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The scope of this article is to analyze the trend of the standardized mortality rate (SMR) for tuberculosis and its correlation with the developmental status in Brazil. An ecological time series study was conducted to analyze data of deaths from tuberculosis reported between 2005 and 2019 in all states. Data were extracted from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and the Global Burden of Disease study. The temporal trend was analyzed using Prais-Winsten regression. Spearman's correlation analysis between SMR and Socio-Demographic Index (SDI) was also performed. From 2005 to 2019, 68,879 deaths from tuberculosis were recorded in Brazil. The average mortality rate was 2.3 deaths per 100,000 inhabitants. The decreasing trend of SMR due to tuberculosis was observed in Brazil and in all regions. There was a significant negative correlation between SDI and TMP. TMP due to tuberculosis revealed a decreasing trend in Brazil and in all regions. Most states showed a decreasing trend and none of them had an increasing trend. An inverse relationship was found between developmental status and mortality due to tuberculosis.

O objetivo do artigo é analisar a tendência da taxa de mortalidade padronizada (TMP) por tuberculose e sua correlação com o status de desenvolvimento no Brasil. Estudo ecológico de séries temporais que analisou dados de óbitos por tuberculose notificados entre 2005 e 2019 de todos os estados. Os dados foram extraídos do Sistema de Informação sobre Mortalidade, do Instituto Brasileiro de Geografia e Estatística e do estudo da Carga Global de Doenças. A tendência temporal foi analisada pela regressão de Prais-Winsten. A análise da correlação de Spearman entre a TMP e o índice sociodemográfico (socio-demographic index - SDI) também foi realizada. De 2005 a 2019, foram registrados 68.879 óbitos por tuberculose no Brasil. A taxa média de mortalidade foi de 2,3 óbitos por 100.000 habitantes. A tendência decrescente da TMP por tuberculose foi observada no Brasil e em todas as regiões. Verificou-se correlação negativa significativa entre o SDI e a TMP. A maioria dos estados apresentou tendência decrescente e nenhum deles teve tendência crescente. Uma relação inversa foi verificada entre o SDI e a mortalidade por tuberculose.

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Background: Scant studies have examined alcohol consumption among transgender women in Latin America. This cross-sectional study estimated the prevalence and associated factors of risky alcohol use among transgender women in Goiás, a state located in the center of Brazil. Methods: Participants were 440 transgender women (median age = 35 years, interquartile range = 9) recruited through respondent-driven sampling. All participants were interviewed about sociodemographic characteristics, violence, and risk behavior. Alcohol use was assessed using the alcohol use disorders identification test (AUDIT). An AUDIT score greater than or equal to eight was considered as risky alcohol consumption. Logistic regression analysis was used to examine predictors of risky alcohol use, and p-values <0.05 were considered significant. Results: The majority were young, single, sex workers. Most transgender women had used alcohol in the previous year (85.7%), and more than half (56.6%) reported binge drinking and risky alcohol consumption (60.2%). There was a high overlap between sexual behavior, drugs, and alcohol use. Using alcohol during sex (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.7-4.8), cocaine/crack use (aOR: 2.3; 95% CI: 1.5-3.7) and having a drug user as a sexual partner (aOR: 2.9; 95% CI: 1.5-5.9) were independently associated with risky alcohol consumption. Conclusion: Alcohol consumption was highly prevalent, and drugs seem to play an important role in risky alcohol consumption among transgender women Goiás. These findings support stakeholders to promote intervention strategies to reduce this pattern of alcohol consumption and reduce the burden of substance use disorders among transgender women.

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OBJECTIVE: To estimate the prevalence of Sexually Transmitted Infections (STIs) in immigrants and refugees living in the metropolitan region of Goiânia, Goiás. METHOD: This is a cross-sectional and analytical study. Data collection was carried out from July 2019 to January 2020 and 308 immigrants and refugees were included in the sample. All were underwent face-to-face interviews and were tested for HIV, Syphilis, and Hepatitis B, using rapid tests. RESULTS: The general prevalence for any of the STIs investigated was 8.8% (95%CI 6.0% - 12.3%), being 5.8% (95%CI 3.6% - 8.9%) for Hepatitis B, 2.3% for Syphilis (95%CI 1.00% - 4.4%) and 0.7% for HIV (95%CI 0.1% - 2.1%). Multiple analysis, using logistic regression, showed that the variables male gender (OR = 2.7) and length of time living in Brazil (OR = 2.6) were significantly associated with STIs (p < 0.05). CONCLUSION: The results of this study suggest that STIs are a health problem in immigrants/refugees, which appear to be enhanced with the length of migration in the country. Public policies that guarantee health care for this population shall be considered.

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Resumo O objetivo do artigo é analisar a tendência da taxa de mortalidade padronizada (TMP) por tuberculose e sua correlação com o status de desenvolvimento no Brasil. Estudo ecológico de séries temporais que analisou dados de óbitos por tuberculose notificados entre 2005 e 2019 de todos os estados. Os dados foram extraídos do Sistema de Informação sobre Mortalidade, do Instituto Brasileiro de Geografia e Estatística e do estudo da Carga Global de Doenças. A tendência temporal foi analisada pela regressão de Prais-Winsten. A análise da correlação de Spearman entre a TMP e o índice sociodemográfico (socio-demographic index - SDI) também foi realizada. De 2005 a 2019, foram registrados 68.879 óbitos por tuberculose no Brasil. A taxa média de mortalidade foi de 2,3 óbitos por 100.000 habitantes. A tendência decrescente da TMP por tuberculose foi observada no Brasil e em todas as regiões. Verificou-se correlação negativa significativa entre o SDI e a TMP. A maioria dos estados apresentou tendência decrescente e nenhum deles teve tendência crescente. Uma relação inversa foi verificada entre o SDI e a mortalidade por tuberculose.

Abstract The scope of this article is to analyze the trend of the standardized mortality rate (SMR) for tuberculosis and its correlation with the developmental status in Brazil. An ecological time series study was conducted to analyze data of deaths from tuberculosis reported between 2005 and 2019 in all states. Data were extracted from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and the Global Burden of Disease study. The temporal trend was analyzed using Prais-Winsten regression. Spearman's correlation analysis between SMR and Socio-Demographic Index (SDI) was also performed. From 2005 to 2019, 68,879 deaths from tuberculosis were recorded in Brazil. The average mortality rate was 2.3 deaths per 100,000 inhabitants. The decreasing trend of SMR due to tuberculosis was observed in Brazil and in all regions. There was a significant negative correlation between SDI and TMP. TMP due to tuberculosis revealed a decreasing trend in Brazil and in all regions. Most states showed a decreasing trend and none of them had an increasing trend. An inverse relationship was found between developmental status and mortality due to tuberculosis.

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El queratocono es una ectasia corneal bilateral asimétrica, en etapas iniciales no se evidencia la afectación binocular. El conocimiento del grado de asimetría en el queratocono pediátrico permite tomar decisiones oportunas en el manejo de los pacientes. Se realizó este trabajo con el objetivo de describir las características clínicas y el tratamiento de tres casos pediátricos con diferente grado de asimetría interocular del queratocono, atendidos en la consulta provincial de ectasias corneales pediátricas en Ciego de Ávila. Los pacientes mostraron diferencia entre ambos ojos de los signos clínicos, la refracción y las variables topográficas. Al paciente dos se le diagnosticó queratocono en un ojo, sin evidencias clínicas ni topográficas de la enfermedad en el ojo contralateral. Todos los pacientes mostraron astigmatismo miópico compuesto en ambos ojos y se les indicó corrección óptica. Al paciente uno se le corrigió con cristales, al dos con lentes de contacto rígidos de gas permeable y al tercero con piggyback en un ojo y lentes de contacto rígidos de gas permeable en el otro. Presentaron, además, una ambliopía asociada y se les orientó tratamiento oclusivo y tareas de visión cercana en los pacientes dos y tres. Es frecuente encontrar asimetría interocular en pacientes pediátricos con queratocono por la diferencia de progresión entre ambos ojos. El seguimiento periódico permite diagnosticar la enfermedad en el ojo contralateral en pacientes con diagnóstico de queratocono en un ojo, indicar una corrección óptica individualizada, sobre todo en presencia de anisometropía, y monitorizar la evolución de la ambliopía refractiva asociada con frecuencia(AU)

Keratoconus is an asymmetric bilateral corneal ectasia, in early stages binocular involvement is not evident. Knowledge of the degree of asymmetry in pediatric keratoconus allows timely decisions in patient management. This research was carried out with the objective of describing the clinical characteristics and the treatment of three pediatric cases with different degree of interocular asymmetry of keratoconus, treated in the provincial consultation of pediatric corneal ectasia in Ciego de Avila. Patients showed difference between both eyes in clinical signs, refraction and topographic variables. Patient two was diagnosed with keratoconus in one eye, with no clinical or topographic evidence of the disease in the contralateral eye. All patients showed compound myopic astigmatism in both eyes and optical correction was indicated. Patient one was corrected with glasses, patient two with rigid gas permeable contact lenses and patient three with piggyback in one eye and rigid gas permeable contact lenses in the other eye. They also presented an associated amblyopia and were directed occlusive treatment and near vision tasks in patients two and three. It is common to find interocular asymmetry in pediatric patients with keratoconus due to the difference in progression between the two eyes. Periodic follow-up makes it possible to diagnose the disease in the contralateral eye in patients diagnosed with keratoconus in one eye, to indicate individualized optical correction, especially in the presence of anisometropia, and to monitor the evolution of frequently associated refractive amblyopia(AU)

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The present study characterized a genetically and phenotypically diverse collection of 27 purple and two non-purple (one orange and one yellow) carrot accessions for concentration of root anthocyanins, phenolics, and carotenoids, and antioxidant capacity estimated by four different methods (ORAC, DPPH, ABTS, FRAP), in a partially replicated experimental design comprising data from two growing seasons (2018 and 2019). Broad and significant (p < 0.0001) variation was found among the accessions for all the traits. Acylated anthocyanins (AA) predominated over non-acylated anthocyanins (NAA) in all the accessions and years analyzed, with AA accounting for 55.5-100% of the total anthocyanin content (TAC). Anthocyanins acylated with ferulic acid and coumaric acid were the most abundant carrot anthocyanins. In general, black or solid purple carrots had the greatest TAC and total phenolic content (TPC), and the strongest antioxidant capacities, measured by all methods. Antioxidant capacity, estimated by all methods, was significantly, positively, and moderately-to-strongly correlated with the content of all individual anthocyanins pigments, TAC, and TPC, in both years (r = 0.59-0.90, p < 0.0001), but not with the carotenoid pigments lutein and ß-carotene; suggesting that anthocyanins and other phenolics, but not carotenoids, are major contributors of the antioxidant capacity in purple carrots. We identified accessions with high concentration of chemically stable AA, with potential value for the production of food dyes, and accessions with relatively high content of bioavailable NAA that can be selected for increased nutraceutical value (e.g., for fresh consumption).

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Fresh-cut produce have become widely popular, increasing vegetable consumption in many parts of the word. However, they are more perishable than unprocessed fresh vegetables, requiring cold storage to preserve their quality and palatability. In addition to cold storage, UV radiation has been used experimentally to try to increase nutritional quality and postharvest shelf life, revealing increased antioxidant levels in some fruits and vegetables, including orange carrots. Carrot is one of the main whole and fresh-cut vegetables worldwide. In addition to orange carrots, other root color phenotypes (e.g., purple, yellow, red) are becoming increasingly popular in some markets. The effect of the UV radiation and cold storage has not been explored in these root phenotypes. This study investigated the effect of postharvest UV-C radiation in whole and fresh-cut (sliced and shredded) roots of two purple, one yellow, and one orange-rooted cultivar, with regard to changes in concentration of total phenolics (TP) and hydroxycinnamic acids (HA), chlorogenic acid (CGA), total and individual anthocyanins, antioxidant capacity (by DPPH and ABTS), and superficial color appearance, monitoring such changes during cold storage. Results revealed that the UV-C radiation, the fresh-cut processing, and the cold storage influenced the content of antioxidant compounds and activities to varying extents, depending on the carrot cultivar, the degree of processing, and the phytochemical compound analyzed. UV-C radiation increased antioxidant capacity up to 2.1, 3.8, 2.5-folds; TP up to 2.0, 2.2, and 2.1-folds; and CGA up to 3.2, 6.6, and 2.5-folds, relative to UV-C untreated controls, for orange, yellow, and purple carrots, respectively. Anthocyanin levels were not significantly modified by the UV-C in both purple carrots evaluated. A moderate increase in tissue browning was found in some fresh-cut processed UV-C treated samples of yellow and purple but not orange roots. These data suggest variable potential for increasing functional value by UV-C radiation in different carrot root colors.

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ABSTRACT Objective: To estimate the prevalence of Sexually Transmitted Infections (STIs) in immigrants and refugees living in the metropolitan region of Goiânia, Goiás. Method: This is a cross-sectional and analytical study. Data collection was carried out from July 2019 to January 2020 and 308 immigrants and refugees were included in the sample. All were underwent face-to-face interviews and were tested for HIV, Syphilis, and Hepatitis B, using rapid tests. Results: The general prevalence for any of the STIs investigated was 8.8% (95%CI 6.0% - 12.3%), being 5.8% (95%CI 3.6% - 8.9%) for Hepatitis B, 2.3% for Syphilis (95%CI 1.00% - 4.4%) and 0.7% for HIV (95%CI 0.1% - 2.1%). Multiple analysis, using logistic regression, showed that the variables male gender (OR = 2.7) and length of time living in Brazil (OR = 2.6) were significantly associated with STIs (p < 0.05). Conclusion: The results of this study suggest that STIs are a health problem in immigrants/refugees, which appear to be enhanced with the length of migration in the country. Public policies that guarantee health care for this population shall be considered.

RESUMEN Objetivo: Estimar la prevalencia de Enfermedades de Transmisión Sexual (ETS) en inmigrantes y refugiados residentes en la región metropolitana de Goiânia, Goiás. Método: Se trata de un estudio transversal y analítico. La recolección de datos se llevó a cabo desde julio de 2019 hasta enero de 2020 y se incluyeron en la muestra 308 inmigrantes y refugiados. Todos fueron entrevistados cara a cara y sometidos a pruebas de VIH, Sífilis y Hepatitis B, mediante pruebas rápidas.. Resultados: La prevalencia general para cualquiera de las ETS investigadas fue de 8,8% (IC95% 6,0% - 12,3%), siendo 5,8% (IC95% 3,6% - 8,9%) para Hepatitis B, 2,3% para Sífilis (IC95% 1,00% - 4,4%) y 0,7% para VIH (IC95% 0,1% - 2,1%). El análisis múltiple, mediante regresión logística, mostró que las variables género masculino (OR = 2,7) y tiempo de residencia en Brasil (OR = 2,6) se asociaron significativamente con las ETS (p < 0,05). Conclusión: Los resultados de este estudio sugieren que las ETS son un problema de salud en inmigrantes/refugiados, que parecen exacerbarse con la duración de la migración en el país. Se deben considerar políticas públicas que garanticen la atención de la salud de esta población.

RESUMO Objetivo: Estimar a prevalência de Infecções Sexualmente Transmissíveis (IST) em imigrantes e refugiados residentes na região metropolitana de Goiânia, Goiás. Método: Trata-se de um estudo transversal e analítico. A coleta de dados foi realizada no período de julho de 2019 a janeiro de 2020 e integraram a amostra 308 imigrantes e refugiados. Todos foram entrevistados face-a-face e testados para HIV, Sífilis e Hepatite B, por meio de testes rápidos. Resultados: A prevalência geral para alguma das IST investigadas foi de 8,8% (IC95% 6,0% - 12,3%), sendo 5,8% (IC95% 3,6% - 8,9%) para Hepatite B, 2,3% para Sífilis (IC95% 1,00% - 4,4%) e 0,7% para HIV (IC95% 0,1% - 2,1%). A análise múltipla, por regressão logística, mostrou que as variáveis sexo masculino (OR = 2,7) e tempo de moradia no Brasil (OR = 2,6) foram associadas significativamente às IST (p < 0,05). Conclusão: Os resultados deste estudo sugerem que as IST são um problema de saúde em imigrantes/refugiados, que parecem ser exacerbadas com o tempo de migração no país. Políticas públicas que garantam a assistência à saúde dessa população devem ser consideradas.

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Despite the great importance of gills for bivalve mollusks (respiration, feeding, immunity), the microbiota associated with this tissue has barely been characterized in scallops. The scallop Argopecten purpuratus is an important economic resource that is cultivated in areas where coastal upwelling is intensifying by climate change, potentially affecting host-microbiota interactions. Thus, we first characterized the bacterial community present in gills from cultivated scallops (by 16S rRNA gene amplicon sequencing) and assessed their stability and functional potential in animals under farm and laboratory conditions. Results showed that under both conditions the gill bacterial community is dominated by the phylum Campylobacterota (57%), which displays a chemoautotrophic potential that could contribute to scallop nutrition. Within this phylum, two phylotypes, namely symbionts A and B, were the most abundant; being, respectively, taxonomically affiliated to symbionts with nutritional functions in mussel gills, and to uncultured bacteria present in coral mucus. Additionally, in situ hybridization and scanning electron microscopy analyses allowed us to detect these symbionts in the gills of A. purpuratus. Given that shifts in upwelling phenology can cause disturbances to ecosystems, affecting bacteria that provide beneficial functions to the host, we further assessed the changes in the abundance of the two symbionts (via qPCR) in response to a simulated upwelling intensification. The exposure to combined decreasing values in the temperature, pH, and oxygen levels (upwelling conditions) favored the dominance of symbiont B over symbiont A; suggesting that symbiont abundances are modulated by these environmental changes. Overall, results showed that changes in the main Campylobacterota phylotypes in response to upwelling intensification could affect its symbiotic function in A. purpuratus under future climate change scenarios. These results provide the first insight into understanding how scallop gill-microbial systems adapt and respond to climate change stressors, which could be critical for managing health, nutrition, and scallop aquaculture productivity.

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As a means to evaluate the potential of carrot anthocyanins as food colorants and nutraceutical agents, we investigated the physicochemical stability and antioxidant capacity of purple carrot extracts under different pH (2.5-7.0) and temperature (4-40 °C) conditions, in comparison to a commercial synthetic (E131) and a natural grape-based (GRP) colorant. During incubation, the colorants were weekly-monitored for various color parameters, concentration of anthocyanins and phenolics, and antioxidant capacity. Carrot colorants were more stable than GRP; and their thermal stability was equal (at 4 °C) or higher than that of E131 (at 25-40 °C). Carrot anthocyanins had lower degradation rate at low pH and temperature, with acylated anthocyanins (AA) being significantly more stable than non-acylated anthocyanins (NAA). Anthocyanins acylated with feruloyl and coumaroyl glycosides were the most stable carrot pigments. The higher stability of carrot colorants is likely due to their richness in AA and -to a lesser extent- copigmentation with other phenolics.

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Omicron is the most mutated SARS-CoV-2 variant-a factor that can affect transmissibility, disease severity, and immune evasiveness. Its genomic surveillance is important in cities with millions of inhabitants and an economic center, such as Mexico City. Results. From 16 November to 31 December 2021, we observed an increase of 88% in Omicron prevalence in Mexico City. We explored the R346K substitution, prevalent in 42% of Omicron variants, known to be associated with immune escape by monoclonal antibodies. In a phylogenetic analysis, we found several independent exchanges between Mexico and the world, and there was an event followed by local transmission that gave rise to most of the Omicron diversity in Mexico City. A haplotype analysis revealed that there was no association between haplotype and vaccination status. Among the 66% of patients who have been vaccinated, no reported comorbidities were associated with Omicron; the presence of odynophagia and the absence of dysgeusia were significant predictor symptoms for Omicron, and the RT-qPCR Ct values were lower for Omicron. Conclusions. Genomic surveillance is key to detecting the emergence and spread of SARS-CoV-2 variants in a timely manner, even weeks before the onset of an infection wave, and can inform public health decisions and detect the spread of any mutation that may affect therapeutic efficacy.

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Una meta del sistema de salud es la prevención de enfermedades, por ello cobra especial importancia el estudio de la relación de enfermedades con el espacio. Existen evidencias del empleo de los Sistemas de Información Geográfica en estudios sobre la distribución espacial de problemas de salud. A pesar de esto, los trabajos reportados en la literatura consultada no explotan la componente espacial de los datos, lo que limita su integralidad. Por otra parte, existe dispersión en las metodologías, herramientas y técnicas para abordar estudios de este tipo. En esta investigación se presenta un método de estratificación de territorios basado en Sistemas de Información Geográfica y medidas de similitud geométrica, definidas a partir de los criterios: distancia, tamaño y conectividad. La propuesta permite realizar estudios estratificados según la primera ley de la geografía y garantiza la obtención de estratos más compactos. El método propuesto cuenta con cinco etapas: Selección de indicadores y territorios, Preprocesamiento de indicadores, Agrupamiento, Postprocesamiento y Visualización, soportado en una solución informática basada en software libre. Como parte de la validación se aplica el método en un caso de estudio y se realiza el análisis de índices de validación que avalan la efectividad y competitividad de la propuesta(AU)

A goal of the health system is the prevention of diseases, which is why the study of the relationship of diseases with space is of special importance. There is evidence of the use of Geographic Information Systems in studies on the spatial distribution of health problems. Despite this, the works reported in the consulted literature do not exploit the spatial component of the data, which limits its comprehensiveness. On the other hand, there is dispersion in the methodologies, tools and techniques to approach studies of this type. This research presents a method of stratification of territories based on Geographic Information Systems and geometric similarity measures, defined from the criteria: distance, size and connectivity. The proposal allows for stratified studies according to the first law of geography and guarantees the obtaining of more compact strata. The proposed method has five stages: Selection of indicators and territories, Pre-processing of indicators, Grouping, Post-processing and Visualization, supported by a computer solution based on free software. As part of the validation, the method is applied in a case study and the analysis of validation indices is carried out that guarantee the effectiveness and competitiveness of the proposal(AU)

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Immune thrombocytopenia (ITP) has been widely reported as a complication of SARS-CoV-2 infection, but to our knowledge, there have been no reports on the association of the COVID-19 vaccine with thrombocytopenia. Here, we report a case of secondary ITP in a patient who was recently immunised with the messenger RNA COVID-19 vaccine BNT162b2 (Pfizer-BioNTech).

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BACKGROUND: Few studies have described the epidemiology and clinical behavior of inflammatory bowel disease (IBD) in South America. The aim of this study was to report on the prevalence, phenotype, and treatment of patients with IBD diagnosis in Capital Department of the Province of Córdoba, Argentina. METHODS: Data from adult patients (≥ 18 years-old) with IBD diagnosis that attended 12 public or private centers between 05/2014 and 05/2019 were included in a common registry. RESULTS: A total of 655 patients were included (females: 53.4%). The ratio of ulcerative colitis (UC) (n = 561) to Crohn's disease (CD) (n = 88) was 6.38, with age-adjusted IBD prevalence being 70.1 (95% confidence interval 70.08-70.12) cases/100,000 habitants. Extraintestinal manifestations were diagnosed in 22.8% of patients, and left-side colitis (46%) was the most frequent extension in UC patients. In CD patients, colonic involvement (55.7%) and non-stricturing/non-penetrating behavior (74%) were the most frequent presentations. Biologic therapy was used in 36.4% of CD patients and 9.1% of UC patients (P<0.001). CONCLUSION: In this population registry study, IBD prevalence was similar to that reported in other series in the region. A higher UC/CD ratio was observed due to the lower prevalence of CD compared to similar studies in South America.

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The interaction between host immune response and the associated microbiota has recently become a fundamental aspect of vertebrate and invertebrate animal health. This interaction allows the specific association of microbial communities, which participate in a variety of processes in the host including protection against pathogens. Marine aquatic invertebrates such as scallops are also colonized by diverse microbial communities. Scallops remain healthy most of the time, and in general, only a few species are fatally affected on adult stage by viral and bacterial pathogens. Still, high mortalities at larval stages are widely reported and they are associated with pathogenic Vibrio. Thus, to give new insights into the interaction between scallop immune response and its associated microbiota, we assessed the involvement of two host antimicrobial effectors in shaping the abundances of bacterial communities present in the scallop Argopecten purpuratus hemolymph. To do this, we first characterized the microbiota composition in the hemolymph from non-stimulated scallops, finding both common and distinct bacterial communities dominated by the Proteobacteria, Spirochaetes and Bacteroidetes phyla. Next, we identified dynamic shifts of certain bacterial communities in the scallop hemolymph along immune response progression, where host antimicrobial effectors were expressed at basal level and early induced after a bacterial challenge. Finally, the transcript silencing of the antimicrobial peptide big defensin ApBD1 and the bactericidal/permeability-increasing protein ApLBP/BPI1 by RNA interference led to an imbalance of target bacterial groups from scallop hemolymph. Specifically, a significant increase in the class Gammaproteobacteria and the proliferation of Vibrio spp. was observed in scallops silenced for each antimicrobial. Overall, our results strongly suggest that scallop antimicrobial peptides and proteins are implicated in the maintenance of microbial homeostasis and are key molecules in orchestrating host-microbiota interactions. This new evidence depicts the delicate balance that exists between the immune response of A. purpuratus and the hemolymph microbiota.

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Resumen: Se realizó una simulación in situ del proceso de atención de paciente con diagnóstico de COVID-19 programado para una cirugía de urgencia. Se observó desde la llegada al Departamento de Urgencias y hasta su salida del quirófano. Se llevaron a cabo los protocolos previamente establecidos y se observó por áreas de oportunidad.

Abstract: An in situ simulation was performed of a patient with COVID-19 diagnosis that is schedule for emergency surgery. From the arrival to the Emergency Department to the exit from the operating theatre. Previously stablished protocols were performed, and areas of improvement were looked for.

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The scallop Argopecten purpuratus is one of the most economically important cultured mollusks on the coasts from Chile and Peru but its production has declined, in part, due to the emergence of mass mortality events of unknown origin. Driven by this scenario, increasing progress has been made in recent years in the comprehension of immune response mechanisms in this species. However, it is still not entirely understood how different mucosal interfaces participate and cooperate with the immune competent cells, the hemocytes, in the immune defense. Thus, in this work we aimed to characterize the transcriptome of three tissues with immune relevance from A. purpuratus by next-generation sequencing and de novo transcriptome assembly. For this, 18 cDNA libraries were constructed from digestive gland, gills and hemocytes tissues of scallops from different immune conditions and sequenced by the Illumina HiSeq4000 platform. A total of 967.964.884 raw reads were obtained and 967.432.652 clean reads were generated. The clean reads were de novo assembled into 46.601 high quality contigs and 32.299 (69.31%) contigs were subsequently annotated. In addition, three de novo specific assemblies were performed from clean reads obtained from each tissue cDNA libraries for their comparison. Gene ontology (GO) and KEGG analyses revealed that annotated sequences from digestive gland, gills and hemocytes could be classified into both general and specific subcategory terms and known biological pathways, respectively, according to the tissue nature. Finally, several immune related candidate genes were identified, and the differential expression of tissue-specific genes was established, suggesting they could display specific roles in the host defense. The data presented in this study provide the first insight into the tissue specific transcriptome profiles of A. purpuratus, which should be considered for further research on the interplay between the hemocytes and mucosal immune responses.

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Big defensins are antimicrobial peptides (AMPs) that are proposed as important effectors of the immune response in mollusks, chelicerates and chordates. At present, only two members of the big defensin family have been identified in scallop. In the present work, a cDNA sequence encoding a new big defensin homologue was characterized from the scallop Argopecten purpuratus, namely ApBD1. ApBD1 cDNA sequence comprised 585 nucleotides, with an open reading frame of 375 bp and 5'- and 3'-UTRs of 41 and 167 bp, respectively. The deduced protein sequence contains 124 amino acids with a molecular weight of 13.5 kDa, showing characteristic motifs of the big defensin family and presenting 76% identity with the big defensin from the scallop A. irradians. Phylogenetic analysis revealed that ApBD1 is included into the cluster of big defensins from mollusks. Tissue-specific transcript expression analysis by RT-qPCR showed that ApBD1 was present in all tissues tested from non-immune challenged scallops but it was most strongly expressed in the mantle. The transcript levels of ApBD1 were significantly up-regulated in gills at 24 and 48 h post-injection with the heat-attenuated bacteria Vibrio splendidus. Additionally, immunofluorescence analysis using a polyclonal anti-ApBD1 antibody showed that this protein was abundantly located in epithelial linings of gills and mantle; and also in digestive gland showing ApBD1-infiltrating hemocytes from immune challenged scallops. This is the first time that a big defensin is detected and located at the protein level in a mollusk. These results suggest an important role of ApBD1 in the mucosal immune response of A. purpuratus.

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Fundamento. La combinación de un embarazo intrauterino con uno extrauterino se conoce como embarazo heterotópico, esta es una patología poco reportada cuando se presenta en forma espontánea (1 caso cada 20 000 o 30 000 embarazos). Objetivo: Reportar un caso la infrecuencia de la forma en que se presenta la combinación de los dos embarazos y la emergencia de cuando uno está roto. Presentation of the case: Paciente de 26 años de edad, con el antecedente de tres gestaciones previas (tres partos a término); presentó una historia de amenorrea de tres meses asociada a dolor hipogástrico de 24 horas de evolución. Al examen físico tenía la TA de 90/50 mHg, el pulso de 120 pulsaciones por minutos, frialdad y sudoración, la temperatura axilar de 36,4 °C. Su abdomen estaba levemente distendido, blando, depresible, con ruidos hidroaéreos, sensible a la palpación profunda en hipogastrio y en fosa ilíaca derecha con Blumberg negativo. Se le realizó una laparotomía exploradora con el diagnóstico presuntivo de embarazo ectópico derecho, y se observó en ésta un hemoperitoneo de 500 ml, útero, ovario y trompa izquierdas normales. Se le realizó una ecografía que informó un embarazo intrauterino de primer trimestre, que al momento de la cirugía tenía una edad gestacional estimada de 15 semanas. Conclusiones: El diagnóstico del embarazo heterotópico no es fácil definirlo debido a las diversas manifestaciones clínicas y a la existencia del embarazo intrauterino que continúa; se debe tener en cuenta que la ecografía es un pilar importante en el diagnóstico e identificación temprana de esta patología.

Background: The combination of an intra-uterine pregnancy with an extra uterine one is known as heterotopic pregnancy, this is a pathology little reported when it is presented in an spontaneous form (1 case each 20 000 or 30 000 pregnancies). Objective: To report a case the seldomness in the way in that it is presented the combination of the two pregnancies and the emergency of when one is broken. Report of case: Patient of 26 years old, with the antecedent of three previous pregnancies (three childbirths to term);she presented a history of a three months amenorrhea associated to hypogastria pain of 24 hours of evolution. To the physical exam she had the TA of 90/50 mHg, the pulse of 120 pulsations for minutes, indifference and sweating, the axillary temperature of 36, 4 °C. Her abdomen was slightly loosened, soft, depressive, with noises hydro air, sensitive to the deep palpation in hypogastrium and in grave right iliac with negative Blumberg. It was carried out an exploratory laparotomy with the presumptive diagnosis of right ectopic pregnancy, and it was observed in this a hemoperitoneum of 500 ml, uterus, lefts ovary and trumpet normal. It was carried out an ultrasound that informed an intra-uterine pregnancy of first trimester that had an estimated gestational age of 15 weeks at the moment of the surgery. Conclusions: The diagnosis of the heterotopic pregnancy is not easy to define due the diverse clinical manifestations and the existence of the intra-uterine pregnancy that continues; it should be kept in mind that the ultrasound is an important pillar in the diagnosis and early identification of this pathology.

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Reactive oxygen intermediates (ROI) are metabolites produced by aerobic cells which have been linked to oxidative stress. Evidence reported in vertebrates indicates that ROI can also act as messengers in a variety of cellular signaling pathways, including those involved in innate immunity. In a recent study, an inhibitor of NF-kB transcription factors was identified in the scallop Argopecten purpuratus, and its functional characterization suggested that it may regulate the expression of the big defensin antimicrobial peptide ApBD1. In order to give new insights into the messenger role of ROI in the immune response of bivalve mollusks, the effect of ROI production on gene transcription of ApBD1 was assessed in A. purpuratus. The results showed that 48 h-cultured hemocytes were able to display phagocytic activity and ROI production in response to the ß-glucan zymosan. The immune stimulation also induced the transcription of ApBD1, which was upregulated in cultured hemocytes. After neutralizing the ROI produced by the stimulated hemocytes with the antioxidant trolox, the transcription of ApBD1 was reduced near to base levels. The results suggest a potential messenger role of intracellular ROI on the regulation of ApBD1 transcription during the immune response of scallops.

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