Fungal Infections in the ICU during the COVID-19 Pandemic in Mexico.

Background: Invasive Fungal Infections (IFI) are emergent complications of COVID-19. In this study, we aim to describe the prevalence, related factors, and outcomes of IFI in critical COVID-19 patients. Methods: We conducted a nested case-control study of all COVID-19 patients in the intensive care unit (ICU) who developed any IFI and matched age and sex controls for comparison (1:1) to evaluate IFI-related factors. Descriptive and comparative analyses were made, and the risk factors for IFI were compared versus controls. Results: We found an overall IFI prevalence of 9.3% in COVID-19 patients in the ICU, 5.6% in COVID-19-associated pulmonary aspergillosis (CAPA), and 2.5% in invasive candidiasis (IC). IFI patients had higher SOFA scores, increased frequency of vasopressor use, myocardial injury, and more empirical antibiotic use. CAPA was classified as possible in 68% and 32% as probable by ECMM/ISHAM consensus criteria, and 57.5% of mortality was found. Candidemia was more frequent for C. parapsilosis Fluconazole resistant outbreak early in the pandemic, with a mortality of 28%. Factors related to IFI in multivariable analysis were SOFA score > 2 (aOR 5.1, 95% CI 1.5-16.8, p = 0.007) and empiric antibiotics for COVID-19 (aOR 30, 95% CI 10.2-87.6, p = <0.01). Conclusions: We found a 9.3% prevalence of IFIs in critically ill patients with COVID-19 in a single center in Mexico; factors related to IFI were associated with higher SOFA scores and empiric antibiotic use for COVID-19. CAPA is the most frequent type of IFI. We did not find a mortality difference.

Tracheal Aspirate Galactomannan Testing in COVID-19-Associated Pulmonary Aspergillosis.

Among critically ill patients, COVID-19-associated pulmonary aspergillosis (CAPA) is a challenging complication. The recommended diagnostic methods for this disease are bronchoalveolar lavage (BAL) culture and galactomannan (GM) testing, which were not widely available during the pandemic. There is scarce information regarding GM testing in other respiratory specimens. Our objective was to compare the agreement of GM between BAL and tracheal aspirate (TA) samples. We selected patients with COVID-19 and those with suspected CAPA who were admitted in the intensive care unit (ICU). GM was routinely done in BAL. We performed GM in TA samples and compared the results. The agreement was evaluated with Cohen's Kappa coefficient. GM was considered positive when an OD index ≥ 1 in BAL and ≥ 2 in TA were found. Probable CAPA was considered when the ECMM/ISHAM criteria were met. A descriptive analysis of clinical characteristics and mortality was made. We included 20 patients with suspected CAPA from 54 patients with critical COVID-19, of which 5 (9%) met the probable category. Aspergillus fumigatus was the most frequent isolate. We found moderate agreement between BAL and TA GM (Kappa = 0.47, p = 0.01, 95% CI.04-0.9), whereas TA GM had 75% sensitivity (95% CI 19.4-99.4%), 81.2% specificity (95% CI 54.4-95.9%), 50% positive predictive value (95% CI 23.8-76.3%),] and 92.8% negative predictive value (95% CI 70.1-98.6%), and 80% accuracy (95% CI 56.3-94.3%). Lastly, three (60%) patients with CAPA died during hospitalization compared to 40% (6/15) without CAPA (p = 0.4). In conclusion, a moderate agreement between TA GM and BAL was found. Therefore, TA testing may aid in ruling out CAPA due to high negative predictive value when bronchoscopies are unavailable.

Soil Odor as An Extra-Official Criterion for Qualifying Remediation Projects of Crude Oil-Contaminated Soil.

Unfortunately, many property owners in southeastern Mexico do not trust environmental authorities, and the de facto method they use to evaluate the progress in environmental remediation projects is soil smell. This criterion was evaluated to determine if it was reliable to assess soil fertility and toxicity. Three soils (Fluvisol, Gleysol, and Arenosol), were contaminated with 2% medium or heavy crude oil (30.2, 17.1°API, respectively), and treated for 18 months to simulate bioremediation or natural attenuation. Every two months, field capacity, water repellency, hydrocarbon concentration, acute toxicity and soil odor were measured. Odor was measured in controlled conditions with a group of unexperienced panelists. During remediation, the Fluvisol and Gleysol were perceived to have an odor intensity between slight to low, and were considered acceptable. Meanwhile, in the Arenosol, the odor intensity was between low to medium and was considered unacceptable. After treatment, the hydrocarbon concentration was reduced to low levels, very near Mexican norm, and all the soils, including the Arenosol, were perceived to have an intensity between neutral to slightly agreeable, were considered acceptable, and no toxicity was observed in the earthworm bioassay (no false positives). However, in various soil samples from the Fluvisol and Arenosol, important risks were present with respect to field capacity and water repellency. Due to these observations, even though soil smell may be a trustworthy guide to soil toxicity, it does not ensure that the remediated soil's fertility has been restored.

Predicting Human miRNA-like Sequences within Human Papillomavirus Genomes.

BACKGROUND: This study presents a prediction of putative miRNA within several Human Papillomavirus (HPV) types by using bioinformatics tools and a strategy based on sequence and structure alignment. Currently, little is known about HPV miRNAs. METHODS: Computational methods have been widely applied in the identification of novel miRNAs when analyzing genome sequences. Here, ten whole-genome sequences from HPV-6, -11, -16, -18, -31, -33, -35, -45, -52, and -58 were analyzed. Software based on local contiguous structure-sequence features and support vector machine (SVM), as well as additional bioinformatics tools, were utilized for identification and classification of real and pseudo microRNA precursors. RESULTS: An initial analysis predicted 200 putative pre-miRNAs for all the ten HPV genome variants. To derive a smaller set of pre-miRNAs candidates, stringent validation criteria was conducted by applying <‒10 ΔG value (Gibbs Free Energy). Thus, only pre-miRNAs with total scores above the cut-off points of 90% were considered as putative pre-miRNAs. As a result of this strategy, 19 pre-miRNAs were selected (hpv-pre-miRNAs). These novel pre-miRNAs were located in different clusters within HPV genomes and some of them were positioned at splice regions. Additionally, the 19 identified pre-miRNAs sequences varied between HPV genotypes. Interestingly, the newly identified miRNAs, 297, 27b, 500, 501-5, and 509-3-5p, were closely implicated in carcinogenesis participating in cellular longevity, cell cycle, metastasis, apoptosis evasion, tissue invasion and cellular growth pathways. CONCLUSIONS: The novel putative miRNAs candidates could be promising biomarkers of HPV infection and furthermore, could be targeted for potential therapeutic interventions in HPV-induced malignancies.

Luminarias en estomatología y su reparación óptico–oftalmológica / Lighting in stomatology and its optic-opthalmologic repairing

Se realizó un estudio observacional de carácter descriptivo a 55 estomatólogos de la clínica estomatológica docente General Manuel de Jesús Cedeño, Bayamo, Granma; con el objetivo de evaluar las luminarias y su repercusión óptico oftalmológica en cuanto a la visión cromática de afecciones oculares. La intensidad de la luz se obtuvo en los puestos de trabajo, cumpliéndose para ello las normas nacionales. Se determinó 10.7 por ciento de visión cromática y 23.1 por ciento de visión de contraste alterado. En solamente 4 por ciento de las luminarias en el plato y 16 por ciento intrabucal fue adecuado. Las afecciones oftalmológicas más frecuentes fueron las retinopatías arterioscleróticas, trombosis de la vena central de la retina (VCR) y el glaucoma, concluyendo en el estudio que existe una relación directa, entre las afecciones y la falta de iluminación en las áreas de trabajo de los estomatólogos, recomendamos por ello la revisión de las normas nacionales de iluminación en Estomatología(AU)

CorticotomÍa y el movimiento dentario: presentación de 1 caso / Corticotomy and alveolar movement. A case report

Se presenta un paciente adulto de 32 años de edad, mestizo con historia de buena salud anterior que asiste a la consulta de periodontología del Policlínico Guillermo González del municipio Guisa, por presentar sensación de encía inflamada y sangramiento al cepillado. Después de su valoración con el departamento de Ortodoncia de la Clínica de Especialidades de Bayamo, se decide tratamiento previo periodontal mediante colgajo con corticotomía y continuar de inmediato con la corrección de la mal posición dentaria por ortodoncia(AU)

Sydney crease in children with febrile seizures

Introducción. En el presente estudio se compararon las características clínicas y algunas variables previamente consideradas como factores de riesgo en niños con convulsiones febriles (CF) con y sin línea Sydney (LS); además se determinó la variación de los pliegues de flexión palmares en sus padres. Material y métodos. Noventa y un niños con un evento de CF se incluyeron en un estudio de corte transversal. Las características clínicas de las CF y algunos factores de riesgo para la recurrencia de CF o convulsiones no febriles fueron comparados en relación a la presencia (n= 43) o ausencia (n= 48) de LS. Además, se evaluaron los pliegues de flexión palmares en 85 de sus madres y 39 de sus padres. Resultados. Las características clínicas y las variables estudiadas fueron similares en los niños con y sin LS, con excepción de una menor frecuencia de infecciones respiratorias superiores como causa de la fiebre en los niños con CF y LS (P= < 0.05). Los padres de los niños con CF y LS mostraron mayor frecuencia estadística de LS (P= < 0.01), al compararlos con los padres de niños con CF sin LS, con razón de momios= 21.11 (intervalo de confianza al 95 por ciento 2.20 a 962.79). Conclusiones. Las características clínicas de las CF no se modificaron sustancialmente por la presencia o ausencia de LS. No se demostró asociación entre los factores de riesgo explorados y la presencia de LS. La transmisión paterna observada de la LS en la asociación CF/LS, sugiere la presencia de factores genéticos en la embriogénesis de los pliegues palmares y las CF.