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Introduction: Chronic hepatitis C (CHC) is considered an important public health challenge. Traditionally identified risk factors have undergone an epidemiological transition where other risk factors have become the main cause of new infections. Objective: To describe risk factors associated to hepatitis C positivity through the evaluation of the epidemiological profile in hepatitis‐C high‐risk populations. Methods: Cross‐sectional study was conducted as part of an HCV screening program in Mexican population. All participants answered an HCV risk‐factor questionnaire and took a rapid test (RT). All patients reactive to the test were subject to HCV PCR (polymerase chain reaction) confirmation. A logistic regression model was used to examine associations between HCV infection and risk factors. Results: The study included 297 631 participants that completed a risk factor questionnaire and underwent an HCV rapid test (RT). In total, 12 840 (4.5%) were reactive to RT and 9257 (3.2% of participants) were confirmed as positives by PCR test. Of these, 72.9% had at least one risk factor and 10.8% were in prison. Most common risk factors were history of acupuncture/tattooing/piercing (21%), intravenous drug use (15%) and high‐risk sexual practices (12%). Logistic regressions found that having at least one risk factor increased the probability of having an HCV‐positive result by 20% (OR = 1.20, 95% CI: 1.15–1.26), compared to the population without risk factors. Conclusions: We identified 3.2% of HCV‐viremic subjects, all associated with risk factors and older age. Screening and diagnosis of HCV in high‐risk populations (including underserved populations) should be more efficient. [ABSTRACT FROM AUTHOR]

Tree diversity exerts a strong influence on consumer communities, but most work has involved single time point measurements over short time periods. Describing temporal variation associated with diversity effects over longer time periods is necessary to fully understand the effects of tree diversity on ecological function.We conducted a year‐long study in an experimental system in southern Mexico assessing the effects of tree diversity on the abundance and diversity of foraging birds. To this end, we recorded bird visitation patterns in 32 tree plots (21 × 21 m; 12 tree species monocultures, 20 four‐species polycultures) every 45 days (n = 8 surveys) and for each plot estimated bird abundance, richness, functional diversity (FD) and phylogenetic diversity (PD). In each case, we reported temporal (intra‐annual) variation in the magnitude of tree diversity effects, and calculated the temporal stability of these bird responses.Across surveys, tree diversity noticeably affected bird responses, demonstrated by significantly higher abundance (43%), richness (32%), PD (25%) and FD (25%) of birds visiting polyculture plots compared to monoculture plots, as well as a distinct species composition between plot types. We also found intra‐annual variation in tree diversity effects on these response variables, ranging from surveys for which the diversity effect was not significant to surveys where a significant 80% increase (e.g. for bird FD and PD) was observed in polyculture relative to monoculture plots. Notably, tree diversity increased the stability of all bird responses, with polycultures having a greater stability abundance (18%), richness (38%), PD (32%), and FD (35%) of birds visiting tree species polycultures compared to monocultures.These results show that tree diversity not only increases bird visitation to plots, but also stabilizes bird habitat usage over time in ways that could implicate insurance‐related mechanisms. Such findings are highly relevant for understanding the long‐term effects of plant diversity on vertebrates and the persistence of bird‐related ecosystem functions. More work is needed to unveil the ecological mechanisms behind temporal variation in vertebrate responses to tree diversity and their consequences for community structure and function. [ABSTRACT FROM AUTHOR]

At the Hospital General de México Dr. Eduardo Liceaga, a large number of potential donors of corneal tissue are discarded owing to various contraindications such as shock septic. The objective of this study is to determine the number of patients with postmortem diagnosis of septic shock and analyze whether there is an overdiagnosis of it. It is a cross-sectional and descriptive study in which 144 (n = 144) medical records were reviewed between January 2018 and May 2019 and where septic shock was identified within postmortem diagnoses. Exclusion criteria were age <2 or ≥75 years; infection due to human immunodeficiency virus, hepatitis B virus, or hepatitis C virus; active tuberculosis; neuroinfection; endocarditis; or cancer. The Sequential Organ Failure Assessment (SOFA) scale was calculated, and a descriptive analysis of the data was performed. According to the third international consensus for the definition of sepsis and septic shock (SEPSIS 3) using its SOFA diagnostic tool, 46 (32%) patients did not meet the criteria for septic shock because they did not require vasopressor nor had a lactate ≥ 18 mg/dL. These were potential donors of corneal tissue that were not considered as such; 35 of them met the diagnosis of sepsis with SOFA scores of ≥2 and the suspected or documented presence of infection. Eleven patients were not considered septic. It is important to train the hospital medical staff to properly diagnose septic shock, based on international consensus, and perform all the laboratory studies that allow doctors to calculate the SOFA to confirm or rule out the presence of septic shock. • Over 6000 persons are on the waiting list for a corneal transplantation in Mexico. • Medical staff from the Hospital General de México Dr. Eduardo Liceaga does not properly diagnose septic shock. • Forty-six of the 144 cases did not meet the criteria of septic shock and were discarded cases for donation. • The necessary laboratory studies to calculate the SOFA score are not being requested, making it more difficult to know if a patient has septic shock. • The term "sepsis" is rarely used; instead, the term "septic shock" is abused. [ABSTRACT FROM AUTHOR]

Background: With only a third of Latinos achieving sustained virologic response (SVR), there is a need for enhanced HCV treatment. Amantadine has been proposed to improve response rates in addition to standard therapy with peginterferon alpha and ribavirin. Our objective is to evaluate whether triple therapy with amantadine improves SVR rates in this special population.Method: Treatment-naïve Latino subjects with HCV genotype 1 infection were randomized to receive peginterferon alpha-2a plus weight-based ribavirin for 48 weeks (double therapy) or the same regimen plus amantadine 200 mg daily (triple therapy). The primary endpoint was SVR. Predictors of liver fibrosis using APRI and Forns indices were also evaluated.Results: We enrolled 124 patients with chronic hepatitis C genotype 1. Sixty-three received conventional therapy and 61 patients had triple therapy with amantadine. SVR at week 72 was achieved in 25 patients (39.7%) vs. 26 patients (42.6%) in the double and triple regimen, respectively (p=0.561). After multivariate analysis, advanced fibrosis, obesity, and low pretreatment ALT levels were associated with non-response in both groups (p=0.0234, p=0.0012, p=0.0249, respectively). APRI values delimited an area under the ROC curve (AUROC) of 0.724 and Forns index with AUROC of 0.733. There was no difference between both indices in predicting significant fibrosis (Knodell index: F3-F4).Conclusion: Our study demonstrates that the addition of amantadine to standard treatment of chronic HCV does not improve SVR rates in Latino patients with genotype 1. Further research to improve response rates in this special population is needed. [ABSTRACT FROM AUTHOR]

The effects of fragmentation on tropical bee communities are not well understood. The present study investigated these effects on wild bee species richness and diversity in fragments of tropical forest in the Yucatan Estate (Mexico). We present an analysis of bee community structure based on fragment size, connectivity, and bee life form, and include an analysis of m-dominance to evaluate if large fragments sustain greater species diversity compared to small fragments. Results indicated that the bee community within each fragment was composed of different bee species, and that species richness and diversity increased with fragment size, although this relationship varied between the life forms. Results suggest a high degree of isolation between fragments and greater differences in species composition. The m-dominance analysis indicated that 37% of the species recorded were restricted to medium and large-size fragments, while all other species were randomly distributed across fragments of different size in general; ours results indicate that not only do large fragments support greater species diversity than small fragments, but they are also essential for the conservation of wild bee species. [ABSTRACT FROM AUTHOR]

Folivory may indirectly impact plant reproduction through changes in sexual expression ( i.e., number or proportion of male and female flowers produced), which influence plant–pollinator interactions via changes in pollinator preference or efficiency. This study is an experimental evaluation of the effect that defoliation has on sex expression in the monoecious shrub Cnidoscolus aconitifolius, how such effect varies across sites, as well as how such changes indirectly affect pollinator visitation rates. The present study used three populations of C. aconitifolius, each one located in a different site in Yucatán (México): pasture, deciduous forest and subdeciduous medium height forest and three levels of defoliation: 50 percent, 100 percent, and a control (no damage). Results showed that defoliation reduced significantly the total number of male flowers produced in two of the sites. Defoliation did not impact female flower production or the proportion of female flowers produced. Finally, floral visit rates were not affected by defoliation via changes in sexual expression and neither by site or by the interaction site × defoliation. Findings showed that defoliation had an effect on sex expression in C. aconitifolius, although apparently this change did not affect the plant–pollinator interactions. [ABSTRACT FROM AUTHOR]

We present two cases of acute liver injury resulting from consumption of wild mushrooms. The first case was a male who developed acute hepatitis after ingestion of diverse mushrooms including Amanita species. His clinical course was favorable with complete recovery of liver function. The second case was a male who developed acute liver failure (ALF) after ingestion of Amanita bisporigera. He required MARS therapy as a bridge to liver transplantation but transplantation was not performed because he succumbed to multiorgan failure. There are few trials demonstrating the efficacy of the different treatments for mushroom poisoning. These cases demonstrate that the consumption of wild mushrooms without proper knowledge of toxic species represents a serious and under recognized health problem.

Objective: To determine the epidemiological situation of Chronic Hepatitis C (CHC) in our country., Background Data: Chronic Hepatitis C affects 170 million people worldwide, and about 0.7% of Mexican population. There is no enough epidemiological information about CHC in our country, and it is very probable that some cases are not even detected., Methods: An investigation poll was performed. Age, gender, birthday, weight, race, residence and birth place, routes of transmission, ALT levels, histological, serological and molecular diagnosis, evidence of complications and previous treatments were recorded. A data recollection sheet was dispatched to different country provinces; they had 6 months to answer it, in order to recollect all information., Results: 831 patients were analized (58.6% female and 41.4% male) with the following distribution in our country provinces: Aguascalientes 15, Chihuahua 12, Distrito Federal 495, Durango 10, Jalisco 89, Guanajuato 78, Yucatán 8, Querétaro 11, Sonora 40, Tabasco 15, Baja California 5, Veracruz 13, Tamaulipas 2 and 38 patients of Nuevo León. The highest incidence of CHC was found at fifth and sixth decade of life (28.5% y 26.7% respectively. The weight distribution was 36.2% < 65kg, 34.6% 65-75 kg and 29.2% > 75 kg. 86.5% had chronic hepatitis and 13.2% cirrhosis. The risk factors for HCV infection analysis showed that the main route of transmission was via contaminated blood (64.2%); when we excluded the patients that were exposed before 1995, the incidence was lowered to 4.5%. The higher incidence was showed between 1970 and 1990 (68%). The intravenous drug users were predominantly male and on those patients in the provinces near the north border line of our country. The predominant genotype was gen- 1 no matter the province (72.2%), in the intravenous drug users genotype 3 was found in 25%. The viral load was similar in all the provinces. 75% of the patients had have treatment and 22.5% had have two cycles, 50% of cirrhotic patients had have treatment whereas only 28% of the patients with late complications had have it. The most common treatment was pegylated alpha-2a interferon plus ribavirine., Conclusions: 1. The main route of transmission was blood transfusion. There is a marked decrease in the incidence of post-transfusional hepatitis since the introduction of anti-VHC antibody screening of blood donors (4.5%). 2. The time between the infection and diagnosis was 23 years for chronic hepatitis and 26 years for cirrhosis. 3. Intravenous drugs use was an important route of transmission in the north of our country. 4. The predominant genotype was gen-1. 5. Almost all the patients with chronic hepatitis received treatment, the most common used was pegylated interferon alpha-2a and ribavirin. 6.50% of the patients with CHC have late complications.