Temporal distribution and genetic variants in influenza A(H1N1)pdm09 virus circulating in Mexico, seasons 2012 and 2013

The 2012 and 2013 annual influenza epidemics in Mexico were characterized by presenting different seasonal patterns. In 2012 the A(H1N1)pdm09 virus caused a high incidence of influenza infections after a two-year period of low circulation; whereas the 2013 epidemic presented circulation of the A(H1N1)pdm09 virus throughout the year. We have characterized the molecular composition of the Hemagglutinin (HA) and Neuraminidase (NA) genes of the A(H1N1)pdm09 virus from both epidemic seasons, emphasizing the genetic characteristics of viruses isolated from Yucatan in Southern Mexico. The molecular analysis of viruses from the 2012 revealed that all viruses from Mexico were predominantly grouped in clade 7. Strikingly, the molecular characterization of viruses from 2013 revealed that viruses circulating in Yucatan were genetically different to viruses from other regions of Mexico. In fact, we identified the occurrence of two genetic variants containing relevant mutations at both the HA and NA surface antigens. There was a difference on the temporal circulation of each genetic variant, viruses containing the mutations HA-A141T / NA-N341S were detected in May, June and July; whereas viruses containing the mutations HA-S162I / NAL206S circulated in August and September. We discuss the significance of these novel genetic changes

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Evaluación de los efectos microclimáticos que tiene la vegetación en la mitigación de la isla de calor urbana: Parque en la ciudad de Torreón, México

The magnitude of the impacts caused by the climate variation over the cities will depend on their capacity for resilience. The literature about this issue identifies the urban green areas and the environmental services as a strategy to mitigate the urban heat island (UHI), a phenomenon of urban microclimate that has an impact on air quality, water, and energy demand: central themes in urban sustainability. Diverse studies refer to the consolidation of urban green areas as a strategy to mitigate climate risks; at the same time, these studies recognize the need of evaluating the environmental benefits, mainly in arid zones. This work explores, through the microclimatic analysis, the performance of the urban park of a greater surface in the city as a thermal sink. The analysis was conducted in two stages. The first one intended to classify the different environments inside the park; later, in the second stage, these environments were measured as microclimates using transects with HOBO data logger devices. In addition to demonstrating the convenience of the method, the results contribute to the evaluation of benefits of the green areas as thermal sink, and with this, to lay the foundations for the establishment of an urban planning policy aimed at mitigating the UHI in the city, contributing to the process of adaptation to climate change in cities with arid climate.A magnitude dos impactos devido à variação climática sobre as cidades dependerá de sua capacidade de resiliência. A literatura sobre o tema identifica as áreas verdes urbanas e seus serviços ambientais como uma estratégia para mitigar a ilha de calor urbana (ICU), um fenômeno do microclima urbano que repercute na qualidade do ar e na demanda de água e energia; temas centrais na sustentabilidade urbana. São diversas as pesquisas que fazem referência à consolidação de espaços verdes nas cidades, com a finalidade de reduzir os riscos ambientais. Igualmente, estes estudos reconhecem a necessidade de avaliar os benefícios ambientais, principalmente em zonas áridas. Este trabalho explora, através da análise de ambientes e suas temperaturas correspondentes, o papel que desempenha o parque urbano de maior hierarquia na cidade como amenizadora térmica. A análise foi desenvolvida em 2 fases, a primeira orientada a classificar os distintos ambientes e sua densidade de vegetação; a segunda, corresponde à campanha de monitoramento, mediante transeptos com dispositivos data logger HOBO. Os resultados, além de mostrarem a conveniência do método, contribuem para a avaliação dos benefícios das áreas verdes como amenizadoras térmicas e, com isso, firmar as bases para o estabelecimento de uma política de planificação urbana orientada à mitigação da ICU na cidade, coadjuvando no processo de adaptação ante a mudança climática em cidades com clima áridoLa magnitud de los impactos a causa de la variación climática sobre las ciudades dependerá de su capacidad de resiliencia. La literatura sobre el tema identifica las áreas verdes urbanas y sus servicios ambientales como una estrategia para mitigar la isla de calor urbana (ICU), un fenómeno del microclima urbano que repercute en la calidad del aire, la demanda de agua y energía; temas centrales en sustentabilidad urbana. Son diversas las investigaciones que hacen referencia a la consolidación de espacios verdes en las ciudades, con el fin de reducir los riegos ambientales. De igual manera, estos estudios reconocen la necesidad de evaluar los beneficios ambientales, principalmente en zonas áridas. Este trabajo explora, a través del análisis de ambientes y sus temperaturas correspondientes, el papel que desempeña el parque urbano de mayor jerarquía en la ciudad como resumidero térmico. El análisis se desarrolló en 2 fases, la primera orientada a clasificar los distintos ambientes y su densidad de vegetación; la segunda, corresponde a la campaña de monitoreo, mediante transectos con dispositivos data logger HOBO. Los resultados, además de mostrar la conveniencia del método, contribuyen a la evaluación de los beneficios de las áreas verdes como resumideros térmicos y, con ello, a sentar las bases para el establecimiento de una política de planificación urbana orientada a mitigar la ICU en la ciudad, que coadyuve al proceso de adaptación ante el cambio climático en ciudades con clima árido

Evaluación de los efectos microclimáticos que tiene la vegetación en la mitigación de la isla de calor urbana: Parque en la ciudad de Torreón, México

La magnitud de los impactos a causa de la variación climática sobre las ciudades dependerá de su capacidad de resiliencia. La literatura sobre el tema identifica las áreas verdes urbanas y sus servicios ambientales como una estrategia para mitigar la isla de calor urbana (ICU), un fenómeno del microclima urbano que repercute en la calidad del aire, la demanda de agua y energía; temas centrales en sustentabilidad urbana. Son diversas las investigaciones que hacen referencia a la consolidación de espacios verdes en las ciudades, con el fin de reducir los riegos ambientales. De igual manera, estos estudios reconocen la necesidad de evaluar los beneficios ambientales, principalmente en zonas áridas. Este trabajo explora, a través del análisis de ambientes y sus temperaturas correspondientes, el papel que desempeña el parque urbano de mayor jerarquía en la ciudad como resumidero térmico. El análisis se desarrolló en 2 fases, la primera orientada a clasificar los distintos ambientes y su densidad de vegetación; la segunda, corresponde a la campaña de monitoreo, mediante transectos con dispositivos data logger HOBO. Los resultados, además de mostrar la conveniencia del método, contribuyen a la evaluación de los beneficios de las áreas verdes como resumideros térmicos y, con ello, a sentar las bases para el establecimiento de una política de planificación urbana orientada a mitigar la ICU en la ciudad, que coadyuve al proceso de adaptación ante el cambio climático en ciudades con clima árido

Tumor de células esteroideas de ovario: Reporte de un caso.

The suggestive clinical characteristics of hyperandrogenism are very common problems in women and have been related with excessive androgen production from ovaries, suprarenal glands or both. The most common identifiable cause of androgen excess is the polycystic ovary syndrome. The virilizing tumors are rare. We report the case of a postmenopausal women with virilizing signs and a left anexial mass. Testosterone 4.3ng/mL (0.2-0.95); DHEAS 56ug/dL (35-430); androstenedione: 10ng/ml (0.4-2.7); Cortisol 16ug/dL. Testosterone post dexamethasone suppression test 3.5ng/mL. Ovarian steroid cell tumors secrete great quantities of testosterone or androstenedione and differ from Leydig cell tumors in that they lack crystals of Reinke. Usually, they are benign, but 20% of malignancy has been reported. They can produce different substances. The election treatment is oophorectomy. As in our patient, the androgens levels are normalized after surgery

Phylogenetic tree of NA sequences of the A(H1N1)pdm09 viruses for the period 2013.

<p>Sequences from Yucatan are indicated in blue, from other regions of Mexico in red and worldwide in black. Additional amino acid changes at the node are also indicated.</p

Amino acid changes and frequency of occurrence in the hemagglutinin (HA) protein of the influenza A(H1N1)pdm09 viruses isolated in Yucatan.

<p>Frequencies of detection for each mutation are also indicated for sequences from other regions of Mexico (non-Yucatan) and worldwide for the period 2012–2013. Percentages were calculated based on the total number of sequences analysed in this study (<i>n</i>). Empty cells indicate values = 0.</p

Schematic representation of the HA molecule of the A(H1N1)pdm09 virus.

<p>HA molecules were modelled using as template the crystal structure of A 2009 H1N1 virus hemagglutinin from A/California/04/2009 (PDB 3LZG). Molecules were generated under flusurver structural model database (<a href="http://flusurver.bii.a-star.edu.sg/" target="_blank">http://flusurver.bii.a-star.edu.sg</a>). Protein sequences were blast against A/California/07/2009 to identify differences on amino acid composition. Right side HA molecule was modelled based on the strain A/Yucatan/116/2013 to indicate localization of the amino acid change S162I (red oval). The HA molecule in the middle represents the amino acidic composition of the strain A/Yucatan/81/2013 indicating the position of the mutation A141T (blue oval). Mutations at residues V234I, K283E and E499K (HA2) placed these viruses in clade 6C. Left side molecule corresponds to the HA protein sequence of the strain A/Yucatan/18/2012.</p

Temporal occurrence of genetic variants in Yucatan.

<p>Viruses from Yucatan with changes in HA and NA were distributed in time from epidemiological week 23 to 38. The bars represent the total number of influenza cases reported by the Regional Laboratory. The clear section indicates the number of confirmed cases of influenza A(H1N1)pdm09 and the grey section indicates the number of influenza A(H1N1)pdm09 viruses with genetic changes in HA and NA (HA–A141T / HA–S162I / NA–N341S / NA–L206S). The black section corresponds to the number of samples negative to influenza A(H1N1)pdm09 virus.</p