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Microplastic (MP) environmental contamination has been widely studied in Mexico. However, the evaluation of the associated risk to MPs in environmental compartments is scarce. Therefore, this study addresses this issue using diverse indicators such as the Pollution Load Index (PLI), the Polymer Risk Index (PRI), and the Potential Ecological Risk Index (PERI). The results of a meta-analysis revealed high MP contamination levels in most of the studied compartments, which included marine and estuarine waters, beach sand, freshwater, sediments, and biota. Regarding the risk assessment indicators, PLIs indicated low (56%), dangerous (22%), moderate (12%), and high (10%) levels across compartments. Meanwhile, PRIs displayed concerning values, with 36%, 35%, 20%, and 9% exhibiting dangerous, high, moderate, and low levels, respectively. Thus, high PRI values emphasized the significant rise in MP pollution, largely attributed to high-hazard polymer compositions. Otherwise, PERIs showed low (56%), very dangerous (29%), moderate (6%), high (5%), and dangerous (4%) levels. Thus, the ecological risk in Mexico is widespread and mainly linked to MP abundance, polymer type, environmental matrix, and characteristics of organisms. This study represents the first attempt at MP ecological risk assessment in Mexico, providing crucial insights for developing mitigation strategies to address concerns about MP contamination.

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Metal pollution is a significant environmental and health problem in aquatic ecosystems worldwide, particularly in coastal systems impacted by emissions from thermoelectric plants, as is the case of the Tampamachoco lagoon. To evaluate the seasonal contamination levels of Cd, Pb, Cr, and Cu in species of commercial interest in the Tampamachoco lagoon and estimate the health risk associated with their consumption, a total of 180 fish, 90 oysters (Crassostrea virginica), 27 crabs (Callinectes sapidus), and 24 shrimp (Litopenaeus setiferus) were sampled. Metal concentrations in the species analyzed were Cu > Pb > Cr > Cd. According to the Target Hazard Quotient and the health risk index, consumption of the marine species examined should be considered safe for human health, as both values are <1. However, Carcinogenic risk values for Pb and Cr indicated that consumers may be at risk of cancer (10-3), due to exposure from the thermoelectric emissions.

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OBJECTIVES: The prognostic value of hematological markers has not been extensively explored in the geriatric population, particularly in the presence of the frailty phenotype among hospitalized individuals. Therefore, our study aimed to assess the influence of the frailty phenotype in hospitalized geriatric individuals on hematological markers and their impact on short- and long-term outcomes. METHODS: This is a secondary analysis of a prospective cohort study. This study involved hospitalized individuals who were followed during their hospitalization and for nearly 2 years after discharge. At baseline, Fried's frailty phenotype was assessed, as well as hematological markers, including neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, neutrophil-monocyte ratio, platelet-lymphocyte ratio, systemic inflammation index, prognostic nutritional index, geriatric nutritional risk index (GNRI), and C-reactive protein-albumin ratio. The phase angle derived from bioelectrical impedance analysis was likewise considered a prognostic biomarker. Our main outcomes were hospital length of stay and mortality during follow-up. RESULTS: Frailty occurred in 43.2% of the population. Individuals with the frailty phenotype exhibited worse hematological markers and lower phase angle values. Low GNRI and elevated C-reactive protein-albumin ratio values were independently associated with mortality (hazard ratio = 6.88, 95% confidence interval 2.0-23.6; hazard ratio = 2.2, 95% confidence interval 1.1-4.4). Only higher values of the systemic inflammation index were independently associated with prolonged hospital stays. CONCLUSION: Hematological markers may serve as a feasible tool for prognostic assessment. Individuals with the frailty phenotype and low GNRI represented a worst-case scenario. Geriatr Gerontol Int 2024; 24: 312-318.

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The Araguaia River floodplain is an important biogeographic boundary between the two largest South American biomes: the Cerrado (Brazilian Savanna) and the Amazon rainforest. The large-scale degradation due to land use conversion experienced in the Araguaia River watershed represents a potential source of mercury (Hg) transport to aquatic ecosystems. However, more information is needed about the dynamics of Hg distribution in savanna floodplains, including the Araguaia River floodplain. We analyzed total mercury (THg) concentrations in the bottom sediments of 30 lakes connected to the Araguaia River and four tributaries, aiming to evaluate the environment's integrity based on the geoaccumulation index (Igeo) and the ecological risk index (ERI). The principal component analysis was applied to examine associations between Hg concentrations, environmental conditions, and land use intensity among lakes associated with different river systems. We used indicator cokriging to identify areas with a greater probability of Hg pollution and ecological risk associated with land use intensity. The land use data showed the predominance of areas used for pasture in the Araguaia River basin. THg concentrations in the sediments varied between 22.6 and 81.9 ng g-1 (mean: 46.5 ± 17.7 ng g-1). Sediments showed no significant pollution (Igeo: 1.35 - 0.50; Classes 1 and 2) and low to considerable ecological risks (ERI: 23.5-85.1; Classes 1 to 3). THg in bottom sediments was associated with land use, water turbidity and electrical conductivity, and sediment organic matter. The indicator cokriging indicates a moderate to strong spatial dependence between land use intensity and Hg, confirming the contribution of anthropic sources to the increment of ecological risk but also the influence of extrinsic factors (such as environmental conditions, geology, and hydrology). Integrating sediment assessment and land use indices with geostatistical methods proved a valuable tool for identifying priority areas for Hg accumulation at a regional scale.

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Dyslipidemia is a risk factor for cardiovascular disease and mortality; however, the association of this variable with a wide range of personal and psychological variables has not been researched. Therefore, the aim of this study was to compare lipid levels and anthropometric measures between sexes and to determine the association between personal and psychological variables with the atherogenic risk index (ARI). An adult population which auto-reported as healthy was invited to participate via social media and in person. They filled out a questionnaire with personal and psychological variables; in addition, the body mass index (BMI) and waist-to-hip ratio (WHR) were measured, and a blood sample was obtained to determine serum lipids. A total of 172 participants were included, from which 92 (53.49%) were women; both sexes were comparable in age and most sociodemographic values. Men showed significantly higher levels of total cholesterol, LDL cholesterol, triglycerides, ARI, and lower levels of HDL cholesterol. The men also showed higher values of WHR than the women. In the bivariate analysis, ARI showed the highest correlation with WHR (r = 0.664) in the men and with BMI (r = 0.619) in the women. In the multivariate analysis, the quality of food intake was negatively correlated with ARI in the global and women's samples, and the psychological variables of assertiveness and positive relations with others were negatively correlated with ARI in women, while purpose in life was negatively correlated with ARI in men. In conclusion, the higher levels of serum lipids and ARI in men can be explained by the higher values of WHR in this sex. Behavioral and psychological variables could be protective factors for high ARI.

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OBJECTIVE: To verify the frequency of risk factors for hearing loss in newborns and their possible associations with universal neonatal hearing screening results before and during the COVID-19 pandemic. METHODS: Historical cohort study with data analysis of newborns attended in a reference hearing health service of the Unified Health System (SUS) between January 2017 and December 2021. RESULTS: Those born in 2020 and 2021 were 91% less likely to fail the screening than those born in 2017, 2018, and 2019; therefore, they had a lower percentage of referrals for a retest. There was a decrease in congenital syphilis (1.00%), decrease in HIV (0.95%), and an increase in toxoplasmosis (0.58%) and increase in rubella cases in 2021 in relation to 2017. Syphilis had lower frequency rates during the COVID-19 pandemic (2020-2021). CONCLUSION: Newborns born in the pandemic year compared to those born pre-pandemic showed a reduction in the presence of two risk indicators for hearing loss and, consequently, a lower chance of failing the UNHS and a lower percentage of referral for retest.

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Petrogenic hydrocarbon spills (PHS) are harmful to mangrove ecosystems along tropical coastlines in the short and long term. The aim of this study was to assess the environmental risk of recurrent PHS on mangrove ecosystems in Tumaco municipality, Colombian Pacific. Mangrove characteristics and management aspects led to subdividing the study area into 11 units-of-analysis (UAs) for which threats, vulnerability, potential impacts, and risks were assessed based on environmental factors and the formulation and use of indicators in a rating scale with five categories, which are very low, low, moderate, high, and very high. The results showed that all UAs are highly (64%; 15,525 ha) or moderately (36%; 4,464 ha) threatened by PHS, highly (45%; 13,478 ha) or moderately (55%; 6,511 ha) vulnerable to this kind of pollution, and susceptible to high (73%; 17,075 ha) or moderate (27%; 2,914 ha) potential impacts. The environmental risk was high in 73% (17,075 ha) of the UAs, indicating likely irreversible damage to mangrove ecosystems by PHS, thus pointing to the need of urgent intervention by responsible authorities to ease their recovery and conservation. The methodology and results of this study become technical inputs that serve for environmental control and monitoring, which can be incorporated into contingency and risk management plans.

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Abstract Background Health has dynamic conditions and overlapping pathophysiological factors. For health prevention and promotion, actions are necessary to understand the most common risk combinations. Objective Describe noncommunicable chronic diseases (NCDs) clusters and investigate specific multimorbidity combinations in Brazilian adults and older adults. Method This study used data from Vigitel 2013 survey held in the Brazilian capitals (52,929 interviews). A self-report of diabetes, dyslipidemia, hypertension, and obesity was used. The analyses were the descriptive cluster of NCDs and an adjusted binary logistic regression (odds ratio [OR]), stratified by age. Results Among adults, the clusters of diabetes, dyslipidemia, hypertension, and obesity (O/E = 18.74) and diabetes, hypertension, and obesity (O/E = 16.83) were higher. There was a higher clustering between diabetes and obesity (O/E = 7.25). Among adults, diabetes was associated with dyslipidemia (OR: 3.04), hypertension (OR: 3.84), and hypertension with obesity (OR: 3.34). In older adults, hypertension was associated with diabetes (OR: 2.79), dyslipidemia (OR: 2.06), and obesity (OR: 2.26). Conclusion Other diseases combined with diabetes and hypertension were more frequent in adults and older adults. It is suggested to combine preventive and control measures for these diseases for the non-occurrence of new diagnoses.

Resumo Introdução A saúde apresenta condições dinâmicas e fatores fisiopatológicos sobrepostos. Para ações de prevenção e promoção da saúde é necessário entender as combinações comuns de risco. Objetivo Descrever os agrupamentos de doenças crônicas não transmissíveis (DCNT) e investigar combinações específicas de multimorbidade em adultos e idosos no Brasil. Método Este estudo utilizou dados da pesquisa Vigitel 2013, realizada nas capitais brasileiras (total de 52.929 entrevistas). Foi utilizado um relato de diabetes, dislipidemia, hipertensão e obesidade. Nas análises foram utilizados o agrupamento descritivo de DCNT e uma regressão logística binária ajustada (razão de odds [RO]), estratificada por idade. Resultados Entre os adultos, os grupos de diabetes, dislipidemia, hipertensão e obesidade (O / E = 18,74), bem como diabetes, hipertensão e obesidade (O / E = 16,83) foram maiores. Nos idosos, houve maior agrupamento entre diabetes e obesidade (O / E = 7,25). Entre os adultos, o diabetes foi associado à dislipidemia (RO: 3,04) e hipertensão (RO: 3,84), enquanto a hipertensão à obesidade (RO: 3,34). Nos idosos, a hipertensão foi associada a diabetes (RO: 2,79), dislipidemia (RO: 2,06) e obesidade (RO: 2,26). Conclusão Os agrupamentos de outras doenças combinadas com diabetes e hipertensão foram mais frequentes em adultos e idosos. Sugere-se que além das medidas existentes de prevenção para essas doenças também sejam propostas medidas de controle para a não ocorrência de novos diagnósticos.

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There is a need to revise the framework used to project species risks under climate change (CC) and land-use/cover change (LUCC) scenarios. We built a CC risk index using the latest Intergovernmental Panel on Climate Change framework, where risk is a function of vulnerability (sensitivity and adaptive capacity), exposure, and hazard. We incorporated future LUCC scenarios as part of the exposure component. We combined a trait-based approach based on biological characteristics of species with a correlative approach based on ecological niche modeling, assigning risk scores to species, taxonomic (orders), and functional (trophic, body size, and locomotion) groups of terrestrial mammals occurring in Mexico. We identified 15 species projected to lose their climatic suitability. Of the 11 taxonomic orders, Eulipotyphla, Didelphimorphia, Artiodactyla, and Lagomorpha had the highest risk scores. Of the 19 trophic groups, piscivores, insectivores under canopy, frugivores-granivores, herbivores browser, and myrmecophagous had the highest risk scores. Of the five body-sized groups, large-sized species (>15 kg) had highest risk scores. Of the seven locomotion groups, arboreal and semi-aquatics had highest risk scores. CC and LUCC scenarios reduced suitable areas of species potential distributions by 37.5% (with CC), and 51% (with CC and LUCC) under a limited full-dispersal assumption. Reductions in suitable areas of species potential distributions increased to 50.2% (with CC), and 52.4% (with CC and LUCC) under a non-dispersal assumption. Species-rich areas (>75% species) projected 36% (with CC) and 57% (with CC and LUCC) reductions in suitability for 2070. Shifts in climatic suitability projections of species-rich areas increased in number of species in northeast and southeast Mexico and decreased in northwest and southern Mexico, suggesting important species turnover. High-risk projections under future CC and LUCC scenarios for species, taxonomic, and functional group diversities, and species-rich areas of terrestrial mammals highlight trends in different impacts on biodiversity and ecosystem function.

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The Sepetiba Bay (SB; SE Brazil) has been severely affected by growing of urbanization and industrial activity. This work aims to analyze the evolution of contamination by metals of sediments in SB. The results show a marked increasing trend in the concentrations of potentially toxic elements (PTEs), which is consistent with the rapid populational and industrial growth, mostly since 1970 CE. The remobilization and redistribution of sediments by currents have contributed to the dispersion of metals from the main source of pollutants to relatively distant regions. "Moderately to strongly polluted" sediments are also recorded in some sites in deeper sedimentary layers (namely in preindustrial periods), probably due to lithologic sources of the sediments. The concentrations of PTEs in SB are relatively high when compared with those found globally and in other Brazilian water bodies. Samples of high-resolution sediment cores confirmed that potential ecological risk to the coastal system is influenced not only through human actions but also by natural causes.

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Baseline data on concentration, fractionation, pollution level and ecological risk index for seventeen beach sediments from Santa Rosalia mining region of Baja California Sur, Mexico were assessed. Higher concentrations of Rare Earth Elements (REEs) (mean. 341.49 µg/g) indicated that it is higher than most of the mining regions around the world. Normalization pattern showed enrichment of Eu (>4) and calculated geochemical indices revealed that light and middle REEs are moderately polluted with most of the sampling points located closer to the river discharge. Potential Ecological Risk Index (PERI) showed that Eu (20.2), Tb (20.88), and Lu (28.57) pose moderate ecological risk to the soil at selected stations (10, 11, 15 and 16) with a risk index value ranging from 245 to 359. Pearson's correlation matrix suggested that all REEs are highly correlated (r2 0.95) with each other having similar geochemical characteristics and indicating identical source due to continuous mining activity.

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As infecções congênitas estão relacionadas à mortalidade fetal e neonatal e fazem parte dos Indicadores de Risco para a Deficiência Auditiva previstos na Triagem Auditiva Neonatal. O estudo objetiva descrever a proporção de infecções congênitas no Programa de Triagem Auditiva Neonatal do Hospital Público Municipal de Macaé, Rio de Janeiro. Realizou-se um estudo retrospectivo, descritivo, de base secundária, a partir dos registros de neonatos obtidos no setor de Fonoaudiologia, entre 2016 e 2017. No biênio, detectaram-se 114 neonatos com infecções congênitas, 36,0% (n=41) em 2016, e 64,0% (n=73) em 2017. Destes, 46,3% e 46,6% apresentavam sífilis congênita; 29,3% e 24,7% o vírus da imunodeficiência humana; 17,1% e 15,1% toxoplasmose, em 2016 e 2017, respectivamente. O aumento de infecção por citomegalovírus no período passou de 2016 (2,4%) para 2017 (8,2%). Conclui-se que as infecções congênitas de maior proporção foram a sífilis congênita, o vírus da imunodeficiência humana e a toxoplasmose. (AU)

Congenital infections are related to fetal and neonatal mortality and are part of the Risk Indicators for Hearing Impairment provided for in the Neonatal Hearing Screening. This study aims to describe the proportion of congenital infections in the Neonatal Hearing Screening Program of the Municipal Public Hospital Public in Macaé, Rio de Janeiro. A retrospective, descriptive, secondary-based study was carried out from the records of newborns obtained in the Speech Therapy sector, between 2016 and 2017. In the biennium, 114 cases of congenital infections in neonates were detected, 36.0% (n=41) in 2016, and 64.0% (n=73) in 2017. Of these, 46.3% and 46.6% had congenital syphilis; 29.3% and 24.7% the human immunodeficiency virus; 17.1% and 15.1% toxoplasmosis, in 2016 and 2017, respectively. The increase in cytomegalovirus infection in the period went from 2016 (2.4%) to 2017 (8.2%). It is concluded that thehighest proportion of congenital infections were syphilis, human immunodeficiency virus and toxoplasmosis. (AU)

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Resumo Fundamento: Para pacientes com infarto do miocárdio com elevação do segmento ST (IAMCST) que sofrem de obstrução coronariana microvascular funcional e estrutural (OCM) subsequente, nenhuma abordagem terapêutica específica e definitiva de atenuação foi comprovada como válida em testes de larga escala atuais, o que destaca a necessidade de abordar seu reconhecimento precoce. Objetivos: Este estudo teve como objetivo comparar o desempenho de dois escores de risco clínico com uma medida objetiva de OCM durante intervenção coronária percutânea (ICP) em casos de IAMCST Métodos: A medição do índice de resistência microcirculatória (IRM) foi realizada e os parâmetros clínicos e angiográficos basais também foram registrados. Os pacientes foram divididos em entre os grupos OM (obstrução microvascular) e NOM (não-obstrução microvascular), de acordo com o valor de IRM pós-procedimento. O risco de OCM foi avaliado para todos os participantes pelos escores preditivos SAK e ATI, respectivamente. Cada sistema foi calculado somando-se as pontuações de todas as variáveis. As curvas de características do operador receptor (ROC) e a área sob a curva (AUC) de dois modelos de risco foram utilizadas para avaliar o desempenho discriminatório. Um ecocardiograma foi realizado sete dias após o procedimento para avaliar a fração de ejeção do ventrículo esquerdo (FEVE). Um valor P bicaudal de <0,05 foi considerado estatisticamente significativo. Resultados: Entre os 65 pacientes elegíveis com IAMCST, 48 foram alocados no grupo NOM e 17 no grupo OM, com uma incidência de OCM de 26,15%. Não houve diferença significativa na AUC entre os dois escores. A FEVE avaliada para o grupo NOM foi maior do que para o grupo OM. Conclusão: Os escores SAK e ATI tiveram bom desempenho para estimar o risco de OCM após ICP primário para pacientes com IAMCST.

Abstract Background: For patients with ST-segment elevation myocardial infarction (STEMI) that are suffering from subsequent coronary microvascular functional and structural obstruction (CMVO), no specific and definitive therapeutic approaches of attenuation have been proven valid in up-to-date large-scale tests, which highlights the urge to address its early recognition. Objectives: This study aimed to compare the performance of two clinical risk scores with an objective measurement of CMVO during percutaneous coronary intervention (PCI) with STEMI. Methods: The Index of Microcirculatory Resistance (IMR) measurement was conducted and the baseline clinical and angiographic parameters were also recorded. The patients were divided into MO (Microvascular obstruction) or NMO (Non-microvascular obstruction) groups according to the post-procedure IMR value. The CMVO risk was evaluated for all participants by SAK and ATI predictive scores, respectively. Each system was calculated by summing the scores of all variables. The receiver operator characteristic (ROC) curves and the area under the curve (AUC) of two risk models were used to evaluate the discriminatory performance. An echocardiography was performed seven days after the procedure to evaluate left ventricular ejection fraction (LVEF). A two-sided P-value of <0.05 was considered statistically significant. Results: Among the 65 eligible STEMI patients, 48 patients were allocated in the NMO group and 17 in the MO group, with a CMVO incidence of 26.15%. There was no significant difference in the AUC between both scores. The LVEF evaluated for the NMO group was higher than that of MO group. Conclusion: Both SAK and ATI scores performed well in estimating CMVO risk after primary PCI for STEMI patients.

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The derelict Remance gold mine is a possible source of pollution with potentially toxic elements (PTEs). In the study area, diverse mine waste has been left behind and exposed to weather conditions, and poses risks for soil, plants and water bodies, and also for the health of local inhabitants. This study sought to perform an ecological and health risk assessment of derelict gold mining areas with incomplete remediation, including: (i) characterizing the geochemical distribution of PTEs; (ii) assessing ecological risk by estimating the pollution load index (PLI) and potential ecological risk index (RI); (iii) assessing soil health by dehydrogenase activity; and iv) establishing non-carcinogenic (HI) and carcinogenic risks (CR) for local inhabitants. Soil health seems to depend on not only PTE concentrations, but also on organic matter (OM). Both indexes (PLI and RI) ranged from high to extreme near mining and waste accumulation sites. As indicated by both the HI and CR results, the mining area poses a health risk for local inhabitants and particularly for children. For this reason, it will be necessary to set up environmental management programs in the areas that are most affected (tailings and surrounding areas) and accordingly establish the best remediation strategies to minimize risks for the local population.

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RESUMEN Introducción: Existen varias escalas a nivel mundial en la predicción de riesgo de los pacientes con infarto, pero aún no se ha encontrado la "escala ideal". Objetivos: Determinar la capacidad de discriminación para la mortalidad hospitalaria por infarto agudo de miocardio de las escalas GRACE, TIMI Risk Score, InTIME e ICR. Método: Se realizó un estudio prospectivo en el Servicio de Cardiología del Hospital General Docente Dr. Ernesto Guevara de la Serna de Las Tunas, Cuba, entre 2018 y 2019. El universo estuvo conformado por 452 pacientes ingresados en las primeras 24 horas del infarto y la muestra, por 430 casos a los cuales se les pudo recoger la totalidad de las variables en estudio. Se utilizó la estadística descriptiva. Para determinar la capacidad de discriminación de la escalas de riesgo se determinaron sensibilidad, especificidad y área bajo la curva. Resultados: El 70% de los pacientes fallecidos eran del sexo masculino y su media de edad fue 10 años mayor que en los egresados vivos. La hipertensión arterial fue el factor asociado más frecuente tanto en los pacientes fallecidos (90%) como en los egresados vivos (73.4%). El 70% de los fallecidos presentaron algún grado de disfunción sistólica del ventrículo izquierdo. El área bajo la curva de las escalas ICR, InTIME y GRACE fue de 0,683; 0,681 y 0,662, respectivamente. El TIMI Risk Score presentó un área bajo la curva de 0,598. Conclusiones: Las escalas ICR, InTime y GRACE presentaron pobre capacidad predictiva para la mortalidad hospitalaria. La escala TIMI Risk Score presentó una fallida capacidad predictiva.

ABSTRACT Introduction: There are several scores worldwide for risk stratification in patients with myocardial infarction, but the "ideal score" has not yet been found. Objectives: To determine the discriminatory capacity of GRACE, TIMI Risk Score, InTIME and ICR scores for in-hospital mortality due to acute myocardial infarction. Method: A prospective study was carried out in the Department of Cardiology of the Hospital General Docente Dr. Ernesto Guevara de la Serna of Las Tunas, Cuba, between 2018 and 2019. The study's population consisted of 452 patients admitted in the first 24 hours after myocardial infarction, and the sample consisted of 430 cases from which all the variables under study could be collected. Descriptive statistics were used. Sensitivity, specificity and area under the curve were determined to be able to determine the discriminatory capacity of the risk scores as well. Results: The 70% of the deceased patients were male and their mean age was 10 years older than in the patients discharged alive. High blood pressure was the most frequent associated risk factor in both deceased patients (90%) and in those who left the hospital alive (73.4%). The 70% of deaths had certain degree of left ventricular systolic dysfunction. The area under the curve of ICR, InTIME and GRACE scores was of 0.683; 0.681 and 0.662 respectively. TIMI Risk Score had an area under the curve of 0.598. Conclusions: ICR, InTime and GRACE scores had poor predictive capacity for in-hospital mortality. TIMI Risk Score had a very poor predictive capacity.

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BACKGROUND: The Health Sentinel (Centinela de la Salud, CDS), a mobile crowdsourcing platform that includes the CDS app, was deployed to assess its utility as a tool for COVID-19 surveillance in San Luis Potosí, Mexico. METHODS: The CDS app allowed anonymized individual surveys of demographic features and COVID-19 risk of transmission and exacerbation factors from users of the San Luis Potosí Metropolitan Area (SLPMA). The platform's data processing pipeline computed and geolocalized the risk index of each user and enabled the analysis of the variables and their association. Point process analysis identified geographic clustering patterns of users at risk and these were compared with the patterns of COVID-19 cases confirmed by the State Health Services. RESULTS: A total of 1554 COVID-19 surveys were administered through the CDS app. Among the respondents, 50.4 % were men and 49.6 % women, with an average age of 33.5 years. Overall risk index frequencies were, in descending order: no-risk 77.8 %, low risk 10.6 %, respiratory symptoms 6.7 %, medium risk 1.4 %, high risk 2.0 %, very high risk 1.5 %. Comorbidity was the most frequent vulnerability category (32.4 %), followed by the inability to keep home lockdown (19.2 %). Statistically significant risk clusters identified at a spatial scale between 5 and 730 m coincided with those in neighborhoods containing substantial numbers of confirmed COVID-19 cases. CONCLUSIONS: The CDS platform enables the analysis of the sociodemographic features and spatial distribution of individual risk indexes of COVID-19 transmission and exacerbation. It is a useful epidemiological surveillance and early detection tool because it identifies statistically significant and consistent risk clusters in neighborhoods with a substantial number of confirmed COVID-19 cases.

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Introdução: A triagem auditiva neonatal universal (TANU) é realizada por meio do exame de potencial evocado auditivo de tronco encefálico (PEATE), na população com indicador de risco para deficiência auditiva. A resposta auditiva de estado estável (RAEE) é uma técnica objetiva e automática de determinação dos limiares auditivos por frequência específica, porém ainda pouco explorada antes da alta hospitalar. Objetivo: analisar os resultados obtidos no exame de PEATE e RAEE em lactentes com indicadores de risco para deficiência auditiva, antes da alta hospitalar, com e sem falha na TANU. Métodos: Estudo observacional analítico prospectivo feito em lactentes com risco para a deficiência auditiva e que realizaram o PEATE e a RAEE na mesma sessão. Resultados: Atenderam ao critério de inclusão 66 lactentes, de ambos os gêneros, idade mediana de 1,2 meses, idade gestacional média de 31 semanas, peso médio ao nascimento 1601 g. Tiveram PEATE normal, 53 (80%) lactentes, denominados de G1 e 13 (20%) tiveram PEATE alterado, denominados de G2. Os limiares eletrofisiológicos da RAEE foram estatisticamente menores nos lactentes de G1. Conclusão: Houve relação entre os achados dos exames de PEATE e RAEE em lactentes de risco para deficiência auditiva, quando realizado antes da alta hospitalar. A mediana dos limiares eletrofisiológicos da RAEE foi menor para os lactentes que tiveram PEATE normal e maior para aqueles que tiveram PEATE alterado na TANU.

Introduction: Universal neonatal hearing screening (UNHS) is performed by examining brainstem auditory evoked potential (BAEP), in the population with a risk indicator for hearing loss. The auditory steady-state response (ASSR) is an objective and automatic technique for determining hearing thresholds by specific frequency, but still little explored before hospital discharge. Objective: to analyze the results obtained in the BAEP and RAEE tests in infants with risk indicators for hearing loss, before hospital discharge, with and without failure in UNHS. Methods: Prospective analytical observational study carried out in infants at risk for hearing loss and who underwent BAEP and ASSR in the same session. Results: 66 infants attempted the inclusion criteria, of both genders, the median age was 1.2 months, the mean gestational age was 31 weeks and the mean weight at birth was 1601 g. 53 (80%) infants, called G1, had normal BAEP, and 13 (20%) had abnormal BAEP, called G2. The electrophysiological thresholds of ASSR were statistically lower in infants of G1. Conclusion: There was a relationship between the findings of the BAEP and ASSR exams in infants at risk for hearing loss, when performed before hospital discharge. The median of the ASSR electrophysiological thresholds was lower for the infants who had normal BAEP and higher for those who had abnormal BAEP in the UNHSque tenían un PEATC normal y mayor para aquellos que tenían un PEATC alterado en CANU.

Introducción: El cribado auditivo neonatal universal (CANU) se realiza examinando el potencial evocado auditivo del tronco cerebral (PEAC), en la población con un indicador de riesgo de hipoacusia. La respuesta auditiva en estado estable (RAEE) es una técnica objetiva y automática para determinar los umbrales de audición por frecuencia específica, pero aún poco explorada antes del alta hospitalaria. Objetivo: analizar los resultados obtenidos en la exploración de PEAC y RAEE en lactantes con indicadores de riesgo de hipoacusia, antes del alta hospitalaria, con y sin fallo en CANU. Metodos: Estudio observacional analítico prospectivo realizado en lactantes con riesgo de hipoacusia a los que se les realizó PEATC y RAEE en una misma sesión. Resultados: Los criterios de inclusión cumplieron con 66 lactantes, de ambos sexos, edad media de 1,2 meses, edad gestacional media de 31 semanas, peso medio al nacer 1601 g. Tenían un PEATC normal, 53 (80%) lactantes, llamados G1 y 13 (20%) tenían un PEATC anormal, llamado G2. Los umbrales electrofisiológicos de RAEE fueron estadísticamente más bajos en lactantes del G1. Conclusión: Hubo una relación entre los hallazgos de los exámenes PEATC y RAEE en lactantes con riesgo de hipoacusia, cuando se realizaron antes del alta hospitalaria. La mediana de los umbrales electrofisiológicos de RAEE fue menor para los lactantes.

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Tympanoplasty performed in childhood has been controversial over the years because there is no clarity in determining what prognostic factors lead to surgical success. The objective of this study was to evaluate the effect of the Middle Ear Risk Index (MERI) score on the success of pediatric tympanoplasty. A retrospective case-control study was performed at a tertiary pediatric referral center. A database was created with surgical and clinical records of pediatric patients (<18 years of age) with tympanic membrane perforation, assessed and surgically managed by the same surgical team from January 2012 through March 2018. Mild MERI before tympanoplasty was found to be a protective factor against surgical failure, with an odds ratio of 0.24 (p: 0.002). The odds ratio for severe MERI in unsuccessful tympanoplasty was 5.87, with a p: 0.003, standing out as a risk factor for surgical failure. Presurgical MERI in children may be a useful tool to determine if patients are candidates for tympanoplasty, more aggressive interventions, or if medical treatment before tympanoplasty is necessary to improve prognosis. When facing a high MERI score, parents and family should be advised before surgery about the possibility of tympanoplasty failure.

Assuntos

RESUMO

The safety of food is a matter of global concern today. Continuous monitoring of canned tuna and canned sardines quality is essential regarding metal, nonmetal, and metalloid content. In this article, we present the data on the elemental content obtained in canned tuna and canned sardines by using inductively coupled plasma optical spectrometry (ICP OES), as well as the data on Pollution Index (PI) and Health Risk Index (HRI). Pollution index and health risk index are tools used to assess elemental contamination in the environment and food. A total of 6 metals (Al, Ba, Ca, Cu, Fe, and Zn), one nonmetal (Se), and one metalloid (As) were quantified in the samples of the canned tuna and canned sardines. For elements as Al, Cu, Fe, and Se, PI > 1. In addition, Cd, Co, Cr, Ni, Zn, and Pb have PI values less than 1. The HRI values for some canned tuna samples were above 1 for elements such as Al, Ba, Ca, and As. For canned sardines, the elements Cr, Ni, and As showed HRI values >1.

RESUMO

BACKGROUND: Metabolic syndrome (MetS) is a cluster of conditions that increases the risk of cardiovascular disease (CVD) and is related to genetic background, dietary habits, and lifestyle. Anthropometric indices and lipid parameters have been shown to be simple and useful tools in clinical practice for predicting MetS. The aim of the present study was to evaluate the differential magnitudes of anthropometric characteristics (waist circumference and body mass index [BMI]) and lipid parameters, namely, lipid accumulation product (LAP), cardiometabolic index (CMI), and Castelli Risk Index (CRI-I), to estimate MetS, usingappropriate cut-off values, among adults from a public hospital in Yucatan, Mexico. METHODS: A cross-sectional study among 250 adults (77 men, 173 women) was carried out in the Regional High Speciality Hospital of the Yucatan Peninsula (HRAEPY) in Merida, Yucatan. MetS was diagnosed using standard criteria (central obesity, arterial hypertension, hyperglycemia, and dyslipidemia), and derived parameters (LAP, CMI, and CRI-I) were calculated. Binary logistic regression analysis-based receiver operating characteristics (ROC) curves were used to predict MetS. RESULTS: Of the 250 participants, 48% had MetS. High prevalences of overweight (35.2%) and obesity (48.8%) were found in the sample. The CMI and LAP were found to be the best parameters in the prediction of MetS in men and women. The optimal cut-off values of the parameters were higher in men and decreased with advancing age. CONCLUSION: The CMI and LAP were shown to be the most effective indicators to diagnose MetS among adults from Yucatan, Mexico.