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The impact of COVID-19 on paracoccidioidomycosis (PCM) in Argentina and the consequences generated by the pandemic are discussed. From 2018 to 3 years after the pandemic declaration, 285 proven PCM patients were registered. No association between both diseases was documented. PCM frequency decreased to extremely low levels in 2020. Mandatory social isolation and the emotional and psychological effects generated under pandemic circumstances led to delays in diagnosis, severe disseminated cases, and other challenges for diagnosis in subsequent years. Probable underdiagnosis should be considered due to the overlap of clinical manifestations, the low index of suspicion and the lack of sensitive diagnostic tools.
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COVID-19 , Paracoccidioidomicose , Paracoccidioidomicose/epidemiologia , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/complicações , Humanos , COVID-19/epidemiologia , COVID-19/complicações , Argentina/epidemiologia , Masculino , Adulto , Pessoa de Meia-Idade , Feminino , SARS-CoV-2 , Idoso , Adulto Jovem , Pandemias , Adolescente , Diagnóstico TardioRESUMO
This article aims to study open education competency data through machine learning models to determine whether models can be built on decision rules using the features from the students' perceptions and classify them by the level of competency. Data was collected from a convenience sample of 326 students from 26 countries using the eOpen instrument. Based on a quantitative research approach, we analyzed the eOpen data using two machine learning models considering these findings: 1) derivation of decision rules from students' perceptions of knowledge, skills, and attitudes or values related to open education to predict their competence level using Decision Trees and Random Forests models, 2) analysis of the prediction errors in the machine learning models to find bias, and 3) description of decision trees from the machine learning models to understand the choices that both models made to predict the competency levels. The results confirmed our hypothesis that the students' perceptions of their knowledge, skills, and attitudes or values related to open education and its sub-competencies produced satisfactory data for building machine learning models to predict the participants' competency levels.
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Streptococcus pneumoniae is a gram-positive, aerotolerant bacterium that naturally colonizes the human nasopharynx, but also causes invasive infections and is a major cause of morbidity and mortality worldwide. This pathogen produces high levels of H2O2 to eliminate other microorganisms that belong to the microbiota of the respiratory tract. However, it also induces an oxidative stress response to survive under this stressful condition. Furthermore, this self-defense mechanism is advantageous in tolerating oxidative stress imposed by the host's immune response. This review provides a comprehensive overview of the strategies employed by the pneumococcus to survive oxidative stress. These strategies encompass the utilization of H2O2 scavengers and thioredoxins, the adaptive response to antimicrobial host oxidants, the regulation of manganese and iron homeostasis, and the intricate regulatory networks that control the stress response. Here, we have also summarized less explored aspects such as the involvement of reparation systems and polyamine metabolism. A particular emphasis is put on the role of the oxidative stress response during the transient intracellular life of Streptococcus pneumoniae, including coinfection with influenza A and the induction of antibiotic persistence in host cells.
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Information on paracoccidioidomycosis (PCM) in Argentina is fragmented and has historically been based on estimates, supported only by a series of a few reported cases. Considering the lack of global information, a national multicentric study in order to carry out a more comprehensive analysis was warranted. We present a data analysis including demographic and clinical aspects of a historical series of 466 cases recorded over 10 years (2012-2021). Patients were aged from 1 to 89 years. The general male: female (M:F) ratio was 9.5:1 with significant variation according to the age group. Interestingly, the age range 21-30 shows an M:F ratio of 2:1. Most of the cases (86%) were registered in northeast Argentina (NEA), showing hyperendemic areas in Chaco province with more than 2 cases per 10,000 inhabitants. The chronic clinical form occurred in 85.6% of cases and the acute/subacute form occurred in 14.4% of cases, but most of these juvenile type cases occurred in northwestern Argentina (NWA). In NEA, the incidence of the chronic form was 90.6%; in NWA, the acute/subacute form exceeded 37%. Diagnosis by microscopy showed 96% positivity but antibody detection displays 17% of false negatives. Tuberculosis was the most frequent comorbidity, but a diverse spectrum of bacterial, fungal, viral, parasitic, and other non-infectious comorbidities was recorded. This national multicenter registry was launched in order to better understand the current status of PCM in Argentina and shows the two endemic zones with a highly diverse epidemiology.
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Glaucoma is an eye disease that gradually deteriorates vision. Much research focuses on extracting information from the optic disc and optic cup, the structure used for measuring the cup-to-disc ratio. These structures are commonly segmented with deeplearning techniques, primarily using Encoder-Decoder models, which are hard to train and time-consuming. Object detection models using convolutional neural networks can extract features from fundus retinal images with good precision. However, the superiority of one model over another for a specific task is still being determined. The main goal of our approach is to compare object detection model performance to automate segment cups and discs on fundus images. This study brings the novelty of seeing the behavior of different object detection models in the detection and segmentation of the disc and the optical cup (Mask R-CNN, MS R-CNN, CARAFE, Cascade Mask R-CNN, GCNet, SOLO, Point_Rend), evaluated on Retinal Fundus Images for Glaucoma Analysis (REFUGE), and G1020 datasets. Reported metrics were Average Precision (AP), F1-score, IoU, and AUCPR. Several models achieved the highest AP with a perfect 1.000 when the threshold for IoU was set up at 0.50 on REFUGE, and the lowest was Cascade Mask R-CNN with an AP of 0.997. On the G1020 dataset, the best model was Point_Rend with an AP of 0.956, and the worst was SOLO with 0.906. It was concluded that the methods reviewed achieved excellent performance with high precision and recall values, showing efficiency and effectiveness. The problem of how many images are needed was addressed with an initial value of 100, with excellent results. Data augmentation, multi-scale handling, and anchor box size brought improvements. The capability to translate knowledge from one database to another shows promising results too.
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Light chain (AL) amyloidosis is a form of systemic amyloidosis, causing organ dysfunction, mainly affecting the heart and kidney. Patient-tailored and risk-adapted decision making is critical in AL amyloidosis management. There is limited real-world evidence data from Argentina and Latin America regarding the treatment approaches for AL amyloidosis. This retrospective cohort study aimed to describe the treatment patterns and outcomes in adult patients (>18 years) diagnosed with AL amyloidosis at the Hospital Italiano in Buenos Aires, Argentina, using a 10-yearfollow-up data (June 1, 2010 to May 31, 2019) from the institutional registry of amyloidosis (IRA). The study population had a mean age of 63 years and 54.4% weremale. Heart and kidney were the most frequently affected organs. Of the 90 eligible patients included in the study, 70underwent treatment. Bortezomib-based regimen was the preferred first-line treatment (75.7% patients). Overall,54.4% of the patients presented a deep response (complete or very good partial response). Median overall survival (OS) was 5years, the 1-year OS and progression free survival rates were 80% (95% confidence interval [CI]: 68-87) and 80% (95%CI 68-87)), respectively. This study provides vital real-world evidence for the long-term treatment patterns and survival in a large cohort of AL amyloidosis patients in Argentina.
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Amiloidose , Amiloidose de Cadeia Leve de Imunoglobulina , Adulto , Humanos , Pessoa de Meia-Idade , Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico , Amiloidose de Cadeia Leve de Imunoglobulina/terapia , Bortezomib/uso terapêutico , Estudos Retrospectivos , Argentina/epidemiologia , Amiloidose/diagnóstico , Amiloidose/terapia , Sistema de RegistrosRESUMO
BACKGROUND: Strongyloidiasis and Chagas disease are endemic in northern Argentina. In this study we evaluate the association between S. stercoralis and T. cruzi infections in villages with diverse prevalence levels for these parasites. Further understanding in the relationship between these Neglected Tropical Diseases of South America is relevant for the design of integrated control measures as well as exploring potential biologic interactions. METHODOLOGY: Community based cross-sectional studies were carried in different villages of the Chaco and Yungas regions in Argentina. Individuals were diagnosed by serology for S. stercoralis and T. cruzi. The association between S. stercoralis and T. cruzi, and between anemia and the two parasites was evaluated using two approaches: marginal (Ma) and multilevel regression (Mu). RESULTS: A total of 706 individuals from six villages of northern Argentina were included. A total of 37% were positive for S. stercoralis, 14% were positive for T. cruzi and 5% were positive for both. No association was found between infection with S. stercoralis and T. cruzi in any of the models, but we found a negative correlation between the prevalence of these species in the different villages (r = -0.91). Adults (> 15 years) presented association with S. stercoralis (Ma OR = 2.72; Mu OR = 2.84) and T. cruzi (Ma OR = 5.12; Mu OR = 5.48). Also, 12% and 2% of the variance of infection with S. stercoralis and T. cruzi, respectively, could be explained by differences among villages. On the other hand, anemia was associated with infection with S. stercoralis (Ma OR = 1.73; Mu OR = 1.78) and was more prevalent in adults (Ma OR = 2.59; Mu OR = 2.69). CONCLUSION: We found that coinfection between S. stercoralis and T. cruzi is not more frequent than chance in endemic areas. However, the high prevalence for both parasites, raises the need for an integrated strategy for the control of STH and Chagas disease.
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Doença de Chagas/parasitologia , Coinfecção/parasitologia , Strongyloides stercoralis/fisiologia , Estrongiloidíase/parasitologia , Trypanosoma cruzi/fisiologia , Adolescente , Adulto , Animais , Argentina/epidemiologia , Doença de Chagas/epidemiologia , Criança , Pré-Escolar , Coinfecção/epidemiologia , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Doenças Endêmicas/estatística & dados numéricos , Fezes/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Strongyloides stercoralis/genética , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/epidemiologia , Trypanosoma cruzi/genética , Trypanosoma cruzi/isolamento & purificação , Adulto JovemRESUMO
INTRODUCTION: Several reports have emerged describing the long-term consequences of COVID-19 and its effects on multiple systems. METHODS: As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of the long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). RESULTS: We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased (p < 0.00001). Women were more prone than men to develop long-term symptoms, and invasive mechanical ventilation also increased the frequency of symptoms at 30 days post-discharge. CONCLUSION: Overall, we observed that symptoms often persisted regardless of disease severity. We hope these findings will help promote public health strategies that ensure equity in the access to solutions focused on the long-term consequences of COVID-19.
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Entre junio y noviembre de 2021 la Dirección de Investigación en Salud del Ministerio de Salud de la Nación realizó la Convocatoria a Becas Salud Investiga 2021-2022. Su objetivo fue promover investigaciones en salud sobre lineamientos y temas priorizados en la Agenda Nacional de Investigación en Salud Pública. La particularidad de este llamado fue incorporar un grupo de becas de Estudios de Múltiples Investigadores (EMI) y EMI en Hospitales Nacionales en el marco del Plan Nacional de Investigación Traslacional en Salud para la Red de Hospitales. Se otorgaron 47 becas para Estudios Individuales (EI), 221 para EMI y 32 para EMI en Hospitales Nacionales. El lineamiento con más proyectos ganadores (14) fue el de impacto sanitario/social/económico de la pandemia COVID-19 en poblaciones vulnerables (pueblos originarios, pobreza estructural, inmigrantes, trabajo informal). El 68% de los becarios de EI y el 83% de los becarios de EMI y EMI en Hospitales Nacionales provenían de instituciones públicas, mayormente establecimientos hospitalarios. Las formaciones disciplinares predominantes fueron las Ciencias de la Salud y las Ciencias Sociales y Humanidades. Los ganadores residían mayormente en la Ciudad Autónoma de Buenos Aires (40% EI y 29% EMI y EMI Hospitales) y en la Provincia de Buenos Aires (17% EI y 36% EMI y EMI Hospitales). Las mujeres de entre 30 y 39 años fueron el subgrupo con mayor representación entre los ganadores de ambos tipos de beca.
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Política Pública , Bolsas de Estudo , Pesquisa Translacional Biomédica , SARS-CoV-2 , Pesquisa sobre Serviços de SaúdeRESUMO
BACKGROUND: Bisphenol A (BPA) exposure has been linked to altered behavior in children. Within the European Human Biomonitoring Initiative (HBM4EU), an adverse outcome pathway (AOP) network was constructed supporting the mechanistic link between BPA exposure and brain-derived neurotrophic factor (BDNF). OBJECTIVE: To test this toxicologically-based hypothesis in the prospective INMA-Granada birth cohort (Spain). METHODS: BPA concentrations were quantified by LC-MS/MS in spot urine samples from boys aged 9-11 years, normalized by creatinine and log-2 transformed. At adolescence (15-17 years), blood and urine specimens were collected, and serum and urinary BDNF protein levels were measured using immunoassays. DNA methylation levels at 6 CpGs in Exon IV of the BDNF gene were also assessed in peripheral blood using bisulfite-pyrosequencing. Adolescent's behavior was parent-rated using the Child Behavior Checklist (CBCL/6-18) in 148 boys. Adjusted linear regression and mediation models were fit. RESULTS: Childhood urinary BPA concentrations were longitudinally and positively associated with thought problems (ß = 0.76; 95% CI: 0.02, 1.49) and somatic complaints (ß = 0.80; 95% CI: -0.16, 1.75) at adolescence. BPA concentrations were positively associated with BDNF DNA methylation at CpG6 (ß = 0.21; 95% CI: 0.06, 0.36) and mean CpG methylation (ß = 0.10; 95% CI: 0.01, 0.18), but not with total serum or urinary BDNF protein levels. When independent variables were categorized in tertiles, positive dose-response associations were observed between BPA-thought problems (p-trend = 0.08), BPA-CpG6 (p-trend ≤ 0.01), and CpG6-thought problems (p-trend ≤ 0.01). A significant mediated effect by CpG6 DNA methylation was observed (ß = 0.23; 95% CI: 0.01, 0.57), accounting for up to 34% of the BPA-thought problems association. CONCLUSIONS: In line with toxicological studies, BPA exposure was longitudinally associated with increased BDNF DNA methylation, supporting the biological plausibility of BPA-behavior relationships previously described in the epidemiological literature. Given its novelty and preliminary nature, this effect biomarker approach should be replicated in larger birth cohorts.