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This study updates knowledge on historical geographic distribution of sand fly species through identifying altitudinal and bioclimatic patterns in leishmaniasis endemic areas in Mexico. We analyze and identify sand fly specimens obtained through national efforts by the Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE, Mexico), collected between 1995 and 2001, 2008-2012, and 2017-2023, and add bibliographic information (427 additional records). After a principal components analysis of WorldClim variables and altitudinal ranges, variables that better explain the distribution of sand fly species were chosen (BIO6, BIO12, and BIO16, explaining 72 % of variation). A total of 1,187 specimens of 22 species were retrieved from eight states, providing 29 new municipalities and 48 new localities, being Lutzomyia cruciata, Micropygomyia chiapanensis, and Psathyromyia shannoni the most common species. We presented new historical records of distribution for sand fly species from Morelos (3), Oaxaca (7) and Tabasco (1). The 82.7 % of sand fly species analyzed were distributed in areas with altitudinal ranges below 420 m. The anthropophilic species Psathyromyia shannoni, and Lutzomyia cruciata showed the greatest variability regarding altitudinal range, and climatic preferences, while several wild species showed abiotic preferences. It is likely that the effect of urbanization and climate change generate new beneficial biotopes for the proliferation of the vector sand fly species. Complementary studies that consider seasonality, vegetation types, and change in land use could provide new information to better understand the spread of vector-borne diseases.

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Naegleria fowleri is the causative agent of primary amoebic meningoencephalitis, a rapid and acute infection of the central nervous system with a fatal outcome in >97% of cases. Due to the infrequent report of cases and diagnostic gaps that hinder the possibility of recovering clinic isolates, studies related to pathogenesis of the disease are scarce. However, the secretion of cytolytic molecules has been proposed as a factor involved in the progression of the infection. Several of these molecules could be included in extracellular vesicles (EVs), making them potential virulence factors and even modulators of the immune response in this infection. In this work, we evaluated the immunomodulatory effect of EVs secreted by two clinic isolates of Naegleria fowleri using in vitro models. For this purpose, characterization analyses between EVs produced by both isolates were first performed, for subsequent gene transcription analyses post incubation of these vesicles with primary cultures from mouse cell microglia and BV-2 cells. Analyses of morphological changes induced in primary culture microglia cells by the vesicles were also included, as well as the determination of the presence of nucleic acids of N. fowleri in the EV fractions. Results revealed increased expression of NOS, proinflammatory cytokines IL-6, TNF-α, and IL-23, and the regulatory cytokine IL-10 in primary cultures of microglia, as well as increased expression of NOS and IL-13 in BV-2 cells. Morphologic changes from homeostatic microglia, with small cellular body and long processes to a more amoeboid morphology were also observed after the incubation of these cells with EVs. Regarding the presence of nucleic acids, specific Naegleria fowleri DNA that could be amplified using both conventional and qPCR was confirmed in the EV fractions. Altogether, these results confirm the immunomodulatory effects of EVs of Naegleria fowleri over microglial cells and suggest a potential role of these vesicles as biomarkers of primary acute meningoencephalitis.

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Introducción:En Cuba, las enfermedades cerebrovasculares (ECV) son padecimientos crónicos no trasmisibles muy frecuentes. Objetivos: Caracterizar a pacientes de la unidad de cuidados intensivos, con diagnóstico anatomopatológico de ECV. Métodos: Estudio observacional, descriptivo y transversal en una muestra de 176 pacientes. Variables estudiadas: edad (19-39 años, 40-59 años, 60-100 años), sexo, tipo de ECV (hemorrágica, isquémica), escala APACHE II (≤ 15, > 15 puntos) y de coma Glasgow al ingreso (≤ 8, > 8 puntos), ventilación mecánica (sí, no), estadía (≤ 7, > 7 días) y causa directa de muerte. Se calcularon las frecuencias, medidas de tendencia central, pruebas de ji cuadrado y t de Student (nivel de significación el 5 por ciento). Resultados: Predominaron la enfermedad cerebrovascular hemorrágica, el sexo masculino (52,8 por ciento) y el grupo de edad de 60-100 años (64,8 por ciento). La edad media fue de 63,8 años. La media del valor de las escalas APACHE II y Glasgow fue de 21,6 y 6,5 puntos. El 97,6 por ciento recibió ventilación mecánica. La estadía media fue de 7,0 días. El edema cerebral intenso constituyó la principal causa de muerte directa (79,3 por ciento). Conclusiones: Existe predominio de la ECV de tipo hemorrágica, en pacientes del sexo masculino, de 60-100 años, con APACHE II > 15 puntos, Glasgow ≤ 8 puntos, ventilados, estadía ≤ 7 días y edema cerebral intenso(AU)

Introduction: In Cuba, cerebrovascular diseases (CVD) are very common non-communicable chronic conditions. Objectives: Characterize patients from intensive care unit with a pathological diagnosis of CVD. Methods: Observational, descriptive and transversal study in a sample of 176 patients. Variables: age (19-39 years, 40-59 years, 60-100 years), sex, type of CVD (hemorrhagic, ischemic), APACHE II scale (≤ 15, > 15 score) and Glasgow coma on admission (≤ 8, > 8 score), mechanical ventilation (yes, no), length of stay (≤ 7, > 7 days) and direct cause of death. Frequencies, measures of central tendency, chi-square and Student's t tests (significance level of 5 percent) were calculated. Results: Hemorrhagic cerebrovascular disease, male sex (52.8 percent) and the age group of 60-100 years (64.8 percent) predominated. The mean age was 63.8 years. The average value of the APACHE II and Glasgow scales was 21.6 and 6.5. 97.6 percent received mechanical ventilation. The mean stay was 7.0 days. Severe cerebral edema was the main cause of direct death (79.3 percent). Conclusions: There is a predominance of hemorrhagic CVD, in male patients, aged 60-100 years, APACHE II score > 15, Glasgow score ≤ 8, ventilated patients, stay ≤ 7 days and intense cerebral edema(AU)

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One of the largest health problems worldwide is the development of chronic noncommunicable diseases due to the consumption of hypercaloric diets. Among the most common alterations are cardiovascular diseases, and a high correlation between overnutrition and neurodegenerative diseases has also been found. The urgency in the study of specific damage to tissues such as the brain and intestine led us to use Drosophila melanogaster to study the metabolic effects caused by the consumption of fructose and palmitic acid in specific tissues. Thus, third instar larvae (96 ± 4 h) of the wild Canton-S strain of D. melanogaster were used to perform transcriptomic profiling in brain and midgut tissues to test for the potential metabolic effects of a diet supplemented with fructose and palmitic acid. Our data infer that this diet can alter the biosynthesis of proteins at the mRNA level that participate in the synthesis of amino acids, as well as fundamental enzymes for the dopaminergic and GABAergic systems in the midgut and brain. These also demonstrated alterations in the tissues of flies that may help explain the development of various reported human diseases associated with the consumption of fructose and palmitic acid in humans. These studies will not only help to better understand the mechanisms by which the consumption of these alimentary products is related to the development of neuronal diseases but may also contribute to the prevention of these conditions.

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Zearalenone (ZEN) is a non-steroidal mycoestrogen produced by the Fusarium genus. ZEN and its metabolites compete with 17-beta estradiol for cytosolic estrogen receptors, causing reproductive alterations in vertebrates. ZEN has also been associated with toxic and genotoxic effects, as well as an increased risk for endometrial adenocarcinomas or hyperplasia, breast cancer, and oxidative damage, although the underlying mechanisms remain unclear. Previous studies have monitored cellular processes through levels of transcripts associated with Phase I Xenobiotic Metabolism (Cyp6g1 and Cyp6a2), oxidative stress (hsp60 and hsp70), apoptosis (hid, grim, and reaper), and DNA damage genes (Dmp53). In this study, we evaluated the survival and genotoxicity of ZEN, as well as its effects on emergence rate and fecundity in Drosophila melanogaster. Additionally, we determined levels of reactive oxygen species (ROS) using the D. melanogaster flare and Oregon R(R)-flare strains, which differ in levels of Cyp450 gene expression. Our results showed that ZEN toxicity did not increase mortality by more than 30%. We tested three ZEN concentrations (100, 200, and 400 µM) and found that none of the concentrations were genotoxic but were cytotoxic. Taking into account that it has previously been demonstrated that ZEN administration increased hsp60 expression levels and apoptosis gene transcripts in both strains, the data agree with an increase in ROS and development and fecundity alterations. Since Drosophila lacks homologous genes for mammalian estrogen receptors alpha and beta, the effects of this mycotoxin can be explained by a mechanism different from estrogenic activity.

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The current pandemic generated by SARS-CoV-2 has led to mass vaccination with different biologics that have shown wide variations among human populations according to the origin and formulation of the vaccine. Studies evaluating the response in individuals with a natural infection before vaccination have been limited to antibody titer analysis and evaluating a few humoral and cellular response markers, showing a more rapid and intense humoral response than individuals without prior infection. However, the basis of these differences has not been explored in depth. In the present work, we analyzed a group of pro and anti-inflammatory cytokines, antibody titers, and cell populations in peripheral blood of individuals with previous SARS-CoV-2 infection using BNT162b2 biologic. Our results suggest that higher antibody concentration in individuals with an earlier disease could be generated by higher production of plasma cells to the detriment of the presence of memory B cells in the bloodstream, which could be related to the high baseline expression of cytokines (IL-6 and IL-10) before vaccination.

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Extracellular vesicles (EVs) are small lipid vesicles released by both prokaryotic and eukaryotic cells, involved in intercellular communication, immunomodulation and pathogenesis. In this study, we performed a characterization of the EVs produced by trophozoites of a clinical isolate of the free-living amoeba Naegleria fowleri (N. fowleri). Size distribution, zeta potential, protein profile and protease activity were analyzed. Under our incubation conditions, EVs of different sizes were observed, with a predominant population ranging from 206 to 227 nm. SDS-PAGE revealed protein bands of 25 to 260 KDa. The presence of antigenic proteins was confirmed by Western blot, which evidenced strongest recognition by rat polyclonal antibodies raised against N. fowleri in the region close to 80 KDa and included peptidases, as revealed by zymography. Proteins in selected immunorecognized bands were further identified using nano-ESI-MS/MS. A preliminary proteomic profile of the EVs identified at least 184 proteins as part of the vesicles' cargo. Protease activity assays, in combination with the use of inhibitors, revealed the predominance of serine proteases. The present characterization uncovers the complexity of EVs produced by N. fowleri, suggesting their potential relevance in the release of virulence factors involved in pathogenicity. Owing to their cargo's diversity, further research on EVs could reveal new therapeutic targets or biomarkers for developing rapid and accurate diagnostic tools for lethal infections such as the one caused by this amoeba.

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RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica se caracteriza por la limitación del flujo aéreo, no completamente reversible, progresiva y asociada a respuesta inflamatoria anormal de los pulmones. Objetivos: Caracterizar a pacientes con antecedentes de enfermedad pulmonar obstructiva crónica, ingresados en cuidados intensivos. Métodos: Se realizó un estudio descriptivo, retrospectivo en una serie de 347 pacientes con enfermedad pulmonar obstructiva crónica ingresados en cuidados intensivos. Se estudiaron las variables edad, sexo, causa de ingreso, estado al egreso, valor de la escala APACHE II al ingreso, ventilación mecánica invasiva, traqueostomía, y causa directa de muerte según necropsias realizadas. Se calcularon distribuciones de frecuencia absoluta y relativa, medidas de tendencia central y para comparación, las pruebas de ji cuadrado y t de Student, con un nivel de significación del 5 %. Resultados: La edad media fue de 72,1 ± 8,2 años. Predominaron el sexo femenino (52,7 %) y el grupo de edad de 60-79 años (67,1 %). La proporción sexo femenino/ masculino fue de 1,1:1,0. Egresaron fallecidos 64,8 % de los pacientes. Hubo diferencias significativas entre la edad media de los fallecidos y los vivos (p = 0,001). La causa de ingreso clínico tuvo el mayor número de ingresos (86,7 %). La media del valor del APACHE II fue superior en los fallecidos (21,0 vs. 15,2). El 81,3 % de los pacientes recibió ventilación mecánica, y al 17,3 % se le realizó traqueostomía. La principal causa de muerte fue la bronconeumonía bacteriana (67,2 %). Conclusiones: Los pacientes con enfermedad pulmonar obstructiva crónica ingresados en la unidad de cuidados intensivos tienen alta mortalidad y está asociada a tres principales causas directas de muertes: bronconeumonía bacteriana, tromboembolismo pulmonar y el choque séptico.

ABSTRACT Introduction: COPD is characterized by limitation of the airflow, progressive, partially reversible and associated to an abnormal inflammatory responsive of the lungs. Objective: To characterize patients with COPD admitted at the Intensive Care Unit. Methods: A descriptive, retrospective study was carried out in a series of 347 patients with chronic obstructive pulmonary disease admitted to intensive care. The variables age, sex, cause of admission, discharge status, APACHE II scale value at admission, invasive mechanical ventilation, tracheostomy, and direct cause of death according to autopsies performed were studied. Absolute and relative frequency distributions, measures of central tendency, and for comparison, the chi-square and Student's t tests were calculated, with a significance level of 5%. Results: The mean age was of 72,1 ± 8,2 years. The female sex (52.7%) and the age group of 60-79 years (67.1%) predominated. The female / male sex ratio was 1.1: 1.0. 64.8% of the patients were discharged dead. There were significant differences between the mean age of the deceased and the living (p = 0.001). The cause of clinical admission had the highest number of admissions (86.7%). The mean APACHE II value was higher in the deceased (21.0 vs. 15.2). 81.3% of the patients received mechanical ventilation, and 17.3% underwent a tracheostomy. The main cause of death was bacterial bronchopneumonia (67.2%). Conclusions: Patients with chronic obstructive pulmonary disease admitted to the intensive care unit have high mortality and it is associated with three main direct causes of death: bacterial bronchopneumonia, pulmonary thromboembolism and septic shock.

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Introducción: El ingreso de pacientes de la cuarta edad en unidades de cuidados intensivos se incrementó en los últimos años. Objetivo: Determinar la morbilidad y mortalidad de pacientes de la cuarta edad en la unidad de cuidados intensivos. Métodos: Estudio descriptivo, retrospectivo. Serie constituida por 703 pacientes. Variables: edad, sexo, causas de ingreso, estadía, APACHE II, ventilación mecánica, estado al egreso y causa directa de muerte. Estadísticos: distribuciones de frecuencia absoluta y relativa, medidas de tendencia central, pruebas de Chi-cuadrado y t de Student. Nivel de significación 5 por ciento. esultados: La edad media fue de 84,2 ± 3,2 años. Predominaron el sexo femenino (57,7 por ciento) y el grupo de edad de 75 - 79 años (46,8 por ciento). La proporción del sexo femenino/masculino fue de 1,09:1,0. Más de la mitad de los pacientes egresaron fallecidos (60,7 por ciento). No hubo diferencias significativas entre las medias de la edad de los fallecidos y de los egresados vivos (80,7 vs 80,4 años). El ingreso clínico tuvo el mayor número de pacientes (69,7 por ciento). La media del valor de la escala APACHE II al ingreso fue de 20,1; en los fallecidos fue superior (23,0 vs 15,5). La estadía media fue de 5,7 días, más prolongada en los fallecidos (6,7 vs 4,3). El 61,5 por ciento de los pacientes recibieron ventilación mecánica. La principal causa directa de muerte fue la bronconeumonía bacteriana (36,9 por ciento). Conclusiones: Los pacientes de la cuarta edad tuvieron mortalidad elevada, asociada principalmente a la bronconeumonía bacteriana y un porcentaje alto requirió ventilación mecánica(AU)

Introduction: The admission of patients of fourth age in intensive care units has increased in the last years. Objectives: To determinate the mortality and morbidity of the patients of the fourth age. Methods: A retrospective and descriptive study. The series consisted of 703 patients. Variables: age, sex, cause of admitted, stay, APACHE II, mechanical ventilation, status of issue, direct cause of death. The statistical methods used were the absolute and relative frequency distributions, measures of central tendency, as well as the Chi-square and Student´s t tests. A significant level of 5 percent was considered. Results: The average age was 84.2 ± 3.2 years. Females (57. 7 percent) and the 75-79 years age group (46, 8 percent) predominated. The ratio of women/men was 1. 09/1. 0. Over half of the patients died on discharge (60. 7 percent). There were not significant differences between average ages of deceased and the living patients (80. 7 vs 80. 4 years). The clinical admission showed the highest number of patients (69. 7 percent). The mean of APACHE II was 20. 1, being higher in patients dead that in the ones alive (23. 0 vs 15. 5). The average stay was 5.7 days, longer in the deceased patients (6. 7 vs 4. 3). 71.5 percent of patients received mechanical ventilation. The main direct cause of death was bacterial bronchial pneumonia (36. 9 percent). Conclusions: the patient of fourth age admitted to the intensive care unit has higher mortality and high percentage require mechanical ventilationAU

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A collection of more than one hundred medical recipes from the late 18th century was donated by Presbyter Cipriano Rodríguez Santa María, institutional eponym of the collection at the Historical Archive "Octavio Arizmendi Posada" of the library of the Universidad de La Sabana in Colombia. These texts represent an important historical and medical legacy and they constitute an important basis for understanding the colonial and traditional therapeutics related to various diseases. In this article, we describe one of these recipes for the treatment of smallpox and measles as a contribution to the history of medicine in Colombia.

En el Archivo Histórico de la Biblioteca "Octavio Arizmendi Posada" de la Universidad de La Sabana, se encuentra una colección de más de un centenar de recetas médicas de finales del siglo XVIII donadas por el presbítero Cipriano Rodríguez Santa María, epónimo institucional del archivo. Estos textos son un legado histórico médico y un fundamento para comprender la terapéutica colonial y tradicional de diversas enfermedades. En este artículo, se describen algunas recetas para el tratamiento de la viruela y el sarampión, como aporte a la historia de la medicina en Colombia.

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En el Archivo Histórico de la Biblioteca "Octavio Arizmendi Posada" de la Universidad de La Sabana, se encuentra una colección de más de un centenar de recetas médicas de finales del siglo XVIII donadas por el presbítero Cipriano Rodríguez Santa María, epónimo institucional del archivo. Estos textos son un legado histórico médico y un fundamento para comprender la terapéutica colonial y tradicional de diversas enfermedades. En este artículo, se describen algunas recetas para el tratamiento de la viruela y el sarampión, como aporte a la historia de la medicina en Colombia.

A collection of more than one hundred medical recipes from the late 18th century was donated by Presbyter Cipriano Rodríguez Santa María, institutional eponym of the collection at the Historical Archive "Octavio Arizmendi Posada" of the library of the Universidad de La Sabana in Colombia. These texts represent an important historical and medical legacy and they constitute an important basis for understanding the colonial and traditional therapeutics related to various diseases. In this article, we describe one of these recipes for the treatment of smallpox and measles as a contribution to the history of medicine in Colombia.

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Introducción: El alcoholismo constituye el tercer factor de riesgo de morbilidad y mortalidad en el mundo. Objetivo: Caracterizar pacientes con antecedentes de alcoholismo crónico, ingresados en una unidad de cuidados intensivos. Métodos: Estudio descriptivo, retrospectivo. La serie quedó constituida por 123 pacientes. Se utilizaron para las variables cualitativas el análisis estadístico univariado, (frecuencia absoluta y relativa) y en las cuantitativas la media aritmética y desviación estándar. Para el contraste de hipótesis se utilizó la prueba del Chi cuadrado para los datos cualitativos y la prueba t de Student. La cuantificación del riesgo se efectuó por el odds ratio con intervalo de confianza del 95 por ciento. Se consideró como nivel de significación el 5 por ciento. Resultados: La edad media fue de 58,5 ± 12,4 años. Predominó el grupo de edad de 40-59 años (48,8 por ciento) y el sexo masculino (92,7 por ciento). La proporción sexo masculino/ femenino fue de 12,7:1. Más de la mitad de los pacientes egresaron fallecidos (56,1 por ciento). El ingreso por causa clínica presentó el mayor número de pacientes (67,5 por ciento). La media del valor de la escala APACHE II fue de 18,1; en los fallecidos fue superior que en los vivos (22,0 vs 13,1). Más de la mitad de los pacientes fueron ventilados (67,4 por ciento). La estadía media fue de 6,9 días, más prolongada en los fallecidos (8,1 vs 5,4). La principal causa de muerte fue la bronconeumonía bacteriana (28,6 por ciento). Conclusiones: La mortalidad de pacientes con antecedentes de alcoholismo crónico fue elevada(AU)

Objective: Characterization of alcoholic patients with admitted at the Intensive Care Unit. Method: A descriptive and retrospective study. The final sample was 123 patients. The statistical methods for the study included absolute and relative frequency distributions, central tendency measures, Chi-square and Student´s t tests. Results: Average age was of 58, 5 ± 12,4 years old. The 40-59 (48, 8 percent) prevailed as well as Males (92, 7 percent). The proportion of male/female sex was of 12, 7:1, 0. More than half of the patients died (56, 1 percent). The media age of this group was lightly high to that of the alive discharged patients (60,0 vs 56,6 years old). The clinic admittance cause was most frequent (67, 5 percent). The mean of APACHE II value was 18, 1 and it was higher in the diseased than in the survivors (22, 0 vs 13, 1). Most patients ventilated (71, 5 percent). The main stay was 6, 9 days, more extended in the dead (8, 1 vs 5, 4). The main causes of death were bacterial bronchopneumonia (28, 6 percent). Conclusion: Patients with antecedent of alcoholism have high mortality(AU)

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Resumen La salud cada vez tiene más presencia en la prensa generalista, especialmente cuando los temas que se abordan afectan a países desarrollados. Esta investigación expone las diferencias que se generan en la cobertura periodista cuando ocurre un hecho relevante como pueda ser una epidemia y que afecta tanto a países occidentales como a países africanos subdesarrollados. El trabajo que presentamos evidencia que en la epidemia de Ébola, reconocida como tal por la Organización Mundial de la Salud en el año 2014, el volumen de las noticias sobre la epidemia solo aumentó la información relativa a esta enfermedad cuando hubo occidentales afectados directamente por la misma. Así se observa en los resultados que ofrece el análisis de contenido realizado en tres diarios de diferentes nacionalidades como son el español El País, el francés Le Figaro y el mexicano Reforma durante las fechas de marzo de 2014 a enero de 2015.

Abstract It is increasingly common to see the issue of health included in the general press, particularly when the topic being discussed affects developed nations. This research project shows the differences that appear in press coverage when there is a relevant event, such as an epidemic, which affects both developed, western nations and underdeveloped African ones. This work shows that, in the case of the Ebola epidemic - which was recognised as such by the World Health Organisation in 2014 -, the press only gave the problem greater coverage when there were cases of westerners being directly affected by it. That can be observed in the results of the content analysis in three daily newspapers from different countries: El País (Spain), Le Figaro (France) and Reforma (Mexico), between March 2014 and January 2015.

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Introducción: La bacteriemia es la infección caracterizada por la presencia de bacterias en la sangre, fenómeno frecuente en el medio hospitalario y más en las unidades de cuidados intensivos. Objetivo: Determinar las características clínicas y epidemiológicas de pacientes con bacteriemias en la unidad de cuidados intensivos. Métodos: Estudio descriptivo, en la unidad de cuidados intensivos del Hospital Militar Central "Dr. Carlos J. Finlay", durante los años 2016 y 2017. De 397 pacientes con bacteriemia, fueron incluidos quienes tenían 18 años o más de edad, con ingreso en cuidados intensivos durante 48 horas o más y con hemocultivos positivos. Resultados: Hemocultivos; resultaron positivos 143 (5,75 por ciento). Pacientes: el 37,1 por ciento resultó mayor de 60 años. Fueron bacteriemias secundarias el 87,41 por ciento, el foco de infección más frecuente fue el catéter venoso central (44,05 por ciento) y el sistema respiratorio (40,55 por ciento). Los gérmenes que crecieron en los hemocultivos fueron Estafilococo coagulasa positivo (23,77 por ciento) seguido del Acinetobacter (16,78 por ciento). Fueron monomicrobianos 103 cultivos y 40 polimicrobianos. Hubo shock séptico en 54 pacientes (37,76 por ciento) y fallecieron 47. La mortalidad global fue de 32,86 por ciento. Conclusiones: La incidencia de bacteriemias secundarias fue superior a las primarias, así como las monomicrobianas sobre las polimicrobianas. El foco de infección más frecuente fue el sistema respiratorio y los factores de riesgo presentes fueron: nutrición parenteral, diabetes mellitus, neoplasia y edad superior a los 60 años. El germen más frecuente fue el estafilococo coagulasa positivo. La incidencia de shock séptico y la mortalidad fueron elevadas(AU)

Introduction: Bacteremia is the infection characterized by the presence of bacteria in the blood, a frequent phenomenon in the hospital environment and more in the intensive care units. Objective: To determine the clinical and epidemiological characteristics of patients with bacteremia in the intensive care unit. Method: Descriptive study in the intensive care unit of the Central Military Hospital "Dr. Carlos J. Finlay ", during the years 2016 and 2017. Of 397 patients with bacteremia, those aged 18 years and over were included, admitted to intensive care for 48 hours or more and with positive blood cultures. Results: 143 blood cultures (5.75 percent) were positive; 37.1 percent of the patients were older than 60 years. Secondary bacteremia was 87.41%, the most common source of infection was the central venous catheter (44.05 percent) and the respiratory system (40.55 percent). Germs that grew in blood cultures: positive coagulase staphylococcus (23.77 percent) followed by Acinetobacter (16.78 percent); 103 cultures were monomicrobial and 40 polymicrobial. There was septic shock in 54 patients (37.76 percent) and 47 died. The overall mortality was 32.86 percent. Conclusions: The incidence of secondary bacteremia was higher than the primary, as well as the monomicrobial over the polymicrobial. The most frequent source of infection was the respiratory system and the risk factors present were: parenteral nutrition, diabetes mellitus, neoplasia and age over 60 years. Staphylococcus coagulase positive was the most frequent germ. The incidence of septic shock and mortality were high(AU)

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BACKGROUND: The strong association between HLA-B27 and spondyloarthritis (SpA) has demonstrated that typing the HLA-B27 antigen is a crucial step in diagnosis and aids in defining the progression and severity of disease. OBJECTIVE: To describe the frequency of HLA-B27 in Colombian individuals with clinical manifestations associated with SpA. MATERIALS AND METHODOLOGY: We retrospectively analyzed 4109 HLA-B27 typing requests to the Hospital Militar Central and the Instituto de Referencia Andino from Colombian individuals with clinical signs suggestive of SpA between 2009 and 2012. We used basic digital cytometry followed by Polymerase Chain Reaction with sequence specific primers when confirmation was needed. We determined the frequency of HLA-B27 in the population and levels of association of HLA-B27 with SpA. RESULTS: Our population included 1585 men (36.8%) and 2524 women (61.4%). The predominant age range was between 19 and 45 years (49.9%). The majority (95.4%) of the study population came from the Andean region and eastern plains. The most frequent clinical manifestations were peripheral. Only a small fraction (12.1%) of the 4109 subjects was HLA-B27 positive. Of those, 56.9% were male, and 54.7% were between 19 and 45 years old. In contrast, when rheumatologists referred the HLA B27, 64% were found to be positive. CONCLUSION: The frequency of the HLA-B27 allele in individuals with clinical signs suggestive of SpA was low, in accordance with the lower prevalence found in Colombian patients diagnosed with SpA compared to American and European population.

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Resumen Introducción. El ADN antiguo que se extrae de los restos óseos humanos permite analizar la composición genética de las poblaciones precolombinas y determinar las dinámicas poblacionales que dieron origen a la diversidad de las poblaciones contemporáneas. Objetivo. Determinar la diversidad genética y la relación con otras comunidades contemporáneas y antiguas de América, de los restos óseos asociados al Templo del Sol en Sogamoso, Colombia. Materiales y métodos. Se analizaron 13 individuos pertenecientes al periodo precolombino muisca (siglos IX-XVI d. C.), provenientes de los alrededores del Templo del Sol en Sogamoso, Boyacá, Andes orientales colombianos. Se amplificó el ADN mitocondrial (ADNmt) y se determinaron los polimorfismos de la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism, RFLP) para los cuatro haplogrupos amerindios (A, B, C y D). Además, se amplificaron y analizaron los marcadores autosómicos, incluida la amelogenina, y los marcadores de los polimorfismos de repeticiones cortas en tándem (Short Tandem Repeat, STR) del cromosoma Y. Resultados. El haplogrupo A fue el linaje mitocondrial más frecuente en esta población, seguido de los haplogrupos B y C; no se detectó el haplogrupo D. Los análisis de variación genética indicaron una diversidad semejante a la de las poblaciones pertenecientes a la familia lingüística chibcha, contemporánea en Colombia y Centroamérica. Se logró hacer la determinación molecular del sexo de los individuos estudiados y compararla con los datos osteológicos. Con una sola excepción, los datos bioantropológicos y moleculares concordaron. Conclusiones. Estos resultados aportan nuevos elementos a la hipótesis del origen centroamericano de los grupos chibchas del altiplano cundiboyacense con base en marcadores genéticos, y permitieron establecer el sexo y las relaciones de parentesco.

Abstract Introduction: DNA extracted from ancient human bones allows to analyze the genetic makeup of preColumbian populations and to determine the dynamics that gave rise to the diversity of contemporary populations. Objective: To determine the genetic diversity of skeletal remains associated with the Templo del Sol (Sun Temple) and their relationship with other contemporary and ancient communities of America. Materials and methods: We analyzed 13 individuals belonging to the pre-Columbian Muisca Period (IX-XVI centuries AD) from the vicinities of the Templo del Sol (Sun Temple) (Sogamoso, Boyacá) in the eastern Colombian Andes. Mitochondrial DNA was amplified and RFLPs were performed in order to type the four traditional Amerindian haplogroups (A, B, C and D). In addition, autosomal markers including amelogenin and Y-chromosome STRs were amplified. Results: Among the observed mitochondrial lineages, haplogroup A was the most frequent, followed by haplogroups B and C; no evidence of haplogroup D was found. The genetic variation analysis indicated a similar diversity of pre-Columbian Muiscas to that of contemporary populations belonging to the Chibcha linguistic family from Colombia and Central America. Molecular sexing was accomplished and it was compared to osteological data. With only one exception, anthropological and molecular data were consistent. Conclusions: Our results contribute new genetic elements supporting the hypothesis of Central American origin of the Chibcha groups of the Cundiboyacense plateau, and allowed sex typing and kinship evaluations.

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Acute myeloid leukemia is characterized by its high biological and clinical heterogeneity, which represents an important barrier for a precise disease classification and accurate therapy. While epigenetic aberrations play a pivotal role in acute myeloid leukemia pathophysiology, molecular signatures such as change in the DNA methylation patterns and genetic mutations in enzymes needed to the methylation process can also be helpful for classifying acute myeloid leukemia. Our study aims to unveil the relevance of DNMT3A and TET2 genes in global and specific methylation patterns in acute myeloid leukemia. Peripheral blood samples from 110 untreated patients with acute myeloid leukemia and 15 healthy control individuals were collected. Global 5-methylcytosine and 5-hydroxymethylcytosine in genomic DNA from peripheral blood leukocytes were measured by using the MethylFlashTM Quantification kits. DNMT3A and TET2 expression levels were evaluated by real-time quantitative polymerase chain reaction. The R882A hotspot of DNMT3A and exons 6-10 of TET2 were amplified by polymerase chain reaction and sequenced using the Sanger method. Methylation patterns of 16 gene promoters were evaluated by pyrosequencing after treating DNA with sodium bisulfite, and their transcriptional products were measured by real-time quantitative polymerase chain reaction.Here, we demonstrate altered levels of 5-methylcytosine and 5-hydroxymethylcytosine and highly variable transcript levels of DNMT3A and TET2 in peripheral blood leukocytes from acute myeloid leukemia patients. We found a mutation prevalence of 2.7% for DNMT3A and 11.8% for TET2 in the Mexican population with this disease. The average overall survival of acute myeloid leukemia patients with DNMT3A mutations was only 4 months. In addition, we showed that mutations in DNMT3A and TET2 may cause irregular DNA methylation patterns and transcriptional expression levels in 16 genes known to be involved in acute myeloid leukemia pathogenesis. Our findings suggest that alterations in DNMT3A and TET2 may be associated with acute myeloid leukemia prognosis. Furthermore, alterations in these enzymes affect normal methylation patterns in acute myeloid leukemia- specific genes, which in turn, may influence patient survival.

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Introducción: el paludismo es la enfermedad parasitaria más importante del ser humano, causa anualmente entre uno y tres millones de muertes. Objetivos: caracterizar a los pacientes con paludismo grave por Plasmodium falciparum ingresados en una unidad de cuidados intensivos. Métodos: se realizó un estudio observacional, descriptivo en una Unidad de Cuidados Intensivos en Angola, de julio de 2014 hasta julio de 2016. La serie quedó constituida por 485 pacientes. Resultados: la serie representó el 99,6 por ciento de los ingresos. La edad media fue de 23,4 ± 11,2 años. Predominaron el sexo masculino (66,4 por ciento) y los grupos de edades de 30 años o menos (83,6 por ciento). La proporción del sexo masculino/femenino fue de 1,97:1. La mortalidad fue de 43,1 por ciento. El sexo femenino tuvo mayor proporción de fallecidos (61 por ciento). Fue más alto el por ciento de fallecidos en los que presentaron parasitemia >= 50000 x mm3. La media del valor del Acute Physiology, Age, Chronic Health Evaluation II fue de 14,8 ± 5,4; en los fallecidos fue superior que en los vivos (17,6 vs 12,3). Las complicaciones más frecuentes fueron de tipo neurológicas (90,1 por ciento), hematológicas (77 por ciento), respiratorias (61,8 por ciento), hepáticas (58,7 por ciento), y renales (40,3 por ciento). El 51,6 por ciento de los pacientes recibieron ventilación mecánica. Conclusiones: los jóvenes representaron la mayor parte de los ingresos por malaria en la unidad de cuidados intensivos, un porcentaje alto requirió ventilación mecánica, la mortalidad en las mujeres fue mayor y la global elevada(AU)

Introduction: Malaria is the most important parasitic disease of the human being, causes between one and three million deaths annually. Objectives: To characterize patients with severe malaria due to plasmodium falciparum admitted to an intensive care unit. Methods: An observational, descriptive study was carried out in an Intensive Care Unit in Luanda, from July 2014 to July 2016. The series consisted of 485 patients. Results: The series represented 99.6 percent of admissions. The mean age was 23.4 ± 11.2 years. The male sex predominated (66.4 percent) and the age groups were 30 years old or younger (83.6 percent). The male / female ratio was 1.97: 1. The mortality was 43.1 percent. The female sex had a higher proportion of deaths (61 percent). The percentage of deaths in those with blood parasites count >= 500003 x mm was higher. The mean value of Acute Physiology, Age, Chronic Health Evaluation II was 14.8 ± 5.4; in the deceased it was higher than in the living (17.6 vs. 12.3). The most frequent complications were neurological (90.1 percent), hematological (77 percent), respiratory (61.8 percent), hepatic (58.7 percent), and renal (40.3 percent). 51.6 percent of the patients received mechanical ventilation. Conclusions: Young people accounted for most of the admissions for malaria in the intensive care unit, a high percentage required mechanical ventilation, and mortality in women was higher and overall high(AU)

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INTRODUCTION: Chronic hepatitis C virus infection is a worldwide public health problem; it has been estimated that over 180 million people are infected with this virus worldwide. Its precise incidence and prevalence (i.e., epidemiology) and the most frequent circulating genotypes in Colombia are unknown. OBJECTIVE: To describe the hepatitis C virus (HCV) genotypes and subtypes in infected Colombian patients. MATERIALS AND METHODS: We recovered the data on 1,538 HCV isolates from 1,527 patients in two Colombian reference laboratories typed by PAGE or qPCR. RESULTS: Patients' mean age was 53 years; 70% of them were 40 to 70 years old, and 52%, females; 57% of all tests were ordered in Bogotá and 80% of cases were from Cundinamarca, Valle and Atlántico departments. Genotype 1 was detected in 88.6% of cases, distributed as follows: 70% subtype 1b, 13.5% subtype 1a and 5.1%, undetermined subtypes. Genotype 2 was found in 5.4% of the patients, genotype 3 in 2% and genotype 4 in 4%. Mixed genotypes were found in 0.8% of the samples. CONCLUSION: Genotype 1 is the most common HCV genotype circulating in Colombia, and subtype 1b the most frequent.

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