RESUMEN
Tuberculosis (TB) poses a significant global public health challenge, particularly in developing countries. Over the years, scientific research has played a pivotal role in addressing this disease. In this study, we aimed to analyze and outline the trends in scientific output on TB and identify research priorities in Latin America (LA) from 1990 to 2021. Scientific production was analyzed, and the number of publications, financing sources, and journal characteristics were evaluated. Collaboration networks and keywords were visualized using mapping analysis with VOSviewer software. Research themes were prioritized by country based on co-occurrence frequency. In total, 4399 documents were identified, a significant trend was evident in the number of publications per year (R2 = 0.981), and research substantially contributed to the reduction of TB-related mortality (R2 = -0.876). Most publications were original articles (83.8 %). The International Journal of Tuberculosis and Lung Disease had the highest publication and citation rates per document. International collaboration was predominantly with the United States, France, and Canada. Brazil, Argentina, and Mexico had the highest number of publications and external collaborations. In LA, interest in researching studies related to treatment and diagnosis (32.5 %) was notably high, followed by epidemiology and screening (26.9 %). Among the 20 countries in LA, research priorities varied, with the highest emphasis on HIV/AIDS (14/20), epidemiology (9/20), anti-TB agents (6/20), and mortality (5/20). TB resistance was only considered a research priority in Brazil, Peru, and Haiti. Therefore, LA experienced significant growth in its scientific output, playing a crucial role in TB control. Strategic adaptation to the region's specific challenges was observed, particularly in HIV/AIDS coinfection, epidemiological studies, and drug resistance. This progress was achieved by outstanding international scientific collaboration. This holistic approach emphasizes the importance of research in the fight against TB in LA.
RESUMEN
During the assessment of a third-degree atrioventricular (AV) block in a patient with syncope, different etiologies should be considered and evaluated. Extrinsic vagal paroxysmal AV block, extrinsic idiopathic AV block and intrinsic paroxysmal AV block are among the types of third-degree AV block in the differential diagnoses. Extrinsic vagal paroxysmal third-degree atrioventricular block (EV-AVB) is linked to parasympathetic influence on cardiac conduction and can be observed in bladder distention and urinary retention. Topical and ophthalmic beta-blockers have shown systemic effects such as bradycardia with and without syncope. We present the case of an 80-year-old male with symptomatic EV-AVB likely precipitated by bladder outlet obstruction and chronic use of an ophthalmic beta-blocker, often overlooked causes of third-degree AV block.
RESUMEN
This case report presents a 53-year-old male patient infected with COVID-19 who developed acute respiratory distress syndrome (ARDS) and septic shock due to meningococcemia, despite the absence of clinical signs of meningitis. This patient's condition was complicated by pneumonia in the setting of myocardial failure. In the curse of the disease, it is remarked that the importance of early recognition of sepsis symptoms is crucial in distinguishing patients with COVID-19 from those with other infections and preventing fatal outcomes. The case presented an excellent opportunity to review meningococcal disease's intrinsic and extrinsic risk factors. With the identified risk factors, we propose different measures to be considered to diminish and recognize this fatal disease early.
RESUMEN
Paragonimiasis is a zoonosis caused by the ingestion of raw or undercooked crustaceans parasitized with metacercaria of Paragonimus spp. In Peru, Cajamarca is considered an endemic region for paragonimiasis. A 29-year-old man from the department of San Martín, Peru presented with a three-year history of cough, chest pain, fever, and hemoptysis. Treatment for tuberculosis (TB) was initiated even with negative results for sputum acid-fast bacillus (AFB), due to the patient's clinical characteristics and the high prevalence of the condition in the region. After eight months, due to the lack of any clinical improvement, he was referred to a regional hospital, where Paragonimus eggs were evidenced in direct sputum cytology. The patient received treatment with triclabendazole and showed clinical and radiological improvement. It is important to consider eating habits, even in non-endemic areas, for diagnosing paragonimiasis in patients with TB symptoms who do not respond to a specific treatment.
RESUMEN
Aminoglycoside antibiotics are widely used to treat infectious diseases. Among them, streptomycin and kanamycin (and derivatives) are of importance to battle multidrug-resistant (MDR) Mycobacterium tuberculosis. Both drugs bind the small ribosomal subunit (30S) and inhibit protein synthesis. Genetic, structural, and biochemical studies indicate that local and long-range conformational rearrangements of the 30S subunit account for this inhibition. Here, we use intramolecular FRET between the C- and N-terminus domains of the flexible IF3 to monitor real-time perturbations of their binding sites on the 30S platform. Steady and pre-steady state binding experiments show that both aminoglycosides bring IF3 domains apart, promoting an elongated state of the factor. Binding of Initiation Factor IF1 triggers closure of IF3 bound to the 30S complex, while both aminoglycosides revert the IF1-dependent conformation. Our results uncover dynamic perturbations across the 30S subunit, from the A-site to the platform, and suggest that both aminoglycosides could interfere with prokaryotic translation initiation by modulating the interaction between IF3 domains with the 30S platform.