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The incidence and distribution of coccidioidomycosis are increasing. Information scarcity is evident in Mexico, particularly in non-endemic zones and specific populations. We compared the treatment and outcomes for patients with isolated pulmonary infections and those with disseminated coccidioidomycosis, including mortality rates within six weeks of diagnosis. Of 31 CM cases, 71% were male and 55% were disseminated. For 42% of patients, there was no evidence of having lived in or visited an endemic region. All patients had at least one comorbidity, and 58% had pharmacologic immunosuppressants. The general mortality rate was 30%; without differences between disseminated and localized disease. In our research, we describe a CM with a high frequency of disseminated disease without specific risk factors and non-significant mortality. Exposure to endemic regions was not found in a considerable number of subjects. We consider diverse reasons for why this may be, such as climate change or migration.

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Histoplasmosis is an endemic and invasive mycosis caused by Histoplasma capsulatum. We conducted a retrospective study comparing immunosuppressed patients without human immunodeficiency virus (HIV) with a historical cohort of people with HIV and histoplasmosis. We included 199 patients with proven or probable histoplasmosis, of which 25.1% were people without HIV. Diabetes mellitus, chronic kidney disease, hematologic neoplasms, rheumatologic diseases, and transplantations were more frequent among people without HIV (P < .01). Forty-four percent of immunocompromised patients without HIV died within the first 6-week period following their diagnosis. A high suspicion index for histoplasmosis should be kept in immunosuppressed patients.

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Background: Even though worldwide death rates from coronavirus disease 2019 (COVID-19) have decreased, the threat of disease progression and death for high-risk groups continues. Few direct comparisons between the available severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antivirals have been made. Objective: We aimed to compare two SARS-CoV-2 antivirals (nirmatrelvir/ritonavir and remdesivir) against all-cause hospitalization or death. Design: This is a propensity score-matched cohort study. Methods: We included all high-risk outpatients with COVID-19 in a tertiary referral center in Mexico City from 1 January 2022 to 31 July 2023. The primary outcome was all-cause hospitalization or death 28 days after symptom onset. The secondary outcome was COVID-19-associated hospitalization or death 28 days after symptom onset. Logistic regression analysis for characteristics associated with the primary outcome and a multi-group comparison with Kaplan-Meier survival estimates were performed. Results: Of 1566 patients analyzed, 783 did not receive antiviral treatment, 451 received remdesivir, and 332 received nirmatrelvir/ritonavir. The median age was 60 years (interquartile range: 46-72), 62.5% were female and 97.8% had at least one comorbidity. The use of nirmatrelvir/ritonavir was associated with an absolute risk reduction of 8.8% and a relative risk reduction of 90% for all-cause hospitalization or death. The use of remdesivir was associated with an absolute risk reduction of 6.4% and a relative risk reduction of 66% for all-cause hospitalization or death. In multivariable analysis, both antivirals reduced the odds of 28-day all-cause hospitalization or death [nirmatrelvir/ritonavir odds ratio (OR) 0.08 - 95% confidence interval (CI): 0.03-0.19, remdesivir OR 0.29 - 95% CI: 0.18-0.45]. Conclusion: In high-risk COVID-19 outpatients, early antiviral treatment with nirmatrelvir/ritonavir or remdesivir was associated with lower 28-day all-cause hospitalization or death.

Nirmatrelvir/ritonavir and remdesivir against symptomatic treatment in high-risk COVID-19 outpatients In this study, we included high-risk non-hospitalized patients with confirmed mild COVID-19. We compared those who received antiviral treatment (nirmatrelvir/ritonavir or remdesivir) against those who only received symptomatic treatment. The aim was to detect differences in hospitalization or death 28 days after symptom onset. We analyzed 1566 patients: 783 did not receive antiviral treatment, 451 received remdesivir, and 332 received nirmatrelvir/ritonavir. Most patients were female and over 60 years old. The most common comorbidities were chronic hypertension (44%), diabetes mellitus (26%), and autoimmune diseases (25%); systemic immunosuppression was registered in 35% of patients. Hospitalization or death 28 days after symptom onset occurred in 168 patients (136 in the symptomatic treatment group, 27 in the remdesivir group, and 5 in the nirmatrelvir/ritonavir group). Considering multiple variables like age, sex, comorbidities, and previous vaccination, both antivirals significantly reduced the odds of hospitalization or death (nirmatrelvir/ritonavir odds ratio 0.08, 95% confidence interval 0.03-0.19; remdesivir odds ratio 0.29, 95% confidence interval 0.18-0.45).

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Aim: To identify psychosocial predictors of the intention to get a booster COVID-19 vaccine in a low-income country, given that increasing booster vaccination rates against COVID-19 remains a global challenge, especially among low- and middle-income countries (LMIC). Subject and methods: We used an online survey to collect responses from a non-probabilistic sample of 720 Bolivians regarding vaccine uptake, motives, perceived confidence, information sources, attitudes favouring COVID-19 vaccines, biosafety behaviour, and sociodemographic characteristics. Descriptive, bivariate, and multivariate analyses were performed to identify significant associations and predictors. Results: We found that having already received the third dose, obtaining recommendations from family or friends, recommendation from the government, perceived confidence in the previously received dose, and higher attitudes in favour of COVID-19 vaccines significantly predicted the intention to get a booster dose. The associations were significant even when adjusting the model for sociodemographic variables. Conclusion: Including certain psychosocial factors could enhance the promotion of voluntary booster doses among residents of low- and middle-income countries such as Bolivia, where cultural, social, political, and contextual variables may influence health behaviour and increase health-associated risk factors. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01937-x.

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To date, few studies have been carried out aimed at characterizing the toxins synthesized by hydrocorals of the genus Millepora. The purpose of this study was to explore the toxin diversity and antibacterial activity of the "fire coral" M. complanata using a transcriptomic data mining approach. In addition, the cytolytic and antibacterial activities of the M. complanata nematocyst proteome were experimentally confirmed. Cytolysins were predicted from the transcriptome by comparing against the Animal Toxin Annotation Project database, resulting in 190 putative toxins, including metalloproteases, hemostasis-impairing toxins, phospholipases, among others. The M. complanata nematocyst proteome was analyzed by 1D and 2D electrophoresis and zymography. The zymograms showed different zones of cytolytic activity: two zones of hemolysis at ~25 and ~205 kDa, two regions corresponding to phospholipase A2 (PLA2) activity around 6 and 25 kDa, and a proteolytic zone was observed between 50 and 205 kDa. The hemolytic activity of the proteome was inhibited in the presence of PLA2 and proteases inhibitors, suggesting that PLA2s, trypsin, chymotrypsin, serine-proteases, and matrix metalloproteases are responsible for the hemolysis. On the other hand, antimicrobial peptide sequences were retrieved from their transcripts with the amPEPpy software. This analysis revealed the presence of homologs to SK84, cgUbiquitin, Ubiquicidin, TroTbeta4, SPINK9-v1, and Histone-related antimicrobials in the transcriptome of this cnidarian. Finally, by employing disk diffusion and microdilution assays, we found that the nematocyst peptidome of M. complanata showed inhibitory activity against both Gram-positive and Gram-negative bacteria including S. enteritidis, P. perfectomarina, E. coli, and C. xerosis, among others. This is the first transcriptomic data mining analysis to explore the diversity of the toxins synthesized by an organism of the genus Millepora. Undoubtedly, this work provides information that will broaden our general understanding of the structural richness of cnidarian toxins.

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We present a cohort of individuals who reached CD4+ T cell counts of greater than 1,000 cells/mm3 (Hypers) after starting antiretroviral treatment (ART) and compared them with those who reached between 350 and 999 CD4+ T cells/mm3 (Concordants). Demographic data, immune recovery kinetics, T CD4+ subset phenotypes, and integrated HIV DNA were analyzed. Data from individuals living with HIV on their first ART regimen and after 48 months of follow-up were obtained. Immune phenotype by Flow Cytometry analysis on whole blood was performed, cytokines were measured, and integrated HIV-1 DNA was measured by polymerase chain reaction. From a total of 424 individuals, 26 Hypers (6.1%), 314 Concordants (74.1%), and 84 (19.8%) discordants were identified. Hypers had a higher proportion of CD4+-naive (Nv) T cells (37.6 vs. 24.8, p < .05), and a low proportion of CD4+ effector memory T cells (27.9 vs. 39.4, p < .05), with similar results found in CD8+ T cells. Hypers demonstrated a higher percentage of CD4+CD45RA+CD31neg cells with a lower response to interleukin-2 stimulation and a lower integrated HIV-1 DNA/CD4 ratio (1.2 vs. 2.89, p < .05). In Hypers, T cell recovery occurs very early after initiation of ART. Following this initial recovery state, their CD4+ T cell level homeostasis seems to be driven by nonthymic-central-Nv cells. This exceptional recovery is associated with a lower HIV reservoir, which may be related to an increase in noninfected CD4+ T cells. These patients could then be eligible candidates for cure trials.

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Coral bleaching caused by global warming has resulted in massive damage to coral reefs worldwide. Studies addressing the consequences of elevated temperature have focused on organisms of the class Anthozoa, and up to now, there is little information regarding the mechanisms by which reef forming Hydrozoans face thermal stress. In this study, we carried out a comparative analysis of the soluble proteome and the cytolytic activity of unbleached and bleached Millepora complanata ("fire coral") that inhabited reef colonies exposed to the 2015-2016 El Niño-Southern Oscillation in the Mexican Caribbean. A differential proteomic response involving proteins implicated in key cellular processes, such as glycolysis, DNA repair, stress response, calcium homeostasis, exocytosis, and cytoskeleton organization was found in bleached hydrocorals. Four of the proteins, whose levels increased in bleached specimens, displayed sequence similarity to a phospholipase A2, an astacin-like metalloprotease, and two pore forming toxins. However, a protein, which displayed sequence similarity to a calcium-independent phospholipase A2, showed lower levels in bleached cnidarians. Accordingly, the hemolytic effect of the soluble proteome of bleached hydrocorals was significantly higher, whereas the phospholipase A2 activity was significantly reduced. Our results suggest that bleached M. complanata is capable of increasing its toxins production in order to balance the lack of nutrients supplied by its symbionts.

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El objetivo del trabajo es presentar los resultados de la tarea de investigación y asistencia que realizó un equipo de psicología perinatal entre 1996 y 1999 ante la angustia y ansiedad que desencadena en la madre la internación prolongada de su bebé o la propia despues del nacimiento. Se detectaron: sucesos significativos,problemas físicos y/o psicológicos y conflictos infantiles que emergen detrás de los trastornos de angustia y ansiedad. Se administró un modelo de entrevista psicológica con diseño óptico y se realizó el estudio comparativo con un modelo de entrevista "clasica". El trabajo permitió analizar y sistematizar 1264 entrevistas psicológicas administradas a madres e incorporar a las historias clínicas neonatales un protocolo que detecte factores psicológicos. La investigación coomprobó que los sucesos significativos para la madre se centran principalmente en: muertes,problemas de pareja, problemas actuales y problemas sociales. Ello implica el reconocimiento de la dimensión psicológica en ámbitos tan influídos por el "saber" médico ,y el desarrollo de la Psicología perinatal.

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El objetivo de la investigación fue la construcción de una entrevista que tomara en cuenta los sucesos significativos de vida ("life event") que pudieron influír durante el embarazo y parto a los efectos de introducir la dimensión psicosocial de la madre en las maternidades.Con el propósito de incorporarla a la historia clínica obstétrica y neonatal la entrevista fue transformada en un instrumento de diseño óptico de fácil interpretación para el equipo médico.La aplicación en ambos Servicios permitió clasificar la problemática materna en seis categorías generales: pareja, muerte, problemas sociales, preocupacion por otros hijos , problemas asociados al embarazo fisicos o psicologicos y conclictos en la infancia.Se administró desde 1996 a 1999 en el servicio de Neonatología a un total de 1.264 madres en las primeras 96 horas de vida del bebé y en Obstetricia ( salas de internación embarazo de riesgo) se aplicó a 212 pacientes desde el mes de Marzo de 1998 hasta el mes de Julio de 2000. Incorporar a las historias clínicas un protocolo que detecte factores psicológicos implica el reconocimiento de la dimensión psicológica en ámbitos tan influidos por el "saber" médico y el desarrollo de la psicología perinatal...

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Se presenta un modelo de entrevista psicológica con diseño óptico para ser aplicado en el posparto inmediato.El equipo esta formado por un grupo de profesionales que realizan el acompañamiento psicológico de la madre y su bebé durante las primeras interacciones, cuando los acontecimientos se desarrollan normalmente, pero también cuando sobreviven incidentes, amenazas de partos prematuros, muerte fetal , nacimiento prematuro y descompensación postnatal.Se elaboró una lista de temas preocupantes que surgen del discurso materno a partir de la aplicación del instrumento.

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El objetivo de la investigación fue la construcción de una entrevista que tomara en cuenta los sucesos significativos de vida ("life event") que pudieron influír durante el embarazo y parto a los efectos de introducir la dimensión psicosocial de la madre en las maternidades. Con el propósito de incorporarla a la historia clínica obstétrica y neonatal la entrevista fue transformada en un instrumento de diseño óptico de fácil interpretación para el equipo médico. La aplicación en ambos Servicios permitió clasificar la problemática materna en seis categorías generales: pareja, muerte, problemas sociales, preocupacion por otros hijos , problemas asociados al embarazo fisicos o psicologicos y conclictos en la infancia. Se administró desde 1996 a 1999 en el servicio de Neonatología a un total de 1.264 madres en las primeras 96 horas de vida del bebé y en Obstetricia ( salas de internación embarazo de riesgo) se aplicó a 212 pacientes desde el mes de Marzo de 1998 hasta el mes de Julio de 2000. Incorporar a las historias clínicas un protocolo que detecte factores psicológicos implica el reconocimiento de la dimensión psicológica en ámbitos tan influidos por el "saber" médico y el desarrollo de la psicología perinatal

As a research goal we created a schedule interview to consider the significant "life events" that could appear during the pregnancy and childbirth, giving us mother's psychosocial dimension into the maternity hospital. Incorporated to the obstetric an neonatal clinical history, it's an easy "optical designed" tool to every medical team. There are six items classified: couples, death, social problems, worry about other children, psychological or physical problems associated with pregnancy, childhood conflicts. This interview was used since 1996 up to 1999: in Neonatology with 1264 mother in the first 96 hours baby life; in Obstetrics it was applied to 212 patients since March 1998 till July 2000. Incorporing to clinical histories a protocol which detects psychological events, denotes recognition psychological dimension in medical knowledge and perinatal psychology develop

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El presente trabajo tuvo por objetivo detectar los factores psicosociales que intervienen en las amenazas de partos prematuros, bebés de bajo peso al nacer, muertes fetales y descompensaciones posnatales.Numerosas investigaciones dieron cuenta de la incidencia de los factores biológicos, genéticos y médicos en los nacimientos prematuros, de bajo peso u otras complicaciones al nacer.Sin embargo, quedan aún por investigar los factores psicosociales, e identificar cuales son los sucesos significativos de la vida (life event) que impiden el normal desarrollo del embarazo, parto y puerperio. Para ello hemos elaborado y aplicado una entrevista psicológica semidirigida, que interrogaba sobre sucesos significativos de vida (lige event) durante el último año a 80 madres con bebés internados en Unidad de terapia neonatológica (grupo experimental) con otro grupo de madres (grupo control) cuyos bebés no habían tenido problemas al nacer. Se compararon ambos grupos en cuanto a la edad, educación, pareja y sucesos significativos de vida. Se encontró diferencias significativas (p< o.o1) en relación a los sucesos significativos que habían sufrido ese año. Las madres del grupo experimental habían padecido problemas en 55 casos (80 en total). Y las madres del grupo control manifestaron problemas en 25 casos (80 casos)...

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