Avances en políticas públicas y vigilancia epidemiológica relacionadas con el virus de inmunodeficiencia humana/sida en Ecuador

El virus de inmunodeficiencia humana constituye uno de los principales problemas de salud a nivel mundial. Se reconoce como un fenómeno multifactorial, donde las políticas públicas en materia de prevención, diagnóstico oportuno y tratamiento resultan claves. El objetivo del presente estudio es describir los avances en políticas públicas y vigilancia epidemiológica relacionadas con el virus de inmunodeficiencia humana/sida en Ecuador. Se evidencian importantes pasos con respecto al compromiso político y responsabilidad social para conseguir frenar los estragos del virus de inmunodeficiencia humana/sida, e infecciones de transmisión sexual, a partir de estrategias centradas en la prevención, así como en el tratamiento profiláctico, antirretroviral, y el seguimiento de los pacientes. Con vistas a ello se han implementado proyectos destinados a cumplir lo acordado en la declaración de las Naciones Unidas, y en el marco del plan nacional para el desarrollo. Persisten dificultades relacionadas con el acceso al diagnóstico del virus y pruebas de seguimiento, principalmente por la concentración de estas en una única institución.

The human immunodeficiency virus is one of the main health problems worldwide. It is recognized as a multifactorial phenomenon, where public policies regarding prevention, timely diagnosis and treatment are key. The objective of this study is to describe the advances in public policies and epidemiological surveillance related to the human immunodeficiency virus/AIDS in Ecuador. Important steps are evident in relation to political commitment and social responsibility to stop the injuries of the human immunodeficiency virus/AIDS, and sexually transmitted infections, based on strategies focused on prevention, as well as prophylactic, antiretroviral, and treatment patient follow-up. Some projects have been implemented aimed at fulfilling what was agreed in the United Nations declaration, and within the framework of the national development plan. Difficulties persist related to access to virus diagnosis and follow-up tests, mainly due to the concentration of these in a single institution.

Morita-Baylis-Hillman adducts derived from thymol: synthesis, in silico studies and biological activity against Giardia lamblia.

Giardiasis is a neglected disease, and there is a need for new molecules with less side effects and better activity against resistant strains. This work describes the evaluation of the giardicidal activity of thymol derivatives produced from the Morita-Baylis-Hillman reaction. Thymol acrylate was reacted with different aromatic aldehydes, using 1,4-diazabicyclo[2.2.2]octane (DABCO) as a catalyst. Eleven adducts (8 of them unpublished) with yields between 58 and 80% were obtained from this reaction, which were adequately characterized. The in silico prediction showed theoretical bioavailability after oral administration as well as antiparasitic activity against Giardia lamblia. Compound 4 showed better biological activity against G. lamblia. In addition to presenting antigiardial activity 24 times better than thymol, this MBHA was obtained in a short reaction time (3 h) with a yield (80%) superior to the other investigated molecules. The molecule was more active than the precursors (thymol and MBHA 12) and did not show cytotoxicity against HEK-293 or HT-29 cells. In conclusion, this study presents a new class of drugs with better antigiardial activity in relation to thymol, acting as a basis for the synthesis of new bioactive molecules. Molecular hybridization technique combined with the Morita-Baylis-Hillman reaction provided new thymol derivatives with giardicidal activity superior to the precursor molecules.

Alien hotspot: Benthic marine species introduced in the Brazilian semiarid coast.

In this study, we provide a baseline assessment of introduced marine species along the extensive (~600 km) Brazilian semiarid coast. We reported 27 introduced and 26 cryptogenic species. Moreover, the main vectors of introduction were ballast water, shipping lines, oil and gas activities, biofouling, and rafting on plastic debris. The taxa were Ascidiacea (17 species) and Bryozoa (17), followed by Crustacea (6), Mollusca (6), Cnidaria (3), Echinodermata (3), and Porifera (1). Among these invertebrates, some species are recognized as drivers of impacts such as the invasive corals (Tubastraea tagusensis and Tubastraea coccinea), the bivalves Isognomom bicolor and Perna viridis, the crab Charybdis hellerii, the brittle star Ophiothela mirabilis, and, finally, the bryozoan Membraniporopsis tubigera. These species threaten the biodiversity of unique ecosystems such as intertidal sandstone reefs, shallow-water coral reefs, and mesophotic ecosystems. Moreover, the up-to-date results highlight that this region is a hotspot of bioinvasion in the tropical South Atlantic.

Prevalencia y caracterización de mujeres vírgenes con diagnóstico de cáncer de cérvix, endometrio y ovario, un estudio de centro único / Prevalence and characterization of virgin women diagnosed with cervical, endometrial and ovarian cancer, a single center study

Introducción: El cáncer de endometrio, el cáncer de ovario y el cáncer cervicouterino son las neoplasias, dentro del cáncer del aparato reproductor femenino, que se consideran más frecuentes en la actualidad. La aparición de cáncer ginecológico en mujeres vírgenes demuestra que se deben consideran otras factores causales de la enfermedad, sin embargo, en nuestro país, no hay la suficiente evidencia de documentación sobre estos casos. El objetivo del presente estudio medir la prevalencia de cáncer de cuello uterino, útero y ovarios en mujeres vírgenes atendidas en un centro de referencia de Ginecología Oncológica de Guayaquil. Metodología: El estudio es observacional y transversal, se realizó en el Hospital de Especialidades Teodoro Maldonado Carbo, del Instituto Ecuatoriano de Seguridad Social, Guayaquil-Ecuador, de enero del 2013 al diciembre del 2017. Se incluyeron pacientes con cáncer cervicouterino, de útero y ovarios divididos en Grupo 1 (G1) Mujeres vírgenes y Grupo 2 (G2): Mujeres con vida sexual activa. Las variables fueron edad, órgano afectado, comorbilidades, antecedente familiar de cáncer, tipo histológico y muerte. La muestra fue no probabilística, tipo censo. Se utiliza estadística analítica, la muestra dividida en 2 grupos se compara usando Chi2. Se reporta Odds Ratio con intervalo de confianza del 95%. Resultados: En G1 fueron 44 casos y en G2 fueron 337 casos. Lo que representa una prevalencia de 11.55% (IC95% 11.38-11.71%). Cáncer de Ovario en G1 fue 29/44 casos (66%) versus 95/337 casos (28.2%) en G2 P<0.0001 con OR: 4.92 (2.53-9.60). Cáncer de endometrio en G1 13/44 casos (29.5%) versus 54/337 casos (16%) en G2, OR 2.20 (1.08-4.47) P=0.03. Cáncer cervical en G1 2/44 casos (4.5%) y en G2 188/337 casos (55.8%) OR 0.38 (0.009-0.159) P<0.0001. La mortalidad en G1 fue 30/44 casos en G2 fue 130/337 casos, OR 4.14 (2.12-8.08) P>0.0001. Conclusión: En mujeres sin antecedentes de vida sexual, existe mayor riesgo de cáncer de ovario y de endometrio y el riesgo de cáncer de cérvix se disminuye un 96%. La mortalidad de este grupo de mujeres se duplica por la mayor existencia de cáncer de ovario y endometrial.

Introduction: Endometrial cancer, ovarian cancer and cervical cancer are the neoplasias, within cancer of the female reproductive system, which are considered more frequent today. The appearance of gynecological cancer in virgin women shows that other causal factors of the disease must be considered, however, in our country, there is not enough documentary evidence on these cases. The objective of this study is to measure the prevalence of cervical, uterine and ovarian cancer in virgin women treated in a reference center for Gynecology Oncology in Guayaquil. Methodology: The study is observational and cross-sectional, it was carried out at the Teodoro Maldonado Carbo Specialties Hospital, of the Ecuadorian Social Security Institute, Guayaquil-Ecuador, from January 2013 to December 2017. Patients with cervical, uterine and cervical cancer were includ-ed. ovaries divided into Group 1 (G1) Virgin women and Group 2 (G2): Women with an active sexual life. The variables were age, affected organ, comorbidities, family history of cancer, histological type, and death. The sample was non-probabilistic, census type. Analytical statistics are used, the sample divided into 2 groups is compared using Chi2. Odds Ratio is reported with a confidence interval of 95%. Results: In G1 there were 44 cases and in G2 there were 337 cases. Which represents a prevalence of 11.55% (95% CI 11.38-11.71%). Ovarian cancer in G1 was 29/44 cases (66%) versus 95/337 cases (28.2%) in G2 P <0.0001 with OR: 4.92 (2.53-9.60). Endometrial cancer in G1 13/44 cases (29.5%) versus 54/337 cases (16%) in G2, OR 2.20 (1.08-4.47) P = 0.03. Cervical cancer in G1 2/44 cases (4.5%) and in G2 188/337 cases (55.8%) OR 0.38 (0.009-0.159) P <0.0001. Mortality in G1 was 30/44 cases in G2 it was 130/337 cases, OR 4.14 (2.12-8.08) P> 0.0001. Conclusion: In women with no history of sexual life, there is a greater risk of ovarian and endometrial cancer and the risk of cervical cancer is decreased by 96%. The mortality of this group of women doubles due to the increased existence of ovarian and endometrial cancer

Market waste composition analysis and resource recovery potential in Kumasi, Ghana.

Municipal solid waste constitutes significant quantities of waste generated in markets. Markets produce substantial quantities of fruit and vegetable waste, a source of nuisance in landfills. In Ghana, market waste (MW) appears to be unexplored and has limited data available. The need for MW valorization in the face of a circular economy requires reliable knowledge of MW properties. The study determined the waste compositions of selected major markets from two different classes of settlement in Kumasi and the seasonal effect on the compositions. The chemical properties of organics were determined via proximate and ultimate analyses and the theoretical biomethane potential, with the Buswell equation. From the results, MW composition in the wet season is 59.6% organic, 11.4% plastics, 8.3% paper, 5.3% textiles, 4.7% inert, 4.1% miscellaneous, 2.1% metal, 1.8% glass and 2.8% leather. The dry season values are 45.8% organic, 14.6% plastics, 12.7% paper, 7.3% textiles, 6.4% inert, 4.3% miscellaneous, 2.3% metal, 2.6% glass and 3.9% leather. An ANOVA indicates significant differences between the two seasons and some waste components; organics, plastics, paper and cardboard, leather, and inert. The high calorific values recorded ranged from 14.8 MJ kg-1 to 16.6 MJ kg-1. The biogas potential and biomethane content ranged from 775.3 l/kgVS to 828.9 L/kgVS and 50% to 57% respectively.Implications: Market waste (MW) in Ghana appears to be an unchartered area and there is limited data on market generation and composition. The need for MW valorization requires reliable knowledge on MW properties. This study explores MW characteristics of six major market from two different classes of settlements in a developing country. Study findings suggest that the quantities of market organics are higher than household waste. Again, MW composition can be influenced by season and geographical location. Furthermore, the study establishes the potential of MW in considerable quantities of biogas and methane generation, in comparison with household waste.

Electrochemical aptasensor for the detection of HER2 in human serum to assist in the diagnosis of early stage breast cancer.

Human epidermal growth factor receptor-2 (HER2) is an important biomarker in the diagnosis and prognosis of breast cancer. This work aimed to develop an aptasensor to detect HER2 in human serum. HER2 aptamer was immobilized by electrostatic adsorption on the surface of a homemade screen-printed electrode modified with poly-L-lysine. Measurements were made by differential pulse voltammetry using methylene blue as a redox indicator. A calibration curve was constructed (R2 = 0.997) using different concentrations of HER2 protein (10-60 ng/mL) in PBS buffer (pH 7.4), with a detection limit of 3.0 ng/mL. The aptasensor showed good reproducibility with relative standard deviations (RSDs) of 3% and remained stable for 3 days with an RSD around 2%. When the tests were performed with serum from a healthy woman, a peak of 6.72 µA was found without the addition of the protein. When we tested the serum of a woman with HER2+ breast cancer, we obtained a signal of 2.65 µA; the same pattern was found when adding to protein in serum control, i.e., the higher the concentration of protein, the lower the signal. The aptasensor was characterized by scanning electron microscopy and isothermal titration calorimetry (ITC), showing excellent interaction between aptamer and target protein. The results revealed a promising and sensitive tool capable of detecting HER2 protein in human serum with albumin depletion, aiding in the molecular diagnosis of breast cancer. Graphical abstract.

Therapeutic bullfrog oil-based nanoemulsion for oral application: Development, characterization and stability.

The aim of this study was to develop, optimize, and characterize a stable therapeutic bullfrog oil based nanoemulsion for oral application using a rational experimental design approach. The optimized oral nanoemulsion contained 0.2 % sodium benzoate and 0.02 % propyl-paraben as preservatives; 0.1 % sucralose and 0.4 % acesulfam K as sweeteners and 0.1 % tutti-frutti as flavoring to mask the unpleasant organoleptic characteristics of bullfrog oil. The oral O/W-nanoemulsion showed the droplet size, PDI, zeta potential, and pH of 410 ± 8 nm, 0.20 ± 0.02, -38 ± 2.5 mV, and 6.43 ± 0.05, respectively. The optimized oral nanoemulsion showed a milky single-phase and optimal physical stability at 25 °C for 90 days. Indeed, higher oxidation induction time and lower formation of peroxides in the oral nanoemulsion were responsible for improving its stability. A therapeutic delivery system containing bullfrog oil for oral application was successfully developed and optimized with ideal thermo-oxidative stability.

Cryoprotectant agents and cooling effect on embryos of Macrobrachium amazonicum.

SummaryThere are few reports of cryopreservation and injuries in Macrobrachium amazonicum embryos. Thus, the aim of this study was to analyze the effects of cryoprotectants agents and cooling on stage VIII of this species. Fertilized eggs from ovigerous females were removed from the incubation chamber, then placed in 10 ml Falcon tubes with a cryoprotectant solution and saline-free calcium solution. Thus, the embryos underwent a cooling curve of 1°C per min until reaching 5°C, and then were stored for 2 h. The tubes containing the embryos were washed to remove the cryoprotectant, acclimated for 5 min and then transferred to 50 ml incubators. At the end of the 24-h period, living embryos from each tube were counted and tabulated. A pool of embryos was fixed with 4% formaldehyde and then subjected to histology using 3-mm thick sections and stained with haematoxylin/eosin. Another pool was used for biometric analysis in which length, width and volume were analyzed. The cryoprotectants agents used were: dimethylsulfoxide (DMSO), methyl alcohol, ethylene glycol at 1, 5 and 10% and sucrose (0.5 M). Variance analysis was performed followed by Tukey's honest significant difference (HSD) test at 5% significance level. DMSO cryoprotectant affected embryo survival the least with rates of 71.8, 36.2 and 0% for concentrations of 1, 5 and 10%, respectively. Ethylene glycol caused 100% mortality at all the concentrations used. It was not possible to observe the interference of cooling and cryoprotectants on embryonic structures in this study.

Deformidad de Madelung: presentación de un caso / Madelung deformity: case report

La deformidad de Madelung es una alteración poco común de la articulación de las muñecas, con una prevalencia desconocida por los pocos casos reportados hasta la actualidad. Se vincula a mutaciones del gen SHOX. Se caracteriza por presentar alteraciones en el radio, el carpo y el cúbito, con predominio bilateral. Afecta principalmente a pacientes de sexo femenino; los signos y síntomas se revelan al inicio de la adolescencia. Presentamos el caso clínico de una paciente de sexo femenino de 17 años que registra las manifestaciones clínicas y radiográficas características. (AU)

Madelung deformity is a rare alteration of the wrist joint of unknown prevalence due to the few cases reported. It has been linked to SHOX gene mutations. Madelung deformity is characterized by alterations of the radius, carpus and ulna, predominantly bilateral and mainly seen in female patients at the beginning of the adolescence. We report the clinical case of a 17-yearold female patient presenting the characteristic clinical and radiographic deformities. (AU)

Synthesis of 16 New Hybrids from Tetrahydropyrans Derivatives and Morita-Baylis-Hillman Adducts: In Vitro Screening against Leishmania donovani.

Leishmaniases are a group of neglected tropical diseases (NTDs) caused by protozoan parasites from >20 Leishmania species. Visceral leishmaniasis (VL), also known as kala-aza, is the most severe form of leishmaniasis, usually fatal in the absence of treatment in 95% of cases. The Morita-Baylis-Hillman adducts (MBHAs) are being explored as drug candidates against several diseases, one of them being leishmaniasis. We present here the design, synthesis and in vitro screening against Leishmania donovani of sixteen new molecular hybrids from analgesic/antiinflammatory tetrahydropyrans derivatives and Morita-Baylis-Hillman adducts. First, acrylates were synthesized from analgesic/anti-inflammatory tetrahydropyrans using acrylic acid under TsOH as a catalyst (70-75% yields). After the 16 new MBHAs were prepared in moderate to good yields (60-95%) promoted by microwave irradiation or low temperature (0 °C) in protic and aprotic medium. The hybrids were evaluated in vitro on the promastigote stage of Leishmania donovani by determining their inhibitory concentrations 50% (IC50), 50% hemolysis concentration (HC50), selectivity index (HC50/IC50,), and comparing to Amphotericin B, chosen as the anti-leishmanial reference drug. The hybrid which presents the bromine atom in its chemical structure presents high leishmanicide activity and the high selectivity index in red blood cells (SIrb > 180.19), compared with the highly-toxic reference drug (SIrb = 33.05), indicating that the bromine hybrid is a promising compound for further biological studies.

Synthesis and In Vitro Anti Leishmania amazonensis Biological Screening of Morita-Baylis-Hillman Adducts Prepared from Eugenol, Thymol and Carvacrol.

Leishmaniasis represents a series of severe neglected tropical diseases caused by protozoa of the genus Leishmania and is widely distributed around the world. Here, we present the syntheses of Morita-Baylis-Hillman adducts (MBHAs) prepared from eugenol, thymol and carvacrol, and their bioevaluation against promastigotes of Leishmania amazonensis. The new MBHAs are prepared in two steps from essential oils in moderate to good yields and present IC50 values in the range of 22.30-4.71 µM. Moreover, the selectivity index to the most potent compound is very high (SIrb > 84.92), far better than that of Glucantime® (SIrb 1.39) and amphotericin B (SIrb = 22.34). Conformational analysis were carried out at the M062X//6-31+G(d,p) level of theory to corroborate a hypothesis about the nitroaromatic bioreduction mechanism.

New Analysis Method Application in Metallographic Images through the Construction of Mosaics Via Speeded Up Robust Features and Scale Invariant Feature Transform.

In many applications in metallography and analysis, many regions need to be considered and not only the current region. In cases where there are analyses with multiple images, the specialist should also evaluate neighboring areas. For example, in metallurgy, welding technology is derived from conventional testing and metallographic analysis. In welding, these tests allow us to know the features of the metal, especially in the Heat-Affected Zone (HAZ); the region most likely for natural metallurgical problems to occur in welding. The expanse of the Heat-Affected Zone exceeds the size of the area observed through a microscope and typically requires multiple images to be mounted on a larger picture surface to allow for the study of the entire heat affected zone. This image stitching process is performed manually and is subject to all the inherent flaws of the human being due to results of fatigue and distraction. The analyzing of grain growth is also necessary in the examination of multiple regions, although not necessarily neighboring regions, but this analysis would be a useful tool to aid a specialist. In areas such as microscopic metallography, which study metallurgical products with the aid of a microscope, the assembly of mosaics is done manually, which consumes a lot of time and is also subject to failures due to human limitations. The mosaic technique is used in the construct of environment or scenes with corresponding characteristics between themselves. Through several small images, and with corresponding characteristics between themselves, a new model is generated in a larger size. This article proposes the use of Digital Image Processing for the automatization of the construction of these mosaics in metallographic images. The use of this proposed method is meant to significantly reduce the time required to build the mosaic and reduce the possibility of failures in assembling the final image; therefore increasing efficiency in obtaining results and expediting the decision making process. Two different methods are proposed: One using the transformed Scale Invariant Feature Transform (SIFT), and the second using features extractor Speeded Up Robust Features (SURF). Although slower, the SIFT method is more stable and has a better performance than the SURF method and can be applied to real applications. The best results were obtained using SIFT with Peak Signal-to-Noise Ratio = 61.38, Mean squared error = 0.048 and mean-structural-similarity = 0.999, and processing time of 4.91 seconds for mosaic building. The methodology proposed shows be more promissory in aiding specialists during analysis of metallographic images.

Abnormal brain connectivity patterns in adults with ADHD: a coherence study.

Studies based on functional magnetic resonance imaging (fMRI) during the resting state have shown decreased functional connectivity between the dorsal anterior cingulate cortex (dACC) and regions of the Default Mode Network (DMN) in adult patients with Attention-Deficit/Hyperactivity Disorder (ADHD) relative to subjects with typical development (TD). Most studies used Pearson correlation coefficients among the BOLD signals from different brain regions to quantify functional connectivity. Since the Pearson correlation analysis only provides a limited description of functional connectivity, we investigated functional connectivity between the dACC and the posterior cingulate cortex (PCC) in three groups (adult patients with ADHD, n=21; TD age-matched subjects, n=21; young TD subjects, n=21) using a more comprehensive analytical approach - unsupervised machine learning using a one-class support vector machine (OC-SVM) that quantifies an abnormality index for each individual. The median abnormality index for patients with ADHD was greater than for TD age-matched subjects (p=0.014); the ADHD and young TD indices did not differ significantly (p=0.480); the median abnormality index of young TD was greater than that of TD age-matched subjects (p=0.016). Low frequencies below 0.05 Hz and around 0.20 Hz were the most relevant for discriminating between ADHD patients and TD age-matched controls and between the older and younger TD subjects. In addition, we validated our approach using the fMRI data of children publicly released by the ADHD-200 Competition, obtaining similar results. Our findings suggest that the abnormal coherence patterns observed in patients with ADHD in this study resemble the patterns observed in young typically developing subjects, which reinforces the hypothesis that ADHD is associated with brain maturation deficits.