Sífilis secundaria en gestante con coinfección por VIH en norte de Santander, Colombia: reporte de caso

Objective: To report the case of a pregnant, Venezuelan migrant woman, diagnosed with secondary syphilis and HIV coinfection. Materials and Methods: A review of the related literature was carried out, identifying the importance of the case in the current migration situation. Case presentation: A 22-year-old woman with a pregnancy of 20.6 weeks, without prenatal check-ups, consulted due to the appearance of skin lesions of 3 months of evolution. Secondary syphilis was diagnosed, antibiotic treatment was started, and the patient was referred to the primary care service for the migrant population. Subsequently, HIV coinfection was diagnosed. The infectious disease service indicated antiretroviral therapy (ART). However, treatment was not started due to her illegal migrant status. After 3 months, the patient consulted for pelvic pain. It was decided to end the pregnancy via cesarean section and to perform tubal ligation. Preoperative prophylaxis was implemented. A female product was obtained in which congenital syphilis was ruled out and which was considered of low risk for HIV infection. Conclusion: The incidence of gestational syphilis in Venezuelan patients who have migrated to Colombia has increased markedly. Public health policies must be established to facilitate access to health services and STD prevention programs in this population.Objetivo: Reportar el caso de una gestante, migrante de nacionalidad venezolana, diagnosticada con sífilis secundaria y coinfección por VIH.Materiales y Métodos: Se realizó revisión de la literatura relacionada, identificando la importancia del caso en la situación de migración actual.Presentación del caso: Mujer de 22 años con embarazo de 20,6 semanas, sin controles prenatales, consulta por lesiones cutáneas de 3 meses de evolución. Se diagnostica sífilis secundaria, se inicia tratamiento, y se remite a la paciente al servicio de atención en población migrante. Posteriormente, se diagnostica coinfección por VIH. Infectología indica terapia antirretroviral (TAR). Sin embargo, el tratamiento no se inicia debido a su condición de migrante ilegal. Transcurridos 3 meses, la paciente consulta por dolor pélvico. Se decide finalizar embarazo vía cesárea y realizar ligadura tubárica. Se implementó profilaxis preoperatoria. Se obtuvo producto de sexo femenino en el que se descartó sífilis congénita y que se consideró de bajo riesgo para infección por VIH.Conclusión: La incidencia de sífilis gestacional en pacientes venezolanos que han migrado a Colombia se ha incrementado notablemente. Se deben instaurar políticas en salud pública que faciliten el acceso a los servicios de salud y a programas de prevención de ETS en esta población

Nudges and other moral technologies in the context of power: Assigning and accepting responsibility

Strawson argues that we should understand moral responsibility in terms of our practices of holding responsible and taking responsibility. The former covers what is commonly referred to as backward-looking responsibility , while the latter covers what is commonly referred to as forward-looking responsibility . We consider new technologies and interventions that facilitate assignment of responsibility. Assigning responsibility is best understood as the second- or third-personal analogue of taking responsibility. It establishes forward-looking responsibility. But unlike taking responsibility, it establishes forward-looking responsibility in someone else. When such assignments are accepted, they function in such a way that those to whom responsibility has been assigned face the same obligations and are susceptible to the same reactive attitudes as someone who takes responsibility. One family of interventions interests us in particular: nudges. We contend that many instances of nudging tacitly assign responsibility to nudgees for actions, values, and relationships that they might not otherwise have taken responsibility for. To the extent that nudgees tacitly accept such assignments, they become responsible for upholding norms that would otherwise have fallen under the purview of other actors. While this may be empowering in some cases, it can also function in such a way that it burdens people with more responsibility that they can (reasonably be expected to) manage

Non-monotonic temperature evolution of dynamic correlations in glass-forming liquids

The viscosity of glass-forming liquids increases by many orders of magnitude if their temperature is lowered by a mere factor of 2-3 [1,2]. Recent studies suggest that this widespread phenomenon is accompanied by spatially heterogeneous dynamics [3,4], and a growing dynamic correlation length quantifying the extent of correlated particle motion [5-7]. Here we use a novel numerical method to detect and quantify spatial correlations which reveal a surprising non-monotonic temperature evolution of spatial dynamical correlations, accompanied by a second length scale that grows monotonically and has a very different nature. Our results directly unveil a dramatic qualitative change in atomic motions near the mode-coupling crossover temperature [8] which involves no fitting or indirect theoretical interpretation. Our results impose severe new constraints on the theoretical description of the glass transition, and open several research perspectives, in particular for experiments, to confirm and quantify our observations in real materials.Comment: 7 page

Molecular diversity and distribution of marine fungi across 130 European environmental samples.

Journal ArticleEnvironmental DNA and culture-based analyses have suggested that fungi are present in low diversity and in low abundance in many marine environments, especially in the upper water column. Here, we use a dual approach involving high-throughput diversity tag sequencing from both DNA and RNA templates and fluorescent cell counts to evaluate the diversity and relative abundance of fungi across marine samples taken from six European near-shore sites. We removed very rare fungal operational taxonomic units (OTUs) selecting only OTUs recovered from multiple samples for a detailed analysis. This approach identified a set of 71 fungal 'OTU clusters' that account for 66% of all the sequences assigned to the Fungi. Phylogenetic analyses demonstrated that this diversity includes a significant number of chytrid-like lineages that had not been previously described, indicating that the marine environment encompasses a number of zoosporic fungi that are new to taxonomic inventories. Using the sequence datasets, we identified cases where fungal OTUs were sampled across multiple geographical sites and between different sampling depths. This was especially clear in one relatively abundant and diverse phylogroup tentatively named Novel Chytrid-Like-Clade 1 (NCLC1). For comparison, a subset of the water column samples was also investigated using fluorescent microscopy to examine the abundance of eukaryotes with chitin cell walls. Comparisons of relative abundance of RNA-derived fungal tag sequences and chitin cell-wall counts demonstrate that fungi constitute a low fraction of the eukaryotic community in these water column samples. Taken together, these results demonstrate the phylogenetic position and environmental distribution of 71 lineages, improving our understanding of the diversity and abundance of fungi in marine environments.Gordon and Betty Moore FoundationDeutsche ForschungsgemeinschaftMarie Curie International Outgoing FellowshipMarie Curie Intra-European FellowshipEMBO Long-Term fellowshi

Hemoglobin A1c above Threshold Level is Associated with Decreased b-Cell Function in Overweight Latino Youth

Objective To examine whether a hemoglobin A1c (HbA1c)-identified prediabetic state (HbA1c $6.0%-6.4%) is associated with decreased insulin sensitivity (SI) and b-cell dysfunction, known factors in the pathogenesis of type 2 diabetes, in an overweight pediatric population. Study design A total of 206 healthy overweight Latino adolescents (124 males and 82 females; mean age, 13.1 AE 2.0 years) were divided into 2 groups: lower risk (n = 179), with HbA1c <6.0%, and higher risk (n = 27), with HbA1c 6.0%-6.4%. Measurements included HbA1c, oral glucose tolerance testing, fasting and 2-hour glucose and insulin, SI, acute insulin response, and disposition index (an index of b-cell function) by the frequently sampled intravenous glucose tolerance test with minimal modeling. Body fat was determined by dual-energy X-ray absorptiometry. Results Compared with the lower risk group, the higher risk group had 21% lower SI (1.21 AE 0.06 vs 1.54 AE 0.13; P < .05), 30% lower acute insulin response (928 AE 102 vs 1342 AE 56; P < .01), and a 31% lower disposition index (1390 AE 146 vs 2023 AE 83; P = .001) after adjusting for age and total percent body fat. Conclusion These data provide clear evidence of greater impairment of b-cell function in overweight Latino children with HbA1c 6.0%-6.4%, and thereby support the adoption of the International Expert Committee's HbA1c-determined definition of high-risk state for overweight children at risk for type 2 diabetes. (J Pediatr 2012;160:751-6). M ore than 40% of the US population suffers from diabetes or prediabetes

An Extension Study of PF-05280586, a Potential Rituximab Biosimilar, versus Rituximab in Subjects with Active Rheumatoid Arthritis

Objective; This extension study provided continued treatment to subjects with active rheumatoid arthritis who had participated for ≥16 weeks in a pharmacokinetic similarity study of PF‐05280586 (potential rituximab biosimilar). Objectives were to evaluate overall pharmacokinetics, pharmacodynamics, immunogenicity, safety, and tolerability of PF‐05280586 after transition from a licensed rituximab product to PF‐05280586, and followup of biomarker and efficacy assessments. Methods; Subjects were offered ≤3 additional courses of treatment of PF‐05280586, with or without a single transition from rituximab EU (rituximab‐EU) or US (rituximab‐US) to PF‐05280586. Each course comprised 2 IV infusions (1,000 mg on Days 1 and 15, separated by 24 weeks [±8 weeks)]. Results; Of 220 subjects in the parent study, 185 were randomized and included in this study. There were no notable differences in drug concentrations between groups or across courses, with little variation in depletion of CD19+ B‐cells between groups, and no apparent relationship between infusion‐related reactions and antidrug antibodies with or without single transition from licensed rituximab to PF‐05280586. Long‐term safety and tolerability of PF‐05280586 was acceptable in all groups for up to 96 weeks, with a low incidence of treatment‐emergent adverse events independent of single drug transition. The percentage of subjects with low disease activity score and disease activity score remission was similar across groups for all time points, and responses were sustained until end of study. Conclusions; This study demonstrated acceptable safety, tolerability, and immunogenicity, with or without single transition from licensed rituximab to PF‐05280586, without increased immunogenicity on single transition

Association of Housing Disrepair Indicators with Cockroach and Rodent Infestations in a Cohort of Pregnant Latina Women and Their Children

Health burdens associated with poor housing and indoor pest infestations are likely to affect young children in particular, who spend most of their time indoors at home. We completed environmental assessments in 644 homes of pregnant Latina women and their children living in the Salinas Valley, California. High residential densities were common, with 39% of homes housing > 1.5 persons per room. Housing disrepair was also common: 58% of homes had peeling paint, 43% had mold, 25% had water damage, and 11% had rotting wood. Evidence of cockroaches and rodents was present in 60% and 32% of homes, respectively. Compared with representative national survey data from the U.S. Department of Housing and Urban Development, homes in our sample were more likely to have rodents, peeling paint, leaks under sinks, and much higher residential densities. The odds of rodent infestations in homes increased in the presence of peeling paint [odds ratio (OR) 2.1; 95% confidence interval (CI), 1.5–3.1], water damage (OR 1.9; 95% CI, 1.2–2.7), and mold (OR 1.5; 95% CI, 1.0–2.1). The odds of cockroach infestation increased in the presence of peeling paint (OR 3.8; 95% CI, 2.7–5.6), water damage (OR 1.9; 95% CI, 1.2–2.9), or high residential density (OR 2.1; 95% CI, 1.2–3.8). Homes that were less clean than average were more prone to both types of infestations. Pesticides were stored or used in 51% of households, partly to control roach and rodent infestations. These data indicate that adverse housing conditions are common in this community and increase the likelihood of pest infestations and home pesticide use. Interventions to improve housing and promote children’s health and safety in this population are needed