Deviation From Normative Whole Brain and Deep Gray Matter Growth in Children With MOGAD, MS, and Monophasic Seronegative Demyelination.

BACKGROUND AND OBJECTIVES: Pediatric-acquired demyelination of the CNS associated with antibodies directed against myelin oligodendrocyte glycoprotein (MOG; MOG antibody-associated disease [MOGAD]) occurs as a monophasic or relapsing disease and with variable but often extensive T2 lesions in the brain. The impact of MOGAD on brain growth during maturation is unknown. We quantified the effect of pediatric MOGAD on brain growth trajectories and compared this with the growth trajectories of age-matched and sex-matched healthy children and children with multiple sclerosis (MS, a chronic relapsing disease known to lead to failure of normal brain growth and to loss of brain volume) and monophasic seronegative demyelination. METHODS: We included children enrolled at incident attack in the prospective longitudinal Canadian Pediatric Demyelinating Disease Study who were recruited at the 3 largest enrollment sites, underwent research brain MRI scans, and were tested for serum MOG-IgG. Children seropositive for MOG-IgG were diagnosed with MOGAD. MS was diagnosed per the 2017 McDonald criteria. Monophasic seronegative demyelination was confirmed in children with no clinical or MRI evidence of recurrent demyelination and negative results for MOG-IgG and aquaporin-4-IgG. Whole and regional brain volumes were computed through symmetric nonlinear registration to templates. We computed age-normalized and sex-normalized z scores for brain volume using a normative dataset of 813 brain MRI scans obtained from typically developing children and used mixed-effect models to assess potential deviation from brain growth trajectories. RESULTS: We assessed brain volumes of 46 children with MOGAD, 26 with MS, and 51 with monophasic seronegative demyelinating syndrome. Children with MOGAD exhibited delayed (p < 0.001) age-expected and sex-expected growth of thalamus, caudate, and globus pallidus, normalized for the whole brain volume. Divergence from expected growth was particularly pronounced in the first year postonset and was detected even in children with monophasic MOGAD. Thalamic volume abnormalities were less pronounced in children with MOGAD compared with those in children with MS. DISCUSSION: The onset of MOGAD during childhood adversely affects the expected trajectory of growth of deep gray matter structures, with accelerated changes in the months after an acute attack. Further studies are required to better determine the relative impact of monophasic vs relapsing MOGAD and whether relapsing MOGAD with attacks isolated to the optic nerves or spinal cord affects brain volume over time.

Chagas disease in northern Chile: Detection of Trypanosoma cruzi in children, dogs and triatomine bugs.

Chagas disease is an anthropozoonotic disease caused by the protozoan Trypanosoma cruzi, transmitted by triatomine vectors. In Chile, there are four species of triatomine bugs that are potential vectors of T. cruzi, being Triatoma infestans the main vector in endemic areas of the country. The "Programa Nacional de Control Vectorial de la Enfermedad de Chagas de Chile" has significantly reduced the rates of home infestation to less than 1% and has interrupted vectorial transmission since 1999. The objective of this study was to evaluate the impact of vectorial control and the continuity of the interruption of vectorial transmission in northern Chile (provincia de El Loa, región de Antofagasta). The study comprised fingerstick blood samples of 2104 children, attending local school, venous blood samples of 65 dogs, associated to houses with T. infestans unique findings and vector infestation, and intestine samples of 284 T. infestans specimens, from the provincia de El Loa, during 2014-2016 period. The samples were analyzed by enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence and/or polymerase chain reaction (PCR) techniques. A total of 5 children (0.24%), 7 dogs (10.8%), and 6 specimens of T. infestans (2.1%) resulted positive to T. cruzi infection. This study showed that the risk of transmission of Chagas disease is low in the north of Chile (provincia de El Loa), detected a low positive rate of chagasic children and of infected triatomine bugs, and showed the existence of T. cruzi transmission in dogs, which are used as natural sentinels for the detection of T. cruzi infection, being especially useful during surveillance program in human population characterized by low seroprevalence.

Impact of the SARS-CoV-2 Pandemic on the Prevalence and Incidence of Gastrointestinal Viruses in Children up to Five Years Old: a Retrospective Cohort Study.

The aim is determining the impact of non-pharmaceutical measures (NPIs) against SARS-CoV-2 in the incidence and prevalence of gastrointestinal viruses (GV) in children. Demographic, analytical, and clinical data of children from which samples were received at the Hospital Universitario La Paz (Madrid, Spain) and that had a gastrointestinal infection with a positive sample through multiplex-PCR for GV were collected. The time periods included were prepandemic (P1): March 14, 2019 to March 14, 2020 and pandemic (P2): March 15, 2020 to March 15, 2021. The global prevalence, relative incidence (RI, per 1,000 admissions) and absolute incidence (AI, per 100,000 population) of GV were compared for both time periods. The prevalence of GV versus SARS-CoV-2 was determined for P2. Seven-hundred and 50 out of 2,547 children analyzed in P1 and 106 out of 1,368 in P2 were positive by PCR for GV (46.3% decrease in P2). Prevalence and RI of GV declined in P2, except for the RI of rotavirus. Adenovirus showed the largest decreased of prevalence and RI (100%), followed by sapovirus. Astrovirus reduction was less pronounced (3.1% versus 0.4%). Norovirus was the most frequent virus in both time periods and its prevalence and RI also decreased in P2 (15.2% versus 4.7% and 3.40 versus 1.74, respectively). Rotavirus had the smallest decrease in prevalence (2.6% versus 2.5%), and its RI increased during P2 from 0.7 to 0.93. After removing the rotavirus vaccine strains from the analysis, the prevalence and RI decreased during P2 (2.1% to 0.7% and 0.5 to 0.3, respectively). The AI decreased during P2 in all GV, and the prevalence of SARS-CoV-2 and GV was inversely proportional over time. Prevalence and incidence of GV have decreased during the pandemic, probably due to the implementation of NPIs against this virus and the reduction of health care attention to infections other than COVID-19. The differences in the decrease of prevalence and incidence for each virus may be explained by differences in the transmission and the resistance in the environment. Prevalence and RI of rotavirus might be biased since the PCR used detects both the infecting and the vaccine strains. IMPORTANCE Our original article contains an analysis of the impact of the measures applied against SARS-CoV-2 on the prevalence and incidence of GV in children. The small number of studies published to date that analyze the impact of these measures individually on each of the GV makes our study of great interest at this time.

[Formula: see text] Disrupted cognitive development following pediatric acquired demyelinating syndromes: a longitudinal study.

Long-term cognitive deficits have been observed in some children who experience an acquired demyelinating syndrome (ADS). We examined changes in cognitive functioning over the first two years following incident ADS andtested whether normalized brain and thalamic volume accounted for decline over time. Twenty-five youth (mean age 12.8 years) with ADS, 9 of whom were diagnosed with multiple sclerosis (MS) and 16 of whom experienced monophasic ADS (monoADS), underwent two neuropsychological evaluationsand MRI scans at approximately6- and 24-months post ADS-onset. We examined changes in cognitive outcomes over time and between patient groups. Generalized linear mixed-effect regression models were used to examine the association of normalized brain and thalamic volumesbetween the two timepointswith cognitive z-scores. Cognitive performance was within the age-expected range for both groups and remained stable over time on 15 measures. In the combined sample of monoADS and MS patients, declines (p < .05) were noted on the Symbol Digit Modalities Test (SDMT), the Auditory Working Memory (AWM), and the WJ-III Visual Matching (VisMat)tests, but did not survive FDR correction. Clinically significant declines, as measured by the Reliable Change Index, were observed on the SDMT,AWM, and VisMattests by 19, 42, and 32%, respectively. Lower normalized brain volume at 6-months predicted a negative change in SDMT (B = 0.45, 95%CI: 0.07,0.83) and AWM (B = 0.30, 95%CI: 0.13, 0.47). Chronicity of demyelination is not required for cognitive decline nor for reduced brain volume, suggesting that even a single demyelinating event may negatively impact cognitive potential in children.

Urban Intersection Classification: A Comparative Analysis.

Understanding the scene in front of a vehicle is crucial for self-driving vehicles and Advanced Driver Assistance Systems, and in urban scenarios, intersection areas are one of the most critical, concentrating between 20% to 25% of road fatalities. This research presents a thorough investigation on the detection and classification of urban intersections as seen from onboard front-facing cameras. Different methodologies aimed at classifying intersection geometries have been assessed to provide a comprehensive evaluation of state-of-the-art techniques based on Deep Neural Network (DNN) approaches, including single-frame approaches and temporal integration schemes. A detailed analysis of most popular datasets previously used for the application together with a comparison with ad hoc recorded sequences revealed that the performances strongly depend on the field of view of the camera rather than other characteristics or temporal-integrating techniques. Due to the scarcity of training data, a new dataset is created by performing data augmentation from real-world data through a Generative Adversarial Network (GAN) to increase generalizability as well as to test the influence of data quality. Despite being in the relatively early stages, mainly due to the lack of intersection datasets oriented to the problem, an extensive experimental activity has been performed to analyze the individual performance of each proposed systems.

Systematic Review: Comparison of the Main Variables of Interest in Publications of Canine Bite Accidents in the Written Press, Gray and Scientific Literature in Chile and Spain, between the Years 2013 and 2017.

Dog bites are a major public health problem, with consequences such as physical injury, psychological trauma, transmission of zoonoses, infections, and economic costs. For this reason, it is necessary to develop preventive programs, which require quality information to support the authorities' decision-making and to raise public awareness about the application of the proposed measures. The objective of this review was to analyze the press, indexed and gray dog bite literature published during the 2013-2017 period. During that period, 385 articles from three sources of information were analyzed: Press literature, scientific literature, and gray literature. Of these, the greatest amount of information corresponding to the context and the aggressor animal was found in the press literature, where it was recorded that the greatest number of records reported in the Chilean articles were caused by potentially dangerous breeds (87.50%), having significant differences with the gray literature (p = 0.030), and in Spain, the greatest number of attacks was also made by potentially dangerous dogs 91.30% (21/23), statistically significant differences with the gray literature (p = 0.002) and with the indexed (p < 0.001). In the case of the scientific and gray literature, the greatest amount of information was found about the victim of the attack and the treatments applied to them. In these cases, the highest percentage of victims included in the reports contained both sexes for the two literatures (44.62% and 87.71%, respectively). Regarding the treatment applied, in the scientific literature in most of the reports, the patients received washings, rabies vaccine, and tetanus vaccine (46.26%) and presented significant differences in Chile with the information contained in the gray literature (p = 0.023), in Spain with the gray (p = 0.017) and with the press (p = 0.023). In conclusion, the press literature differs in multiple variables with the information reported in the scientific literature and, in some cases, with the gray literature. The reason why the material that is being distributed to the population would not coincide in multiple relevant variables in other literature and the representative reality of the problem is the basis for this topic.

Epidemiology of Dog Bite Incidents in Chile: Factors Related to the Patterns of Human-Dog Relationship.

Dog bites are one of the main public health problems. They produce important consequences for those who suffer them (physical and psychological injuries, secondary infections, sequelae, risk of transmission of zoonoses and surgeries, among others). The objective of this study was to characterize epidemiologically the incidents of bites in Chile and the patterns of human-dog relationship involved. The records analyzed in this article were obtained from bitten patients who attended the main public health facilities in Chile during the period 17 September 2017 and 17 September 2018: In the period studied, 17,299 animal bites were recorded; however, only 7220 (41.74%) cases were analyzed in which the offending species could be identified. Of the bites analyzed, 6533 were caused by dogs (90.48%). Of these, 41.05% were caused by medium-sized dogs. Most bites were caused by dogs of mixed breeds (55.99%), followed by dogs of the German Shepherd breed (8.50%). Most of the dogs that bit were known to the victim (99.95%) and most of the attacks occurred indoors (57.48%). Although dog bite records have improved in Chile, it would be useful to also include background information on the context in which the incident occurred, which would be very useful for developing effective bite prevention programs.

Sensors and Sensing for Intelligent Vehicles.

Over the past decades, both industry and academy have made enormous advancements in the field of intelligent vehicles, and a considerable number of prototypes are now driving our roads, railways, air and sea autonomously. However, there is still a long way to go before a widespread adoption. Among all the scientific and technical problems to be solved by intelligent vehicles, the ability to perceive, interpret, and fully understand the operational environment, as well as to infer future states and potential hazards, represent the most difficult and complex tasks, being probably the main bottlenecks that the scientific community and industry must solve in the coming years to ensure the safe and efficient operation of the vehicles (and, therefore, their future adoption). The great complexity and the almost infinite variety of possible scenarios in which an intelligent vehicle must operate, raise the problem of perception as an "endless" issue that will always be ongoing. As a humble contribution to the advancement of vehicles endowed with intelligence, we organized the Special Issue on Intelligent Vehicles. This work offers a complete analysis of all the mansucripts published, and presents the main conclusions drawn.

A 19 Year Analysis of Small Mammals Associated with Human Hantavirus Cases in Chile.

Small mammals present in areas where hantavirus cardiopulmonary syndrome (HCPS) cases had occurred in central and southern Chile were captured and analyzed to evaluate the abundance of rodents and seroprevalence rates of antibodies to Andes orthohantavirus (ANDV). Sampling areas ranged from the Coquimbo to Aysén regions (30-45° S approx.) regions. Ninety-two sites in peridomestic and countryside areas were evaluated in 19 years of sampling. An antibody against ANDV was detected by strip immunoassay in 58 of 1847 specimens captured using Sherman traps. Of the eleven species of rodents sampled, Abrothrix olivacea, Oligoryzomys longicaudatus and Abrothrix hirta were the most frequently trapped. O. longicaudatus had the highest seropositivity rate, and by logistic regression analysis, O. longicaudatus of at least 60 g had 80% or higher probability to be seropositive. Sex, age and wounds were significantly related to seropositivity only for O. longicaudatus. Across administrative regions, the highest seropositivity was found in the El Maule region (34.8-36.2° S), and the highest number of HCPS cases was registered in the Aysén region. Our results highlight the importance of long term and geographically extended studies, particularly for highly fluctuating pathogens and their reservoirs, to understand the implications of the dynamics and transmission of zoonotic diseases in human populations.

Developmental trajectories of neuroanatomical alterations associated with the 16p11.2 Copy Number Variations.

Most of human genome is present in two copies (maternal and paternal). However, segments of the genome can be deleted or duplicated, and many of these genomic variations (known as Copy Number Variants) are associated with psychiatric disorders. 16p11.2 copy number variants (breakpoint 4-5) confer high risk for neurodevelopmental disorders and are associated with structural brain alterations of large effect-size. Methods used in previous studies were unable to investigate the onset of these alterations and whether they evolve with age. In this study, we aim at characterizing age-related effects of 16p11.2 copy number variants by analyzing a group with a broad age range including younger individuals. A large normative developmental dataset was used to accurately adjust for effects of age. We normalized volumes of segmented brain regions as well as volumes of each voxel defined by tensor-based morphometry. Results show that the total intracranial volumes, the global gray and white matter volumes are respectively higher and lower in deletion and duplication carriers compared to control subjects at 4.5 years of age. These differences remain stable through childhood, adolescence and adulthood until 23 years of age (range: 0.5 to 1.0 Z-score). Voxel-based results are consistent with previous findings in 16p11.2 copy number variant carriers, including increased volume in the calcarine cortex and insula in deletions, compared to controls, with an inverse effect in duplication carriers (1.0 Z-score). All large effect-size voxel-based differences are present at 4.5 years and seem to remain stable until the age of 23. Our results highlight the stability of a neuroimaging endophenotype over 2 decades during which neurodevelopmental symptoms evolve at a rapid pace.

Assessing the risk zones of Chagas' disease in Chile, in a world marked by global climatic change

BACKGROUND Vector transmission of Trypanosoma cruzi appears to be interrupted in Chile; however, data show increasing incidence of Chagas' disease, raising concerns that there may be a reemerging problem. OBJECTIVE To estimate the actual risk in a changing world it is necessary to consider the historical vector distribution and correlate this distribution with the presence of cases and climate change. METHODS Potential distribution models of Triatoma infestans and Chagas disease were performed using Maxent, a machine-learning method. FINDINGS Climate change appears to play a major role in the reemergence of Chagas' disease and T. infestans in Chile. The distribution of both T. infestans and Chagas' disease correlated with maximum temperature, and the precipitation during the driest month. The overlap of Chagas' disease and T. infestans distribution areas was high. The distribution of T. infestans, under two global change scenarios, showed a minimal reduction tendency in suitable areas. MAIN CONCLUSION The impact of temperature and precipitation on the distribution of T. infestans, as shown by the models, indicates the need for aggressive control efforts; the current control measures, including T. infestans control campaigns, should be maintained with the same intensity as they have at present, avoiding sylvatic foci, intrusions, and recolonisation of human dwellings.

Assessing the risk zones of Chagas' disease in Chile, in a world marked by global climatic change.

BACKGROUND: Vector transmission of Trypanosoma cruzi appears to be interrupted in Chile; however, data show increasing incidence of Chagas' disease, raising concerns that there may be a reemerging problem. OBJECTIVE: To estimate the actual risk in a changing world it is necessary to consider the historical vector distribution and correlate this distribution with the presence of cases and climate change. METHODS: Potential distribution models of Triatoma infestans and Chagas disease were performed using Maxent, a machine-learning method. FINDINGS: Climate change appears to play a major role in the reemergence of Chagas' disease and T. infestans in Chile. The distribution of both T. infestans and Chagas' disease correlated with maximum temperature, and the precipitation during the driest month. The overlap of Chagas' disease and T. infestans distribution areas was high. The distribution of T. infestans, under two global change scenarios, showed a minimal reduction tendency in suitable areas. MAIN CONCLUSION: The impact of temperature and precipitation on the distribution of T. infestans, as shown by the models, indicates the need for aggressive control efforts; the current control measures, including T. infestans control campaigns, should be maintained with the same intensity as they have at present, avoiding sylvatic foci, intrusions, and recolonisation of human dwellings.

Characterization of the epidemiology of bat-borne rabies in Chile between 2003 and 2013.

Rabies is a zoonotic disease of great impact to public health. According to the World Health Organization, the country of Chile is currently declared free from human rabies transmitted by dogs. An epidemiological characterization and description was conducted using rabies data from 2003 to 2013 held by the National Program for Prevention and Control of Rabies from the Ministry of Health, consisting of bats samples reported as suspect and samples taken by active surveillance (bats brain tissue). Spatial autocorrelation analysis was performed using Local Indicators of Spatial Association (LISA) statistics, particularly Moran's I index, for the detection of spatial clusters. Temporal descriptive analysis was also carried out. Nine hundred and twenty-seven positive cases were reported, presenting an average of 84 cases per year, mainly originated from passive surveillance (98.5%), whilst only 1.5% of cases were reported by active surveillance. Global positivity for the study period was 7.02% and 0.1% in passive and active surveillance respectively. Most of the cases were reported in the central zone of Chile (88.1%), followed by south zone (9.1%) and north zone (2.8%). At a regional level, Metropolitana (40.6%), Valparaíso (19.1%) and Maule (11.8%) regions reported the majority of the cases. Tadarida brasiliensis (92%) presented the majority of the cases reported, with viral variant 4 (82%) being most commonly diagnosed. Only two cases were detected in companion animals. The central zone presented a positive spatial autocorrelation (Moran's I index=0.1537, 95% CI=0.1141-0.1933; p-value=0.02); north and south zones returned non-significant results (Moran's I index=0.0517 and -0.0117, 95% CI=-0.0358-0.1392 and -0.0780-0.0546, and p-values=0.21 and 0.34 respectively). The number of rabies cases decreased between May and August (late fall and winter) and tended to increase during the hot season (December to March), confirmed with the evidence from Autocorrelation analysis and the Ljun-Box test (X2=234.85 and p-value<0.0001). Knowledge of animal rabies epidemiologic behaviour becomes relevant when designing prevention and control measures and surveillance programs. This is especially important considering the high impact to Public Health of this disease and that wildlife rabies in bats remains endemic in Chile.

Paciente joven diagnosticada de intoxicación por hidroxicloroquina / Young patient diagnosed with hydroxychloroquine intoxication

No disponible

Novedades en la farmacoterapia del dolor óseo de origen maligno y no maligno / New drugs in the pharmacotherapy of bone pain both, with malignant and non-malignant origin

Introducción: El dolor óseo es un síntoma debilitante que puede aparecer en un gran número de trastornos tanto malignos como no malignos y existen indicios que la prevalencia va a aumentar en las próximas décadas. El objetivo de esta revisión es recopilar y resumir la evidencia disponible sobre el tratamiento farmacológico actual del dolor óseo tanto en patologías de origen oncohematológico como de origen no maligno. Método: Para responder al objetivo de nuestro trabajo se realizó una búsqueda exhaustiva de la literatura publicada en las principales bases de datos hasta el 31 de abril de 2016. Resultados: Los fármacos antirresortivos, como los bifosfonatos, y aquellos que estimulan la formación del hueso, como la teriparatida, junto a analgésicos, como los AINEs y lo opioides, son actualmente la base farmacológica para tratar el dolor óseo (dependiendo de qué patología se trate). Existen nuevas hipótesis sobre diferentes mecanismos que pueden estar relacionados con la génesis del dolor, con el consecuente desarrollo de nuevas moléculas con distintos y novedosos mecanismos de acción. Conclusiones: Es necesario que se desarrollen más estudios que aclaren aspectos inciertos relacionados con el tratamiento del dolor óseo y permita el desarrollo de nuevos fármacos. Los farmacéuticos deben de estar actualizados sobre el arsenal terapéutico disponible en la actualidad para el tratamiento del dolor óseo como el primer paso para llevar a cabo una atención farmacéutica de calidad

Introduction: Bone pain is a debilitating symptom that can appear in many malignant and non-malignant disorders. There are indications that its prevalence will increase in the coming decades. The aim of this review is to collect and summarize the available evidence on the current drug treatment in oncohaematological bone pain and the one that has a non-malignant origin. Methods: To meet the objective of our work an exhaustive search of the literature published in major databases until April 31, 2016 was made. Results: Currently, Antiresorptive drugs, such as bisphosphonates and those that stimulate bone formation, such as teriparatide together with analgesics, such as NSAIDs and opioids constitute the pharmacological basis for treating bone pain (depending on every pathology case). There are new hypotheses about different mechanisms that may be related to the genesis of pain, with the consequent development of new and novel molecules with different mechanisms of action. Conclusions: To clarify some aspects related to the treatment of bone pain and to develop new drugs, other studies are necessary. Pharmacists must be updated on the therapeutic arsenal available at present for the treatment of bone pain as the first step to carry out a quality pharmaceutical care

Paciente joven con tuberculosis multifármaco-resistente complicada / Young patient with complicated multidrug-resistant tuberculosis

No disponible

Factores de riesgo en la infección vaginal / Risk Factors in Vaginal Infection

Se aplicó el análisis clúster para clasificar factores de riesgo de infección vaginal en 576 mujeres, atendidas durante el periodo de junio a septiembre de 2007 en la Policlínica Pe dro del Toro Saad de Holguín, Cuba. Las pacientes presentaban síntomas de infección vaginal, como leucorrea, prurito y ardor e indicaciones de exudados vaginales. Se excluyeron las mujeres menores de 15 y mayores de 45 años, embarazadas, con tratamiento de antibióticos y antecedentes de enfermedad inflamatoria pélvica. Se comprobó la elevada frecuencia de vaginosis bacteriana, candidiasis vulvovaginal y trichomoniasis. Se determinaron tres grupos de variables asociadas: condón-dispositivo intrauterino, edad de inicio de las relaciones sexuales-número de parejas y cambio de pareja sexual-infecciones vaginales. Se demostró una mayor probabilidad de infección vaginal en las mujeres con comportamientos sexuales de riesgo y se recomendó realizar campañas de promoción y prevención de estas infecciones por sus implicaciones para la salud materno-infantil...(AU)

A cluster analysis on vaginal infection risk factors was carried out in 576 women, who were assisted from June to September 2007. The patients had vaginal infection symptoms such as leucorrhea, itching, and burning, with vaginal exudates. Women under 15 years old, or being pregnant or under antibiotics treatments, or having a past history of pelvic inflammatory disease were excluded. A high rate of bacterial vaginosis, vulvovaginal candidiasis and trichomoniasis was observed. Three associated variable groups were found: condom - intrauterine device, sexual intercourse starting age - number of couples, couple change vaginal infections. A higher rate of probability to suffer from vaginal infections in women with risk sexual behavior was showed. The authors of this work recommended to promote a health program in order to prevent these infections, due to their impacts upon the maternal-infant health...(AU)