Synchronic distribution of the dinoflagellate Protoceratium reticulatum and yessotoxins in a high stratified fjord system: Tidal or light modulation?

Protoceratium reticulatum is the main yessotoxin-producer along the Chilean coast. Thus far, the yessotoxin levels recorded in this region have not posed a serious threat to human health. However, a bloom of P. reticulatum during the austral summer of 2022 caused the first ban of shellfish collection, due to the high toxin levels. A bloom of P. reticulatum during the austral summer of 2020 allowed an evaluation of the fine-scale distribution of the dinoflagellate during a tidal cycle. High-resolution measurements of biophysical properties were carried out in mid-summer (February 18-19) at a fixed sampling station in Puyuhuapi Fjord, Chilean Patagonia, as part of an intensive 24-h biophysical experiment to monitor the circadian distributions of P. reticulatum vegetative cells and yessotoxins. High P. reticulatum cell densities (>20 × 103 cells L-1) were found in association with a warmer (14.5-15 °C) and estuarine (23.5-24.5 g kg-1) sub-surface water layer (6-8 m). P. reticulatum cell numbers and yessotoxins followed a synchronic distribution pattern consistent with the excursions of the pycnocline. Nevertheless, the surface aggregation of the cells was modulated by the light cycle, suggesting daily vertical migration. The yessotoxin content per P. reticulatum cell ranged from 9.4 to 52.2 pg. This study demonstrates both the value of fine-scale resolution measurements of biophysical properties in a highly stratified system and the potential ecosystem impact of P. reticulatum strains producing high levels of yessotoxins.

Understanding the Potential of CBD for Health Benefits: an Overview.

Cannabinoids are compounds with increasing scientific interest, particularly due to their interaction with the endocannabinoid system via CBR1 and CBR2 receptors. They can interfere with appetite, pain, and sleep or develop mood changes of the individual. Cannabidiol (CBD) is a well-known cannabinoid with potential benefits, including reducing epilepsy seizures, alleviating anxiety, and obsessive-compulsive disorder (OCD) symptoms, aiding in Tourette Syndrome (a neurodevelopmental disorder), depression, sleep disorders, and promising in the treatment of cancer, pain relief, and heart health. Although generally safe, CBD can have side effects, including drug metabolism interference, fertility, and liver function. In addition, it can be administered by oral, sublingual, transdermal or inhalation via, each one with different bioavailability. The application of nanotechnology, specifically through colloidal carrier systems, holds promising potential for maximizing CBD's efficacy and pharmacological profile. There are reported CBD extraction methods using ethanol, carbon dioxide, deionised water, and non-polar oils like olive or coconut oil. The green extraction methods have gained popularity for their higher yields, shorter extraction time, and reduced costs. A specific dose with the desired effects is challenging due to individual factors, with most studies suggesting a range between less than 1 and 50 mg/kg/d. This review aims to explore the principles of CBD-based products development, focusing on extraction methods and purification processes of this cannabinoid for tinctures, topicals, and other pharmaceutical forms, as well as further research to attain the objectives.

A Long Way to Go: A Scenario for Clinical Trials of PI3K Inhibitors in Treating Cancer.

BACKGROUND: Alterations in PI3K function are directly related to cancer, making PI3K inhibitors suitable options for anticancer therapies. Information on therapy using different types of PI3K inhibitors is available in literature, providing indications of trends in developing new therapies. Although some studies on PI3K inhibitors for cancer treatment provide clinical evidence, they do not allow a careful search for potential PI3K inhibitors conducted by development indicators. Here, we performed a foresight study of clinical trials involving PI3K inhibitors from the past 11 years using indicators of clinical evolution to identify technological trends and provide data for supporting recommendations for new study designs. METHODS: A comprehensive foresight study was designed based on documents from clinical trials on PI3K inhibitors to perform a systematic and comparative analysis, in order to identify technological trends on new cancer therapies. RESULTS: Our results demonstrate that total number of clinical trials has decreased over the years and, currently, there is a clear prevalence of studies using isoform-specific inhibitors in combined interventions. Clinical trials in Phases I and II were the most frequently found in the database, whereas Phase III trials correspond to 7% of studies. The measurement of clinical trials progression using indicators (drugs in Phase III profile, top-10 drugs, and top-10 combined drugs) demonstrated that the 3 new medicines BKM120, IBI-376, and PF-05212384 have a high potential to provide more efficient cancer treatment in combined interventions. These data also include the groups of targets for each drug, providing a useful and reliable source for design new combinations to overcome the resistance and the poor tolerability observed in some PI3K therapies. CONCLUSIONS: The establishment of development indicators based on clinical trials for cancer treatment was useful to highlight the clinical investment in 3 new PI3K drugs and the advantages of combine therapy using FDA-approved drugs.

An Unprecedented Bloom of Oceanic Dinoflagellates (Karenia spp.) Inside a Fjord within a Highly Dynamic Multifrontal Ecosystem in Chilean Patagonia.

At the end of summer 2020, a moderate (~105 cells L-1) bloom of potential fish-killing Karenia spp. was detected in samples from a 24 h study focused on Dinophysis spp. in the outer reaches of the Pitipalena-Añihue Marine Protected Area. Previous Karenia events with devastating effects on caged salmon and the wild fauna of Chilean Patagonia had been restricted to offshore waters, eventually reaching the southern coasts of Chiloé Island through the channel connecting the Chiloé Inland Sea to the Pacific Ocean. This event occurred at the onset of the COVID-19 lockdown when monitoring activities were slackened. A few salmon mortalities were related to other fish-killing species (e.g., Margalefidinium polykrikoides). As in the major Karenia event in 1999, the austral summer of 2020 was characterised by negative anomalies in rainfall and river outflow and a severe drought in March. Karenia spp. appeared to have been advected in a warm (14-15 °C) surface layer of estuarine saline water (S > 21). A lack of daily vertical migration patterns and cells dispersed through the whole water column suggested a declining population. Satellite images confirmed the decline, but gave evidence of dynamic multifrontal patterns of temperature and chl a distribution. A conceptual circulation model is proposed to explain the hypothetical retention of the Karenia bloom by a coastally generated eddy coupled with the semidiurnal tides at the mouth of Pitipalena Fjord. Thermal fronts generated by (topographically induced) upwelling around the Tic Toc Seamount are proposed as hot spots for the accumulation of swimming dinoflagellates in summer in the southern Chiloé Inland Sea. The results here provide helpful information on the environmental conditions and water column structure favouring Karenia occurrence. Thermohaline properties in the surface layer in summer can be used to develop a risk index (positive if the EFW layer is thin or absent).

Dioclea violacea lectin inhibits tumorigenesis and tumor angiogenesis in vivo.

Dioclea violacea seed mannose-binding lectin (DvL) has attracted considerable attention because of its interesting biological activities, including antitumor, antioxidant, and anti-inflammatory activities. This study evaluated the cytotoxic effect of DvL on tumor and normal cells using the mitochondrial activity reduction (MTT) assay, the carcinogenic and anti-carcinogenic activity by the epithelial tumor test (ETT) in Drosophila melanogaster, and the anti-angiogenic effect by the chick embryo chorioallantoic membrane (CAM) assay. Data demonstrated that DvL promoted strong selective cytotoxicity against tumor cell lines, especially A549 and S180 cells, whereas normal cell lines were weakly affected. Furthermore, DvL did not promote carcinogenesis in D. melanogaster at any concentration tested, but modulated DXR-induced carcinogenesis at the highest concentrations tested. In the CAM and immunohistochemical assays, DvL inhibited sarcoma 180-induced angiogenesis and promoted the reduction of VEGF and TGF-ß levels at all concentrations tested. Therefore, our results demonstrated that DvL is a potent anticancer, anti-angiogenic, and selective cytotoxic agent for tumor cells, suggesting its potential application as a prototype molecule for the development of new drugs with chemoprotective and/or antitumor effects.

Long-Term Effects of Whole-Body Vibration on Hind Limb Muscles, Gait and Pain in Lame Dogs with Borderline-to-Severe Hip Dysplasia-A Pilot Study.

This pilot study aimed to evaluate the long-term effects of Whole-Body Vibration (WBV) on hind limb muscles, gait and pain in lame dogs with borderline-to-severe hip dysplasia. Ten lame client-owned dogs with borderline-to-severe hip dysplasia, aged from 1.5 to 9.0 years and weighing 14.5 to 53.0 kg, were enrolled. The WBV training program consisted of 15 min sessions three times weekly for 16 weeks. Muscles of the hind limbs were evaluated using measurements of thigh circumference, the cross-sectional thickness of selected hind limb muscles by ultrasound assessment, and vastus lateralis muscle activity determined by surface electromyography (EMG). Lameness and clinical signs of pain were assessed by visual lameness scoring, orthopedic examination and an owner-based questionnaire. Kinetic analysis was performed by using a pressure-sensitive walkway. Manual thigh circumference measurements of both hind limbs showed significant increases over the trial period with a greater degree of change observed after week 8. Ultrasound measurements of the left gluteal muscles and the quadriceps femoris muscles of both hind limbs showed significant increases in the cross-section thickness post WBV. Owner's perception of pain also showed a decrease in signs of pain at week 12 and week 16 compared to baseline. Based on graphs of the EMG activity patterns of the vastus lateralis muscle, 65% of the hind limbs had an improvement after 48 WBV sessions when compared to pre-session patterns. However, no significant differences were observed in visual lameness evaluation and kinetic analysis. Therefore, further studies will help to better clarify the role of WBV in canine rehabilitation protocols.

Small and patchy is enough: An example about how toxic HAB events can spread through low resting cyst loads.

The frequency of harmful algal blooms (HABs) has increased over the last two decades, a phenomenon enhanced by global climate change. However, the effects of climate change will not be distributed equally, and Chile has emerged as one important, vulnerable area. The Chilean Patagonian region (41‒56°S) hosts two marine ecoregions that support robust blue economies via wild fisheries, aquaculture, and tourism. However, the harmful algal bloom-forming dinoflagellate Alexandrium catenella, a causative agent of paralytic shellfish poisoning outbreaks, threatens the viability of blue industries in this region and others worldwide. Despite the proliferation of A. catenella blooms over the last few decades, the role of sedimentary resting cysts in the recurrence of harmful algal blooms and the species' northward expansion across Chilean Patagonia is not well understood. As a resting cyst-producing species, the sediment-cyst dynamics of A. catenella likely contribute to the geographical expansion and bloom recurrence of this species. For this purpose, we analyzed a decade of A. catenella surface sediment cyst records across the two ecoregions of the Chilean Patagonian System that were further stratified into five subregions based on water temperature, salinity, dissolved oxygen, and nutrient characteristics. We also analyzed spatio-temporal cyst dynamics in a pre-, during-, and post-bloom scenario of the Chiloense ecoregion (more northern) of the Magellanic province. Our results indicated highly variable A. catenella resting cyst abundances, with a maximum of 221 cysts cm-3 recorded in 2002 after an intense bloom. Generalized linear mixed models and linear mixed models found that sampling season, subregion, and Total Organic Matter (%) explained resting cyst presence and density. The results also demonstrated the presence of A. catenella cysts in northern subregions, evidencing the northward geographical expansion observed during the last few decades. The risks of A. catenella bloom recurrence from small, patchy resting cyst distributions across broad geographical areas and under changing environmental conditions are discussed.

From lipophilic to hydrophilic toxin producers: Phytoplankton succession driven by an atmospheric river in western Patagonia.

Phytoplankton succession is related to hydroclimatic conditions. In this study we provide the first description of a toxic phytoplankton succession in the Patagonian Fjord System. The shift was modulated by atmospheric-oceanographic forcing and consisted of the replacement of the marine dinoflagellate Dinophysis acuta in a highly stratified water column during austral summer by the diatom Pseudo-nitzschia calliantha in a mixed water column during late summer and early autumn. This transition, accompanied by a change in the biotoxin profiles (from lipophilic dinophysis toxins to hydrophilic domoic acid), was induced by the arrival of an intense atmospheric river. The winds in Magdalena Sound may have been further amplified, due to its west-east orientation and its location within a tall, narrow mountain canyon. This work also documents the first known appearance of toxic P. calliantha in Northern Patagonian. The potential impacts of the biotoxins of this species on higher trophic levels are discussed.

Percepción de enfermedad y calidad de vida en pacientes con inyecciones ilícitas de biopolímeros cosméticos: estudio transversal / Disease perception and quality of life in patients with illicit cosmetic biopolymers injections: a cross-sectional study

Introducción y objetivo: La enfermedad inducida por adyuvantes (EIA) secundaria a inyección de biopolímeros es reciente pero compleja, con un alto impacto en la mortalidad, la salud de los pacientes y en su calidad de vida. La percepción de enfermedad se considera un factor influyente para que los pacientes busquen ayuda y prevengan la evolución de la misma. El objetivo del presente estudio es evaluar cómo los pacientes con EIA por inyección ilícita de biopolímeros perciben su enfermedad y cómo el proceso de la enfermedad afecta a su calidad de vida. Material y método: Estudio descriptivo transversal utilizando el Cuestionario Brief IPQ que incluyó pacientes mayores de 18 años con inyecciones ilícitas de biopolímeros; fueron excluidos los pacientes con resección completa del biomaterial. Resultados: Un total de 441 mujeres con una edad media de 35 años respondieron a la encuesta. Observamos una asociación significativa entre mala percepción de la enfermedad y deterioro de la calidad de vida con la inyección ilícita de biopolímeros. Conclusiones: Nuestro estudio sugiere que la EIA por inyección ilícita de biopolímeros tiene un alto impacto en la calidad de vida de los pacientes. El uso ilegal de estos materiales es una práctica que no solo tiene repercusiones en la calidad de vida, sino que puede tener riesgos y consecuencias letales. (AU)

Background and objective: Adjuvant human disease (AHD) by injection of modeling substances is a relatively recent yet complex disease with a high impact on mortality, health of patients and their quality of life. Disease perception is considered an influential factor for patients to seek help and prevent disease evolution to detrimental outcomes. The objective of this study is to assess how patients with AHD by injection of illicit cosmetic biopolymers perceive their illness and how the disease process impacts their quality of life. Methods: Descriptive cross-sectional study using the Brief IPQ Questionnaire which included female patients with biopolymer injection. Inclusion criteria were patients older than 18 years with illicit cosmetic biopolymer injections; patients with complete surgical resection of the biomaterial were excluded. Results: A total of 441 females with a mean age of 35 years responded to the survey. A significant association between poor illness perception, quality of life deterioration, and illicit cosmetic biopolymer injection was observed. Conclusions: Our study suggests that AHD by injection of illicit cosmetic biopolymers has a high impact on the patient's quality of life. The illegal use of these materials is a practice that carries not only repercussions on quality of life but is considered to have life-threatening risks and lethal consequences. (AU)

Prospective life cycle assessment of viticulture under climate change scenarios, application on two case studies in France.

Viticulture needs to satisfy consumers' demands for environmentally sound grape and wine production while envisaging adaptation options to diminish the impacts of projected climate change on future productivity. However, the impact of climate change and the adoption of adaptation levers on the environmental impacts of future viticulture have not been assessed. This study evaluates the environmental performance of grape production in two French vineyards, one located in the Loire Valley and another in Languedoc-Roussillon, under two climate change scenarios. First, the effect of climate-induced yield change on the environmental impacts of future viticulture was assessed based on grape yield and climate data sets. Second, besides the climate-induced yield change, this study accounted for the impacts of extreme weather events on grape yield and the implementation of adaptation levers based on the future probability and potential yield loss due to extreme events. The life cycle assessment (LCA) results associated with climate-induced yield change led to opposite conclusions for the two vineyards of the case study. While the carbon footprint of the vineyard from Languedoc-Roussillon is projected to increase by 29 % by the end of the century under the high emissions scenario (SSP5-8.5), the corresponding footprint is projected to decrease in the vineyard from the Loire Valley by approximately 10 %. However, when including the effect of extreme events and adaptation options, the life cycle environmental impacts of grape production are projected to drastically increase for both vineyards. For instance, under the SSP5-8.5 scenario, the carbon footprint for the vineyard of Languedoc-Roussillon is projected to increase fourfold compared to the current footprint, while it will rise threefold for the vineyard from the Loire Valley. The obtained LCA results emphasized the need to account for the impact of both climate change and extreme events on grape production under future climate change scenarios.

Effect of acupuncture on hematologic, muscular biomarkers, fibrinogen and serum lactate parameters in training rodeo bulls.

The study aimed to evaluated the effects of acupuncture in rodeo bulls in training, by determining hematological variables, creatine kinase (CK), aspartate aminotransferase (AST), fibrinogen, and plasma lactate. Thirty adult healthy bulls, crossbred, were included in the study and randomly allocated into two groups of 15 animals, according to the use of acupuncture treatment for six months (GA) or not (GB). The variables were measured 30 min before (TP0) and 10 min (TP10min), 12 (TP12h), 24 (TP24h), 48 (TP48h), and 72 h (TP72h) after a single episode of jumping emulating rodeo exercise. The GB group showed variations in hemoglobin between TP0 and TP10min (p = 0.002) and TP0 and TP12h (p = 0.004), and the GA presented an increase in eosinophil values between TP0 and TP12h (p = 0.013) and TP0 and TP24h (p = 0.034). Leukopenia was observed in GB between TP10min and TP72h ((p = 0.008). The CK values were high (↑ 300 UI/l) after exercise until the TP24h, and decreased in TP48h, in both groups. The plasma lactate elevation was lower in the GA at TP10min (p = 0.011), TP12h (p = 0.008), TP72h (p < 0.001). The rodeo bulls submitted to acupuncture treatment showed smaller variations in hemogram, elevated eosinophils levels, and lower plasma lactate levels after exercise.

Dinophysis acuminata or Dinophysis acuta: What Makes the Difference in Highly Stratified Fjords?

Dinophysis acuminata and D. acuta, which follows it seasonally, are the main producers of lipophilic toxins in temperate coastal waters, including Southern Chile. Strains of the two species differ in their toxin profiles and impacts on shellfish resources. D. acuta is considered the major cause of diarrhetic shellfish poisoning (DSP) outbreaks in Southern Chile, but there is uncertainty about the toxicity of D. acuminata, and little information on microscale oceanographic conditions promoting their blooms. During the austral summer of 2020, intensive sampling was carried out in two northern Patagonian fjords, Puyuhuapi (PUY) and Pitipalena (PIT), sharing D. acuminata dominance and D. acuta near detection levels. Dinophysistoxin 1 (DTX 1) and pectenotoxin 2 (PTX 2) were present in all net tow samples but OA was not detected. Although differing in hydrodynamics and sampling dates, D. acuminata shared behavioural traits in the two fjords: cell maxima (>103 cells L-1) in the interface (S ~ 21) between the estuarine freshwater (EFW)) and saline water (ESW) layers; and phased-cell division (µ = 0.3-0.4 d-1) peaking after dawn, and abundance of ciliate prey. Niche analysis (Outlying Mean Index, OMI) of D. acuta with a high marginality and much lower tolerance than D. acuminata indicated an unfavourable physical environment for D. acuta (bloom failure). Comparison of toxin profiles and Dinophysis niches in three contrasting years in PUY-2020 (D. acuminata bloom), 2018 (exceptional bloom of D. acuta), and 2019 (bloom co-occurrence of the two species)-shed light on the vertical gradients which promote each species. The presence of FW (S < 11) and thermal inversion may be used to provide short-term forecasts of no risk of D. acuta blooms and OA occurrence, but D. acuminata associated with DTX 1 pose a risk of DSP events in North Patagonian fjords.

Increase in mucormycosis hospitalizations in southeastern Brazil during the COVID-19 pandemic: a 2010-2021 time series.

BACKGROUND: Mucormycosis is a severe invasive fungal disease. During the coronavirus disease 2019 (COVID-19) pandemic, outbreaks have been reported worldwide, but epidemiological studies are still scarce in Brazil. METHODS: We conducted a time-series cohort hospitalization study (2010-2021) in southeastern Brazil. RESULTS: There were 311 cases (85 during the pandemic), with significant (P < 0.05) involvement of patients older than 40 years (84%), white patients (78%), rhinocerebral site (63%), and São Paulo State residents (84%). CONCLUSIONS: Mucormycosis hospitalizations were highly prevalent. Further studies are needed to assess the burden of COVID-19 on mucormycosis in Brazil.

The impact of local and climate change drivers on the formation, dynamics, and potential recurrence of a massive fish-killing microalgal bloom in Patagonian fjord.

Harmful algal blooms (HABs) in southern Chile are a serious threat to public health, tourism, artisanal fisheries, and aquaculture in this region. Ichthyotoxic HAB species have recently become a major annual threat to the Chilean salmon farming industry, due to their severe economic impacts. In early austral autumn 2021, an intense bloom of the raphidophyte Heterosigma akashiwo was detected in Comau Fjord, Chilean Patagonia, resulting in a high mortality of farmed salmon (nearly 6000 tons of biomass) within 15 days. H. akashiwo cells were first detected at the head of the fjord on March 16, 2021 (up to 478 cells mL-1). On March 31, the cell density at the surface had reached a maximum of 2 × 105 cells mL-1, with intense brown spots visible on the water surface. Strong and persistent high-pressure anomalies over the southern tip of South America, consistent with the positive phase of the Southern Annular Mode (SAM), resulted in extremely dry conditions, high solar radiation, and strong southerly winds. A coupling of these features with the high water retention times inside the fjord can explain the spatial-temporal dynamics of this bloom event. Other factors, such as the internal local physical uplift process (favored by the north-to-south orientation of the fjord), salt-fingering events, and the uplift of subantarctic deep-water renewal, likely resulted in the injection of nutrients into the euphotic layer, which in turn could have promoted cell growth and thus high microalgal cell densities, such as reached by the bloom.

Increase in mucormycosis hospitalizations in southeastern Brazil during the COVID-19 pandemic: a 2010-2021 time series

ABSTRACT Background: Mucormycosis is a severe invasive fungal disease. During the coronavirus disease 2019 (COVID-19) pandemic, outbreaks have been reported worldwide, but epidemiological studies are still scarce in Brazil. Methods: We conducted a time-series cohort hospitalization study (2010-2021) in southeastern Brazil. Results: There were 311 cases (85 during the pandemic), with significant (P < 0.05) involvement of patients older than 40 years (84%), white patients (78%), rhinocerebral site (63%), and São Paulo State residents (84%). Conclusions: Mucormycosis hospitalizations were highly prevalent. Further studies are needed to assess the burden of COVID-19 on mucormycosis in Brazil.

Impact of the Route and Schedule of Immunization on the Serological and Virological Response of Chronic Hepatitis B Patients Treated with HeberNasvac.

HeberNasvac is a recently developed therapeutic vaccine for chronic hepatitis B (CHB) administered by intranasal (IN) and subcutaneous (SC) routes in a 14 days/10 doses schedule. To compare different schedules and routes of immunizations, a group of patients received four different vaccination regimens in a placebo-controlled factorial study. Subsequently, patients were followed for a minimum time of 48 weeks. Samples collected at the end of the follow-up were compared with initial samples. Groups I and II received the product by IN/SC routes, every 14 and 7 days, respectively. Groups III and IV were treated by SC route alone following a 14 and 7 days schedule. A group of 21 CHB patients received the vaccine in four different schedules and eight patients received placebo for a total of 29 patients enrolled. The 61.9% of vaccinees reduced their VL ≥2Log compared with baseline levels and 25% in placebo group. The 47.6% of vaccines reduced HBV levels to undetectable, 25% in placebo. HBeAg loss and seroconversion to anti-HBeAg was only achieved in vaccinees, 4 out of 9 (44.4%), and 40% (8 out of 20) developed anti-HBs response, none in placebo group. Reduction of HBsAg level in ≥1Log was achieved in the 35.0% of vaccinees and in none of the placebo-treated patients. Considering the individual and factorial analysis, significant HBV DNA reduction was detected in groups I and II, immunized by IN/SC routes. A significantly higher proportion of patients reducing VL to ≥2Log was also detected grouping the patients treated by IN/SC routes (G I + II) and grouping those inoculated every 14 days (G I + III), with 72.7% and 63.6%, respectively, compared with the placebo group (25.0%). The patients immunized every 14 days (G I + G III) also reduced the HBsAg levels compared with baseline. In conclusion, after more than 48 weeks of treatment-free follow-up, HeberNasvac-treated patients demonstrated superior responses compared with the placebo group in terms of antiviral and serological responses. The factorial analysis evidenced that the schedule combining the IN route of immunization and the frequency of 14 days resulted in the stronger antiviral and serological responses. Present results support the study of IN-only immunization schedules in future and was consistent with previous results. Long-lasting follow-ups were done to explore histological variables and the progression of serological variables in order to detect late responders. How to cite this article: Freyre FM, Aguiar JA, Cinza Z, et al. Impact of the Route and Schedule of Immunization on the Serological and Virological Response of Chronic Hepatitis B Patients Treated with HeberNasvac. Euroasian J Hepato-Gastroenterol 2023;13(2):73-78.

[Social vulnerability, survival, and hospital lethality by COVID-19 in patients aged 50 years and over: retrospective cohort of cases in Brazil in 2020 and 2021]. / Vulnerabilidade social, sobrevida e letalidade hospitalar pela COVID-19 em pacientes com 50 anos ou mais: coorte retrospectiva de casos no Brasil em 2020 e 2021.

The outcome of SARS-CoV-2 infection is not only associated with age and comorbidities but is also aggravated by social vulnerability. This study aims to analyze - according to social vulnerability - survival and hospital lethality by COVID-19 in the first 100 days from symptoms to death in individuals aged 50 years or older hospitalized in Brazil. This is a retrospective cohort from Epidemiological Week 11 of 2020 to week 33 of 2021. The Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) provided clinical and epidemiological data. The Geographic Index of the Socioeconomic Context for Health and Social Studies (GeoSES) measured social vulnerability. The Kaplan-Meier curve and the adjusted proportional risk model by Cox were used for survival, with hazard ratio (HR) and 95% confidence intervals (95%CI). Among the 410,504 cases, overall lethality was of 42.2% in general and 51.4% in the most vulnerable. We found a higher lethality according to worse socioeconomic status in all categories by age group; the double is registered for 50-59 years. The adjusted Cox model showed a 32% increase in risk of death (HR = 1.32; 95%CI: 1.24-1.42). Moreover, men, older adults, black or indigenous adults, with multiple comorbidities, and subjected to invasive ventilation, have a higher risk of death after hospitalization. Intersectoral policy measures need to be targeted to alleviate the effects of the COVID-19 pandemic aggravated by social vulnerability.

O desfecho da infecção pelo SARS-CoV-2 não se associa apenas à idade e a comorbidades, mas também agrava-se por vulnerabilidade social. Este estudo tem como objetivo analisar, segundo vulnerabilidade social, a sobrevida e a letalidade hospitalar por COVID-19 para os primeiros 100 dias entre sintomas até o óbito em indivíduos de 50 anos ou mais hospitalizados no Brasil. Trata-se de uma coorte retrospectiva das Semanas Epidemiológicas 11, de 2020, a 33, de 2021. O Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) forneceu dados clínico-epidemiológicos. O Índice Socioeconômico do Contexto Geográfico para Estudos em Saúde (GeoSES) mensurou vulnerabilidade social. Para sobrevida, utilizou-se a curva de Kaplan-Meier e o modelo ajustado de riscos proporcionais de Cox, com hazard ratio (HR) e intervalos de 95% de confiança (IC95%). Dentre os 410.504 casos, a letalidade geral foi de 42,2%, sendo 51,4% os indivíduos mais vulneráveis. Por faixa etária, registra-se a presença de maior letalidade para os piores status socioeconômicos em todas as categorias; para 50-59 anos, registra-se o dobro. O modelo ajustado de Cox mostrou aumento de 32% de risco para óbito (HR = 1,32; IC95%: 1,24-1,42). Ademais, homens, idosos, pretos ou indígenas, com múltiplas comorbidades e submetidos à ventilação invasiva apresentam maior risco de óbito após hospitalização. É necessário que medidas políticas intersetoriais sejam direcionadas para mitigar os efeitos da pandemia de COVID-19 agravados pela vulnerabilidade social.

El pronóstico de la infección por SARS-CoV-2 no sólo está asociado a la edad y a las comorbilidades, sino que también empeora por la vulnerabilidad social. El presente estudio tiene como objetivo analizar, según la vulnerabilidad social, la supervivencia y la letalidad hospitalaria por COVID-19 durante los primeros 100 días entre los síntomas hasta la muerte en individuos de 50 años o más hospitalizados en Brasil. Se trata de una cohorte retrospectiva desde la Semana Epidemiológica 11 de 2020 hasta la 33 de 2021. El Sistema de Información de Vigilancia Epidemiológica de la Gripe (SIVEP-Gripe) proporcionó datos clínico-epidemiológicos. El Índice Socioeconómico del Contexto Geográfico para los Estudios de Salud (GeoSES) midió la vulnerabilidad social. Para la supervivencia se utilizó la curva de Kaplan-Meier y el modelo ajustado de riesgos proporcionales de Cox, con cociente de riesgos (hazard ratio - HR) e intervalos del 95% de confianza (IC95%). Entre los 410.504 casos la letalidad global fue del 42,2%; el 51,4% en los más vulnerables. Por grupos de edad, se registra la presencia de una mayor letalidad a medida que empeora el estatus socioeconómico en todas las categorías; para 50-59 años es el doble. El modelo de Cox ajustado mostró un aumento del 32% en el riesgo de muerte (HR = 1,32; IC95%: 1,24-1,42). Además, los hombres de edad avanzada, de raza negra o indígena, con múltiples comorbilidades y sometidos a ventilación invasiva tienen un mayor riesgo de muerte tras la hospitalización. Es necesario que las medidas políticas intersectoriales se dirijan a mitigar los efectos de la pandemia de COVID-19 agravada por la vulnerabilidad social.

Modelling the Spatial and Temporal Dynamics of Paralytic Shellfish Toxins (PST) at Different Scales: Implications for Research and Management.

Harmful algal blooms, in particular recurrent blooms of the dinoflagellate Alexandrium catenella, associated with paralytic shellfish poisoning (PSP), frequently limit commercial shellfish harvests, resulting in serious socio-economic consequences. Although the PSP-inducing species that threaten the most vulnerable commercial species of shellfish are very patchy and spatially heterogeneous in their distribution, the spatial and temporal scales of their effects have largely been ignored in monitoring programs and by researchers. In this study, we examined the spatial and temporal dynamics of PSP toxicity in the clam (Ameghinomya antiqua) in two fishing grounds in southern Chile (Ovalada Island and Low Bay). During the summer of 2009, both were affected by an intense toxic bloom of A. catenella (up to 1.1 × 106 cells L-1). Generalized linear models were used to assess the potential influence of different environmental variables on the field detoxification rates of PSP toxins over a period of 12 months. This was achieved using a four parameter exponential decay model to fit and compare field detoxification rates per sampling site. The results show differences in the spatial variability and temporal dynamics of PSP toxicity, given that greater toxicities (+10-fold) and faster detoxification (20% faster) are observed at the Ovalada Island site, the less oceanic zone, and where higher amounts of clam are annually produced. Our observations support the relevance of considering different spatial and temporal scales to obtain more accurate assessments of PSP accumulation and detoxification dynamics and to improve the efficacy of fisheries management after toxic events.

Continental shelf off northern Chilean Patagonia: A potential risk zone for the onset of Alexandrium catenella toxic bloom?

Harmful Algal Blooms (HAB) pose a severe socio-economic problem worldwide. The dinoflagellate species Alexandrium catenella produces potent neurotoxins called saxitoxins (STXs) and its blooms are associated with the human intoxication named Paralytic Shellfish Poisoning (PSP). Knowing where and how these blooms originate is crucial to predict blooms. Most studies in the Chilean Patagonia, were focused on coastal areas, considering that blooms from the adjacent oceanic region are almost non-existent. Using a combination of field studies and modelling approaches, we first evaluated the role of the continental shelf off northern Chilean Patagonia as a source of A. catenella resting cysts, which may act as inoculum for their toxic coastal blooms. This area is characterized by a seasonal upwelling system with positive Ekman pumping during spring-summer, and by the presence of six major submarine canyons. We found out that these submarine canyons increase the vertical advection of bottom waters, and thus, significantly enhance the process of coastal upwelling. This is a previously unreported factor, among those involved in bloom initiation. This finding put this offshore area at high risk of resuspension of resting cysts of A. catenella. Here, we discuss in detail the physical processes promoting this resuspension.

Effects of Reticulated Hyaluronic Acid Alone or Associated With Whole-Body Vibration in Dogs With Osteoarthritis Due to Hip Dysplasia.

This study aimed to evaluate the effects of reticulated hyaluronic acid (HA) alone or associated with whole-body vibration (WBV) in dogs with osteoarthritis due to hip dysplasia. Fourteen dogs were randomized assigned into 2 groups of 7 animals: Group 1 (G1) - single intra-articular injection of hyaluronic acid; Group 2 (G2) - single intra-articular injection of hyaluronic acid associated with WBV sessions. The affected hip joint received 0.70 mL of reticulated HA guided by ultrasound. Dogs were submitted to a single session of WBV (30 and 50 Hz, for 15 min) every 48 hours for 12 weeks. Dogs were evaluated for morphometric measurements; orthopedic, radiographic and lameness scores of the hip joints; kinetic analysis; and ultrassonographic measurement of the following muscles: middle gluteal, vastus lateralis and biceps femoris. The morphometric measurements, lameness scores, and muscle measurements were conducted at 10 minutes before treatments (TP0), and at days 30 (TP30), 60 (TP60) and 90 (TP90) after treatments. The orthopedic and radiographic scores and kinetic analysis were performed at TP0 and TP90. The scores of lameness showed a statistical decrease in G1 and G2 between time-points. Significant decreases (P = .01) were observed in orthopedic scores in both groups between time-points. The Peak Vertical Force between TP0 and TP90 was significantly higher in G2 (P = .01). Vertical Impulse was null in G1 and positive in G2. Dogs treated with single intra-articular injection of hyaluronic acid alone and associated with WBV had beneficial effects in dogs with osteoarthritis due to hip dysplasia, however the association of viscosupplementation with hyaluronic acid and WBV had an earlier improvement clinical outcome and allowed better kinetic results.