Evaluation of the water quality of an artificial inter-andean lake in northern Peru.

Lake Burlan, a lentic ecosystem artificially created by untreated runoff from adjacent rice fields, is located in the Amazon region within the dry forests of northern Peru. This body of water plays a fundamental role in agriculture and recreational activities in the area, which are fundamental to the local economy. This research aimed to evaluate the water quality of Lake Burlan using the Water Quality Index of Peru (WQI-PE). In addition, both spatial and depth variations of limnological parameters and trace elements were determined. The WQI-PE was calculated at seven sampling stations at two depths (surface level and one meter), using 18 limnological parameters and nine trace elements. The WQI-PE assessment indicated that the lake water quality ranged from poor to fair for both depths. Statistical analysis showed that nine limnological parameters and five trace elements showed spatial differences across seven sampling stations, while three limnological parameters and two trace elements showed depth-dependent variations. Concentrations of arsenic, cadmium, mercury, and lead were in exceedance of the national and international standards on environmental water quality. Therefore, the water quality of Lake Burlan is affected mainly by the impact of the surrounding rice fields and recreational activities. This research establishes a starting point for future monitoring to assist in the implementation of prevention and mitigation.

Enhancing Eritadenine Production in Submerged Cultures of Shiitake (Lentinula edodes Berk. Pegler) Using Blue LED Light and Activated Charcoal. Revealing Eritadenine's Novel In Vitro Bioherbicidal Activity Against Chrysanthemum morifolium.

Eritadenine from shiitake mushroom is a secondary metabolite with hypocholesterolemic, hypotensive and antiparasitic properties, thus promising for pharmaceutical and agricultural applications. Eritadenine is obtained from submerged mycelial cultures of shiitake, but the actual yields remain unsatisfactory to explore potential applications or industrial-scale production. In this study, green and blue LED lights were tested to increase yields of eritadenine in submerged cultures of shiitake. Notably, blue LEDs increased yields by 13-14 times, reaching 165.7 mg/L, compared to darkness (11.2 mg/L) and green light (12.1 mg/L) (p < 0.05, Tukey test). Nitrogen sources yeast extract (YE) and peptone (at 2 g/L) increased eritadenine production. YE promoted 22.6 mg/L, while peptone 18.3 mg/L. The recovery of eritadenine was evaluated using amberlite and activated charcoal (AC) adsorption isotherms. AC demonstrated the highest adsorption rate, with 75 mg of eritadenine per gram of AC, according to the Freundlich isotherm. The desorption rate reached 93.95% at pH 10. The extract obtained from submerged cultures had eritadenine content of 63.31%, corresponding to 87.86% of recovery, according to HPLC analysis. Furthermore, the novel bioherbicidal potential of eritadenine was tested on in vitro Chrysanthemum morifolium plants. The cultures extract containing eritadenine had a detrimental impact on plant development, generating mortality of 100% at 3%, 0.5%, and 0.25%. Moreover, pure eritadenine exhibited a phytotoxic effect similar than glyphosate on leaves, stems and roots. These findings highlight the significant bioherbicidal properties of eritadenine. Further studies are needed to understand the biosynthetic pathway of eritadenine and its bioherbicidal properties on weeds and illicit crops.

A Novel Trypsin Kunitz-Type Inhibitor from Cajanus cajan Leaves and Its Inhibitory Activity on New Cancer Serine Proteases and Its Effect on Tumor Cell Growth.

A novel trypsin inhibitor from Cajanus cajan (TIC) fresh leaves was partially purified by affinity chromatography. SDS-PAGE revealed one band with about 15 kDa with expressive trypsin inhibitor activity by zymography. TIC showed high affinity for trypsin (Ki = 1.617 µM) and was a competitive inhibitor for this serine protease. TIC activity was maintained after 24 h of treatment at 70 °C, after 1 h treatments with different pH values, and ß-mercaptoethanol increasing concentrations, and demonstrated expressive structural stability. However, the activity of TIC was affected in the presence of oxidizing agents. In order to study the effect of TIC on secreted serine proteases, as well as on the cell culture growth curve, SK-MEL-28 metastatic human melanoma cell line and CaCo-2 colon adenocarcinoma was grown in supplemented DMEM, and the extracellular fractions were submitted salting out and affinity chromatography to obtain new secreted serine proteases. TIC inhibited almost completely, 96 to 89%, the activity of these serine proteases and reduced the melanoma and colon adenocarcinoma cells growth of 48 and 77% respectively. Besides, it is the first time that a trypsin inhibitor was isolated and characterized from C. cajan leaves and cancer serine proteases were isolated and partial characterized from SK-MEL-28 and CaCo-2 cancer cell lines. Furthermore, TIC shown to be potent inhibitor of tumor protease affecting cell growth, and can be one potential drug candidate to be employed in chemotherapy of melanoma and colon adenocarcinoma.

Knowledge and Attitudes of Parents about Oral Health in the Primary Dentition Stage in a Peruvian High Andean City.

Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.

Antileishmanial effects of Crotalaria spectabilis Roth aqueous extracts on Leishmania amazonensis.

Fifteen polar extracts from leaf, seed, pod, stem, flower and root of Crotalaria spectabilis were prepared using aqueous systems, based on the principles of green chemistry, and showed different protease inhibitor (PI) activities on trypsin, papain, pepsin and the extracellular L. amazonensis serine protease (LSPIII). The most pronounced inhibitory effect on LSPIII was observed in leaf (CS-P), root, stem, flower (CS-FPVPP) and pod (CS-VA) extracts. Crotalaria extracts exhibited low cytotoxicity on macrophages; however, they decreased the viability of L. amazonensis promastigotes and amastigotes, as observed in leaf (CS-AE, CS-P, CS-T and CS-PVPP), seed (CS-ST), flower and root (CS-RA) extracts. CS-P was chosen to study PI and secondary metabolites and a 10-12 kDa protein, analyzed by mass spectrometry, was identified as a serine PI homologous with papaya latex serine PI. Glycosylated flavonoids, such as quercetins, vitexin and tricin were the major secondary metabolites of CS-P. The presence of PIs in C. spectabilis is a new finding, especially in other organs than seeds since PIs have been reported only in seed legumes. Besides, this is the first report of antileishmanial activity of C. spectabilis extracts and the identification of serine polypeptide PI and glycosylated flavonoids from leaf.

Interaction and integration among behaviors of adult Drosophila in nature.

Living in environments whose ecologies vary in periods as short as 24 h is a challenge for animals as Drosophila species that inhabit pear and apple orchards. These orchards have sunny and shady sections. The size and shape of these habitats change daily according to the position of the sun in the sky. Sunny areas are related to dryness and water loss, and shady places have lower temperatures and higher humidity. The presence of heterospecific flies may lead to competition for space and food. In sunny habitats we did not find adult Drosophila. In shady sections we found conspecific groups D. melanogaster, D. simulans, D. immigrans, D. subobscura, and the Chilean endemic D. pavani perched on grasses and herbs at 8-10 cm from fruits that had fallen on the ground. In the fruits, 99% of the adults were females and they were not grouped. The way in which daily changes in the size and shape of shady habitats together with the presence of heterospecific adults influence the selection of places to live is poorly understood in Drosophila. Our experiments show that adults of the five species prefer dark areas. The experimental results show that the odors of each species: i) influence conspecifics to select similar perch sites and decrease mobility, and ii) increase mobility in heterospecific adults and modify their perch site preferences. Attractions between conspecifics, the repulsions between species, and preferences for shaded areas matter in choosing a place to live in the five Drosophila species. These behaviors seem to have evolved as coordinated routines, contributing to the coexistence of the five Drosophila species in the apple and pear orchards examined.

The Era of Biomaterials: Smart Implants?

Conditions, accidents, and aging processes have brought with them the need to develop implants with higher technology that allow not only the replacement of missing tissue but also the formation of tissue and the recovery of its function. The development of implants is due to advances in different areas such as molecular-biochemistry (which allows the understanding of the molecular/cellular processes during tissue repair), materials engineering, tissue regeneration (which has contributed advances in the knowledge of the properties of the materials used for their manufacture), and the so-called intelligent biomaterials (which promote tissue regeneration through inductive effects of cell signaling in response to stimuli from the microenvironment to generate adhesion, migration, and cell differentiation processes). The implants currently used are combinations of biopolymers with properties that allow the formation of scaffolds with the capacity to mimic the characteristics of the tissue to be repaired. This review describes the advances of intelligent biomaterials in implants applied in different dental and orthopedic problems; by means of these advances, it is expected to overcome limitations such as additional surgeries, rejections and infections in implants, implant duration, pain mitigation, and mainly, tissue regeneration.

Factors interfering screening for gynecological cancers in peruvian women / Factores que interfieren los cribados para cánceres ginecológicos en mujeres peruanas

Objective: To identify the factors associated with the interference of gynecological cancer screening in women aged 25-69 years, according to the Demographic and Family Health Survey (ENDES) for the years 2019 and 2020. Materials and methods: Quantitative, observational, analytical cross- sectional study. It was a secondary database analysis obtained by ENDE for the years 2019 and 2020. Generalized linear Poisson family crude and adjusted models were used to estimate the association. The measure of association. The measure of association used was the adjusted prevalence ratio (Rpa) with 95% confidence interval (95% CI). Results: We worked with a total of 18,113 women aged 25-69 who were interviewed at the ENDES 2019-2020. In the descriptive analysis, it is observed that 19.3% did not take a PAP smear (PAP) and 53.6% did not perform "screening for breast cancer". Women with a primary education level have 19% and 58% more opportunities to present interference for taking PAP and screening for breast cancer respectively (RPa: 1,19, 95% CI 1.08-1,31 and RPa:1.58, 95% CI 1:51 ­ 1:64). Living in the jungle increases 56%and 20%more chance of presenting interference for taking PAP and screening for breast cancer respectively (RPa: 1.46, 95% CI 1.42-1.71 and RPa: 1.20, 95% CI: 1.15- 1.25). The level of knowledge increases the interference for taking PAP and screening for breast cancer by 43% and 3% respectively (RPa: 1.43, 95% CI: 1.34- 1.54 and RPa: 1.03, 95% CI:1.00 -1.06) Conclusions: Sociodemographic, sociocultural and economic factors have a marked influence on the performance of gynecological cancers such as cervical cancer and breast cancer, so it is necessary to implement strategies to promote the prevention of these pathologies.

Objetivo: Identificar los factores asociados con la interferencia de los cribados para cánceres ginecológicos en mujeres peruanas de 25 ­ 69 años de edad, según la Encuesta Demográfica y de Salud Familiar (ENDES) de los años 2019 y 2020. Materiales y métodos: Estudio cuantitativo, observacional, analítico de corte transversal. Fue un análisis de base de datos secundaria obtenido por ENDES de los años 2019 y 2020. Se usó modelos lineales generalizados de familia Poisson crudas y ajustadas para poder estimar la asociación. La medida de asociación utilizada fue la razón de prevalencia ajustada (RPa) con un intervalo de confianza al 95% (IC95%). Resultados: Se trabajó con un total de 18113 mujeres peruanas de 25-69 años entrevistadas en la ENDES 2019-2020. En el análisis descriptivo se observa que un 19,3% no se realizó la toma de Papanicolaou (PAP) y 53,6 no se realizó "cribado para cáncer de mama". Las mujeres con nivel educativo primario tienen 20% y 58% más oportunidades de presentar interferencia para la toma de PAP y cribado para cáncer de mama respectivamente (RPa: 1.20, IC95%: 1.09-1.32 y RPa: 1.58, IC95%: 1.52-1.65). Vivir en la selva aumenta en 57% y 20% más oportunidades de presentar interferencia para la toma de PAP y cribado para cáncer de mama respectivamente (RPa: 1.57, IC95%: 1.43-1.71 y RPa: 1.20, IC95%: 1.15-1.25). El nivel de conocimiento aumenta en un 44% y 4% la interferencia para la toma de PAP y cribado para cáncer de mama respectivamente (RPa: 1.44, IC95%: 1.34-1.54 y RPa: 1.04, IC95%: 1.01-1.07). Conclusión: Los factores sociodemográficos, socioculturales y económicos influyen de manera marcada en la realización de los cribados de cánceres ginecológicos como el cáncer de cuellouterino y el cáncer de mama, por lo que es necesario implementar estrategias para promover la prevención de estas patologías.

Towards the Configuration of a Photoelectrocatalytic Reactor: Part 2-Selecting Photoreactor Flow Configuration and Operating Variables by a Numerical Approach.

This work aims to select a photoreactor flow configuration and operational conditions that maximize the Photocatalytic Space-time Yield in a photoelectrocatalytic reactor to degrade Reactive Red 239 textile dye. A numerical study by Computational Fluid Dynamics (CFD) was carried out to model the phenomena of momentum and species transport and surface reaction kinetics. The photoreactor flow configuration was selected between axial (AF) and tangential (TF) inlet and outlet flow, and it was found that the TF configuration generated a higher Space-time Yield (STY) than the AF geometry in both laminar and turbulent regimes due to the formation of a helical movement of the fluid, which generates velocity in the circumferential and axial directions. In contrast, the AF geometry generates a purely axial flow. In addition, to maximize the Photocatalytic Space-time Yield (PSTY), it is necessary to use solar radiation as an external radiation source when the flow is turbulent. In conclusion, the PSTY can be maximized up to a value of 45 g/day-kW at an inlet velocity of 0.2 m/s (inlet Reynolds of 2830), solar radiation for external illumination, and internal illumination by UV-LEDs of 14 W/m2, using a photoreactor based on tangent inlet and outlet flow.

Towards the Configuration of a Photoelectrocatalytic Reactor: Part 1-Determination of Photoelectrode Geometry and Optical Thickness by a Numerical Approach.

Photoelectrocatalysis has been highlighted as a tertiary wastewater treatment in the textile industry due to its high dye mineralisation capacity. However, design improvements are necessary to overcome photo-reactors limitations. The present work proposes a preliminary configuration of a photoelectrocatalytic reactor to degrade Reactive Red 239 (RR239) textile dye, using computational fluid dynamics (CFD) to analyse the mass transfer rate, radiation intensity loss (RIL), and its effect on kinetics degradation, over a photoelectrode based on a TiO2 nanotube. A study to increase the space-time yield (STY) was carried out through mass transfer rate and kinetic analysis, varying the optical thickness (δ) between the radiation entrance and the photocatalytic surface, photoelectrode geometry, inlet flow rate, and the surface radiation intensity. The RIL was determined using a 1D Beer-Lambert-based model, and an extinction coefficient experimentally determined by UV-Vis spectroscopy. The results show that in RR239 solutions below concentrations of 6 mg/L, a woven mesh photoelectrode and an optimal optical thickness δ of 1 cm is enough to keep the RIL below 15% and maximise the mass transfer and the STY in around 110 g/m3-day.

Desarrollo de las reflexiones metapragmáticas sobre la función de la ironía verbal en adolescentes

Objetivo. Analizar las reflexiones metapragmáticas que presentan 32 adolescentes de 12 y 15 años de edad (16 por grupo etario) sobre la función de la ironía verbal en dos tipos de actos de habla: agradecimiento y ofrecimiento irónicos. Método. Los participantes se enfrentaron a ocho historias que terminaban con una expresión irónica y mediante un guion de preguntas se indagó sobre las funciones que les atribuían a los enunciados irónicos. Resultados. Se muestran diferencias significativas debidas a la edad, pero no al tipo de enunciado en las reflexiones que hacen los adolescentes, lo que confirma que la capacidad para hacer reflexiones metapragmáticas sobre la ironía verbal se desarrolla de manera muy tardía en el lenguaje infantil.

Objective. Analyse metapragmatic reflections made by adolescents aged 12 and 15 years old (16 per age group) on the functions of verbal irony, in two types of ironic speech acts: ironic thanking and ironic offering. Method. The participants faced eight stories ending with ironic remarks, and through questioning, they were asked about the functions they attributed to the ironic statements. Results. Significant differences are shown due to age, but none related to the type of statement, which confirms that the ability to make metapragmatic reflections on verbal irony develops late in children's language.

Study of protease activity from Aspergillus awamori INCQS2B.361U2/1 extracellular fraction and modification of culture medium composition to isolate a novel aspartic protease.

Aspergillus awamori was cultivated in a modified Breccia medium, and the extracellular fraction was obtained, which presented 260 ± 15 µg of protein/mg and specific protease activity of 3.87 ± 0.52 mM.min-1.mg of protein-1 using Nα-p-tosyl-L-arginine methyl ester hydrochloride (L-TAME) as substrate. This fraction showed major proteins about 104 and 44 kDa and maximal protease activity at pH 5.5, 6.5, and 9.0, suggesting that A. awamori secretes acidic, neutral, and alkaline proteases with expressive thermal stability, however, aspartic protease was the most important activity. When yeast extract was supplemented to a modified Breccia medium, A. awamori protein secretion and protease activity were maximal and the affinity chromatography on pepstatin-agarose was employed to isolate the aspartic protease activity, which was called ASPA, with approximately 75 kDa. ASPA maximal activity was obtained at pH 4.5 and 6.5, and 50 °C. Pepstatin inhibited about 80% of ASPA activity, with IC50 and Ki values of 0.154 and 0.072 µM, respectively. ASPA cleaved protein and peptides substrates with the highest activity against gelatin (95 U/mg) and good peptidase activity with KM 0.0589 mM and Vmax 1.909 mM.min-1.mg protein-1, using L-TAME as substrate. A. awamori extracellular fraction is a source of proteases with important activity, and the supplementation of modified Breccia medium increased the aspartic protease production. This enzyme presented different biochemical characteristics from the previously reported A. awamori aspartic proteases. Therefore, ASPA is an excellent candidate for biotechnological application due to its important activity and thermostability.

Hallazgos clínicos, epidemiológicos y virológicos del primer brote de covid-19 en Medellín, Antioquia, Colombia / Clinical, epidemiological and virological findings of the first covid-19 outbreak in Medellín, Antioquia, Colombia / Achados clínicos, epidemiológicos e virológicos do primeiro surto de covid-19 em Medellín, Antioquia, Colômbia

Resumen Objetivo: Caracterizar clínica, epidemiológica y virológicamente el primer brote de covid-19, a partir del caso primario en Medellín (Colombia), a través de las acciones de vigilancia y control epidemiológico realizadas para su contención. Metodología: Estudio descriptivo retrospectivo. Los casos secundarios se identificaron teniendo en cuenta la definición del protocolo del Instituto Nacional de Salud. La recolección de datos fue obtenida del Sistema de Vigilancia en Salud Pública, la investigación epidemiológica de campo, historia clínica y resultados de laboratorio. Se tuvieron en cuenta patrones clínicos de la enfermedad (signos y síntomas), componentes epidemiológicos (acciones de vigilancia y control de la transmisión) y virológicos (con el uso de la prueba diagnóstica para sars-CoV-2 y la evaluación de la recuperación virológica). La confirmación de los casos se hizo por técnica de detección diagnóstica de coronavirus Wuhan 2019 por Reverse Transcription Polymerase Chain Reaction - Real Time, protocolo Charité, Berlín, Alemania 2020, procesadas en e informadas por el Laboratorio Nacional de Referencia del Instituto Nacional de Salud. Resultados: El caso primario de Medellín ingresó al país el 2 de marzo de 2020, procedente de Madrid (España) y fue confirmado el 9 de marzo. Se identificaron 52 contactos estrechos en 9 conglomerados. Las acciones de vigilancia en salud pública permitieron identificar 5 casos relacionados en una fase temprana de la enfermedad. Conclusiones: La caracterización del caso primario en Medellín permitió identificar el primer brote de covid-19 y orientar las medidas de control epidemiológico, como aislamientos, tomas de muestras, seguimiento a contactos y búsquedas de casos secundarios.

Abstract Objective: To characterize clinically, epidemiologically and virologically the first outbreak of covid-19, from the primary case in Medellín (Colombia), through surveillance and epidemiological control carried out for its containment. Methodology: Retrospective descriptive study. Secondary cases are identified taking into account the definition of the protocol of the National Institute of Health. Data collection was obtained of the Public Health Surveillance System, research epidemiological field, medical history and results of laboratory. Clinical patterns of the disease (signs and symptoms), epidemiological components (transmission surveillance and control actions) and virological (with the use of the diagnostic test for sars-CoV-2 and the evaluation of virological recovery). The confirmation of the cases was done by the diagnostic detection technique of Wuhan coronavirus 2019 by reverse transcription polymerase Chain Reaction - Real Time, Charité protocol, Berlin, Germany 2020, processed in and reported by the National Laboratory of Reference of the National Institute of Health. Results: The Medellín's primary case entered the country on March 2, 2020, from Madrid (Spain) and was confirmed on March 9. 52 close contacts were identified in 9 clusters. The surveillance actions in public health made it possible to identify 5 related cases in an early phase of the disease. Conclusions: The characterization of the primary case in Medellín seek to identify the first outbreak of covid-19 and guide the epidemiological control measures, such as isolations, intakes of samples, follow-up contacts and case searches secondary.

Resumo Objetivo: Caracterizar clínica, epidemiológica e virologicamente o primeiro surto de covid-19, desde o caso primário em Medellín (Colômbia), por meio das ações de vigilância e controle epidemiológico realizadas para sua contenção. Metodologia: Estudo descritivo retrospectivo. Os casos secundários foram identificados tendo em consideração a definição do protocolo do National Institute of Health. A coleta de dados foi obtida junto ao Sistema Único de Vigilância em Saúde, pesquisa epidemiológica de campo, história clínica e resultados laboratoriais. Foram considerados os padrões clínicos da doença (sinais e sintomas), componentes epidemiológicos (ações de vigilância e controle da transmissão) e virológicos (com uso do teste diagnóstico para sars-CoV-2 e avaliação da recuperação virológica). A confirmação dos casos foi feita pela técnica de detecção diagnóstica de coronavírus Wuhan 2019 por Reação em Cadeia da Polimerase de Transcrição Reversa - Tempo Real, protocolo Charité, Berlim, Alemanha 2020, processada e relatada pelo Laboratório de Referência Nacional do Instituto Nacional de Saúde. Resultados: O caso primário de Medellín entrou no país em 2 de março de 2020, a partir de Madrid (Espanha) e foi confirmado em 9 de março. 52 contatos próximos foram identificados em 9 clusters. As ações de vigilância em saúde pública possibilitaram a identificação de 5 casos relacionados em fase inicial da doença. Conclusões: A caracterização do caso primário em Medellín permitiu identificar o primeiro surto de covid-19 e orientar medidas de controle epidemiológico, como isolamento, amostragem, acompanhamento de contatos e busca de casos secundários.

Use of Sanger protocols to identify variants of concern, key mutations and track evolution of SARS-CoV-2.

Vaccination and the emergence of SARS-CoV-2 variants mark the second year of the pandemic. Variants have amino acid mutations at the spike region, a viral protein central in the understanding of COVID-19 pathogenesis and vaccine response. Variants may dominate local epidemics, as Gamma (P.1) in Brazil, emerging in 2020 and prevailing until mid-2021. Different obstacles hinder a wider use of Next-Generation Sequencing for genomic surveillance. We describe Sanger based sequencing protocols: i) Semi-nested RT-PCR covering up to 3.684 kb (>96 %) spike gene; ii) One-Step RT-PCR for key Receptor Binding Domain (RBD) mutations (codons 417-501); iii) One-Step RT-PCR of partial N region to improve genomic capability. Protocols use leftovers of RNA extracted from nasopharyngeal swabs for quantitative RT-PCR diagnosis; with retro-transcribed DNA sequenced at ABI 3500 using dye termination chemistry. Analyses of sequences from 95 individuals (late 2020/early 2021) identified extensive amino acid variation, 57 % with at least one key mutation at the Receptor Binding Domain, with B.1.1.28 lineage most prevalent, followed by Gamma and Zeta variants, with no Delta variant observed. The relatively low cost and simplicity may provide an accessible tool to improve surveillance of SARS-CoV-2 evolution, monitor new variants and vaccinated breakthroughs.

Covid-19 y tuberculosis: el encuentro entre nuevas amenazas y viejas enfermedades / Covid-19 And Tuberculosis: The Encounter Between New Threats And Old Diseases

Una tormenta llamada COVID-19 lleva desestabilizando los sistemas de salud de casi todo el mundo. En casi 8 meses ha pasado de ser un reporte de neumonía atípica con etiología desconocida a ser la pandemia del siglo XXI. En el Perú, el primer caso confirmado fue el 06 de marzo, y hasta inicios de julio lleva cobrando la vida de más de 10 000 personas.

A storm called COVID-19 has been destabilizing the health systems of almost everything the world. In almost 8 months it has gone from being a report of atypical pneumonia with etiology unknown to be the pandemic of the 21st century. In Peru, the first confirmed case was March 6, and until the beginning of July has been claiming the lives of more than 10,000 people.

Economic and Epidemiological Impact of an Improvement Plan for the Decrease of Ventilator-Associated Pneumonia in a Tertiary Hospital in Mexico.

INTRODUCTION: The objective of this work is to measure the economic and epidemiological impact of the implementation of a comprehensive quality improvement plan (CQIP) for the prevention and reduction of ventilator-associated pneumonia (VAP) in the adult intensive care unit in a Mexican hospital. MATERIALS AND METHODS: A cross-sectional, ambispective, comparative, analytical, observational study was conducted with epidemiological data on cases of health care-associated infections and with information from the Hospital Epidemiological Surveillance Unit from August 2017 to July 2018. RESULTS: Before to the implementation of the CQIP, there were a total of 26 VAPs, with a rate of 32.2 per 1000 ventilator-days. After the implementation of CQIP, there were 14 VAPs, with a rate of 23.4 per 1000 ventilator-days, with a 46.2% decrease in incidence (P = 0.02). Before the installation of the interventions, the expense was $4,471,073.80, with an average cost per case of $171,964.38. The total cost per bed-day in the adult intensive care unit was $331,280.00, and for hospitalization, the cost was $192,038.00; for the use of antimicrobials, an expense of $749,689.20 was calculated, and for the use of mechanical ventilation, the cost was $2,974,275.60. The percentage of decrease in the cost of VAP after CQIP implementation was 46.5%. CONCLUSIONS: The implementation of CQIP based on the risk evaluation factors of VAP resulted in their decrease, which is reflected in a patient safety and quality care improvement.

Chemotactic activities of vasoactive intestinal peptide, neuropeptide Y and substance P in Leishmania braziliensis.

Cell-cell interaction and active migration (and invasion) of parasites into skin host-cell(s) are key steps for successful infection by Leishmania. Chemotaxis constitutes a primordial chapter of Leishmania-host cell interaction, potentially modulated by neuropeptides released into the skin due, for example, to the noxious stimuli represented by the insect bite. Herein we have evaluated in vitro the effect of sensory (Substance P, SP) and autonomic (Vasoactive Intestinal Peptide, VIP, and Neuropeptide Y, NPY) neuropeptides on parasite taxis, and investigated the potential modulatory effect of SP on Leishmania (Viannia) braziliensis-macrophage interaction. We demonstrated that VIP (10-10 M) and NPY (10-9 M) are chemorepellent to the parasites, while SP (10-8 M) produces a chemoattractant response. SP did not affect macrophage viability but seems to impair parasite-macrophage interaction as it decreased promastigote adherence to macrophages. As this effect is blocked by ([D-Pro 2, D-Trp7,9]-Substance P (10-6 M), the observed action may be mediated by neurokinin-1 (NK1) transmembrane receptors. VIP and NPY repellent chemotactic effect is impaired by their corresponding receptor antagonists. Additionally, they suggest that SP may be a key molecule to guide promastigote migration towards, and interaction, with dendritic cells and macrophage host cells.

Long-term virological effectiveness with darunavir/ritonavir-based salvage therapy in people living with HIV/AIDS from São Paulo, Brazil.

Even though darunavir/ritonavir (DRV/r) has high potency and a greater genetic barrier, there are few studies on the long-term effectiveness of DRV/r-based salvage therapy in people living with HIV (PLWH) in low and middle-income countries. This retrospective cohort study, from São Paulo, Brazil, included ART-experienced PLWH aged ≥18 years with virological failure (VF) who had started DRV/r plus an optimized background regimen (OBR) between 2008 and 2012. The proportion of patients with viral load (VL) <50 copies/mL, the improved mean CD4+ T cell count and the factors associated with VF during the 144-week follow-up were assessed. The study included 173 patients with the following characteristics [median (interquartile range)]: age 48 (42 -53) years; CD4+ T cell count, 229 (89 -376) cells/mm3; VL, 4.26 (3.70 -4.74) log10; 6 (4 -7) previous regimens; and 100 (38 -156) months of VF. After 144 weeks, 129 (75%) patients had VL< 50 copies/mL and a mean increase in the CD4+ T cell count of 190 cells/mm3. VL>100,000 copies/mL and poor adherence were associated with VF. DRV/r plus an OBR showed high long-term virological suppression and immunological recovery. VL>100,000 copies/mL and poor adherence were associated with VF at 144 weeks.

Programación Fetal, Estrés Toxico Intrauterino Y Consecuencias En El Producto / Fetal programmig, intrauterine toxic stress and consequences on the product

Dos décadas atrás Baker dio el concepto de Programación Fetal (PF), donde asociaba el ambiente prenatal y el desarrollo del feto. En consecuencia, la PF representaría "la inducción de las respuestas fetales debido al entorno uterino" que condicionará cambios funcionales y estructurales en el propio feto, con repercusión a corto y largo plazo. En consecuencia, si el ambiente prenatal es adverso en el desarrollo, tendremos posiblemente patologías en la vida extra uterina. Las evidencias señalan, que procesos implicados en el desarrollo de diversas funciones de los sistemas orgánicos complejos, se iniciarían mucho antes del nacimiento y conformarían problemáticas de salud a futuro.

Major drug resistance mutations to HIV-1 protease inhibitors (PI) among patients exposed to PI class failing antiretroviral therapy in São Paulo State, Brazil.

BACKGROUND: Protease inhibitors (PI) are especially important in salvage therapy. Previous treatment failure with a PI containing regimen may elicit resistance mutations, reducing PI susceptibility and limiting treatment options. The aim of this study was to describe major PI mutations among patients exposed to at least one PI to evaluate predictors of mutation emergence and the impact of subtypes on resistance. METHODOLOGY: Partial HIV-1 pol sequences (Sanger Sequencing) from patients exposed to PI with virological failure were genotyped from January 2014 to December 2017. Drug resistance mutations (DRM), antiretroviral susceptibility (GSS) and subtypes, along clinical and laboratory parameters, were evaluated using logistic regression to access the predictors of mutation emergence. RESULTS: In 27.5% (466/1696) of the cases at least one major PI mutations was identified, most commonly M46 (14.7%), V82 (13.8%) and I54 (13.3%). Mutations to NRTI and NNRTI were observed in 69.6% and 59.9%, respectively, of the 1696 sequences. Full activity to darunavir was predicted in 88% (1496/1696), but was only 57% among those with at least one PI-DRM. Subtype C sequences had less major PI-DRMs (10%, 9/87) compared to B (28%, 338/1216) or F (35%, 58/168) (p <0.001) but adjusted analysis suggested that this association is not independent from a shorter treatment time and fewer regimens (OR 0.59, Confidence Interval 95: 0.2-2.5, p = 0.48). Subtype F, together with NRTI mutations and longer time on treatment was associated to presence of PI-DRM, to a lower darunavir GSS and to mutations at codon I50. CONCLUSIONS: Among patients with PI-DRM, full activity to darunavir was compromised in almost half of the cases and efforts to detect failure at earlier time are warranted, particularly for HIV-1 subtype F that showed association to the emergence of resistance, with potential impact in protease inhibitors sequencing. Furthermore, NRTI mutations may serve as an indicative of sufficient adherence to allow PI-DRM emergence.