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During January 2013, a mining spill occurred in the Santa Maria mining region, releasing around 300,000 m3 of tailings on Los Remedios river, which was transported through the San Lorenzo river and finally to El Comedero (EC) dam. Twenty months later, we examined the concentrations of Hg and Se in the muscle, liver, gills, and guts of three fish species (Cyprinus carpio, Oreochromis aureus, Micropterus salmoides) captured in the EC dam to assess the performance of the cleaning operations. A high Se concentration in the liver of all species (carp, 1.2 ± 0.4; tilapia, 3.9 ± 2.1; bass, 3.5 ± 1.1 µg g-1 ww) was consistently observed, while this behavior was only found in the blue tilapia for Hg (0.15 ± 0.11 µg g-1 ww). Tilapia (benthic-detritivorous) exhibited the highest Se concentrations compared to the carp (omnivore) and the largemouth bass (piscivore). In contrast, the largemouth bass had the highest Hg levels in the muscle compared with the other fishes. Such differences could be related to the different metabolism and feeding habits among species. Compared to a tilapia study carried out three months after the mine spill during a mortality event, a decrease was evident in the liver for Se and Hg by 7.2 and 4.7 times, respectively. This reveals that cleaning operations were more efficient for Se and less for Hg, and that a prolonged period was required for the partial recovery of the element levels in fish from sites impacted by mining. Considering the Mexican consumption scenarios for each fish species, it could be concluded that there will be no non-cancer risk by exposure to Hg or Se.

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Prenatal anxiety and depression in pandemic context could introduce changes in the fetal developmental trajectories that, ultimately, could alter the adaptive behaviors of the offspring, potentially affecting, for example, general neurodevelopment. The sample consisted of 105 mother-child dyads, recruited between March and May 2020. The dyads were evaluated longitudinally, prenatally and postnatally (6 months). The Pandemic Impact Questionnaire, the State-Trait Anxiety Inventory, and the Beck-II Depression Inventory were used to assess indicators of maternal anxiety and depression, respectively. Regarding the babies, their mothers responded to Age and Stages: 3, which assesses different dimensions of early neurodevelopment, in addition to a closed questionnaire to identify sociodemographic and maternal and child health variables. A series of mediation models were tested to examine the association between prenatal psychopathology/negative experiences of the pandemic and neurodevelopment. The results indicated that the negative experiences of the pandemic were indirectly associated with the socio-individual and fine motor neurodevelopment of the offspring, through maternal anxiety symptoms, during the third trimester, which functioned as a mediator.  Conclusions: This study provides evidence on the mediating effects of maternal anxiety on infant neurodevelopment in contexts of early adversity. It is important to point out the need to implement public health policies that allow a timely evaluation of neurodevelopmental variables during early childhood, which can implement early interventions to reduce the risks associated with these deficits. What is Known: • Effects of maternal mental health have been reported, effects on child neurodevelopment, in motor, cognitive, linguistic and socio-emotional dimensions. • Contexts of early adversity have been associated with maternal mental health and offspring development. What is New: • The context of pandemic adversity caused by COVID-19 is associated with motor and socio-individual neurodevelopment, mediated by maternal prenatal anxiety.

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Placentas from gestational diabetes mellitus (GDM) patients undergo significant metabolic and immunologic adaptations due to hyperglycemia, which results in an exacerbated synthesis of proinflammatory cytokines and an increased risk for infections. Insulin or metformin are clinically indicated for the treatment of GDM; however, there is limited information about the immunomodulatory activity of these drugs in the human placenta, especially in the context of maternal infections. Our objective was to study the role of insulin and metformin in the placental inflammatory response and innate defense against common etiopathological agents of pregnancy bacterial infections, such as E. coli and S. agalactiae, in a hyperglycemic environment. Term placental explants were cultivated with glucose (10 and 50 mM), insulin (50-500 nM) or metformin (125-500 µM) for 48 h, and then they were challenged with live bacteria (1 × 105 CFU/mL). We evaluated the inflammatory cytokine secretion, beta defensins production, bacterial count and bacterial tissue invasiveness after 4-8 h of infection. Our results showed that a GDM-associated hyperglycemic environment induced an inflammatory response and a decreased beta defensins synthesis unable to restrain bacterial infection. Notably, both insulin and metformin exerted anti-inflammatory effects under hyperglycemic infectious and non-infectious scenarios. Moreover, both drugs fortified placental barrier defenses, resulting in reduced E. coli counts, as well as decreased S. agalactiae and E. coli invasiveness of placental villous trees. Remarkably, the double challenge of high glucose and infection provoked a pathogen-specific attenuated placental inflammatory response in the hyperglycemic condition, mainly denoted by reduced TNF-α and IL-6 secretion after S. agalactiae infection and by IL-1ß after E. coli infection. Altogether, these results suggest that metabolically uncontrolled GDM mothers develop diverse immune placental alterations, which may help to explain their increased vulnerability to bacterial pathogens.

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The COVID-19 pandemic context may predispose mothers to increased maternal psychopathology, which may be associated with offspring socioemotional development. The aim of this study is to analyze the relationships between prenatal anxiety and depression and exposure to the COVID-19 pandemic with offspring socioemotional development, controlling for postnatal anxiety and depression. A total of 105 mother-child dyads were assessed in pre- and postnatal periods. Questionnaires were used to assess the impact of the pandemic, indicators of psychopathology, and the socioemotional development of the offspring. Results suggest that negative pandemic experiences are indirectly associated with offspring socioemotional development via prenatal maternal anxiety symptomatology and after controlling for postnatal anxiety and depression. These indicators predispose to emotional deficits and increase the risks of psychopathological and neurodevelopmental disorders. It is important to adopt health policies that provide timely assessment of development in early childhood to reduce the risks associated with these deficits.

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OBJECTIVE: The aim of this study was to assess resilience, fear of COVID-19, sleep disorders, and menopause-related symptoms after the acute phase of COVID-19 in middle-aged women with positive reverse transcription-polymerase chain reaction and noninfected women. METHODS: This is a cross-sectional, analytical study of climacteric women from 9 Latin American countries, aged 40-64 years, attending a routine health checkup. We evaluated clinical characteristics and used the Connor-Davidson Resilience Scale, the Fear of COVID-19 Scale, the Jenkins Sleep Scale, and the Menopause Rating Scale to evaluate their health. RESULTS: A total of 1,238 women were studied, including 304 who were positive for COVID-19 reverse transcription-polymerase chain reaction. The median (interquartile range) age was 53 (12) years; years of studies, 16 (6); body mass index, 25.6 (5.1) kg/m 2 ; and time since first COVID-19 symptom, 8 (6) months. COVID-19 patients reported fatigability (18.8%), joint and muscular discomfort (14.1%), and anosmia (9.5%). They had a significantly lower resilience score (26.87 ± 8.94 vs 29.94 ± 6.65), higher Fear of COVID-19 score (17.55 ± 7.44 vs 15.61 ± 6.34), and a higher Jenkins Scale score (6.10 ± 5.70 vs 5.09 ± 5.32) compared with control women. A logistic regression model confirmed these results. There was not a significant difference in the total Menopause Rating Scale score, although the odds ratios for both severe menopausal symptoms (1.34; 95% confidence interval, 1.02-1.76) and the use of hypnotics were higher in women with COVID-19 (1.80; 95% confidence interval, 1.29-2.50) compared with those without infection. We found no decrease in studied outcomes between the initial 7 months versus those reported after 8 to 18 months since first COVID-19 symptoms. CONCLUSIONS: COVID-19 climacteric women have sleep disorders, lower resilience and higher fear of COVID-19.

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Resumen OBJETIVO: Determinar la incidencia acumulada de cáncer de mama a cinco años de seguimiento en pacientes con lesiones preinvasoras o premalignas de la glándula mamaria en un centro de referencia y establecer los factores de riesgo asociados. MATERIALES Y MÉTODOS: Estudio de cohorte retrospectiva efectuado en pacientes atendidas en el Hospital Ángeles Lomas entre los años 2012 a 2016 con diagnóstico, durante su tamizaje mastográfico, de alguna lesión precursora o preinvasora de cáncer de mama. El seguimiento fue a cinco años para determinar la incidencia. Las variables categóricas se expresan en frecuencias y porcentajes. Se utilizó la prueba de χ2 para diferencia de proporciones entre grupos. RESULTADOS: Se obtuvieron 3360 pacientes que acudieron al servicio de Mastología durante el tiempo establecido. Se obtuvieron 245 pacientes con lesiones premalignas pero 30 de ellas no cumplieron con el seguimiento a cinco años y se perdieron en ese tiempo estipulado de vigilancia. Al final quedaron 215 pacientes que cumplieron todos los criterios de inclusión establecidos. La incidencia acumulada global de cáncer de mama invasivo fue que a 5 años el 14.9% de las pacientes con lesiones premalignas tendrá cáncer de mama. El carcinoma lobulillar in situ fue el de mayor incidencia o progresión de cáncer invasor, con un 32.1% a los cinco años, seguido de las lesiones mucocele-like, carcinoma ductal in situ y papiloma intraductal con un 23.1, 21.1 y 17.1%, respectivamente. CONCLUSIONES: El cáncer de mama sigue siendo un problema de salud pública en México y en todo el mundo. Si bien cada vez se dispone de más y mejores programas de tamizaje, ello ha traído consigo otras problemáticas, como las lesiones premalignas o de alto riesgo de carcinogénesis, que han aumentado su incidencia.

Abstract OBJECTIVE: To determine the cumulative incidence of breast cancer at five years of follow-up in patients with preinvasive or premalignant lesions of the mammary gland in a referral canter and to establish the associated risk factors. MATERIALS AND METHODS: Retrospective cohort study carried out in patients seen at Hospital Ángeles Lomas between 2012 and 2016 with a diagnosis, during their mastographic screening, of a precursor or pre-invasive lesion of breast cancer. Categorical variables are expressed in frequencies and percentages. The χ2 test was used for difference of proportions between groups. RESULTS: We obtained 3360 patients who attended the mastology service during the established time. We obtained 245 patients with premalignant lesions but 30 of them did not comply with the five-year follow-up and were lost within the stipulated surveillance period. This left 215 patients who met all the inclusion criteria. The overall cumulative incidence of invasive breast cancer was that at 5 years 14.9% of patients with premalignant lesions will have breast cancer. Lobular carcinoma in situ had the highest incidence or progression of invasive cancer, with 32.1% at 5 years, followed by mucocele-like lesions, ductal carcinoma in situ and intraductal papilloma with 23.1, 21.1 and 17.1%, respectively. CONCLUSIONS: Breast cancer remains a public health problem in Mexico and worldwide. Although more and better screening programmes are becoming available, this has brought with it other problems, such as premalignant or high-risk carcinogenic lesions, which have increased in incidence.

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OBJECTIVE: To evaluate the association between factors, especially those linked to the climacteric, and a history of COVID-19 infection. METHODS: This was an observational, cross-sectional, and analytical study in which women from ten Latin American countries, aged 40-64, who attended a routine health check-up were invited to participate. A positive history for COVID-19 was based on reverse transcription-polymerase chain reaction reports. We evaluated sociodemographic, clinical, lifestyle, anthropometric variables, and menopausal symptoms using the Menopause Rating Scale (MRS). RESULTS: A total of 1238 women were included for analysis, of whom 304 (24.6 %) had a positive history for COVID-19. The median [interquartile range: IQR] age of participants was 53 [IQR 12] years, duration of formal education was 16 [6] years, body mass index 25.6 [5.1] kg/m2, and total MRS score 10 [13]. In a logistic regression model, factors positively associated with COVID-19 included postmenopausal status and having a family history of dementia (OR: 1.53; 95 % CI: 1.13-2.07, and 2.40; 1.65-3.48, respectively), whereas negatively associated were use of menopausal hormone therapy (current or past), being a housewife, and being nulliparous (OR: 0.47; 95 % CI: 0.30-0.73; 0.72; 0.53-0.97 and 0.56; 0.34-0.92, respectively). Smoking, being sexually active, and use of hypnotics were also factors positively associated with COVID-19. CONCLUSION: Postmenopausal status and a family history of dementia were more frequent among women who had had COVID-19, and the infection was less frequent among current or past menopause hormone therapy users and in those with less physical contact.

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PURPOSE: PALB2 variants have been scarcely described in Argentinian and Latin-American reports. In this study, we describe molecular and clinical characteristics of PALB2 mutations found in multi-gene panels (MP) from breast-ovarian cancer (BOC) families in different institutions from Argentina. METHODS: We retrospectively identified PALB2 pathogenic (PV) and likely pathogenic (LPV) variants from a cohort of 1905 MP results, provided by one local lab (Heritas) and SITHER (Hereditary Tumor Information System) public database. All patients met hereditary BOC clinical criteria for testing, according to current guidelines. RESULTS: The frequency of PALB2 mutations is 2.78% (53/1905). Forty-eight (90.5%) are PV and five (9.5%) are LPV. Most of the 18 different mutations (89%) are nonsense and frameshift types and 2 variants are novel. One high-rate recurrent PV (Y551*) is present in 43% (23/53) of the unrelated index cases. From the 53 affected carriers, 94% have BC diagnosis with 14% of bilateral cases. BC phenotype is mainly invasive ductal (78%) with 62% of hormone-receptor positive and 22% of triple negative tumors. Self-reported ethnic background of the cohort is West European (66%) and native Latin-American (20%) which is representative of Buenos Aires and other big urban areas of the country. CONCLUSION: This is the first report describing molecular and clinical characteristics of PALB2 carriers in Argentina. Frequency of PALB2 PV in Argentinian HBOC families is higher than in other reported populations. Y551* is a recurrent mutation that seems to be responsible for almost 50% of PALB2 cases.

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Abstract Introduction Since little is known about the factors associated with suicidal ideation in adolescents, identifying them is important for developing suitable preventive strategies. Objective To analyze the variables associated with the presence of suicidal ideation, as well as the predictive power of depressive symptoms and negative automatic thoughts. Method A prospective cross-sectional study was conducted with 409 students between the ages of 15 and 19 randomly selected in a public school in the State of Mexico. An ad hoc questionnaire that gathered information on sociodemographic and psychological variables and substance use, the Depression Scale of the Center for Epidemiological Studies (CESD-R), the Automatic Thoughts Questionnaire (ATQ-30), and the Beck Scale for Suicide Ideation (SSI) were administered. Results From the total of the sample, 14.9% presented suicidal ideation. A positive, significant association was observed between the latter and gender, having divorced parents, professing Catholicism, using tobacco and drugs, and having experienced violence and anguish in the last semester, presenting depressive symptoms, negative automatic thoughts and having attempted suicide. Being a woman (OR = 2.55 [1.02, 6.38]), using drugs (OR = 3.44 [1.23, 9.57]), having probable depression (OR = 4.37 [1.68, 11.36]), experiencing negative thoughts (OR = 6.03 [2.40, 15.10]), and having attempted suicide (OR = 22.66 [1.58, 325.29]) predicted the appearance of suicidal ideas. Discussion and conclusion Risk factors for suicidal ideation in adolescents have been identified and they must be taken into account in preventive programs.

Resumen Introducción Se sabe poco de los factores que se asocian a la ideación suicida en adolescentes e identificarlos es importante para desarrollar estrategias preventivas adecuadas. Objetivo Analizar las variables que se asocian a la presencia de ideación suicida y conocer el poder predictivo de los síntomas depresivos y los pensamientos automáticos negativos. Método Se realizó un estudio transversal prospectivo con 409 estudiantes de entre 15 y 19 años seleccionados aleatoriamente en una escuela pública del Estado de México. Se aplicó un cuestionario ad hoc que recogía información sobre variables sociodemográficas, psicológicas y consumo de sustancias. Para ello se usaron la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R), el Cuestionario de Pensamientos Automáticos (ATQ-30) y la Escala de Ideación Suicida de Beck (ISB). Resultados Un 14.9% de la muestra presentaba ideación suicida. Se observó una asociación positiva y significativa entre la misma y el sexo, tener padres divorciados, profesar la religión católica, consumir tabaco y drogas, así como haber sufrido violencia y angustia en el último semestre, haber presentado síntomas depresivos, pensamientos automáticos negativos e intentos de suicidio. Ser mujer (OR = 2.55 [1.02, 6.38]), consumir drogas (OR = 3.44 [1.23, 9.57]), presentar probable depresión (OR = 4.37 [1.68, 11.36]), tener pensamientos negativos (OR = 6.03 [2.40, 15.10]) y haber intentado suicidarse (OR = 22.66 [1.58, 325.29]) predicen la aparición de ideas suicidas. Discusión y conclusión En adolescentes se han identificado factores de riesgo para presentar ideación suicida, los cuales deben tenerse en cuenta en los programas preventivos.

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Resumen Actualmente el sobrepeso y la obesidad presentan una alta prevalencia a nivel mundial, y se encuentran relacionados con enfermedades crónico-degenerativas, mortalidad prematura y disminución en la calidad de vida. El propósito de esta investigación fue comparar la calidad de vida relacionada con la salud (CVRS) en función del estado de nutrición (EN) y sexo. Participaron 202 adultos (84 hombres y 118 mujeres), con una edad entre 18 y 81 años (M =39.74 DE = 13.77), quienes fueron distribuidos por su EN en: normopeso, sobrepeso y obesidad. Los participantes completaron el cuestionario 36-Item Short Form Health Survey (SF-36). En la muestra predominó la dimensión Función física (FF), considerándola muy buena. Las dimensiones Rol emocional (RE), Rol físico (RF), Vitalidad (VT) y Salud mental (SM) se ubicaron en el nivel de bueno, y solamente la Salud general (SG) se consideró regular. En el caso de la comparación entre los grupos en función del EN no se encontraron diferencias significativas; sin embargo, en la comparación por sexo, los hombres obtuvieron mayores puntuaciones en: FF, SM, VT y RE. Se concluye que no hay diferencia estadísticamente significativa de la CVRS entre los grupos por EN, no obstante, al realizar la comparación por sexo se encuentran diferencias significativas a favor de los hombres.

Abstract Overweight and obesity currently have a high prevalence worldwide, are related to chronic degenerative diseases, premature mortality and the decline in quality of life. The purpose of the present investigation was to compare the quality of life related to health (HRQoL) between groups by their nutritional status (NS) and by sex. There was a sample of 202 participants (84 men and 118 women) with an age between 18 and 81 years (M =39.74 SD = 13.77), distributed by their NS in: normal weight, overweight and obesity, they were administered the questionnaire 36-Item Short Form Health Survey (SF-36). In the general sample, the Physical Function (PF) dimension was predominant, being considered as very good, the scores obtained in the Emotional Role (ER), Physical Role (PR), Vitality (VT) and Mental Health (MH) dimensions were in a range estimated as good and only the General Health (GH) dimension was considered regular. In the case of the comparison between the groups by state of nutrition, no statistically significant differences were found between them, however, in the comparison made by sex, statistically significant differences were found in the factors of PF, MH, VT and ER in favor of the group of men. In conclusion, there is not statistically significant difference of the HRQoL between the groups by NS, nevertheless, when performing the comparison by sex, significant differences are found in favor of the men.