inheritance models to assess the association of the SNPs with the prevalence of CKD, adjusting for known risk factors. Eight SNPs (rs1126616, rs35068180, rs2238135, rs1800247, rs385564, rs4236, rs2248359, and rs1564858) were associated with CKD even after adjusting by sex, age and race. A model containing five of these SNPs (rs1126616, rs35068180, rs1800247, rs4236, and rs2248359), diabetes and hypertension showed better performance than models considering only clinical risk factors, significantly increasing the area under the curve of the model without polymorphisms. Furthermore, one of the SNPs (the rs2248359) showed an interaction with hypertension, being the risk genotype affecting only hypertensive patients. We conclude that 5 SNPs related to proteins implicated in mineral metabolism disturbances (Osteopontin, osteocalcin, matrix gla protein, matrix metalloprotease 3 and 24 hydroxylase) are associated to an increased risk of suffering CKD