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The nutritional status is a determinant of the immune response that promotes a cellular homeostasis. In particular, adequate selenium levels lead to a better antioxidant and immune response. The aim of this work is to assess whether blood selenium levels, at time of SARS-CoV-2 infection, have an impact on the development and severity of COVID-19. A systematic review and meta-analysis of comparative and descriptive studies using MeSH terms, selenium and COVID-19 was performed. We searched bibliographic databases up to 17 July 2022 in PubMed and ScienceDirect. Studies that reported data on blood selenium levels were considered. A total of 629 articles were examined by abstract and title, of which 595 abstracts were read, of which 38 were included in the systematic review and 11 in the meta-analysis. Meta-analysis was conducted to mean difference (MD) with a 95 % confidence interval (CI), and heterogeneity was tested by I2 with random factors with a MD between selenium levels, mortality, morbidity and healthy subjects with a P-value of 0⋅05. Selenium levels were higher in healthy people compared to those in patients with COVID-19 disease (six studies, random effects MD: test for overall effect Z = 3⋅28 (P = 0⋅001), 97 % CI 28⋅36 (11⋅41-45⋅31), P < 0⋅00001), but without difference when compared with the degree of severity in mild, moderate or severe cases. In conclusion, the patients with active SARS-CoV-2 infection had lower selenium levels than the healthy population. More studies are needed to evaluate its impact on clinical severity through randomised clinical trials.

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Introducción. El dengue es un problema de salud pública para el departamento de La Guajira. El control se ha enfocado en el vector con el uso de insecticidas, entre ellos los organofosforados. Objetivo. Evaluar el estado de la sensibilidad a insecticidas organofosforados de quince poblaciones de Aedes aegypti (L.) en el departamento de La Guajira, Colombia. Materiales y métodos. Se realizaron bioensayos para temefos, malatión y pirimifos- metil en larvas de tercer estadio y mosquitos adultos de Ae. aegypti en los municipios de Albania, Barrancas, Dibulla, Distracción, El Molino, Fonseca, Hatonuevo, La Jagua del Pilar, Maicao, Manaure, Riohacha, San Juan del Cesar, Uribia, Urumita y Villanueva, siguiendo la metodología de la Organización Mundial de la Salud (OMS) y la técnica de botellas usando la guía de los de los Centers for Disease Control and Prevention, respectivamente. Se determinó la sensibilidad por medio de la relación de resistencia a CL50 y CL95 (RRCL50, RRCL95) para temefos y a dosis y tiempo diagnóstico para temefos, malatión y pirimifos-metil en las poblaciones de campo evaluadas, usando como control la cepa sensible Rockefeller. Resultados. Las 15 poblaciones del departamento de La Guajira son sensibles a: temefos (relación de la resistencia a CL50<5,0; relación de resistencia a CL95<5,0; 98 a 100 % de mortalidad); pirimifos-metil (99 a 100 % de mortalidad) y malatión (100 % de mortalidad). Conclusión. Con base en los resultados obtenidos, es factible el uso de temefos, malatión y pirimifos-metil para el control de Ae. aegypti en las poblaciones evaluadas.

Introduction. Dengue is a public health problem in La Guajira region. Control has focused on the vector using insecticides, including organophosphates. Objective. To evaluate the state of susceptibility to organophosphates insecticides in fifteen Aedes aegypti (L.) populations in La Guajira, Colombia. Materials and methods. We collected samples of third-instar larvae and adult mosquitoes of Ae. aegypti in the municipalities of Albania, Barrancas, Dibulla, Distracción, El Molino, Fonseca, Hatonuevo, La Jagua del Pilar, Maicao, Manaure, Riohacha, San Juan del Cesar, Uribia, Urumita, Villanueva. Bioassays for temefos, malathion, and pirimiphos-methyl were carried out following the methodology of the World Health Organization, and the bottle technique using the guidance of the Centers for Disease Control and Prevention. Susceptibility to temefos was determined through the resistance ratio between lethal concentration 50 and lethal concentration 95; for the compounds temefos, malathion and pirimiphos-methyl, susceptibility was calculated using diagnostic dose and diagnostic time in the populations evaluated. Rockefeller susceptible strain was used as a control. Results. All evaluated populations of Ae. aegypti from La Guajira were found to be susceptible to temefos (ratio resistance to CL50<5.0; ratio resistance to CL95<5.0; 98 - 100 % mortality); pirimiphosmethyl (99 - 100 % mortality), and malathion (100 % mortality). Conclusion. Based on the results, the use of temefos, malathion, and pirimiphosmethyl is feasible for the control of Ae. aegypti in the evaluated populations.

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Aedes aegypti is a mosquito that transmits viral diseases such as dengue, chikungunya, Zika, and yellow fever. The insect's microbiota is recognized for regulating several biological processes, including digestion, metabolism, egg production, development, and immune response. However, the role of the bacteria involved in insecticide susceptibility has not been established. Therefore, the objective of this study was to characterize the resident microbiota in a field population of A. aegypti to evaluate its role associated with susceptibility to the insecticides permethrin and deltamethrin. Mosquitoes were fed 10% sucrose mixed with antibiotics and then exposed to insecticides using a diagnostic dose. DNA was extracted, and sequencing of bacterial 16S rRNA was carried out on Illumina® MiSeq™. Proteobacteria (92.4%) and Bacteroidetes (7.6%) were the phyla, which are most abundant in mosquitoes fed with sucrose 10%. After exposure to permethrin, the most abundant bacterial species were Pantoea agglomerans (38.4%) and Pseudomonas azotoformans-fluorescens-synxantha (14.2%). Elizabethkingia meningoseptica (38.4%) and Ps. azotoformans-fluorescens-synxantha (26.1%) were the most abundant after exposure to deltamethrin. Our results showed a decrease in mosquitoes' survival when exposed to permethrin, while no difference in survival when exposed to deltamethrin when the microbiota was modified. We found that the change in microbiota modifies the response of mosquitoes to permethrin. These results are essential for a better understanding of mosquito physiology in response to insecticides.

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The head louse Pediculus humanus capitis (De Geer) is a hematophagous ectoparasite that inhabits the human scalp. The infestations are asymptomatic; however, skin irritation from scratching occasionally may cause secondary bacterial infections. The present study determined the presence and frequency of the knockdown resistance (kdr) mutation T929I in 245 head lice collected from Mexico, Peru, and Canada. Head lice were collected manually using a comb in the private head lice control clinic. Allele mutation at T9291 was present in 100% of the total sampled populations (245 lice) examined. In addition, 4.89% of the lice were homozygous susceptible, whereas 6.93% heterozygous and 88.16% homozygous were resistant, respectively. This represents the second report in Mexico and Quebec and fist in Lima.

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Throughout the COVID-19 pandemic, thousands of temporary ICUs have been established worldwide. The outcomes and management of mechanically ventilated patients in these areas remain unknown. OBJECTIVES: To investigate mortality and management of mechanically ventilated patients in temporary ICUs. DESIGN SETTING AND PARTICIPANTS: Observational cohort study in a single-institution academic center. We included all adult patients with severe COVID-19 hospitalized in temporary and conventional ICUs for invasive mechanical ventilation due to acute respiratory distress syndrome from March 23, 2020, to April 5, 2021. MAIN OUTCOMES AND MEASURES: To determine if management in temporary ICUs increased 30-day in-hospital mortality compared with conventional ICUs. Ventilator-free days, ICU-free days (both at 28 d), hospital length of stay, and ICU readmission were also assessed. RESULTS: We included 776 patients (326 conventional and 450 temporary ICUs). Thirty-day in-hospital unadjusted mortality (28.8% conventional vs 36.0% temporary, log-rank test p = 0.023) was higher in temporary ICUs. After controlling for potential confounders, hospitalization in temporary ICUs was an independent risk factor associated with mortality (hazard ratio, 1.4; CI, 1.06-1.83; p = 0.016).There were no differences in ICU-free days at 28 days (6; IQR, 0-16 vs 2; IQR, 0-15; p = 0.5) or ventilator-free days at 28 days (8; IQR, 0-16 vs 5; IQR, 0-15; p = 0.6). We observed higher reintubation (18% vs 12%; p = 0.029) and readmission (5% vs 1.6%; p = 0.004) rates in conventional ICUs despite higher use of postextubation noninvasive mechanical ventilation (13% vs 8%; p = 0.025). Use of lung-protective ventilation (87% vs 85%; p = 0.5), prone positioning (76% vs 79%; p = 0.4), neuromuscular blockade (96% vs 98%; p = 0.4), and COVID-19 pharmacologic treatment was similar. CONCLUSIONS AND RELEVANCE: We observed a higher 30-day in-hospital mortality in temporary ICUs. Although both areas had high adherence to evidence-based management, hospitalization in temporary ICUs was an independent risk factor associated with mortality.

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RESUMEN Contrario a lo que se cree, los milpiés no se consideran animales venenosos, su mecanismo de defensa puede resultar perjudicial para el ser humano, manifestándose como lesiones de carácter eritematoso, purpúrico y cianótico, concomitante dolor local y parestesia; Según la exposición, el cuadro clínico puede evolucionar a lesiones moderadas y severas, ampollas y úlceras. Describimos el caso de un paciente pediátrico de sexo masculino de la región andina de Colombia, con temperaturas diarias que oscilan entre 15° y 30°C y una humedad promedio de 72 %, quien accidentalmente pisó un milpiés, lo cual fue un desafío diagnóstico entre el personal de salud que generó su atención.

ABSTRACT Millipedes are not considered poisonous animals, although in some cases their chemical defense mechanisms may be deleterious for human beings, manifesting as erythematous, purpuric and/ or cyanotic lesions alongside local pain and paresthesia. According to the exposure, the clinical condition may progress to moderate and severe lesions such as ulcers and blisters. We describe a case of a male child from the Andean region in Colombia, an area with daily temperatures between 15° and 30° C and 72% average humidity. The boy accidentally stepped on a millipede, and this occurrence became a challenge for its diagnosis amongst staff who provided emergency health care.

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RESUMEN Objetivo: describir las características sociodemográficas, clínicas y paraclínicas de los pacientes atendidos en el Hospital Universitario de Neiva, entre los años 2014 y 2018 e identificar los factores de riesgo que se asocien con la mortalidad. Materiales y métodos: estudio observacional analítico retrospectivo. Se calcularon las medias, la desviación estándar, frecuencias absolutas y relativas. Se realizó un análisis de normalidad con el Test de Shapiro-Wilk. Se evaluó la asociación de diferentes variables sociodemográficas y clínicas con el riesgo de mortalidad usando regresión logística. Resultados: se registraron 305 eventos, predominantemente leves (117 casos). El 2018 fue el año con mayor número de reportes (35,45 %). La mayoría eran personas jóvenes con una edad media de 17 años, principalmente de los 0 a 11 años (61 %). Más del 90% eran pacientes residentes del departamento Huila y más de la mitad (67 %) pertenecían al régimen subsidiado. La mayoría de las picaduras ocurrieron durante el día, siendo las extremidades la ubicación más frecuentemente reportada (82 %). Se encontró una asociación estadísticamente significativa entre un cuadro grave y la mayor necesidad de UCI. Conclusiones: el escorpionismo es un problema de salud pública infravalorado en Colombia. La población pediátrica tiene mayor riesgo de desarrollar complicaciones y síntomas graves en la escorpiotoxicosis. Un cuadro grave en cualquier edad aumenta la probabilidad de ingreso a una UCI, requerimiento frecuente de soporte hídrico e inotrópico y la necesidad de antihipertensivos, al igual que dosis elevadas de antiveneno.

SUMMARY Objective: To describe the sociodemographic, clinical and paraclinical characteristics of the patients treated at the Neiva University Hospital between 2014 and 2018, and identify risk factors that are associated with mortality. Materials and Methods: Observational, analytic retrospective, study. Absolute and relative frequencies were calculated. Normality analysis was performed with the Shapiro-Wilk Test. The relationship of different sociodemographic and clinical variables and the risk of mortality were evaluated using logistic regression. Results: 305 events were registered, predominantly mild (117 cases), being 2018 the year with the highest number of reports (35.45%). Most were young people, with a mean age of 17 years, mainly between 0-11 years (61%). More than 90% resided in the Huila department and more than half (67%) belonged to the subsidized regime. Most bites occurred during the day, with the extremities being the most frequently reported location (82%). A statistically significant association was found between a severe condition and an increased need for an ICU. Conclusions: Scorpionism is an undervalued public health problem in Colombia. The pediatric population is at increased risk of developing severe complications and symptoms in scorpiotoxicosis. A severe condition at any age increases the probability of ICU admission, more frequent requirement for inotropic and liquids supply, and the use of antihypertensive drugs and high doses of anti-venom.

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Abstract Introduction: drug reactions with eosinophilia and systemic symptoms, known as DRESS syndrome, are a hypersensitivity reaction to medications which can lead to skin lesions and internal organ involvement. This syndrome has typically been associated with a wide variety of medications, including aromatic anticonvulsants, allopurinol and antibiotics as the main culprits. Objective: we present the case of a patient with DRESS syndrome secondary to losartan, manifesting skin symptoms and mild hepatic involvement. Up until now, there have been no reports of losartan as the cause of this condition. Prompt treatment was instated including the withdrawal of the offending medication and initiation of oral systemic steroids, with a satisfactory response. Conclusion: caregivers should be alert to the appearance of skin lesions with the use of different groups of medications, not just those typically reported, since any medication could potentially cause a hypersensitivity reaction. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.2081).

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Emerging and re-emerging vector-borne infections are a global public health threat. In endemic regions, fever is the main reason for medical attention, and the etiological agent of such fever is not usually identified. In this study, non-specific febrile pathogens were molecularly characterized in serum samples from 253 patients suspected of arbovirus infection. The samples were collected in the southern border region of Mexico from April to June 2015, and February to March 2016. ZIKV, CHIKV, DENV, leptospirosis, and rickettsiosis were detected by qPCR and nested PCR to identify flavivirus and alphavirus genera. The results indicated that 71.93% of the samples were positive for CHIKV, 0.79% for ZIKV, and 0.39% for DENV, with the number positive for CHIKV increasing to 76.67% and those positive for ZIKV increasing to 15.41% under the nested PCR technique. Leptospira Kmetyi was identified for the first time in Mexico, with a prevalence of 3.16%. This is the first report of ZIKV in Mexico, as well the first detection of the virus in early 2015. In conclusion, the etiological agent of fever was determined in 94% of the analyzed samples.

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Aedes aegypti control programs require more sensitive tools in order to survey domestic and peridomestic larval habitats for dengue and other arbovirus prevention areas. As a consequence of the COVID-19 pandemic, field technicians have faced a new occupational hazard during their work activities in dengue surveillance and control. Safer strategies to monitor larval populations, in addition to minimum householder contact, are undoubtedly urgently needed. Drones can be part of the solution in urban and rural areas that are dengue-endemic. Throughout this study, the proportion of larvae breeding sites found in the roofs and backyards of houses were assessed using drone images. Concurrently, the traditional ground field technician's surveillance was utilized to sample the same house groups. The results were analyzed in order to compare the effectiveness of both field surveillance approaches. Aerial images of 216 houses from El Vergel village in Tapachula, Chiapas, Mexico, at a height of 30 m, were obtained using a drone. Each household was sampled indoors and outdoors by vector control personnel targeting all the containers that potentially served as Aedes aegypti breeding sites. The main results were that the drone could find 1 container per 2.8 found by ground surveillance; however, containers that were inaccessible by technicians in roofs and backyards, such as plastic buckets and tubs, disposable plastic containers and flowerpots were more often detected by drones than traditional ground surveillance. This new technological approach would undoubtedly improve the surveillance of Aedes aegypti in household environments, and better vector control activities would therefore be achieved in dengue-endemic countries.