Introduction: Climate change poses increasing risks to human health, with heatwaves (HW) being a notable concern. This study pioneers the mapping of mortality risks associated with heat-sensitive Non-Communicable Diseases (NCDs) in Argentina, considering the simultaneous influence of HW and multiple underlying vulnerability factors. Materials and Methods: The study integrates data from the National Statistical System, climate reanalysis, and remote sensing products by following the methodology outlined by Argentina's Climate Change Risk Mapping System. Vulnerability dimensions, including sociodemographic, environmental, pre-existing chronic conditions, and lifestyle-related factors, were analyzed to provide spatially resolved risk assessments. A random-intercept mixed effects model was fitted to assess adherence between the risk map and mortality from a heat-related NCD. Results: Between 2006 and 2010, HW in Argentina displayed varied patterns in both intensity and extent. The vulnerability analyses reveal distinctive spatial patterns, with a notable broad diagonal from southwest to northeast. Maps indicate lower mortality risks in coastal and high-altitude areas of the northwest, with higher risks concentrated in the center-north of the country. Moreover, a positive association (RR 1·68; p < 0·001) was found between age-standardized mortality rates from cardiovascular diseases and the overall risk estimates posed by HW. Discusion and conclusion: The resulting risk map, developed through a protocolized methodology, underscores the intricate connections among contextual conditions, lifestyle attributes, and health outcomes. The study contributes to the empirical evidence base for understanding the relationship between NCDs and HW.

BACKGROUND/OBJECTIVE:the determination of the carotid total plaque area (TPA) is an indicator of subclinical atherosclerosis and a useful tool in early cardiovascular prevention. Classically, diabetes has been considered the most atherogenic disease, even more so than hypertension, but the incidence of stroke and heart attack is higher in patients with hypertension than in patients with diabetes alone. Therefore, in this study, we compared hypertension and diabetes with regard to the burden of atherosclerosis. METHODS:a cross-sectional observational study was carried out on adults (n = 606). Those with a history of a cardiovascular event were excluded. RESULTS:median age was 65 years (IQR 17), 58.6% women. People with diabetes and hypertension had the highest TPA (β exponent: 1.64; 95% CI 1.20-2.26), followed by people with hypertension alone (β exponent: 1.39; 95% CI 1.05-1.86), while people with diabetes alone had no differences (P = .379) with respect to the control group. CONCLUSION:This cross-sectional study, though limited, emphasizes the need for larger prospective studies to validate the clinical significance of these findings and highlights the importance of routine monitoring of subclinical atherosclerosis in hypertensive patients to assess the effectiveness of preventive therapy.

Human biomonitoring of the exposure to pesticides is usually performed in biological matrices such as urine and plasma. However, the possibility of using less invasive matrices allows the screening of large number of subjects. The objective of this study was to evaluate the body burden of the exposure to the most widely used herbicide, Glyphosate (GLY), and its main metabolite, the aminomethylphosphonic acid (AMPA), in different populations from the province of Córdoba (Argentina), and to propose the saliva as a matrix for possible implementation in biomonitoring of the exposure to pesticides.Glyphosate and AMPA concentrations were evaluated in urine, plasma, and saliva of subjects occupationally and environmentally exposed to pesticides from one of the most important agricultural areas of Argentina. Gas chromatography coupled to tandem mass spectrometry (MS/MS) was used for the identification and quantification of the analytes.Both GLY and AMPA were quantified in all matrices with higher detection frequency (DF) in the occupationally exposed group than in non-occupationally exposed individuals. Among evaluated matrices, the highest DF and concentration levels of GLY were found in saliva. Moreover, the only statistical difference between groups of subjects were found for GLY and AMPA concentrations in saliva, indicating the possible use of this non-invasive human matrix to evaluate different levels and scenarios of exposure. No significant correlation was found between GLY and AMPA levels in saliva and the traditional matrices (urine and blood) used to measure exposure to pesticides.This is the first report of the presence and concentrations of GLY and AMPA in human saliva samples. Results of the present study are relevant for future biomonitoring of the exposure to GLY, but also to pesticides in general. Saliva deserved further investigation as an alternative, easy, and economical matrix involving less invasive methods for biomonitoring and screenings of large populations.

Objective:Assessing subclinical atherosclerosis (sAT) is crucial for preventing cardiovascular disease. The Mediterranean diet is considered the gold standard for cardiovascular protection, but cultural and economic barriers can hinder adherence to it. The prudent dietary pattern (DP) has been associated with protective effects against chronic diseases. However, its impact on primary cardiovascular prevention remains uncertain. This study examined adherence to various DPs and their effect on sAT, measured by total carotid plaque area (TPA). Methods:This cross-sectional study included 116 adults enrolled in a cardiovascular prevention program. Demographic, clinical, laboratory, and TPA data were collected. Adherence to DPs was assessed using a food frequency questionnaire. Participants were categorized according to their adherence to 4 mutually exclusive DPs: prudent, traditional, sweet, and mixed. Generalized linear models were used to assess the effect of DPs on TPA, adjusting for relevant cardiovascular variables. Results:The traditional, sweet, and mixed DPs were associated with higher TPA values than the prudent DP, with medians (interquartile range) of 27 (99), 39 (49), 27.5 (58), and 0 (36) mm2, respectively. Gamma regression analysis found that the beta exponents for the traditional, sweet, and mixed DPs versus the prudent DP were 3.78 (p=0.046); 3.73 (p=0.013), and 2.20 (p=0.072), respectively. Systolic blood pressure values were higher for the sweet and mixed DPs than for the prudent DP (133.9±11.7; 132.5±13.9 and 122.7±8.8 mmHg, respectively; p<0.05). Conclusion:These findings underscore the importance of additional research and targeted interventions to promote healthier DPs to promote improvements in cardiovascular health.

INTRODUCTION:The American Heart Association (AHA/ACC) sets as a goal for blood pressure (BP) control not to exceed values of 130/80 mmHg, both in individuals with and without a diagnosis of hypertension (HT), standards not evaluated so far in the Argentine population. The objective was to determine the prevalence of high BP (HBP) in individuals with and without a diagnosis of HT taking into account the AHA/ACC criteria and to evaluate its association with sociodemographic and lifestyle factors. MATERIALS AND METHODS:Cross-sectional populationbased study in 911 persons >18 years of age in Córdoba, Argentina (period 2020-2022). Sociodemographic and lifestyle data, history of HT, diabetes and medication use, anthropometric measurements, BP and dietary intake were collected. HBP was defined for systolic and/or diastolic BP ≥130 / ≥80mmHg, respectively at the time of measurement. The presence of HT was assessed by self-report and/or consumption of antihypertensive medication. The association of HBP with lifestyle was assessed using multiple logistic regression models. RESULTS:84.8% and 55.6% of the patients with and without hypertension had HBP, respectively. HBP was positively associated with age and BMI, the latter only in persons without HT (OR:1.10; 95%CI:1.06-1.14), while hours of sleep showed an inverse association (OR:0.63; 95%CI:0.45-0.88). DISCUSSION:There is a high prevalence of HBP in the city of Córdoba, Argentina. It is of utmost importance and urgency to implement sanitary measures to control BP in order to avoid adverse health consequences.

Chronic kidney disease (CKD) increases cardiovascular risk, however, traditional cardiovascular risk factors cannot entirely explain it. A real-world investigation examined the concept that renal function decline is linked to carotid total plaque area progression, which strongly confirms cardiovascular risk. We analyzed CKD patients in stages 1–3 to find risk factor relationships before the onset of severe CKD. We monitored 328 patients for 16 ± 5 months. Participants were classified at baseline by estimated glomerular filtration rate (eGFR) stage: G1 (≥ 90), G2 (60–89), and G3 (30–59 ml/min/1.73m2). Ultrasound-guided total plaque area tracked atherosclerosis. Age, sex, blood pressure, lipids, and HbA1c were covariates. Total plaque area and variables were measured on day 1 and at the conclusion of observation. We used a multilevel mixed effects model to assess biological and behavioral factors on total plaque area progression in the general population. For validation, this research was conducted on 73 CKD patients with optimal traditional cardiovascular risk factor management during 15 ± 5 months. Multiple analyses showed an inverse relationship between eGFR decline and total plaque area progression [β-exponent = 0.99 (95

Background: Climate change poses increasing risks to human health, with heat waves (HW) being a notable concern. This study pioneers the mapping of mortality risks associated with heat-sensitive Non-Communicable Diseases (NCDs) in Argentina, considering the simultaneous influence of HW and multiple underlying vulnerability factors.Methods: The study integrates data from the National Statistical System, climate reanalysis, and remote sensing products by following the methodology outlined by the Climate Change Risk Mapping System of Argentina. Various vulnerability dimensions, including sociodemographic, environmental, pre-existing chronic conditions, and lifestyle-related factors were analyzed to provide spatially resolved risk assessments. To assess adherence between the risk map and mortality from a heat-related NCD, a random-intercept mixed effects model was fitted.Findings: Between 2006 and 2010, heatwaves (HW) in Argentina displayed varied patterns in both intensity and extent. The vulnerability analyses reveal distinctive spatial patterns, with a notable broad diagonal from southwest to northeast. Maps indicate lower mortality risks in coastal and high-altitude areas of the northwest, with higher risks concentrated in the center-north of the country. Moreover, a positive association (RR 1·68; p<0·001) was found between age-standardized mortality rates from cardiovascular diseases and the overall risk estimates posed by HW.Interpretation: The resulting risk map, developed through a protocolized methodology, underscores the intricate connections among contextual conditions, lifestyle attributes, and health outcomes. The study contributes empirical evidence to the understanding of the relationship between NCDs and HW.Funding: Agencia Nacional de Promoción Científica y Tecnológica Argentina [Grant PICT 2019-04594].Declaration of Interest: The authors declare no conflict of interest.

Background There is ample evidence that considers diet as an important factor in the prevention of gestational diabetes mellitus (GDM). The aim of this review is to synthesise the existing evidence on the relationship between GDM and maternal dietary components. Methods We performed a systematic bibliographic search in Medline, Latin American and Caribbean Health Sciences Literature (Lilacs) and the Latin American Nutrition Archive (ALAN) of regional and local literature, limiting the searches to observational studies published between 2016 and 2022. Search terms related to nutrients, foods, dietary patterns and the relationship to GDM risk were used. The review included 44 articles, 12 of which were from America. The articles considered different topics about maternal dietary components as follows: 14 are about nutrient intake, 8 about food intake, 4 combined nutrient and food analysis and 18 about dietary patterns. Results Iron, processed meat and a low carbohydrate diet were positively associated with GDM. Antioxidant nutrients, folic acid, fruits, vegetables, legumes and eggs were negatively associated with GDM. Generally, western dietary patterns increase GDM risk, and prudent dietary patterns or plant-based diets decrease the risk. Conclusions Diet is considered one of the causes of GDM. However, there is no homogeneity in how people eat nor in how researchers assess diet in different contextual conditions of the world.

OBJECTIVE:To study the trend of colorectal cancer (CRC) incidence, considering its spatiotemporal distribution and its association with the level of urbanisation in Córdoba, Argentina (2004-2014).METHODS:An ecological and longitudinal study was conducted in the province of Córdoba (the second most populated of the country) using annual data for the period 2004-2014. Age-standardised incidence rates (ASIR) (standard national and world population) by sex were calculated for Córdoba and its 26 departments for CRC using the provincial tumour registry database. Joinpoint regression models were adjusted to provincial ASIRs. Departments ASIRs were mapped in quintiles. The departments were grouped into three strata according to urbanisation: High (n1=6, >107,000 people); Intermediate (n2=13, 33,000-107,000 people); and Low (n3=7, <33,000 people). The spatio-temporal correlation analysis of the departments' rates was fulfilled using the multilevel modelling strategy.RESULTS:ASIRs of CRC in Córdoba province were 30.9 ±1.5 and 24.3 ±1.5 cases/100,000 for men and women, respectively. During 2004-2014, ASIRs tended to decrease (annual per cent change: -0.6; CI95% -1.8, 0.6). Maps reflected different geospatial patterns by sex. CRC incidence in males was higher than in females in all strata (high urbanisation, incidence rate ratios (IRR): 1.66; intermediate, IRR: 1.59; and low, IRR: 1.40). There was a significant downward temporary variation in the most populous departments (3% per year).CONCLUSIONS:CRC presents a non-random spatial pattern across the territory with a decreasing temporal variation in the most populous departments. Differential incidence and temporospatial tendency burden in Córdoba involve sex and urbanisation. Men continue to be the population at the greatest risk; this pattern is more noticeable in most urban settings.

Despite potential health implications, data on the presence of Glyphosate (GLY) and other non-GLY herbicides in human matrices remain scarce. This study aimed to develop a simple and cost-effective methodology for detecting and quantifying GLY, its primary biodegradation product; aminomethylphosphonic acid (AMPA); and glufosinate (GLU) in plasma and urine of environmentally and occupationally exposed populations from the province of Córdoba (Argentina). Different alternatives of pre-treatment, derivatization with FMOC-Cl, solid phase extraction, and final sample conditioning steps were evaluated to improve the quantification of the herbicides by a high-performance liquid chromatography system coupled to a triple-quadrupole mass spectrometer. Recoveries ranged from 39 to 84% in both matrices, while limits of quantification were 3, 1, and 0.3 ng/mL and 3.6, 5.1, and 0.3 ng/mL for AMPA, GLY, and GLU in plasma and urine, respectively. In plasma samples, GLY was the most frequently detected analyte (32%), followed by GLU (10%). In urine samples, GLU was the most frequently detected herbicide (13%), followed by GLY (6%). No differences between group or matrix correlations were found. This study is the first report of GLU in human biological matrices and should be used to establish baseline values for future surveillance systems.

BACKGROUND AND AIM: Climate warming is generating new challenges in health, and little is known about its effect on chronic diseases. The aim of this study is to characterize the spatio-temporal pattern of heat waves in the central area of Argentina in the last decades and to assess the association of heat wave frequency with mortality from cerebrovascular disease (CD). METHOD: A longitudinal study with an ecological design (2005-2019; n=26 geographical units) was conducted in Córdoba, Argentina. Data from the European Climate data service were processed to build a 30-year time series of daily Maximum air temperature. Heat waves were identified annually (National Meteorological Service definition). From official mortality data, annual crude mortality rates were estimated for CD (CIE-10 I60-I69). An autoregressive order 2 Poisson regression model was fitted, using CD mortality rates as the outcome, and annual frequency of heat waves (0-7, 8-19, ≥20), urban scale (big cities/middle-sized or small cities/towns) and socioeconomic stratum, as covariates. RESULTS: Aggregated spatial patterns of heat waves were identified, their frequency ranging from 0 to 25 annually. An increasing trend in the annual number of heat waves was observed over the studied period. The intermediate and higher categories of heat waves showed a direct effect with a clear gradient on CD mortality rates in women (OR 1.01; p0.047 and OR 1.04; p0.001, respectively). In males and females, a higher urbanization level (vs. towns) was associated inversely with CD mortality, while an intermediate urbanization level showed increased CD mortality rates. CONCLUSIONS: The spatial and temporal patterns of heat waves were neither homogeneous nor constant. The effect of heat waves on CD mortality is evident only in women, perhaps given their longer life expectancy, considering that age is a vulnerability factor against climatic events. Funding: FONCyT; Grant PICT-2019-04594.

En el siglo XXI, nos encontramos en un momento crucial donde la salud y el bienestar de las personas están intrínsecamente ligados a la preservación del medio ambiente y a la sostenibilidad de nuestro planeta. Cada vez más, comprendemos que no podemos separar el cuidado de nuestra salud de la salud del ecosistema en el que vivimos. Surge así la necesidad imperante de abordar la interrelación entre la salud humana, el cambio climático y la conservación de la biodiversidad. Este enfoque holístico nos exige replantear nuestros conceptos y prácticas en el ámbito de la salud pública, reconociendo que la promoción del bienestar individual y colectivo está estrechamente vinculada con la protección y preservación del entorno natural que nos rodea. Es necesario adoptar una perspectiva integradora y multidimensional en el ámbito de la salud, que abarque desde las dimensiones individuales hasta las colectivas, desde lo biológico hasta lo ambiental, y desde lo local hasta lo global. Cada persona y comunidad tiene una concepción propia de lo que entiende por salud y esta concepción rige el modo en que cada comunidad se organiza para su cuidado. El concepto de salud, por lo tanto, es dinámico y está influido por aspectos socio-históricos propios de cada contexto. Tan es así, que desde las primeras definiciones donde la salud se concebía como la ausencia de enfermedad, el concepto ha evolucionado incorporando cada vez más dimensiones yendo de lo individual a lo colectivo, de lo biológico a lo emocional e interacción con el ambiente[i] y desde una concepción objetiva a la de salud sentida. Hoy, más que nunca, esto cobra cabal importancia, puesto que los desastres naturales y situaciones sanitarias de los últimos años nos han obligado a reconocer la interdependencia del clima, los ecosistemas, la biodiversidad y las sociedades humanas, al punto tal que la Organización de las Naciones Unidas promueve desde 2021 el concepto de “Una salud” (2021) para este enfoque integrador y como aspecto fundamental para alcanzar los objetivos del desarrollo sostenible[ii]. El VI informe del Panel Internacional para el cambio climático[iii] ha mostrado cómo el cambio climático está afectando la salud y el bienestar humano en todo el mundo. La evidencia señala un aumento de las inequidades en salud, mayor frecuencia de enfermedades infecciosas y emergentes, así como el aumento en la intensidad y distribución de enfermedades transmisibles y no transmisibles. En todas las regiones, los sistemas y comunidades más vulnerables son los más afectados por los impactos del cambio climático. Esas comunidades son también las con mayor carga de enfermedad, incluso por causas prevenibles, y por tanto las más desafiadas en su capacidad adaptativa. A los determinantes sociales de la enfermedad se les suman los ambientales y climáticos que exacerban las inequidades. El cambio climático ha provocado ya pérdidas irreversibles en ecosistemas marinos, costeros y terrestres y son mayores a los que se esperaban. El deterioro de los ecosistemas, su resiliencia y capacidad adaptativa, así como cambios en el patrón climático estacional, han tenido importantes consecuencias socioeconómicas. El incremento en frecuencia e intensidad en eventos extremos ha provocado disminución en la biodiversidad y afectado negativamente los sistemas hídricos y productivos de alimentos. La acidificación y calentamiento de los océanos ha ocasionado pérdidas importantes en la acuicultura. Todo ello ha puesto en riesgo la seguridad alimentaria e hídrica principalmente en latitudes medianas y bajas e islas pequeñas. Las pérdidas bruscas en producción y acceso a alimentos han afectado la diversidad de la alimentación, aumentando la malnutrición principalmente en pueblos originarios, hogares de bajos recursos, niños y ancianos y ha provocado migraciones poblacionales a zonas más favorables. En este contexto, los desafíos son múltiples y esta nueva realidad nos convoca a trabajar de manera conjunta e integrada, para anticiparnos en las habilidades para prevenir, mitigar, adaptarnos y mejorar la capacidad de resiliencia a los efectos del cambio climático. Es tal la inminencia de estas necesidades que los principales organismos internacionales vienen trabajando al respecto desde hace varios años para incluir estos aspectos en la agenda de los países, como lo testimonian el acuerdo de París[iv] o los objetivos del desarrollo sostenible[v]. El sistema sanitario en particular, enfrenta retos significativos en muy diversos órdenes, particularmente en la atención a poblaciones eco-refugiadas o migrantes, así como en la integración de registros y sistemas de salud. Las migraciones obligan a pensar en la articulación y acceso a su historial de salud en los lugares de destino dondequiera que estos sean o evaluar las implicancias del desarraigo cultural y las posibilidades de un accionar intersectorial e interjurisdiccional. El accionar con decisiones oportunas y adecuadas a cada contexto, no es un detalle menor a la hora de evaluar la disponibilidad y calidad de la información en sistemas con coexistencia de registros digitales y en papel, o vacíos de información y sistemas de salud desarticulados. El cuidado del ambiente, la preservación de la biodiversidad para la mitigación de los efectos del clima, implica también el desarrollo de nuevas estrategias por parte de los sistemas productivos de bienes y servicios. Se requiere mejorar la articulación entre el sector público y privado (gobiernos y sociedad civil y empresas), estimulando la competitividad de aquellos emprendimientos de prácticas más ecológicas y sostenibles, y la promoción de patrones de consumo amigables con el ambiente. Las nuevas y cambiantes condiciones eco-ambientales demandan la adquisición de nuevas competencias en los profesionales de la salud. En este sentido, numerosos organismos educativos se están nucleando en consorcios internacionales[vi] para trabajar en la adecuación de la currícula de las Universidades a las nuevas problemáticas sanitarias, convencidos de la capacidad de los profesionales de la salud para influir en las políticas ambientales y defender los derechos de las comunidades más vulnerables y su capacidad de resiliencia. Sin embargo, la acción en salud pública no puede limitarse únicamente a las ciencias de la salud, sino que requiere la colaboración de profesionales de diferentes áreas, sociedad civil y responsables de la toma de decisiones. Las instituciones educativas tienen la responsabilidad de generar conciencia y proporcionar una formación integral y transversalmente a todas las disciplinas para enfrentar los desafíos del cambio global, pero también es necesario un profundo ejercicio de responsabilidad individual y colectiva. A medida que enfrentamos los desafíos sin precedentes del cambio climático y la preservación de la salud, también encontramos una gran oportunidad para generar un cambio positivo y construir un futuro más sostenible y saludable. Aprendemos de las lecciones del pasado y nos damos cuenta de que nuestras acciones individuales y colectivas pueden marcar la diferencia. Al adoptar un enfoque integrador, trabajando en colaboración entre sectores, comunidades y países, podemos fortalecer la resiliencia de nuestras sociedades y proteger la salud de las generaciones presentes y futuras. La educación, la conciencia y la responsabilidad son pilares fundamentales en este camino, y cada uno de nosotros tiene un papel relevante que desempeñar. A través de la innovación, la investigación y la implementación de prácticas sostenibles, podemos lograr un equilibrio entre el cuidado de nuestra salud, el respeto por el medio ambiente y la promoción de una sociedad más justa e inclusiva. Con determinación y acción conjunta, podemos forjar un futuro en el que la salud y el bienestar de todos estén en armonía con la salud de nuestro preciado planeta. Construyamos juntos un mundo más saludable y sostenible para todos. [i] Guerrero L, León A. Aproximación al concepto de salud. Revisión histórica. Fermentum. Revista Venezolana de Sociología y Antropología 2008, 18(53) [ii]FAO. Una Salud. https://www.fao.org/one-health/es [iii] IPCC (2022) Intergovernmental Panel on Climate Change. Climate Change 2022: Impacts, Adaptation and Vulnerability. Available in: https://report.ipcc.ch/ar6/wg2/IPCC_AR6_WGII_FullReport.pdf [iv] Acuerdo de Paris. https://unfccc.int/es/acerca-de-las-ndc/el-acuerdo-de-paris [v] Objetivos del Desarrollo sostenible. https://www.un.org/sustainabledevelopment/es/objetivos-de-desarrollo-sostenible/ [vi] Global Consortium on Climate and Health Education. https://www.google.com/url?q=https://www.publichealth.columbia.edu/research/centers/global-consortium-climate-health-education&sa=D&source=docs&ust=1686083471773003&usg=AOvVaw3ibnHkSCuNbCFf5_4CDoeq

La alimentación durante las primeras etapas del ciclo vital es uno de los factores más estudiados por su interacción con diferenciales sociodemográficos y otros factores del estilo de vida, determinantes de los procesos de salud-enfermedad. El objetivo del estudio fue caracterizar el potencial antioxidante del consumo pregestacional de componentes alimentarios y tabaco, a partir de la construcción de un escore de balance oxidativo (EBO), y analizarlo de acuerdo a diferenciales sociodemográficos y del estilo de vida en mujeres embarazadas de Córdoba, Argentina durante el periodo 2021-2022. Recientemente se dio inicio a una cohorte de mujeres gestantes residentes en Córdoba, Argentina. Las 187 mujeres incluídas hasta la fecha completaron una encuesta que evaluó datos sociodemográficos y del estilo de vida y un cuestionario de frecuencia alimentario validado para recolectar datos de consumo alimentario previos al embarazo. Se construyó un EBO que se calculó para cada participante cómo la suma de puntuaciones individuales para componentes prooxidantes (carnes rojas, fuentes alimentarias de hierro, ácidos grasos saturados, etanol y tabaco) y componentes antioxidantes (yerba mate, fuentes alimentarias de b-carotenos, licopenos, polifenoles, E y C, selenio, zinc y ácidos grasos omega 3). El cuartil más bajo de consumo de cada componente prooxidante recibió una puntuación igual a 3 mientras que el cuartil más alto recibió un valor de 0. La puntuación de los componentes antioxidantes se realizó en orden inverso. El EBO se calculó sumando las puntuaciones individuales de prooxidantes y antioxidantes, donde las puntuaciones más altas indican un mayor poder antioxidante. Se aplicó prueba de χ2 para analizar la distribución del EBO en relación al nivel socioeconómico, nivel educacional y el estado nutricional pregestacional y gestacional. Todos los análisis estadísticos se realizaron considerando un nivel de significación α<0.05 y se llevaron a cabo usando el software Stata® 17.1. La mayoría de las mujeres distribuidas dentro del EBO alto pertenecieron a la categoría de nivel educacional alto, lo cual fue estadísticamente significativo (p valor=0,008). Así mismo, las mujeres dentro del EBO alto o medio pertenecían en mayor medida a la categoría regular de actividad física pregestacional, a diferencia de las mujeres dentro del EBO bajo que se distribuyeron de igual manera en ambas categorías (p valor= 0,05). Se destaca la importancia de analizar el balance oxidativo y su efecto modulador de la salud antes y durante el embarazo y evaluar factores sociodemográficos y del estilo de vida que pueden influenciar las elecciones alimentarias y, por lo tanto, tener efectos en los procesos de salud en etapas tempranas del ciclo vital

Objectives: Diet, one of the main risk factors for both metabolic syndrome (MetS) and non-communicable dis-eases (NCDs), is a multidimensional feature whose complexity relies on the individual and contextual charac-teristics of foods. The aim of this study was to build a "diet model" and estimate its relationship with MetS components in two Argentinian populations. Methods: This was a population-based cross-sectional study that assessed bio-socio-anthropometrical varia-bles and dietary habits using food frequency questionnaires. Dietary patterns (DPs) were drawn out using exploratory factor analysis (EFA). A structural equation model (SEM) was used to explore and confirm theo-retical and empirical relationships between DPs and the diet model. The association between individuals' adherence to DPs and MetS were assessed using a multiple logistic regression analysis. We selected two cities in central Argentina according to socio-eco-environmental characteristics. Participants included 493 men and women (1:1 ratio) from 35 to 65 y of age. Results: We identified four DPs: traditional Argentine (TA; processed meats, meats and eggs, fats, starchy veg-etables), prudent (Pr; vegetables, fruits, milk, and yogurt), alcohol and snacks (AS), and sweets (S; candies and sodas). TA and AS DPs were associated with increased waist circumference. The S DP showed a strong effect on hypertension. Moderate adherence to the TA DP was positively associated with dyslipidemia but negatively with hypertension whenever individuals did not adhere to the AS DP. TA was positively correlated to AS and S, but inversely with Pr. Conclusion: This diet model integrated those food groups in an associative structure describing per se a syn-thesis of the Argentine dietary habits and their association with three of the five components of MetS. (c) 2022 Elsevier Inc. All rights reserved.

Sodium ibuprofenate in hypertonic saline (NaIHS) administered directly to the lungs by nebulization and inhalation has antibacterial and anti-inflammatory effects, with the potential to deliver these benefits to hypoxic patients. We describe a compassionate use program that offered this therapy to hospitalized COVID-19 patients. NaIHS (50 mg ibuprofen, tid) was provided in addition to standard of care (SOC) to hospitalized COVID-19 patients until oxygen saturation levels of > 94% were achieved on ambient air. Patients wore a containment hood to diminish aerosolization. Outcome data from participating patients treated at multiple hospitals in Argentina between April 4 and October 31, 2020, are summarized. Results were compared with a retrospective contemporaneous control (CC) group of hospitalized COVID-19 patients with SOC alone during the same time frame from a subset of participating hospitals from Córdoba and Buenos Aires. The evolution of 383 patients treated with SOC + NaIHS [56 on mechanical ventilation (MV) at baseline] and 195 CC (21 on MV at baseline) are summarized. At baseline, NaIHS-treated patients had basal oxygen saturation of 90.7 ± 0.2% (74.3% were on supplemental oxygen at baseline) and a basal respiratory rate of 22.7 ± 0.3 breath/min. In the CC group, basal oxygen saturation was 92.6 ± 0.4% (52.1% were on oxygen supplementation at baseline) and respiratory rate was 19.3 ± 0.3 breath/min. Despite greater pulmonary compromise at baseline in the NaIHS-treated group, the length of treatment (LOT) was 9.1 ± 0.2 gs with an average length of stay (ALOS) of 11.5 ± 0.3 days, in comparison with an ALOS of 13.3 ± 0.9 days in the CC group. In patients on MV who received NaIHS, the ALOS was lower than in the CC group. In both NaIHS-treated groups, a rapid reversal of deterioration in oxygenation and NEWS2 scores was observed acutely after initiation of NaIHS therapy. No serious adverse events were considered related to ibuprofen therapy. Mortality was lower in both NaIHS groups compared with CC groups. Treatment of COVID-19 pneumonitis with inhalational nebulized NaIHS was associated with rapid improvement in hypoxia and vital signs, with no serious adverse events attributed to therapy. Nebulized NaIHS s worthy of further study in randomized, placebo-controlled trials (ClinicalTrials.gov: NCT04382768).

Background: Sodium-ibuprofenate in hypertonic saline (NaIHS) administered directly to the lungs by nebulization and inhalation has antibacterial and anti-inflammatory effects with the potential to deliver these benefits to hypoxic patients. We describe a compassionate use program that offered this therapy to hospitalized COVID-19 patients.Methods: NaIHS (50 mg ibuprofen, tid) was provided in addition to standard of care to hospitalized Covid-19 patients until oxygen saturation levels of >94% were achieved on ambient air. Patients wore a containment hood to diminish aerosolization. Outcome data from participating patients treated at multiple hospitals in Argentina between April 04, 2020, through October 31, 2020 are summarized.Results: 383 patients were treated, including 327 not on mechanical ventilation at baseline (MV) and 56 ICU patients receiving MV. For those not on baseline MV (59±0.8 years), 64% were male, most with at least one recognized risk factor for disease severity, and mean NEWS2 score prior to treatment initiation of 7.0±0.1. The average length of stay (ALOS) was 11.5±0.3 days and length of treatment (LOT) 9.0±0.2 days. In patients on baseline MV (60.6±2.2 years), 69.9% were male, baseline mean NEWS2 Score was 8.8±0.4, ALOS 15.5±1.4 days and LOT 10.5±0.7 days. Reversal of deterioration in oxygenation and NEWS2 scores was observed acutely following initiation of therapy. Overall in-hospital mortality was 10.7% among patients not on MV at baseline, and 19.6% among patients receiving MV at baseline. No serious adverse events were considered related to ibuprofen therapy.Conclusions: Treatment of COVID-19 pneumonitis with inhalational nebulized NaIHS was associated with rapid improvement in hypoxia and vital signs, with no serious adverse events attributed to therapy. Nebulized NaIHS is worthy of further study in randomized, placebo-controlled trials.Trial Registration: (ClinicalTrials.gov:NCT04382768).Funding Statement: The study sponsor, Quimica Luar, provided NaIHS under compassionate use, and conducted the analysis of received safety monitoring and outcome data in this report.Declaration of Interests: Authors have nothing to declare. Ethics Approval Statement: Ethical approval was obtained from the Institutional Independent Ethics Committees and district regulatory agencies of Cordoba and Mendoza Provinces for the compassionate use of Luarprofeno® (sodium ibuprofenate in hypertonic saline, or NaIHS, for nebulization).

Urinary metabolites of organophosphate (OP) and pyrethroid (PYR) pesticides and biomarkers of effects were studied in a population (n=40) residing in an important agricultural area of the province of Córdoba (Argentina). Detection frequencies (DF) higher than 85% were observed for the metabolites of pirimiphos (2-diethylamino-6-methylpyrimidin-4-ol –DEAMPY-, median 7.5 μg/g creatinine, DF: 100%), parathion (p-nitrophenol, 0.99 μg/g creatinine, 100%), and chlorpyrifos (3,5,6-trichloro-2-pyridinol, 0.25 μg/g creatinine, 85%). The DEAMPY concentrations doubled the levels found in other studies and were negatively associated with Er-AChE activity, suggesting the appearance of health effects already in environmental exposure levels below established acceptable daily intakes (ADIs). 3-Phenoxybenzoic acid, the metabolite of several PYR pesticides, was also found in all samples. This metabolite was also significantly negatively correlated with Er-AChE, indicating effects of pyrethroid pesticides on the acetylcholine system even at concentrations below the ADI.

The characterization of the population exposed to pesticides and the use of effective biomarkers to evaluate potential health effects are determinant to identify vulnerable groups, understanding the causality of diverse pathologies and propose prevention policies. This is particularly important in countries where intensive agricultural practices had an explosive expansion in last decades. The aim of this study was assessing the usefulness of two exposure indexes questionnaire-based: Intensity Level of the pesticide Exposure (ILE) and Cumulative Exposure Index (CEI) and their scales, in terrestrial applicators of pesticide from the Province of Córdoba (Argentina). The analysis was performed contrasting ILE and CEI results with perceived symptomatology, in addition to effect and exposure biomarkers. A cross-sectional study was designed to compare pesticides body burdens and effect biomarkers between subjects occupationally (OE) and non-occupationally exposed (NOE) to pesticides. Prevalence of perceived symptomatology and genotoxicity damage was higher in the OE group. The exposure condition was the only variable explaining these differences. Significant associations were found between CEI and neurologic symptomatology (p < 0.05) and between ILE and plasmatic cholinesterase (p < 0.1). However, residues of HCB, β-HCH, α-endosulfan, pp'DDE, endrin, β-endosulfan, pp'DDT, endosulfan sulfate and mirex were found in blood samples from both groups. To our knowledge, this is the first report on pesticides body burdens in occupational exposure settings in Argentina. So far, our current results indicate that the occupational condition affects the health of the workers. Significant associations found between symptomatology and biomarkers with scales of CEI and ILE suggest their usefulness to verify different levels of exposure. Further research is necessary to propose these indexes as an affordable tool for occupational health surveillance in areas with difficult access to health care centres.

Los plaguicidas configuran un aspecto central de las prácticas agrícolas. OBJETIVOS: Describir la distribución espacial de la exposición a plaguicidas en Argentina y su asociación con indicadores de carga de cáncer, construir índices de exposición global y validar índices de exposición individual con biomarcadores de efecto en sujetos laboralmente expuestos. MÉTODOS: Se construyeron dos índices globales (de exposición a plaguicidas [IEP] y de impacto ambiental total [IIAT]), se estudiaron sus distribuciones espaciales y mediante un estudio ecológico a nivel nacional se estimó la asociación con las tasas de mortalidad de cáncer total, mama y próstata, usando los departamentos como nivel de desagregación (n=564). Dos índices de exposición, construidos con información (individual) de agroaplicadores de Córdoba, se validaron mediante biomarcadores (actividad de butirilcolinesterasa y genotoxicidad). RESULTADOS: El área pampeana agrupa un IEP mayor al promedio nacional y los IIAT superiores, correspondientes al 2,4-D y clorpirifos. El aumento en ambos índices de exposición se asoció a incrementos en las tasas de mortalidad por cáncer a nivel departamental. El daño genotóxico en aplicadores no se asoció a los niveles de exposición; sí la disminución de la actividad de butirilcolinesterasa. CONCLUSIONES: Los instrumentos —índices— y resultados alcanzados brindan valiosos elementos para vigilar la exposición a plaguicidas en Argentina.