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INTRODUCTION: Lung cancer continues to be the leading cause of death among cancer patients worldwide. This study aimed to estimate the clinical, economic, and social burdens of stage IV non-small cell lung cancer (NSCLC) in private and public healthcare centers in Mexico, utilizing real-world evidence. METHODS: The study population included patients >18 years of age diagnosed with stage IV NSCLC who received cancer treatment at the Centro Médico Nacional Siglo XXI (IMSS), the Centro Médico Nacional "20 de Noviembre" (ISSSTE), the Mexican Institute of Respiratory Diseases (INER), and the Medical Center ABC (American British Cowdray) from 1 January 2019 to 31 December 2020. The analysis included evaluation of epidemiological data, treatment regimens, and clinical outcomes, and emphasized pharmacological and non-pharmacological treatments, including detailed follow-up investigations, as part of comprehensive clinical management. Additionally, the study assessed the social burden through variables such as working-age absenteeism and presenteeism and caregiver productivity loss, as well as economic burden, considering both clinical and social components, with costs adjusted to 2022 Mexican pesos (MXN) values. RESULTS: A total of 188 patients with metastatic NSCLC were studied. The main type of NSCLC tumor found in the sample was adenocarcinoma (81%). Treatment regimens included pharmacological treatments (78%), non-pharmacological treatments (25%), and palliative care (24%). Complications were present in 73% of the cohort, while 60% presented adverse events. Clinical management costs of up to MXN1,001,579 per patient in the public sector and MXN2,140,604 in the private sector were reported. It was estimated that working-age patients lose 84-335 days yearly due to absenteeism and presenteeism, while caregivers report a productivity loss equivalent to 13-30 days due to the management of NSCLC patients. These indirect costs of NSCLC contribute to the social burden. A working-age patient with stage IV disease is associated with an average indirect cost of MXN49,731-178,287 in public institutions, while in private institutions, the cost elevates to MXN438,103. CONCLUSIONS: This study highlights the substantial clinical, economic, and social burdens of stage IV NSCLC in Mexico, revealing significant disparities between public and private healthcare sectors. It underscores the urgent need for standardized practices and equitable care across all systems.

This study examined the effects of advanced lung cancer (stage IV non-small cell lung cancer [NSCLC]) on patients in Mexico, focusing on the health, financial, and caregiver burdens. Researchers studied adults over 18 years of age undergoing cancer treatment at four medical centers across Mexico, analyzing treatment costs and time lost due to illness. All costs were updated to 2022 Mexican pesos (MXN) values. Treating one patient for 1 year can cost up to MXN 1 million in public hospitals and more than MXN 2 million in private hospitals. Patients might lose about 84­335 days of work annually, with caregivers losing 13­30 days. These lost workdays significantly impact finances, costing approximately MXN50,000­178,000 per patient per year in public hospitals and MXN438,000 in private hospitals. The study concludes that understanding these costs can help create better treatment plans, improving patient care and reducing financial burdens. By aligning treatment strategies across public and private healthcare settings, patients could benefit from more consistent and effective care, potentially leading to better health outcomes and reducing the overall impact of the disease on their lives and the broader healthcare system.

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Phytoremediation is a useful, low-cost, and environmentally friendly alternative for the rehabilitation of heavy-metal-contaminated (HM) soils. This technology takes advantage of the ability of certain plant species to accumulate HMs in their tissues. Crotalaria pumila is a herbaceous plant with a wide geographical distribution that grows naturally in environments polluted with HMs. In this work, the bioaccumulation capacity of roots and leaves in relation to five HMs (Cr, Cu, Fe, Pb, and Zn) was evaluated, as well as the morphological changes presented in C. pumila growing in control substrate (without HMs) and mine-tailing substrate (with HMs) under greenhouse conditions for 150 days. Four metals with the following concentration pattern were detected in both tissues and substrates: Fe > Pb > Cu > Zn. Fe, Pb, and Zn concentrations were significantly higher in the roots and leaves of individuals growing on mine-tailing substrate compared to the control substrate. In contrast, Cu concentration increased over time in the exposed individuals. The bioconcentration factor showed a similar pattern in root and leaf: Cu > Fe > Pb > Zn. Around 87.5% of the morphological characters evaluated in this species decreased significantly in individuals exposed to HMs. The bioconcentration factor shows that C. pumila is efficient at absorbing Cu, Fe, and Pb from the mine-tailing substrate, in the root and leaf tissue, and the translocation factor shows its efficiency in translocating Cu from the roots to the leaves. Therefore, C. pumila may be considered as a HM accumulator plant with potential for phytoremediation of polluted soils with Cu, Pb, and Fe, along with the ability to establish itself naturally in contaminated environments, without affecting its germination rates. Also, it exhibits wide geographical distribution, it has a short life cycle, exhibits rapid growth, and can retain the mine-tailing substrate, extracting HMs in a short time.

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Mining is a major economic activity in many developing countries. However, it disturbs the environment, producing enormous quantities of waste, known as mine tailings, which can have deleterious environmental impact, due to their high heavy metals (HM) content. Often, foundation species that establish on mine tailings are good candidates to study the effects of HM bioaccumulation at different levels of biological organization. Prosopis laevigata is considered a HM hyperaccumulator which presents attributes of a foundation species (FS) and establishes naturally on mine tailings. We evaluated the bioaccumulation of Cu, Pb, and Zn in P. laevigata foliar tissue, the leaf micro- and macro-morphological characters, DNA damage, and population genetic effects. In total, 80 P. laevigata individuals (20/site) belonging to four populations: The individuals from both sites (exposed and reference) bioaccumulated HMs (Pb > Cu > Zn). However, in the exposed individuals, Pb and Cu bioaccumulation was significantly higher. Also, a significant effect of macro- and micro-morphological characters was registered, showing significantly lower values in individuals from the exposed sites. In addition, we found significant differences in genotoxic damage in P. laevigata individuals, between the exposed and reference sites. In contrast, for the micro-morphological characters, none of the analyzed metals had any influence. P. laevigata did not show significant differences in the genetic structure and diversity between exposed and reference populations. However, four haplotypes and four private alleles were found in the exposed populations. Since P. laevigata is a species that establishes naturally in polluted sites and bioaccumulates HM in its foliar tissues, the resulting genetic, individual and population effects have not been severe enough to show detrimental effects; hence, P. laevigata can be a useful tool in phytoremediation strategies for soils polluted with Pb and Cu, maintaining its important ecological functions.

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Mexico is a major center of evolutionary radiation for the genus Quercus, with oak species occurring across different habitat types and showing a wide variation in morphology and growth form. Despite representing about 20% of Mexican species, scrub oaks have received little attention and even basic aspects of their taxonomy and geographic distribution remain unresolved. In this study, we analyzed the morphological and climatic niche differentiation of scrub oak populations forming a complex constituted by six named species, Quercus cordifolia, Quercus frutex, Quercus intricata, Quercus microphylla, Quercus repanda, Quercus striatula and a distinct morphotype of Q. striatula identified during field and herbarium work (hereafter named Q. striatula II). Samples were obtained from 35 sites covering the geographic distribution of the complex in northern and central Mexico. Morphological differentiation was analyzed through geometric morphometrics of leaf shape and quantification of trichome traits. Our results indicated the presence of two main morphological groups with geographic concordance. The first was formed by Q. frutex, Q. microphylla, Q. repanda and Q. striatula, distributed in the Trans-Mexican Volcanic Belt, the Sierra Madre Occidental and a little portion of the south of the Mexican Altiplano (MA). The second group consists of Q. cordifola, Q. intricata and Q. striatula II, found in the Sierra Madre Oriental and the MA. Therefore, our evidence supports the distinctness of the Q. striatula II morphotype, indicating the need for a taxonomic revision. Within the two groups, morphological differentiation among taxa varied from very clear to low or inexistent (i.e. Q. microphylla-Q. striatula and Q. cordifolia-Q. striatula II) but niche comparisons revealed significant niche differentiation in all pairwise comparisons, highlighting the relevance of integrative approaches for the taxonomic resolution of complicated groups such as the one studied here.

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Introduction: Income inequality is often tolerated and justified, but when it brings about disparities in other domains of life (e.g., health or education), it may be seen with different eyes. In this research, we aimed to explore concerns regarding economic inequality in health, education, and income, and its relationship to supporting collective actions to reduce inequality. Method: We used survey data (N = 20,204, 18 countries) from the Latinobarometer 2020. We conducted descriptive analyses, latent class analyses, and analyses of multilevel linear regression to test our hypothesis. Results: We found that people were more concerned about health access and education opportunities than income inequality. We also identified two classes of people: one class concerned about education and health and the other unconcerned about inequality in any domain. In addition, results showed that all concerns and class membership predicted greater support of collective actions to reduce inequality. Conclusions: These preliminary findings suggest that concerns about education and health disparities may serve to increase awareness of overall inequality and mobilise the public.

Introducción: La desigualdad de ingresos a menudo se tolera y justifica, pero cuando esta conlleva desigualdades en otros ámbitos de la vida (e.g., salud o educación), puede que se vea con ojos diferentes. En este artículo tratamos de explorar la preocupación por la desigualdad económica en salud, educación e ingresos, así como su relación con el apoyo a acciones colectivas para reducir la desigualdad. Método: Usamos datos secundarios (N = 20 204, 18 países) del Latinobarómetro 2020. Llevamos a cabo análisis descriptivos, análisis de clases latentes y análisis de regresión multinivel. Resultados: Encontramos que la gente estaba más preocupada por el acceso a la salud y las oportunidades en educación que por la desigualdad en el ingreso. También identificamos dos perfiles de personas: unas preocupadas por la educación y la salud, y otras poco preocupadas por la desigualdad en ninguno de los ámbitos. Además, los resultados mostraron que todas las preocupaciones y los distintos perfiles predecían un mayor apoyo a las acciones colectivas para reducir la desigualdad. Conclusiones: Estos hallazgos preliminares sugieren que la preocupación por las desigualdades en salud y educación podrían servir para aumentar la conciencia sobre la desigualdad general y movilizar al público.

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Heavy metal pollution is a worldwide environmental and human health problem. Prosopis laevigata is a hyperaccumulator legume that bioaccumulates Pb, Cu and Zn. With interest in designing phytoremediation strategies for sites contaminated with heavy metals, we isolated and characterized endophytic fungi from the roots of P. laevigata growing on mine tailings located in Morelos, Mexico. Ten endophytic isolates were selected by morphological discrimination and a preliminary minimum inhibitory concentration was determined for zinc, lead and copper. A novel strain of Aspergillus closest to Aspergillus luchuensis was determined to be a metallophile and presented a marked tolerance to high concentrations of Cu, Zn and Pb, so it was further investigated for removal of metals and promotion of plant growth under greenhouse conditions. The control substrate with fungi promoted larger size characters in P. laevigata individuals in comparison with the other treatments, demonstrating that A. luchuensis strain C7 is a growth-promoting agent for P. laevigata individuals. The fungus favors the translocation of metals from roots to leaves in P. laevigata, promoting an increased Cu translocation. This new A. luchuensis strain showed endophytic character and plant growth-promotion activity, high metal tolerance, and an ability to increase copper translocation. We propose it as a novel, effective and sustainable bioremediation strategy for copper-polluted soils.

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As a result of mining activities, waste of different types is generated. One example is mine tailings that contain potentially toxic elements such as heavy metals that negatively impact the environment and human health. Hence, developing treatments to guarantee its efficient elimination from the environment is necessary. Among these treatments, phytoremediation takes advantage of the potential of different plant species, to remove heavy metals from polluted sites. Gliricidia sepium is a tree that grows up to 15 m high and distributed from southern Mexico to Central America. This study evaluates the heavy metal bioaccumulation capacity in roots and leaves, and the effect of such bioaccumulation on fifteen macro- and one micro-morphological characters of G. sepium growing during 360 days in control, and in mine tailing substrates. G. sepium individuals growing on the exposed substrate registered the following average heavy metal bioaccumulation pattern in the roots: Fe > Pb > Zn > Cu, while in the leaf tissue, the bioaccumulation pattern was Cu > Fe > Pb > Zn. Macro- and micro-morphological characters evaluated in G. sepium decreased in plants exposed to metals. The translocation factor showed that Cu and Pb registered average values greater than 1. In conclusion, G. sepium is a species with potential for the phytoremediation of soils contaminated with Fe, Cu, and Pb, and for phytostabilizing soils polluted with Fe, Pb, Zn, and Cu, along with its ability to establish itself and turn into an abundant plant species in polluted sites, its capacity to bioaccumulate heavy metals in roots and leaves, and its high rate of HM translocation.

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Phytoremediation is a cost-effective technique to remediate heavy metal (HM) polluted sites. However, the toxic effects of HM can limit plant establishment and development, reducing phytoremediation effectiveness. Therefore, the addition of organic amendments to mine wastes, such as biochar, improves the establishment of plants and reduces the bioavailability of toxic HM and its subsequent absorption by plants. Prosopis laevigata can establish naturally in mine tailings and accumulate different HM; however, these individuals show morphological and genetic damage. In this study, the effect of biochar on HM bioaccumulation in roots and aerial tissues, HM translocation, morphological characters and plant growth were evaluated, after three and six months of exposure. Plants grown on mine tailings with biochar presented significantly higher values for most of the evaluated characters, in respect to plants that grew on mine tailing substrate. Biochar addition reduced the bioaccumulation and translocation of Cu, Pb, and Cd, while it favored the translocation of essential metals such as Fe and Mn. The addition of biochar from agro-industrial residues to mine tailings improves the establishment of plants with potential to phytoextract and phytostabilize metals from polluted soils. Using biochar and heavy metal accumulating plants constitutes an assisted phytostabilization strategy with great potential for HM polluted sites such as Cd and Pb.

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Mexico is considered one of the main regions of diversification of the genus Quercus (oaks). Oak species are one of the most important tree groups, particularly in temperate forests, due to its diversity and abundance. Some studies have shown that oak contains specialized metabolites with medicinal importance. In this work, the acetonic extract from leaves of three Mexican oaks (Quercus rugosa, Q. glabrescens, and Q. obtusata) was separated using thin-layer chromatography and column chromatography. Chemical identification of the major compounds was determined using high-performance liquid chromatography and nuclear magnetic resonance. Nineteen compounds were identified, three belonging to the terpenoid family (ursolic acid, ß-amyrin, and ß-sitosterol) and 16 from the phenolic family. Of the isolated compounds, seven are new reports for oak species (scopoletin, ursolic acid, ß-amyrin, luteolin-7-O-glucoside, kaempferol-3-O-sophoroside, kaempferol-3-O-glucoside, and kaempferol-3-O-sambubioside). More compounds were identified in Q. rugosa followed by Q. glabrescens and then Q. obtusata. The characterization of specialized metabolites in oak species is relevant, from both phytocentric and anthropocentric perspectives.

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Methyl parathion is an organophosphorus pesticide widely employed worldwide to control pests in agricultural and domestic environments. However, due to its intensive use, high toxicity, and environmental persistence, methyl parathion is recognized as an important ecosystem and human health threat, causing severe environmental pollution events and numerous human poisoning and deaths each year. Therefore, identifying and characterizing microorganisms capable of fully degrading methyl parathion and its degradation metabolites is a crucial environmental task for the bioremediation of pesticide-polluted sites. Burkholderia zhejiangensis CEIB S4-3 is a bacterial strain isolated from agricultural soils capable of immediately hydrolyzing methyl parathion at a concentration of 50 mg/L and degrading the 100% of the released p-nitrophenol in a 12-hour lapse when cultured in minimal salt medium. In this study, a comparative proteomic analysis was conducted in the presence and absence of methyl parathion to evaluate the biological mechanisms implicated in the methyl parathion biodegradation and resistance by the strain B. zhejiangensis CEIB S4-3. In each treatment, the changes in the protein expression patterns were evaluated at three sampling times, zero, three, and nine hours through the use of two-dimensional polyacrylamide gel electrophoresis (2D-PAGE), and the differentially expressed proteins were identified by mass spectrometry (MALDI-TOF). The proteomic analysis allowed the identification of 72 proteins with differential expression, 35 proteins in the absence of the pesticide, and 37 proteins in the experimental condition in the presence of methyl parathion. The identified proteins are involved in different metabolic processes such as the carbohydrate and amino acids metabolism, carbon metabolism and energy production, fatty acids ß-oxidation, and the aromatic compounds catabolism, including enzymes of the both p-nitrophenol degradation pathways (Hydroquinone dioxygenase and Hydroxyquinol 1,2 dioxygenase), as well as the overexpression of proteins implicated in cellular damage defense mechanisms such as the response and protection of the oxidative stress, reactive oxygen species defense, detoxification of xenobiotics, and DNA repair processes. According to these data, B. zhejiangensis CEIB S4-3 overexpress different proteins related to aromatic compounds catabolism and with the p-nitrophenol  degradation pathways, the higher expression levels observed in the two subunits of the enzyme Hydroquinone dioxygenase, suggest a preferential use of the Hydroquinone metabolic pathway in the p-nitrophenol degradation process. Moreover the overexpression of several proteins implicated in the oxidative stress response, xenobiotics detoxification, and DNA damage repair reveals the mechanisms employed by B. zhejiangensis CEIB S4-3 to counteract the adverse effects caused by the methyl parathion and p-nitrophenol exposure.

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Introduction: Multiple adverse effects have been described for the biological therapy in autoimmune diseases including many secondary to immunosuppression producing bacterial, fungal, or viral infections. Clinical case: We present the case of a 64-year-old female patient with proven disseminated cryptococcosis secondary to the use of tofacitinib. Other possible causes of immunosuppression such as the human immunodeficiency virus (HIV) were ruled out. The patient had been in treatment for rheumatoid arthritis diagnosed three years before. This drug is a biological agent that inhibits JAK enzymes. Very few cases of pulmonary and meningeal cryptococcosis in this type of patient have been described in the literature. Conclusion: This case report should be useful for other clinicians to bear in mind the possibility of this type of invasive fungal infection associated with biological therapy and to take a risk-management approach.

Introducción. Se han descrito múltiples efectos adversos con el uso de la terapia biológica para enfermedades autoinmunitarias, muchos de ellos secundarios al estado de inmunosupresión, como las infecciones bacterianas, fúngicas o virales. Caso clínico. Se presenta el caso de una mujer de 64 años con diagnóstico comprobado de criptococosis diseminada secundaria al uso de tofacitinib. Se descartaron otras causas de inmunosupresión, como infección por el virus de la inmunodeficiencia humana (HIV). Tres años antes se le había diagnosticado artritis reumatoide y se encontraba en tratamiento farmacológico con un agente biológico que inhibe las enzimas JAK. Se han descrito muy pocos casos de criptococosis pulmonar y meníngea en este tipo de pacientes. Conclusión. Este reporte de caso es útil para que otros médicos tratantes tengan presente la posibilidad de este tipo de infección fúngica invasora asociada con la terapia biológica y el enfoque de gestión de riesgo.

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Introducción. Se han descrito múltiples efectos adversos con el uso de la terapia biológica para enfermedades autoinmunitarias, muchos de ellos secundarios al estado de inmunosupresión, como las infecciones bacterianas, fúngicas o virales. Caso clínico. Se presenta el caso de una mujer de 64 años con diagnóstico comprobado de criptococosis diseminada secundaria al uso de tofacitinib. Se descartaron otras causas de inmunosupresión, como infección por el virus de la inmunodeficiencia humana (HIV). Tres años antes se le había diagnosticado artritis reumatoide y se encontraba en tratamiento farmacológico con un agente biológico que inhibe las enzimas JAK. Se han descrito muy pocos casos de criptococosis pulmonar y meníngea en este tipo de pacientes. Conclusión. Este reporte de caso es útil para que otros médicos tratantes tengan presente la posibilidad de este tipo de infección fúngica invasora asociada con la terapia biológica y el enfoque de gestión de riesgo.

Introduction: Multiple adverse effects have been described for the biological therapy in autoimmune diseases including many secondary to immunosuppression producing bacterial, fungal, or viral infections. Clinical case: We present the case of a 64-year-old female patient with proven disseminated cryptococcosis secondary to the use of tofacitinib. Other possible causes of immunosuppression such as the human immunodeficiency virus (HIV) were ruled out. The patient had been in treatment for rheumatoid arthritis diagnosed three years before. This drug is a biological agent that inhibits JAK enzymes. Very few cases of pulmonary and meningeal cryptococcosis in this type of patient have been described in the literature. Conclusion: This case report should be useful for other clinicians to bear in mind the possibility of this type of invasive fungal infection associated with biological therapy and to take a risk-management approach.

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Support for redistribution is crucial for reducing economic inequality. Despite people's desire for reducing extreme inequalities, they still have mixed opinions regarding how to do so. The aim of the article is to examine the underlying latent dimensions of support for redistribution and test its correlates to perceptions of and attitudes toward inequality. In two studies, we found that support for redistribution can be modeled as a latent construct depicting two different dimensions: one focused on taxing the wealthy and changing the income distribution schema, and other focused on assisting people in need and providing opportunities. We also found that the dimension related to taxing the wealthy (vs. assisting people in need) displayed higher internal reliability and correlated consistently with perceptions and attitudes toward inequality: the higher the support for taxing the wealthy, the higher the perceptions and concerns of inequality, and the lower the inequality-justifying ideologies. This research unveils distinct underlying dimensions of support for redistribution that shed light on different motivations that drive people's redistributive preferences.

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Intimate partner violence (IPV) affects thousands of women around the world and is prevalent in the Global South. Unequal social structures perpetuate hierarchies and maintain women's vulnerability to violence. Difficulties women face in accessing education, economic resources, and employment diminish their power in intimate relationships, increasing the likelihood of IPV. These factors can also have a significant effect on women's mental health. However, some studies show that economic empowerment does not necessarily translate into greater agency for women if they cannot use the resources they earn to pursue whatever goals or values they regard as important in life. Agency is women's ability to identify their life goals and act upon them through critical evaluation (intrinsic agency) and autonomous decision-making (instrumental agency). In this article, we aim to analyze the relationship between women's power (educational and economic) and agency and their influence on intimate partner violence and on women's mental health in the context of El Salvador. Currently, El Salvador has one of the highest percentages of femicide worldwide. We used data from the first national survey on violence against women in El Salvador to determine empowerment indicators and investigated their influence on intimate partner violence and women's mental health. Results from a representative sample of 1,274 women aged between 15 and 64 years old and, using a structural equation modeling revealed that education was a protective factor against IPV, but economic power appeared to put women at greater risk of IPV. Education was positively related to both intrinsic and instrumental agency, but only instrumental agency was negatively associated with the likelihood of being a victim of IPV. Finally, both intrinsic and instrumental agencies were positively related to women's mental health. We discuss the importance of identifying specific factors related to women's power and agency to prevent IPV and mental health problems and to promote more gender equity in the Global South.

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This article aims to examine the role of Belief in a Just World (BJW) in the legitimation of economic inequality. Using data from 27 European countries (N=47,086), we conducted multilevel analyses and found that BJW positively predicted the legitimation of economic inequality, measured by three indicators: the perceived fairness of the overall wealth inequality, and the fairness of the earnings made by the Top 10% and the Bottom 10% of society. These results persisted after controlling for individual- and country-level variables. Moreover, the BJW effect was stronger on the legitimation of the Bottom 10% incomes, compared to the legitimation of the Top 10%. We also found that economic inequality at the country-level reduced the BJW effect on legitimation of inequality. Finally, BJW displayed a negative indirect effect on support for redistribution, via the legitimation of economic inequalities.

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Glyphosate is a broad-spectrum herbicide extensively used worldwide to eliminate weeds in agricultural areas. Since its market introduction in the 70's, the levels of glyphosate agricultural use have increased, mainly due to the introduction of glyphosate-resistant transgenic crops in the 90's. Glyphosate presence in the environment causes pollution, and recent findings have proposed that glyphosate exposure causes adverse effects in different organisms, including humans. In 2015, glyphosate was classified as a probable carcinogen chemical, and several other human health effects have been documented since. Environmental pollution and human health threats derived from glyphosate intensive use require the development of alternatives for its elimination and proper treatment. Bioremediation has been proposed as a suitable alternative for the treatment of glyphosate-related pollution, and several microorganisms have great potential for the biodegradation of this herbicide. The present review highlights the environmental and human health impacts related to glyphosate pollution, the proposed alternatives for its elimination through physicochemical and biological approaches, and recent studies related to glyphosate biodegradation by bacteria and fungi are also reviewed. Microbial remediation strategies have great potential for glyphosate elimination, however, additional studies are needed to characterize the mechanisms employed by the microorganisms to counteract the adverse effects generated by the glyphosate exposure.

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Nitrates in drinking water has been associated to adverse health effects, including changes in glucose and lipid levels, thyroid hormone imbalance and adverse reproductive effects. We analyzed metabolic and thyroid hormone alterations and genotoxic damage in women with chronic exposure to nitrates in drinking water. The concentration of nitrates in drinking water was quantified and according to this parameter, participants were divided into three exposure scenarios. Blood and urine samples were collected from 420 women living in Durango, Mexico and biomarkers were determined. We found nitrates concentrations in drinking water above the permissible limit (>50 mg/L), and an increase in the percentage of methemoglobin (p=0.0001), nitrite in blood plasma and urine (p=0.0001), glucose (p=0.0001), total cholesterol (p=0.001), LDL (p=0.001) and triglycerides (p=0.0001). We also found alterations in TSH (p=0.01), fT3 (p=0.0003), T4T (p=0.01) and fT4 (p=0.0004) hormones. Frequency of subclinical hypothyroidism was 8.33%; differences in FOXE1 (rs965513, rs1867277) genotypes distribution were found and both polymorphisms were associated with a decrease in TSH. A high percentage of micronucleus in binucleate lymphocyte cells was found (35%, p=0.0001). In conclusion, the chronic exposure to nitrates in water for human consumption caused metabolic and hormonal alterations and genotoxic damage in women.

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Nitrates are natural compounds present in soil and water; however, the intense use of fertilizers has increased their presence in groundwater with deleterious effects on human health. There is evidence of nitrates acting as endocrine disruptors; however, the underlying molecular mechanisms have not been fully described. Here, we investigated the effect of subchronic exposure to different concentrations of sodium nitrate in female Wistar rats, evaluating thyroid hormonal parameters, such as Nis transporter (Na+ /I- symporter, Slc5a5) and Tsh-R receptor protein expression, as well as transcription of the Tpo (thyroperoxidase), Tg (tiroglobulin), Duox2 (dual oxidase 2), Pds (pendrin), and Mct8 (Mct8 transporter, Slc16a2) genes. Hematological and histochemical changes in the liver and thyroid were also explored. Significant differences were found in platelet and leukocyte counts; although a significant increase in the weight of the thyroid gland was observed, no differences were found in the levels of the hormones Tsh, T3, and T4, but a modulation of the mRNA expression of the Tg, Tpo, Duox2, Mct8, and Pds genes was observed. Morphological changes were also found in liver and thyroid tissue according to the exposure doses. In conclusion, subchronic exposure to sodium nitrate induces leukocytosis consistent with an inflammatory response and upregulation of Sod2 in the liver and increases the expression of genes involved in the synthesis of thyroid hormones, keeping thyroid hormone levels stable. Histological changes in the thyroid gland suggest a goitrogenic effect.

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Wild animals that inhabit inside mine tailings which contain heavy metals are an excellent study model to conduct ecotoxicological studies that analyze chronic metal exposures at low doses (realistic exposures). This study was conducted in Huautla, Morelos, Mexico, in a mining district where 780,000 tons of wastes were deposited in open air. Liomys irroratus is a small mammal species that lives inside these mine tailings. A multibiomarker approach study was performed to analyze metal bioaccumulation levels (biomarker of exposure) by inductively coupled plasma mass spectrometry, DNA damage levels (biomarker of early effects) through the alkaline comet assay, and population genetic structure and diversity (biomarker of permanent effects), using seven microsatellite loci, in 75 L. irroratus individuals, from two mine tailings and one reference site. Concentrations of aluminum, copper, iron, nickel, lead, and zinc were statistically higher in the liver of exposed individuals. Significant DNA damage levels were registered in the mine tailings groups. Aluminum, lead, and nickel had the highest contribution to the genetic damage levels observed, while aluminum and nickel had the highest contribution to genetic diversity effects. A positive and significant relationship was detected between individual genetic diversity (internal relatedness) and genetic damage (DNA single-strand breaks). Genetic structure of L. irroratus populations revealed that the main source of genetic variation was located within populations. We consider that multibiomarker studies in environmental settings using sentinel species are valuable for environmental risk assessment and ecological responses in chronic exposed populations.

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Resumen Introducción: Los microorganismos capaces de producir carbapenemasas vienen incrementándose a nivel mundial y se han convertido en un problema de salud pública global. En Colombia actualmente la resistencia a carbapenémicos en las unidades de cuidado intensivo está aumentando y se desconoce su impacto en desenlaces clínicos. Objetivos: Determinar las características demográficas, clínicas, y los desenlaces de los pacientes adultos en estado crítico con infección por microorganismos productores de carbapenemasas en una unidad de cuidado intensivo polivalente de una institución de alta complejidad. Métodos: Estudio observacional, descriptivo y retrospectivo, incluyendo pacientes con infección por bacterias resistentes a carbapenémicos, ingresados a la unidad de cuidado intensivo entre el 1 de Enero de 2014 y el 1 de Enero de 2018. Se excluyeron los pacientes colonizados. Se evaluaron complicaciones clínicas, estancia en UCI y hospitalaria, así como la mortalidad en UCI y hospitalaria. Resultados: Se incluyó 58 pacientes. La mortalidad global fue de 67,2%, de los cuales 55,17% murió durante su estancia en la unidad de cuidado intensivo y 12.06% en hospitalización. La mediana de estancia en la unidad de cuidado intensivo fue de 18 días (RIQ 4-28). La causa más frecuente de mortalidad fue choque séptico en 51% y las complicaciones más comunes fueron lesión renal aguda y delirium en un 55,2% y 43,1%, respectivamente. La mediana de estancia en la UCI fue de 18 días (RIQ 4-28). Conclusiones: Las infecciones por bacterias resistentes a carbapenémicos en pacientes críticamente enfermos se relacionan con altas tasas de mortalidad, complicaciones y estancia prolongada en UCI

Abstract Introduction: Microorganisms able to produce carbapenemases are spreading worldwide and have become a concerning global public-health problem. In Colombia, the Gram-negative resistance to carbapenems at intensive care units is currently increasing and its impact on clinical outcomes is not well known. Objectives: To determine the demographic, clinical characteristics and outcomes of critically ill adult patients with infection by carbapenemase producing bacteria in a polyvalent intensive care unit of a highly complex institution. Methods: Single-center retrospective, descriptive observational study including critically ill adult patients infected by carbapenemase-producing bacteria and transferred to a polyvalent intensive care unit from January 1th 2014 to January 1th 2018. Known colonized patients were excluded. Clinical complications, ICU and in-hospital days of stay were evaluated, as ICU and in-hospital mortality. Results: A total of 58 patients were included. Overall mortality was 67.2%, of which 55.17% died during their stay in the intensive care unit and 12.06% in hospitalization. The median stay in the intensive care unit was 18 days (IQR 4-28). The most frequent cause of death was septic shock in 51% and the most common complications were acute renal injury and delirium in 55.2% and 43.1%, respectively. The median stay in the ICU was 18 days (RIQ 4-28). Conclusions: Infections caused by carbapenem-resistant bacteria in critically ill patients are associated with high mortality rates, complications and long stay in ICU.

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