Resumen Introducción : La región selar es un sitio infrecuente de metástasis, encontrándose en el 1% de las cirugías hipofisarias. Los tumores primarios más habituales son mama y pulmón. En general son diagnosticadas en pa cientes con enfermedad avanzada, aunque pueden ser el debut de la enfermedad oncológica. Métodos : Análisis retrospectivo de las características clínicas, bioquímicas, radiológicas de pacientes con me tástasis selares o hipofisarias (MS) durante el periodo 2009-2020. Resultados : Se reportaron 18 casos de pacientes, 11 de ellos con confirmación histológica. La mediana de edad fue 53 años (rango: 35-75), 53% hombres. La loca lización del tumor primario fue: 8 pulmón, 6 mama, 1 carcinoma folicular de tiroides, 1 linfoma Hodgkin y 2 carcinomas renales de células claras. La media de tiem po entre el diagnóstico del tumor primario y la aparición de la MS -en los casos de presentación metacrónica- fue 108 meses (rango: 11-180). En 8 pacientes (44.4%), el diagnóstico de la neoplasia primaria se hizo a partir del hallazgo de la masa selar. Diabetes insípida, hipopitui tarismo, trastornos visuales, oftalmoplejía y cefalea se presentaron en el 78, 77, 61, 39 y 39%, respectivamente. Quince pacientes presentaron masas con extensión su pra/paraselar; y 3 lesión limitada a la hipófisis y tallo. Fueron operados 11/18 por vía transesfenoidal, para diagnóstico y/o descompresión. Fallecieron 17, con una mediana de sobrevida de 6 meses (1- 36). Discusión : La sospecha de MS debe estar presente ante una masa selar y supraselar con captación difusa del gadolinio, diabetes insípida, hipopituitarismo y/o disfunción visual, aun en pacientes sin antecedentes oncológicos.

Abstract Introduction : Sellar metastases (SM) are rare mani festations of malignancy. Breast and lung cancer are the most common primary tumors. Most cases are di agnosed in patients with advanced malignant disease; however, symptoms of pituitary involvement can pre cede the diagnosis of the primary tumor. Methods : Retrospective analysis of symptoms at presentation, hormonal, radiological and histological findings, management, and outcome of patients with SM from 2009 to 2020. Results : Eighteen patients´cases were included, 11 with histological confirmation. Median (m) age was 53 years (range 35-75), 53% male. Primary malignant tu mors: 8 lungs, 6 breast, 1 follicular thyroid carcinoma, 1 Hodgkin lymphoma, and 2 clear cell renal carcinomas. The m time between the diagnosis of the primary neo plasm and the occurrence of the SM was 108 months (range: 11-180). In 8 patients the diagnosis of the primary neoplasm was made after the finding of the symptom atic sellar mass. Insipidus diabetes, adenohypophysis deficit, visual disorders, headache, and cranial nerve deficits were evident in 78, 77, 61, 39 and 39% of the cases, respectively. Fifteen patients harbored supra / parasellar masses, in three a lesion was limited to the pituitary gland, and stalk. Eleven out of 18 (61.1%) of the patients were operated on by the trans-sphenoidal approach, for diagnostic and / or decompressive pur poses. Eighteen died, with a median survival time of 6 months (1-36). Discussion : In the presence of a pituitary lesion with diffuse gadolinium uptake, associated with insipidus diabetes and / or visual disorder SM should be suspected even in patients without a history of oncological disease.

Abstract Objective: To evaluate the response of Cenchrus clandestinus (Hochst. ex Chiov.) Morrone to fertilization by nutrient extraction rate, residual height and defoliation timing in the Colombian high tropics. Materials and Methods: Two residual heights (6 and 12 cm) and four fertilization doses were evaluated in plots that were cut with four, five or six live leaves. Agronomic response was evaluated during one year and chemical composition during the months of highest and lowest rainfall. The information was analyzed using a spatially and temporally divided-plot design with three replications. Results: The growth of C. clandestinus was superior when harvested with five leaves and 6-cm residual height in the dry season, and six leaves and 6 cm residual height or five leaves and 12 cm residual height in the rainy season. The nutritional quality of C. clandestinus was higher when it was harvested with greater residual height or when doses of 648 kg N/ha and 114 kg P/ha were used. In addition, it was higher when the plant showed four live leaves in the dry season, but similar in the rainy season. Conclusion: The moment to obtain the maximum growth rate of C. clandestinus depends on the time and residual height of harvest. In addition, higher efficiency is achieved in this forage when edaphic fertilization is applied during the rainy season.

Resumen Objetivo : Evaluar la respuesta de Cenchrus clandestinus (Hochst. ex Chiov.) Morrone a la fertilización mediante la tasa de extracción de nutrientes, la altura residual y el momento de defoliación en el trópico alto colombiano. Materiales y Métodos: Se evaluaron dos alturas residuales (6 y 12 cm) y cuatro dosis de fertilización en parcelas que se cortaron con cuatro, cinco o seis hojas vivas. La respuesta agronómica se evaluó durante un año y la composición química durante los meses de mayor y menor precipitación. La información se analizó mediante un diseño de parcelas divididas en el espacio y el tiempo, con tres repeticiones. Resultados: El crecimiento de C. clandestinus fue superior cuando se cosechó con cinco hojas y altura residual de 6 cm, en la época seca, y seis hojas y 6 cm de altura residual o cinco hojas y 12 cm de altura residual, en la época de lluvias. La calidad nutricional de C. clandestinus fue mayor cuando se cosechó con mayor altura residual o se utilizó dosis de 648 kg de N/ha y 114 kg de P/ha. Además, fue superior cuando la planta presentó cuatro hojas vivas en la época seca, pero similar en la época de lluvias. Conclusión: El momento para obtener la máxima tasa de crecimiento de C. clandestinus depende de la época y la altura residual de la cosecha. Además, se logra mayor eficiencia en este forraje cuando la fertilización edáfica se aplica durante la época de lluvia.

Abstract Germ cell transplantation in fish is a promising technique for surrogate broodstock parents with broader application in aquaculture and conserving endangered and valuable genetic resources. Herein, we describe the establishment of an intrapapillary xenogeneic transplant of germ cells from sexually mature goldfish (C. auratus) males into common carp (C. carpio) males cytoablated with a thermochemical treatment (two doses of busulfan at 40 mg/kg at 35°C). To analyze the presence and development of donor germ cells in recipient testes, donor germ cells were labeled with PKH26, a fluorescent cell membrane dye, before transplantation. Our results demonstrated that thermochemical treatment caused effective spermatogenesis suppression and pronounced germ cell loss. Moreover, transplanted spermatogonial cells were able to colonize the recipients’ testes, resume spermatogenesis, and generate spermatozoa within eight weeks after germ cell transplantation. These findings suggested that recipient testes provided suitable conditions for the survival, colonization, proliferation, and differentiation of donor spermatogonia from a related species. This study indicated that recipients’ testes exhibited a high degree of plasticity to accept and support xenogeneic donor germ cells, which were able to form sperm in a short time frame. This approach has significant implications for assisted animal reproduction, biotechnology, conservation, and the production of valuable genetic resources and endangered fish species. Herein C. C (C auratus carpio two 4 mgkg mg kg 35°C. 35C 35°C . 35 35°C) PKH26 PKH dye loss Moreover recipients survival colonization proliferation species frame reproduction biotechnology conservation 3 PKH2

Resumo O campo da neuromodulação evoluiu significativamente na última década. Esse progresso inclui novas indicações e inovações de hardware, software e técnicas de estimulação, levando a uma expansão das áreas clínicas cobertas e no papel dessas técnicas como intervenções terapêuticas eficazes. Nesta revisão, que é a segunda parte de um esforço para documentar e integrar os fundamentos básicos e os desenvolvimentos recentes e bem-sucedidos no campo, vamos nos concentrar em paradigmas clássicos para colocação de eletrodos, bem como em novos alvos exploratórios, mecanismos de neuromodulação usados por esta técnica e novos desenvolvimentos, incluindo procedimentos ablativos orientados por ultrassom focalizado. década hardware estimulação eficazes revisão bemsucedidos sucedidos eletrodos exploratórios focalizado

Abstract The field of neuromodulation has evolved significantly over the past decade. Developments include novel indications and innovations of hardware, software, and stimulation techniques leading to an expansion in scope and role of these techniques as powerful therapeutic interventions. In this review, which is the second part of an effort to document and integrate the basic fundamentals and recent successful developments in the field, we will focus on classic paradigms for electrode placement as well as new exploratory targets, mechanisms of neuromodulation using this technique and new developments, including focused ultrasound driven ablative procedures. decade hardware software interventions review targets procedures

Resumo Nas últimas três décadas, a estimulação cerebral profunda (ECP) se tornou um tratamento bem estabelecido para doença de Parkinson (DP) e outros transtornos do movimento. A eficácia a longo prazo na DP foi bem documentada para a melhora dos sintomas motores cardinais da DP e das complicações induzidas pelo uso do levodopa, como as flutuações motoras e as discinesias. O momento da seleção do paciente é crucial para se obter os benefícios ideais da ECP, antes que as complicações da DP se tornem irreversíveis. O objetivo desta primeira parte da revisão é examinar os conceitos fundamentais da ECP na prática clínica, discutindo os aspectos históricos, a seleção de pacientes, os potenciais efeitos da ECP nos sintomas motores e não motores da doença e o manejo prático dos pacientes após a cirurgia. décadas (ECP (DP movimento levodopa discinesias irreversíveis clínica históricos cirurgia

Abstract Deep brain stimulation (DBS) is recognized as an established therapy for Parkinson's disease (PD) and other movement disorders in the light of the developments seen over the past three decades. Long-term efficacy is established for PD with documented improvement in the cardinal motor symptoms of PD and levodopa-induced complications, such as motor fluctuations and dyskinesias. Timing of patient selection is crucial to obtain optimal benefits from DBS therapy, before PD complications become irreversible. The objective of this first part review is to examine the fundamental concepts of DBS for PD in clinical practice, discussing the historical aspects, patient selection, potential effects of DBS on motor and non-motor symptoms, and the practical management of patients after surgery. (DBS Parkinsons Parkinson s (PD decades Longterm Long term levodopainduced levodopa induced dyskinesias irreversible practice aspects nonmotor non surgery

The graphene oxide (GO)-silver nanoparticles (AgNPs) hybrid material (GO-AgNPs) has garnered significant interest due to its ability to combine the unique properties of GO and AgNPs, showing promise applications in biomedicine, nanocomposites, biosensors, and antimicrobial materials. However, further investigation is needed to understand the nanobio-interactions and toxicity of GO-AgNPs nanohybrid. Assessing the toxicity of GO-AgNPs on red blood cells (hemolysis) and its interactions with blood biomolecules (biocorona formation) is mandatory for biomedical applications and safety evaluation of this material. In this work, we investigate the biocorona formation associated with GO-AgNPs after interaction with human plasma and hemolysate biomolecules linked to its hemolytic effects. Both GO and GO-AgNPs exhibited a dose-dependent hemolytic effect, with GO-AgNPs showing three times greater hemolysis than GO. Nonetheless, biocorona formation fully mitigated the hemolytic effect of both materials, however, morphological damages in red blood cells may occur yet. Our findings show that biocorona formation dramatically changes the surface chemistry, colloidal behavior and toxicity of this hybrid material. Finally, this work contributes to understanding how graphene-silver nanoparticles interact with blood components to design strategies to minimize toxicity risks and enhance their applications in biomedicine and nanobiotechnology. GOsilver silver AgNPs (AgNPs GOAgNPs (GO-AgNPs nanocomposites biosensors materials However nanobiointeractions nanobio nanohybrid (hemolysis effects dosedependent dose dependent Nonetheless however yet chemistry Finally graphenesilver nanobiotechnology

Abstract Background Alcohol, a widely abused drug, significantly diminishes life quality, causing chronic diseases and psychiatric issues, with severe health, societal, and economic repercussions. Previously, we demonstrated that non-voluntary alcohol consumption increases the opening of Cx43 hemichannels and Panx1 channels in astrocytes from adolescent rats. However, whether ethanol directly affects astroglial hemichannels and, if so, how this impacts the function and survival of astrocytes remains to be elucidated. Results Clinically relevant concentrations of ethanol boost the opening of Cx43 hemichannels and Panx1 channels in mouse cortical astrocytes, resulting in the release of ATP and glutamate. The activation of these large-pore channels is dependent on Toll-like receptor 4, P2X7 receptors, IL-1β and TNF-α signaling, p38 mitogen-activated protein kinase, and inducible nitric oxide (NO) synthase. Notably, the ethanol-induced opening of Cx43 hemichannels and Panx1 channels leads to alterations in cytokine secretion, NO production, gliotransmitter release, and astrocyte reactivity, ultimately impacting survival. Conclusion Our study reveals a new mechanism by which ethanol impairs astrocyte function, involving the sequential stimulation of inflammatory pathways that further increase the opening of Cx43 hemichannels and Panx1 channels. We hypothesize that targeting astroglial hemichannels could be a promising pharmacological approach to preserve astrocyte function and synaptic plasticity during the progression of various alcohol use disorders.

Resumen La hipofisitis es una afección con baja incidencia y prevalencia. Asimismo, las infecciones profundas por hongos en pacientes inmunocompetentes también re presentan un fenómeno infrecuente. Más raro aún es el caso que se describe a continuación, en donde se conjugan estos dos elementos mencionados, a saber: cryptococcoma hipofisario o hipofisitis granulomatosa causado por dicho patógeno en un huésped sin altera ción de la respuesta inmune. Luego de una búsqueda realizada en PubMed, existen limitados casos en la literatura médica de hipofisitis granulomatosa por Cryptococcus spp., que simuló por manifestaciones clínicas e imagenológicas un macro adenoma hipofisario. No encontramos informes en los que no haya evidencia de afectación del tejido meníngeo. La etiología micótica está escasamente descrita en las guías de referencia para hipofisitis y creemos que Cryp tococcus spp. debe ser tenido en cuenta en el diagnóstico diferencial de las hipofisitis granulomatosas secundarias dado que es un patógeno ubicuo y el tratamiento es sustancialmente diferente a otras entidades. Cobra mayor relevancia ante la tendencia actual al uso de glucocorticoides sistémicos a altas dosis para el tratamiento de la hipofisitis, que podría haber gene rado mayor daño de no haberse hecho el diagnóstico correcto.

Abstract Hypophysitis is a pathology with low incidence and prevalence. Likewise, deep fungal infections in immuno competent patients also represent a rare phenomenon. Even rarer is the case described below, where these two mentioned elements are combined, namely: pituitary cryptococcoma or granulomatous hypophysitis caused by said pathogen in a host without altered immune response. After research in PubMed, there are limited cases in the medical literature of granulomatous hypophysitis caused by Cryptococcus spp., which simulated a pituitary macroadenoma by clinical and imaging manifestations. We did not find reports in which there is no evidence of involvement of the meningeal tissue. The fungal etiology is scarcely described in the reference guidelines for hypophysitis and we believe that Cryptococcus spp. it should be taken into account in the differential diagnosis of secondary granuloma tous hypophysitis since it is a ubiquitous pathogen and the treatment is substantially different from other entities. It becomes more relevant given the current trend towards the use of high-dose systemic glucocorticoids for the treatment of hypophysitis, which could have generated greater damage if the correct diagnosis had not been made.

Resumen Introducción. En el manejo integrado de enfermedades es importante incorporar elementos como umbrales de daño económico, monitoreo y sistemas de pronóstico de riesgo, los cuales constituyen herramientas para definir estrategias de control de las mismas. Objetivo. Desarrollar un modelo predictivo de la severidad del tizón foliar por Cercospora (TFC), mediante variables meteorológicas para el norte de la provincia de Buenos Aires, Argentina. Materiales y métodos. Se contó con datos de incidencia y severidad del TFC correspondientes a cinco ciclos productivos de soja (2013-2017) en Pergamino, Buenos Aires, relevados en distintos estados reproductivos R1 a R7. La variable dependiente fue la probabilidad de ocurrencia de niveles categorizados de la tasa de incremento (TI) de la severidad del TFC causado por C. kikuchii. Se registró diariamente la temperatura máxima y mínima, la precipitación y la humedad relativa. Se calculó el coeficiente de correlación no paramétrico de Kendall Tau-b entre los niveles categorizados binariamente de TI de la severidad del TFC y las variables meteorológicas. Resultados. Las variables meteorológicas con mayor correlación en relación a la TI del TFC fueron aquellas relacionadas con la humedad relativa (Días con humedad relativa (HR)>76 % (DHR), días con temperatura máxima (Tmax) <28 °C temperatura mínima (Tmin) >15 °C y HR >76 % (DHRT), días con Tmax <28 °C, Tmin >15 °C, lluvias >0,5 mm y HR >75 %(MOJro)). La inclusión de una variable térmica (en los días donde Tmax <28 °C GDTmax: Σtemperatura máxima-28 ºC) resultó importante para el ajuste del modelo predictivo. Conclusión. Se pudo desarrollar un modelo de predicción de la severidad del TFC que incluyó dos variables meteorológicas, una relacionada con los días de humedad relativa y otra térmica relacionada con un límite de temperatura máxima para el desarrollo de la enfermedad. Para validar y robustecer el modelo propuesto es necesario contar con más datos de severidad a través de los años.

Abstract Introduction. In the integrated management of diseases, it is important to incorporate elements such as economic damage thresholds, monitoring, and risk forecasting systems, which constitute tools to define d control strategies. Objective. To develop a predictive model of the severity of Cercospora leaf blight (TFC) using meteorological variables in the northern region of Buenos Aires Province, Argentina. Materials and methods. Data on the incidence and severity of TFC corresponding to five soybean production cycles (2013-2017) in Pergamino, Buenos Aires, at different reproductive stages (R1 to R7) were available. The dependent variable was the probability of occurrences of categorized levels of the rate of increase (TI) in TFC severity caused by C. kikuchii. Daily maximum and minimum temperature, precipitation, and relative humidity were recorded. The non-parametric Kendall Tau-b correlation coefficient was calculated between the binary categorized levels of TI in TFC severity and meteorological variables. Results. Meteorological variables with the highest correlation in relation to TFC TI were those related to relative humidity (Days with relative humidity (HR) >76 % (DHR), days with maximum temperature (Tmax) <28 °C, minimum temperature (Tmin) >15 °C, and HR >76 % (DHRT), days with Tmax <28 °C, Tmin >15 °C, rainfall >0.5 mm, and HR >75 %(MOJro)). The inclusion of a thermal variable (on days where Tmax <28 °C, GDTmax: ∑maximum temperature-28 °C) was important for the adjustment of the predictive model. Conclusion. A predictive model for TFC severity was developed, which included two meteorological variables, one related to days of relative humidity and another thermal related to a maximum temperature threshold for disease development. To validate and strengthen the proposed model, it is necessary to have more severity data over the years.

Abstract The possibility of application for lignin, a byproduct of paper and pulp production, as a partial replacement for cement in producing mortars and concretes is presented. Initially, mortars were prepared with substitution rates ranging from 0.0% to 50.0% to determine the best rates for subsequent application in concretes. Statistical analysis showed that the rates with the highest potential for application in concretes were 2.5%, 5.0%, and 10.0%. After preparing the concretes, test specimens were molded and subjected to axial compression, splitting tensile strength, water absorption by immersion, void ratio, and capillary water absorption tests after the curing period. The results showed that lignin, in rates higher than 5.0%, led to decreased mechanical strength; however, all concretes with lignin significantly reduced capillary water absorption, which can lead to greater material durability. production presented Initially 00 0 0.0 500 50 50.0 25 2 5 2.5% 5.0% 100 10 10.0% compression strength immersion ratio period however durability 0. 50. 2.5 5.0 1 10.0 2. 5. 10.

Abstract: The Schinus weinmanniifolia (Molle'i) is a plants used in infusion of leaves to treat tonsillitis, sore throats, cough and inflammation of gum. We try to establish a relationship between the secondary metabolites present and their biological activities, the qualitative Phytochemical Screening of the crude extract, Total Phenolic compounds, Total Flavonoids as well as Antioxidant Activity, Hemolytic Activity and LD50 in Drosophila melanogaster was determined. The results revealed the presence of hydrolysable Tannins, saponins and sterols. In the bioassays, high Antioxidant Activity (IC = 39.9%), and an antimicrobial activity of the ethanolic crude extract were observed against strains of E. coli, S. typhimurium, E. faecalis, P. aeruginosa, C. albicans. An LD50 of 15.3 mg.mL-1 was established in Drosophyla melanogaster and also a hemolytic activity of IC of 179 μg.mL-1 with an activity of 55.9%. These values represented a first contribution in order to determine scientifically their biological activity and correlate with the content of molecules.

Resumen: El Schinus weinmanniifolia (Molle’i) es una de las plantas empleadas en forma de infusión de las hojas para tratar amigdalitis, dolores de garganta, tos e inflamaciones de la encía. Para tratar de establecer una relación entre los metabolitos secundarios presentes y sus actividades biológicas se determinó el Perfil Fitoquímico Cualitativo del extracto crudo, Compuestos fenólicos totales, Flavonoides Totales así como Actividad Antioxidante, Actividad Hemolítica y DL50 en Drosophila melanogaster. Los resultados revelaron la presencia de Taninos hidrolizables, saponinas y esteroles. En los bioensayos se observó elevada Actividad de Antioxidantes (IC=39,9%) y una actividad antimicrobiana del extracto bruto etanólico frente a cepas de E. coli, S. typhimurium, E. faecalis, P. aeruginosa, C. albicans. Se estableció una DL50 de 15,3 mg.mL en Drosophyla melanogaster y además una actividad hemolítica de IC50 de 179 µg.mL con una actividad del 55,9 %. Estos valores representaron un primer aporte a fin de determinar científicamente su actividad biológica y correlacionar con el contenido de moléculas.

Resumen Se caracterizaron especies de Candida recuperadas de la cavidad bucal de pacientes oncológicos en una institución prestadora de salud de Barranquilla, Colombia. La investigación tuvo un diseño de corte transversal, mediante un muestreo a conveniencia se seleccionaron 60 pacientes oncológicos con candidiasis oral. Las muestras obtenidas se cultivaron en agar Sabouraud cloranfenicol, CHROMagar® Candida y agar Sabouraud dextrosa. Los microorganismos aislados se identificaron y se estableció el perfil de sensibilidad a los antifúngicos. Se aplicó estadística descriptiva, prueba de X 2 y análisis bivariado utilizando el programa Statgraphics Centurión XVII, con razón de momios (OR) para probabilidad de ocurrencia. Se identificaron un total de 107 cepas de Candida correspondientes a 15 especies, distribuidas del siguiente modo: C. albicans 23%, C. glabrata 18%, C. tropicalis 13%, C. krusei 10%, C. intermedia y C. lipolytica con 1,5%. En 77% de los casos estuvieron implicadas especies diferentes de C. albicans. Se identificó la existencia de relación entre cáncer del sistema reproductor y C. guilliermondii (p = 0,0001, < 0,05; OR 17) y entre C. colliculosa y cánceres respiratorios (p = 0,0003 < 0,05; OR 19,5). El 99% de las especies de Candida identificadas fueron sensibles a los antifúngicos: fluconazol, voriconazol, caspofungina y micafungina. Solo una cepa de C. krusei fue resistente. Se concluye que existió diversidad de especies de Candida en la cavidad bucal de pacientes oncológicos, ya sea como colonizantes únicos o en combinación, de modo que más de una especie de Candida podría ser responsable de la infección micótica en la cavidad bucal de estos enfermos.

Abstract Candida spp. was characterized in the oral cavity of cancer patients in a health care center in Barranquilla, Colombia. This is a cross-sectional investigation including 60 oncological patients with oral candidiasis, selected by convenience sampling, from whom samples were subjected to culture in Sabouraud chloramphenicol agar, CHROMagar® Candida and Sabouraud dextrose agar were taken. The antifungal susceptibility profile was then identified and established. Descriptive statistics, Chi square test, and bivariate analysis were conducted using the Statgraphics Centurion XVII software with odds ratio (OR) for the probability of occurrence. A total of 107 Candida strains were identified belonging to 15 species, C. albicans with 23%, C. glabrata with 18%, C. tropicalis 13%, C. krusei 10%, C intermedia, and C. lipolytica with 1.5%. Species other than C. albicans were identified in 77% of the cases. A relationship between reproductive system cancer and C. guilliermondii was identified (p = 0.0001, <0.05) OR: 17.0. Between C. colliculosa and respiratory cancer (p = 0.0003, <0.05) OR 19.5. With regard to antifungal susceptibility, 99% of the identified Candida species were susceptible to the following antifungals: fluconazole, voriconazole, caspofungin, and micafungin. Only one strain of C. krusei was resistant. It is concluded that there was a diversity of Candida species, either single or mixed in cancer patients, which could determine that only one species is not responsible for fungal infection in the oral cavity.

Resumen Clostridioides difficile es un anaerobio esporulado que se asocia con episodios de diarreas hospitalarias. Su virulencia se encuentra vinculada, principalmente, a las toxinas TcdA y TcdB, codificadas por sus respectivos genes, tcdA y tcdB, que son parte de un locus de patogenicidad (PaLoc). Nuestro objetivo fue caracterizar los toxinotipos de C. difficile circulantes en un hospital público. Los genes tcdA y tcdB fueron amplificados y digeridos con diferentes enzimas de restricción: EcoRI para tcdA; HincII y AccI para tcdB. Además, se evaluó la presencia de cdtB (gen de la toxina binaria B) y de las toxinas A y B (por dot blot), así como el efecto citotóxico de sobrenadantes de cultivo sobre células Vero. En conjunto, estos estudios revelaron tres toxinotipos circulantes según la clasificación de Rupnik: 0, I y VIII; el más prevalente fue el último. Aunque son necesarios más estudios (ej., secuenciación), es interesante notar que la presencia del toxinotipo I podría estar relacionada con la introducción de bacterias de diferente origen geográfico. En los pacientes infectados con el toxinotipo VIII, el análisis multivariante de los resultados de laboratorio mostró que los aislamientos asociados a decesos (GCD13, GCD14 y GCD22) estaban situados en regiones de los biplots relacionados con valores de laboratorio alterados al momento de la internación. En los otros pacientes, aunque no se observó correlación entre los valores de laboratorio al momento de la internación y la evolución clínica, los niveles de urea, creatinina y recuento de glóbulos blancos estuvieron correlacionados positivamente entre sí una vez diagnosticada la infección. Nuestro estudio revela la circulación de diferentes toxinotipos de C. difficile en un mismo hospital público. La variedad de toxinotipos puede originarse a partir de microorganismos preexistentes en la región, así como también por la introducción de bacterias provenientes de otras regiones geográficas. La existencia de microorganismos con diferente potencial patogénico es relevante para el control, el seguimiento y el tratamiento de las infecciones.

Abstract Clostridioides difficile is a spore-forming anaerobe microorganism associated to nosocomial diarrhea. Its virulence is mainly associated with TcdA and TcdB toxins, encoded by their respective tcdA and tcdB genes. These genes are part of the pathogenicity locus (PaLoc). Our aim was to characterize relevant C. difficile toxinotypes circulating in the hospital setting. The tcdA and tcdB genes were amplified and digested with different restriction enzymes: EcoRI for tcdA; HincII and AccI for tcdB. In addition, the presence of the cdtB (binary toxin) gene, TcdA and TcdB toxins by dot blot and the cytotoxic effect of culture supernatants on Vero cells, were evaluated. Altogether, these studies revealed three different circulating toxinotypes according to Rupnik's classification: 0, I and VIII, being the latter the most prevalent one. Even though more studies are certainly necessary (e.g. sequencing analysis), it is worth noting that the occurrence of toxinotype I could be related to the introduction of bacteria from different geographical origins. The multivariate analysis conducted on the laboratory values of individuals infected with the most prevalent toxinotype (VIII) showed that the isolates associated with fatal outcomes (GCD13, GCD14 and GCD22) are located in regions of the biplots related to altered laboratory values at admission. In other patients, although laboratory values at admission were not correlated, levels of urea, creatinine and white blood cells were positively correlated after the infection was diagnosed. Our study reveals the circulation of different toxinotypes of C. difficile strains in this public hospital. The variety of toxinotypes can arise from pre-existing microorganisms as well as through the introduction of bacteria from other geographical regions. The existence of microorganisms with different pathogenic potential is relevant for the control, follow-up, and treatment of the infections.

This study indicates the use of Phallusia nigra as a potential biomonitor of mercury contamination. In this way, Hg levels were measured in seawater and different parts of ascidians (tunic, hepatopancreas, and branchial basket) from eight different sites in the Todos os Santos Bay, Salvador-Bahia. The ascidians were lyophilized, weighed, and taken to the DMA-80 (direct mercury analyzer); the method accuracy was confirmed by analyzing the certified material DORM 4 muscle tissue and MEES-3 marine sediment with a confidence level of 95%. The results were evaluated through the Tukey’s test and it was possible to observe a higher concentration of Hg (82.00 312.7 ng g-1) in the branchial basket, followed by the hepatopancreas (69.67 130.7 ng g-1) and tunic (21.63-33.27 ng g-1). Thus, the branchial basket was the only tissue capable of identifying spatial differences in pollution between the points. contamination way tunic, (tunic Bay SalvadorBahia. SalvadorBahia Salvador Bahia. Bahia Salvador-Bahia lyophilized weighed DMA80 DMA 80 DMA-8 direct analyzer analyzer) MEES3 MEES 3 MEES- 95 95% Tukeys Tukey s 82.00 8200 82 00 (82.0 3127 312 7 312. g1 g 1 g-1 69.67 6967 69 67 (69.6 1307 130 130. 21.6333.27 21633327 21.63 33.27 21 63 33 27 (21.63-33.2 g1. . Thus points DMA8 8 DMA- 9 82.0 820 0 (82. 31 g- 69.6 696 6 (69. 13 6333 21.6333.2 2163332 2163 21.6 3327 33.2 2 (21.63-33. 82. (82 69. (69 633 21.6333. 216333 216 21. 332 33. (21.63-33 (8 (6 21.6333 21633 (21.63-3 ( 21.633 (21.63- (21.63 (21.6 (21. (21 (2

ABSTRACT This article describes progress in tackling noncommunicable diseases (NCDs) in the Americas since the Pan American Health Organization (PAHO) started its NCD program 25 years ago. Changes in the epidemiology of NCDs, NCD policies, health service capacity, and surveillance are discussed. PAHO’s NCD program is guided by regional plans of action on specific NCDs and risk factors, as well as a comprehensive NCD plan. Its work involves implementing evidence-based World Health Organization technical packages on NCDs and their risk factors with the aim of achieving the Sustainable Development Goal target of a one third reduction in premature mortality caused by NCDs by 2030. Important advances have been made in the past 25 years in implementation of: policies on NCD risk factors; interventions to improve NCD diagnosis and treatment; and NCD surveillance. Premature mortality from NCDs decreased by 1.7% a year between 2000 and 2011 and 0.77% a year between 2011 and 2019. However, policies on risk factor prevention and health promotion need to be strengthened to ensure more countries are on track to achieving the NCD-related health goals of the Sustainable Development Goals by 2030. Actions are recommended for governments to raise the priority of NCDs by: making NCDs a core pillar of primary care services, using revenues from health taxes to invest more in NCD prevention and control; and implementing policies, laws, and regulations to reduce the demand for and availability of tobacco, alcohol, and ultra-processed food products.

RESUMO Este artigo descreve o progresso no combate às doenças não transmissíveis (DNTs) nas Américas desde que a Organização Pan-Americana da Saúde (OPAS) iniciou seu programa para essas doenças há 25 anos. Discute-se como evoluíram a epidemiologia das DNTs, as políticas contra essas doenças, a capacidade dos serviços de saúde e a vigilância. O programa da OPAS para as DNTs é orientado por planos de ação regionais sobre DNTs específicas e fatores de risco, bem como por um plano integral contra essas doenças. O trabalho envolve a implementação de pacotes técnicos da Organização Mundial da Saúde baseados em evidências sobre as DNTs e seus fatores de risco, no intuito de alcançar a meta do Objetivo de Desenvolvimento Sustentável de reduzir em um terço a mortalidade prematura causada pelas DNTs até 2030. Avanços importantes foram obtidos nos últimos 25 anos na implementação de políticas sobre fatores de risco das DNTs, intervenções para melhorar o diagnóstico e o tratamento das DNTs, e vigilância das DNTs. A mortalidade prematura causada pelas DNTs diminuiu 1,7% ao ano entre 2000 e 2011 e 0,77% ao ano entre 2011 e 2019. Contudo, as políticas sobre a prevenção dos fatores de risco e a promoção da saúde precisam ser fortalecidas para que mais países estejam no rumo certo para alcançar as metas de saúde relacionadas a essas doenças, no âmbito dos Objetivos de Desenvolvimento Sustentável até 2030. São recomendadas medidas para que os governos elevem a prioridade das DNTs ao torná-las um pilar central dos serviços de atenção primária, usando a receita dos tributos saudáveis para investir mais na prevenção e no controle das DNTs, e ao implementar políticas, leis e regulamentos para reduzir a demanda e a disponibilidade de álcool, tabaco e produtos alimentícios ultraprocessados.

RESUMEN En este artículo se describe el progreso en la lucha contra las enfermedades no transmisibles (ENT) en la Región de las Américas desde que la Organización Panamericana de la Salud (OPS) iniciara su programa contra las ENT hace 25 años. Se abordan los cambios en las características epidemiológicas, las políticas, la capacidad de los servicios de salud y la vigilancia de estas enfermedades. Este programa de la OPS se rige por planes regionales de acción sobre enfermedades y factores de riesgo específicos, así como por un plan integral de ENT. Su labor consiste en poner en práctica paquetes técnicos de la Organización Mundial de la Salud basados en la evidencia sobre las ENT y sus factores de riesgo con el objetivo de alcanzar la meta de los Objetivos de Desarrollo Sostenible (ODS) de reducir en un tercio la mortalidad prematura causada por las ENT para el 2030. En los últimos 25 años se han logrado importantes avances en la ejecución de políticas sobre los factores de riesgo de estas enfermedades, en las intervenciones para mejorar su diagnóstico y tratamiento, y en la vigilancia. La mortalidad prematura por ENT disminuyó 1,7% anual entre el 2000 y el 2011 y 0,77% anual entre los años 2011 y 2019. Sin embargo, es necesario fortalecer las políticas de prevención de factores de riesgo y promoción de la salud para garantizar que más países estén bien encaminados para lograr las metas de salud de los ODS relacionadas con las ENT para el 2030. Se recomiendan medidas para que los gobiernos prioricen más las ENT y las conviertan en un pilar central de los servicios de atención primaria, al usar los ingresos generados por los impuestos en el sector de la salud para incrementar las inversiones en la prevención y control de las ENT, y ejecutar políticas, leyes y regulaciones para reducir la demanda y la disponibilidad de tabaco, alcohol y alimentos ultraprocesados.