RESUMEN

BACKGROUND: A kidney transplant candidate's social network serves as a pool of potential living donors. Sex and racial differences in network size, network strength, and living donor requests may contribute to disparities in living donor kidney transplantation. METHODS: In this multicenter cross-sectional study, we performed an egocentric network analysis via a telephone survey of 132 waitlisted candidates (53% female and 69% Black) to identify demographic and network factors associated with requesting living kidney donations. RESULTS: Female participants made requests to more network members than male participants: incidence rate ratio (IRR) 1.95, 95% confidence interval (CI) [1.24-3.06], P < 0.01. Black participants tended to make more requests than whites (IRR 1.65, 95% CI [0.99-2.73], P = 0.05). The number of requests increased with the size of the network (IRR 1.09, 95% CI [1.02-1.16], P = 0.01); however, network size did not differ by sex or race. Network members who provided greater instrumental support to the candidates were most likely to receive a request: odds ratio 1.39, 95% CI [1.08-1.78], P = 0.01. CONCLUSIONS: Transplant candidates' networks vary in size and in the number of requests made to the members. Previously observed racial and sex disparities in living donor kidney transplantation do not appear to be related to network size or to living donation requests, but rather to the network members themselves. Future living donor interventions should focus on the network members and be tailored to their relationship with the candidate.

Asunto(s)

Fallo Renal Crónico/cirugía , Trasplante de Riñón , Donadores Vivos/provisión & distribución , Red Social , Apoyo Social , Listas de Espera , Adulto , Familia , Femenino , Amigos , Humanos , Relaciones Interpersonales , Fallo Renal Crónico/diagnóstico , Fallo Renal Crónico/psicología , Masculino , Persona de Mediana Edad , Factores Raciales , Estudios Retrospectivos , Factores Sexuales

RESUMEN

In January 2017, hundreds of fires in Mediterranean Chile burnt more than 5000 km2, an area nearly 14 times the 40-year mean. We contextualize these fires in terms of estimates of global fire intensity using MODIS satellite record, and provide an overview of the climatic factors and recent changes in land use that led to the active fire season and estimate the impact of fire emissions to human health. The primary fire activity in late January coincided with extreme fire weather conditions including all-time (1979-2017) daily records for the Fire Weather Index (FWI) and maximum temperature, producing some of the most energetically intense fire events on Earth in the last 15-years. Fire activity was further enabled by a warm moist growing season in 2016 that interrupted an intense drought that started in 2010. The land cover in this region had been extensively modified, with less than 20% of the original native vegetation remaining, and extensive plantations of highly flammable exotic Pinus and Eucalyptus species established since the 1970s. These plantations were disproportionally burnt (44% of the burned area) in 2017, and associated with the highest fire severities, as part of an increasing trend of fire extent in plantations over the past three decades. Smoke from the fires exposed over 9.5 million people to increased concentrations of particulate air pollution, causing an estimated 76 premature deaths and 209 additional admissions to hospital for respiratory and cardiovascular conditions. This study highlights that Mediterranean biogeographic regions with expansive Pinus and Eucalyptus plantations and associated rural depopulation are vulnerable to intense wildfires with wide ranging social, economic, and environmental impacts, which are likely to become more frequent due to longer and more extreme wildfire seasons.

Asunto(s)

Incendios , Pinus , Chile , Sequías , Humanos , Tiempo (Meteorología)

RESUMEN

Hypertension and blood pressure variability (BPV; SD and average real variability) in primary proteinuric glomerulopathies are not well described. Data were from 433 participants in the NEPTUNE (Nephrotic Syndrome Study Network). Hypertensive BP status was defined as previous history of hypertension or BP ≥140/90 mm Hg for adults/≥95th percentile for children at baseline. BPV was measured in participants with ≥3 visits in the first year. Two-hundred ninety-six adults (43 years [interquartile range, 32-57.8 years], 61.5% male) and 147 children (11 years [interquartile range, 5-14 years], 57.8% male) were evaluated. At baseline, 64.8% of adults and 46.9% of children were hypertensive. Histological diagnosis was associated with hypertensive status in adults (P=0.036). In adults, hypertensive status was associated with lower hazard of complete remission (hazard ratio, 0.36; 95% confidence interval, 0.19-0.68) and greater hazard of achieving the composite end point (end-stage renal disease or estimated glomerular filtration rate decline >40%; hazard ratio, 4.1; 95% confidence interval, 1.4-12). Greater systolic and diastolic SD and average real variability were also associated with greater hazard of reaching the composite end point in adults (all P<0.01). In children, greater BPV was an independent predictor of composite end point (determined by systolic SD and average real variability) and complete remission (determined by systolic and diastolic average real variability; all P<0.05). Hypertensive status was common among adults and children enrolled in NEPTUNE. Differences in hypertensive status prevalence, BPV, and treatment were found by age and histological diagnosis. In addition, hypertensive status and greater BPV were associated with poorer clinical outcomes.

Asunto(s)

Atención Ambulatoria , Determinación de la Presión Sanguínea , Hipertensión , Síndrome Nefrótico , Adolescente , Adulto , Atención Ambulatoria/métodos , Atención Ambulatoria/estadística & datos numéricos , Presión Sanguínea/fisiología , Determinación de la Presión Sanguínea/métodos , Determinación de la Presión Sanguínea/estadística & datos numéricos , Niño , Femenino , Tasa de Filtración Glomerular , Humanos , Hipertensión/diagnóstico , Hipertensión/etiología , Hipertensión/fisiopatología , Hipertensión Maligna/diagnóstico , Hipertensión Maligna/epidemiología , Masculino , Persona de Mediana Edad , Síndrome Nefrótico/complicaciones , Síndrome Nefrótico/epidemiología , Síndrome Nefrótico/fisiopatología , Síndrome Nefrótico/orina , Variaciones Dependientes del Observador , Evaluación de Procesos y Resultados en Atención de Salud , Pronóstico , Modelos de Riesgos Proporcionales , Factores de Riesgo , Estados Unidos/epidemiología

RESUMEN

The species of Lutrochidae from the Guianas, and the Lesser Antilles are reviewed, including the first reports of the family from Guyana, Suriname, and Grenada. Four species are described as new: Lutrochus funkae n. sp. and L. wao n. sp. from Guyana and French Guiana, L. grenadensis n. sp. from Grenada, and L. leeanneae n. sp. from Suriname. Photographs, genitalia illustrations, and distribution maps are provided for all species, and habitat photos and notes are presented for the species for which they are available.

Asunto(s)

Escarabajos/clasificación , Distribución Animal , Estructuras Animales/anatomía & histología , Estructuras Animales/crecimiento & desarrollo , Animales , Tamaño Corporal , Escarabajos/anatomía & histología , Escarabajos/crecimiento & desarrollo , Ecosistema , Femenino , Guyana Francesa , Guyana , Masculino , Tamaño de los Órganos , Suriname

RESUMEN

Here we present the first published record of a laraine elmid from Suriname, which represents a new species - Hexanchorus bifurcatus sp. nov. Specimens were collected from the summit of Tafelberg, a table mountain near the Wilhelmina Range of Suriname. This species can be distinguished from all other Hexanchorus by the bifurcate elytral apices and median projection of the third abdominal ventrite of the female, as well as the distinctive male genitalia. Habitus photos, illustrations of the genitalia, a distribution map, notes on habitat, and comparative diagnoses are provided. 

Asunto(s)

Escarabajos/clasificación , Distribución Animal , Estructuras Animales/anatomía & histología , Estructuras Animales/crecimiento & desarrollo , Animales , Tamaño Corporal , Escarabajos/anatomía & histología , Escarabajos/crecimiento & desarrollo , Ecosistema , Femenino , Masculino , Tamaño de los Órganos , Suriname

RESUMEN

The HIV-1 epidemic in South America is dominated by pure subtypes (mostly B and C) and more than 7 BF and BC recombinant forms. In Argentina, circulating recombinant forms (CRFs) comprised of subtypes B and F make up more than 50% of HIV infections. For this study, 28 HIV-1 primary isolates were obtained from patients in Buenos Aires, Argentina and initially classified into subtype B (n = 9, 32.1%), C (n = 1, 3.6%), and CRFs (n = 18, 64.3%) using partial pol and vpu-env sequences, which proved to be inconsistent and inaccurate for these phylogenetic analyses. Near full length genome sequences of these primary HIV-1 isolates revealed that nearly all intersubtype BF recombination sites were unique and countered previous "CRF" B/F classifications. The majority of these Argentinean HIV-1 isolates were CCR5-using but 4 had a dual/mixed tropism as predicted by both phenotypic and genotypic assays. Comparison of the replicative fitness of these BF primary HIV-1 isolates to circulating B, F, and C HIV-1 using pairwise competitions in peripheral blood mononuclear cells (PBMCs) indicated a similarity in fitness of these BF recombinants to subtypes B and F HIV-1 (of the same co-receptor usage) whereas subtype C HIV-1 was significantly less fit than all as previously reported. These results suggest that the multitude of BF HIV-1 strains present within the Argentinean population do not appear to have gained replicative fitness following recent B and F recombination events.

Asunto(s)

VIH-1/genética , VIH-1/patogenicidad , Recombinación Genética/genética , Argentina/epidemiología , Genoma Viral/genética , Infecciones por VIH/epidemiología , VIH-1/clasificación , Humanos , Filogenia , Replicación Viral/genética , Replicación Viral/fisiología

RESUMEN

The species of the riffle beetle subfamily Larainae occurring in Venezuela are revised. Examination of 756 specimens yielded 22 species in nine genera occurring throughout the country. Seven species are newly recorded from the country: Phanoceroides sp. 1, Phanocerus clavicornis Sharp, 1882, Phanocerus congener Grouvelle, 1898, Pharceonus volcanus Spangler & Santiago-Fragoso, 1992, Disersus dasycolus Spangler & Santiago-Fragoso, 1992, Disersus chibcha Spangler & Santiago-Fragoso, 1987, and Disersus inca Spangler & Santiago-Fragoso, 1992. Nine species are found to be new to science, which are here described: Hexanchorus dentitibialis sp. n., H. falconensis sp. n., H. flintorum sp. n., H. homaeotarsoides sp. n., H. inflatus sp. n., Phanocerus rufus sp. n., Pharceonus grandis sp. n., Pharceonus ariasi sp. n., Potamophilops bostrychophallus sp. n. Additionally, a key to species, distribution maps, and photographs and genitalia illustrations are provided for all species.

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Los escarabajos de la subfamilia Larainae de Venezuela son revisados. Se examinaron 756 especimenes, se reportan 22 especies en nueve géneros. Siete especies son nuevos registros para el pais ­ Phanoceroides sp. 1, Phanocerus clavicornis Sharp, 1882, Phanocerus congener Grouvelle, 1898, Pharceonus volcanus Spangler & Santiago-Fragoso, 1992, Disersus dasycolus Spangler & Santiago-Fragoso, 1992, Disersus chibcha Spangler & Santiago-Fragoso, 1987, y Disersus inca Spangler & Santiago-Fragoso, 1992. Se describen nueve especies nuevas ­ Hexanchorus dentitibialissp. n., H. falconensissp. n., H. flintorumsp. n., H. homaeotarsoidessp. n., H. inflatussp. n., Phanocerus rufussp. n., Pharceonus grandissp. n., Pharceonus ariasisp. n., Potamophilops bostrychophallussp. n. Adicionalmente se presenta, una clave para las especies, mapas de distribución son presentadas. Fotografías e ilustraciones genitales se proporcionan para todas las especies.

RESUMEN

The species of Lutrochidae occurring in Venezuela are revised. The only previously recorded species, Lutrochus acuminatus Grouvelle, is redescribed and a lectotype is designated. Lutrochus vestitus Sharp, is recorded from Venezuela and French Guiana for the first time. Six new species Lutrochus gustafsoni n. sp., L. cauraensis n. sp., L. maldonadoi n. sp., L. meridaensis n. sp., L. minutus n. sp., and L. violaceus n. sp. are described. Notes on habitat and habits for most species are provided, as well as a key to the eight species of Lutrochidae occurring in Venezuela. The family is reported from hygropetric habitats for the first time.

Asunto(s)

Escarabajos/clasificación , Distribución Animal , Estructuras Animales/anatomía & histología , Animales , Escarabajos/anatomía & histología , Ecosistema , Femenino , Masculino , Venezuela

RESUMEN

Here we describe a new genus, for a new species of riffle beetle, Hypsilara royigen.n. and sp. n., from the tepui Cerro de la Neblina in southern Venezuela. This new genus can be distinguished from all other laraine genera by its small size (ca. 4.5 mm) and the presence of a shallow, wide, V-shaped groove across the apical third of the pronotum. An updated key to the genera of Western Hemisphere Larainae is provided, along with information on habitat and collection methods for this taxon.