Rapid diagnostic tests duo as alternative to conventional serological assays for conclusive Chagas disease diagnosis

Chagas disease is caused by the parasite Trypanosoma cruzi. It affects several million people, mainly in Latin America, and severe cardiac and/or digestive complications occur in ~30% of the chronically infected patients. Disease acute stage is mostly asymptomatic and infection goes undiagnosed. In the chronic phase direct parasite detection is hampered due to its concealed presence and diagnosis is achieved by serological methods, like ELISA or indirect hemagglutination assays. Agreement in at least two tests must be obtained due to parasite wide antigenic variability. These techniques require equipped labs and trained personnel and are not available in distant regions. As a result, many infected people often remain undiagnosed until it is too late, as the two available chemotherapies show diminished efficacy in the advanced chronic stage. Easy-to-use rapid diagnostic tests have been developed to be implemented in remote areas as an alternative to conventional tests. They do not need electricity, nor cold chain, they can return results within an hour and some even work with whole blood as sample, like Chagas Stat-Pak (ChemBio Inc.) and Chagas Detect Plus (InBIOS Inc.). Nonetheless, in order to qualify a rapidly diagnosed positive patient for treatment, conventional serological confirmation is obligatory, which might risk its start. In this study two rapid tests based on distinct antigen sets were used in parallel as a way to obtain a fast and conclusive Chagas disease diagnosis using whole blood samples. Chagas Stat-Pak and Chagas Detect Plus were validated by comparison with three conventional tests yielding 100% sensitivity and 99.3% specificity over 342 patients seeking Chagas disease diagnosis in a reference centre in Sucre (Bolivia). Combined used of RDTs in distant regions could substitute laborious conventional serology, allowing immediate treatment and favouring better adhesion to it

Cognitive decline and healthy aging: an online activities and psychoeducational program for older adults in the context of COVID-19 Pandemic: preliminary results

AbstractBackground: The preventive and compulsory social isolation regulations due to COVID-19 affected the entire population, but this became more emphasized in the group of older adults. Many older adults who attended workshops, retirement centers and clubs had to interrupt their activities. This has impacted negatively on their activity level, socialization, and emotional state. The aim of the present study is to present preliminary results of the implementation of an online activities and psychoeducational program to prevent cognitive decline and promote healthy aging habits on older adults who live in Argentina in the context of Covid-19 Pandemic.Method. Design: Descriptive study. Subjects: 396 self-validated older adults, male and female. Instruments: socio-demographic and social participation questionnaire. Procedure: The intervention consists of a series of workshops (yoga, meditation, gym, singing lessons, memory, preparation for retirement and reflection about grief) and monthly specialist ´s talks on different topics about healthy aging. All the activities where done through zoom platform. All participants where offer one to one capacitation and written material about how to use this platform. Older adults could choose in how many activities they would take part in.Results. Data of 396 older adults who have taken part in the on-line version of the program on 2020 indicate that median age was 70.66 years old (ds= 8,7) of which 86 % were women. 79 % took part in specialists talks and 68 % on workshops and talks.Discussion: These results provide empirical evidence regarding the need to implement online intervention programs for older adults. Participating in an online educational program could increase participant?s cognitive healthy habits literacy, empowerment and engagement in brain health promotion activities, which in turn could reduce their dementia risk and feeling of loneliness in pandemic context.Fil: Feldberg, Carolina. Instituto de Neurociencias Buenos Aires S. A.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Tartaglini, María Florencia. Instituto de Neurociencias Buenos Aires S. A.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Hermida, Paula Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; ArgentinaFil: Somale, Maria Veronica. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Orellano, Anabel. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Ortiz, Juan Pablo. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Teran, Claudio. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Kasten, Sergio. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: De Cara, Josefina. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Degtiar, Marina. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Langer, Camilo. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Benetti, Laureana. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Redoni, Emiliano. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Gracia, Claudia. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaAlzheimer's Association International ConferenceDenverEstados UnidosAlzheimer's Associatio

We have already heard that the treatment doesn't do anything, so why should we take it?: A mixed method perspective on Chagas disease knowledge, attitudes, prevention, and treatment behaviour in the Bolivian Chaco

Author summary Chagas disease (CD) is caused by infection with the parasite Trypanosoma cruzi and is on the list of the most neglected tropical diseases on Earth. It has become an international health issue affecting 6-7 million people worldwide, mainly in Latin America. We performed a qualitative and quantitative study in Monteagudo, Bolivia, in order to paint an overall picture of CD in one of the most afflicted regions in the world: the Bolivian Chaco. Community members and key informants, such as patients and healthcare staff helped us to understand their current situation. Even after a large health campaign, persistent knowledge gaps, misconceptions and structural barriers were identified, leading to normalization and acceptance of CD and its social consequences. Relevant findings included the broad use of ivermectin for CD treatment without scientific evidence. We also found that misinterpretations of serologic test results contribute to a critical attitude towards biomedical treatment that is stopping patients from seeking treatment. With this research we aim to update the data on current knowledge and to analyse remaining barriers for transmission control and treatment, in order to focus future interventions and advocate for patient's rights. Background: Chagas disease (CD) is highly endemic in the Bolivian Chaco. The municipality of Monteagudo has been targeted by national interventions as well as by Medecins Sans Frontieres to reduce infection rates, and to decentralize early diagnosis and treatment. This study seeks to determine the knowledge and attitudes of a population with increased awareness and to identify remaining factors and barriers for sustained vector control, health care seeking behaviour, and access, in order to improve future interventions. Methodology/Principal findings A cross-sectional survey was conducted among approximately 10% (n = 669) of the municipality of Monteagudo's households that were randomly selected. Additionally, a total of 14 in-depth interviews and 2 focus group discussions were conducted with patients and key informants. Several attitudes and practices were identified that could undermine effective control against (re-)infection. Knowledge of clinical symptoms and secondary prevention was limited, and revealed specific misconceptions. Although 76% of the participants had been tested for CD, only 18% of those who tested positive concluded treatment with benznidazole (BNZ). Sustained positive serologies after treatment led to perceived ineffectiveness of BNZ. Moreover, access barriers such as direct as well as indirect costs, BNZ stock-outs and a fear of adverse reactions triggered by other community members made patients opt for alternative treatments against CD such as veterinary ivermectin, used by 28% of infected participants in our study. The lack of accessible care for chronic complications as well as socioeconomic consequences, such as the exclusion from both job opportunities and bank loans contributed to the ongoing burden of CD. Conclusions/Significance Large scale interventions should be accompanied by operational research in order to identify misconceptions and unintended consequences early on, to generate accessible data for future interventions, and for rigorous evaluation. An integrated, community-based approach tackling social determinants and including both traditional and animal health sectors might help to overcome current barriers and advocate for patients' rights

Expresión de genes involucrados en el estrés oxidativo e inflamación en neoplasias hematológicas

Introducción: varios estudios han encontrado evidencia de estrés oxidativo (EOx) crónico en lasneoplasias hematológicas (NH). Sin embargo, el mecanismo molecular subyacente asociado al EOxe inflamación en estas patologías, actualmente no está claro. Objetivos: analizar la expresión génicade enzimas antioxidantes y citoquinas inflamatorias y relacionarla con la expresión del gen Nrf2 ensujetos con NH. Materiales y Métodos: se realizó un estudio descriptivo entre junio de 2017 y mayode 2018. Se evaluó la expresión génica de catalasa (CAT), superóxido dismutasa (SOD), peroxirredoxina-2 (PRX-2), IL-6, TNF-α y Nrf2 por Retrotranscripción-PCR tiempo real en células mononuclearesde sangre periférica. Resultados: se analizaron 33 pacientes con NH y 22 controles sanos. Las NH detectadas,en orden de frecuencia, fueron: leucemias agudas 70 %, neoplasias linfoproliferativas (NLP)12 %, síndromes mielodisplásicos (SMD) 9 % y neoplasias mieloproliferativas (NMP) 9 %. El grupo NHmostró disminución significativa (p < 0,05) en la expresión de los genes de las enzimas y TNF-α enlos grupos SMD, NLP y NMP. La expresión del gen Nrf2 estuvo fuertemente asociada con la expresióndel gen PRX-2 (R2 = 0,73). Conclusiones: estos hallazgos reforzarían las bases de un potencial vínculoentre la disminución de los antioxidantes y el incremento de EOx en las NH, además de señalar a Nrf2como posible gen regulador del sistema antioxidante.Introduction: Several studies have found evidence of chronic oxidative stress (OxS) in hematologic neoplasia (HN). However, the underlying molecular mechanism associated with OxS and inflammation in these pathologies is currently unclear. Objectives: To analyze the gene expression of antioxidant enzymes and pro-inflammatory cytokines, and relate it to the expression of the Nrf2 gene in subjects with HN. Materials and Methods: A descriptive study was conducted between June 2017 and May 2018. Thirty-three HN patients and 22 healthy controls were studied. Catalase (CAT), superoxide dismutase (SOD), peroxiredoxin-2 (PRX-2), IL-6, TNF-α and Nrf2 gene expression was evaluated by realtime RT-PCR in peripheral mononuclear blood cells. Results: The HN identified, in frequency order, were: acute leukemia 70%, lymphoproliferative neoplasms (LPN) 12%, myelodysplastic syndromes (MDS) 9% and myeloproliferative neoplasms (MPN) 9%. HN patients showed a significant decrease (p<0.05) in the expression of enzyme genes and TNF-α in MDS, LPN and MPN. Nrf2 gene expression showed strong association with PRX-2 gene expression (R2=0.73). Conclusions: These findings strengthen the basis of a potential link between detoxifying enzymes and increased OxS levels in HN, besides showing Nrf2 as a possible regulatory gene of the antioxidant system.Fil: Haro, Ana Cecilia. Universidad Nacional de Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria; Argentina. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Aplicada; ArgentinaFil: Casas Silva, Maria Jimena. Gobierno de la Provincia de Tucumán. Ministerio de Salud. Sistema Provincial de Salud. Hospital Presidente Néstor Kirchner; ArgentinaFil: Agüero Aguilera, Ana Carolina. Universidad Nacional de Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria; Argentina. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Aplicada; ArgentinaFil: Teran, Magdalena María. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; Argentina. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Clínica Aplicada; ArgentinaFil: Ledesma Achem, Miryam Emilse. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Clínica Aplicada; ArgentinaFil: Monaco, Maria Eugenia. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Aplicada; ArgentinaFil: Issé, Blanca Alicia. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Clínica Aplicada; ArgentinaFil: Lazarte, Sandra Stella. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Bioquímica Clínica Aplicada; Argentin

Competencias de Tecnólogos en Radiología para manejo de reacciones adversas por medios de contraste. Pereira-Colombia

Las competencias son entendidas como características de los individuos, que, al enfrentarse a una situación, específicamente laboral, garantizan un acto adecuado a la necesidad del contexto. Este estudio pretende determinar las competencias de los Tecnólogos en Radiología que laboran en Pereira, para el manejo de las reacciones adversas durante la administración de medios de contraste yodados endovenosos, durante el segundo semestre de 2017, a través de un estudio descriptivo con fuente de datos primaria, por medio de la aplicación de un test, donde se evaluarán aspectos teóricos y prácticos, referentes a la reacción frente a casos hipotéticos, buscando evidenciar fortalezas y debilidades del recursohumano, y diseñar estrategias que mejoren la seguridad del paciente en larealización de este tipo de exámenes diagnósticos

Competencias de Tecnólogos en Radiología para manejo de reacciones adversas por medios de contraste. Pereira-Colombia

Las competencias son entendidas como características de los individuos, que, al enfrentarse a una situación, específicamente laboral, garantizan un acto adecuado a la necesidad del contexto. Este estudio pretende determinar las competencias de los Tecnólogos en Radiología que laboran en Pereira, para el manejo de las reacciones adversas durante la administración de medios de contraste yodados endovenosos, durante el segundo semestre de 2017, a través de un estudio descriptivo con fuente de datos primaria, por medio de la aplicación de un test, donde se evaluarán aspectos teóricos y prácticos, referentes a la reacción frente a casos hipotéticos, buscando evidenciar fortalezas y debilidades del recursohumano, y diseñar estrategias que mejoren la seguridad del paciente en larealización de este tipo de exámenes diagnósticos

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Violencia de pareja y dependencia emocional en estudiantes de Psicología de una universidad de Lima, 2022

El presente estudio tuvo como objetivo determinar la relación entre la Violencia de Pareja y la Dependencia Emocional. El enfoque es cuantitativo, de alcance correlacional, diseño de investigación fue no experimental y corte transversal. La muestra estuvo conformada por 345 estudiantes universitarios (mujeres= 286; varones= 59) pertenecientes a la carrera de Psicología de una Universidad Privada de Lima Metropolitana, matriculados y activos en el semestre académico 2022-1. Para la recolección de información se utilizó el Cuestionario de Violencia entre Novios (CUVINO) y el Cuestionario de Dependencia Emocional (CDE). Los resultados del análisis estadístico en torno al grado de correlación de Rho de Spearman entre las variables violencia de pareja y dependencia emocional (Rho= .724) y un p-valor (sig. Bilateral) =.000. Por último, se concluye que, existe una correlación positiva considerable y significativa entre la Violencia de Pareja y la Dependencia Emocional en estudiantes de Psicología