- Research Article
- 10.1016/j.ekir.2026.104872
WCN26-6861 CHRONIC KIDNEY DISEASE IN VULNERABLE AFRO-DESCENDANT, INDIGENOUS, AND AGRICULTURAL COMMUNITIES IN LATIN AMERICA
- Mar 25, 2026
- Kidney International Reports
- Gustavo Aroca + 14 more +14
Publications from 2021 to 2026
Showing 10 of 143 papers
WCN26-6861 CHRONIC KIDNEY DISEASE IN VULNERABLE AFRO-DESCENDANT, INDIGENOUS, AND AGRICULTURAL COMMUNITIES IN LATIN AMERICA
Are functional traits of host fish good predictors of parasite species composition in a tropical middle American stream?
Host functional traits are widely used to explain patterns of parasite diversity and community structure; however, their predictive power in species-rich Neotropical freshwater systems remains poorly understood. We examined whether host traits predict helminth parasite community composition in the Lacantún River (southern Mexico), using presence/absence data for 74 helminth genera recorded from 58 fish species. We evaluated a suite of host traits related to body size, spatial ecology, migration and trophic position, together with a proxy for host phylogenetic relatedness. Multivariate analyses revealed that the first axis explained 17.9% of the total variation in parasite assemblage composition. Trophic level was the strongest contributor to this axis (23.8% of its explained variance), followed by host total length (21.3%) and position in the water column (20.6%). Notably, piscivorous hosts harboured distinct parasite communities. Nevertheless, the overall proportion of explained variation was low, reflecting the complex, multicausal nature of host-parasite systems and the influence of unmeasured factors such as host density, sampling effort and parasite life-history diversity. Consistent with this interpretation, univariate analyses showed no significant linear relationship between helminth genus richness and either host total length or trophic level. Together, these results indicate that host traits act primarily as ecological filters shaping which parasite genera occur, rather than determining the total number of parasite genera per host. Our findings highlight the importance of multivariate, trait-based approaches for understanding parasite community assembly in Neotropical rivers and caution against relying on simple richness-based predictors in highly complex host-parasite networks.
Read moreMassive Bilateral Pulmonary Thromboembolism Due to a Thrombus in Transit to the Right Atrium: A Case Report
A 48-year-old man presented to a rural Honduran hospital with progressive dyspnea for three days, worsening at rest. He was hemodynamically stable and without tachypnea or pulmonary crackles. The electrocardiogram showed sinus tachycardia, suggestive of pulmonary thromboembolism (PTE). Chest CT confirmed the diagnosis of bilateral PTE with total occlusion of the right pulmonary artery and significant stenosis of the left pulmonary artery. Transthoracic echocardiogram revealed a right atrial thrombus. Medical treatment with therapeutic anticoagulation was provided. Echocardiographic follow-up at 10 days showed that the original thrombus had been significantly reduced to two smaller thrombi. The patient was discharged from the hospital with more anticoagulants. Thrombus in transit alongside pulmonary embolism is rare and is an emergent condition; it can quickly progress to cardiogenic shock or cardiac arrest. This patient’s effective diagnosis and treatment highlight the importance of bedside echocardiography in resource-limited settings.
Read moreImpacto de la obesidad en la evolución clínica de la neumonía adquirida en la comunidad en adolescentes
La neumon.a adquirida en la comunidad (NAC) constituye una causa significativa de morbimortalidad en adolescentes. Esta etapa presenta cambios fisiológicos que modifican la estructura pulmonar y la respuesta inmunitaria. La obesidad, cuya prevalencia va en aumento de forma sostenida en este grupo, añade complejidad clínica al considerarse un estado inflamatorio crónico de bajo grado preexistente a la enfermedad aguda asociado a disfunción ventilatoria y alteraciones metabólicas que pueden influir negativamente en la evolución de la enfermedad. Esta revisión examina el impacto de la adolescencia, la obesidad y su combinación en la presentación clínica, progresión y tratamiento de la NAC. La evidencia disponible sugiere que los adolescentes con obesidad presentan mayor frecuencia de síntomas respiratorios, desaturación, recurrencia de cuadros infecciosos, necesidad de soporte ventilatorio, ingreso a cuidados intensivos, estancia hospitalaria prolongada y aumento en los costos asociados. Además, las alteraciones farmacocinéticas propias de los adolescentes con obesidad, como cambios en el volumen de distribución, metabolismo hepático y aclaramiento renal, pueden favorecer la subdosificación de antimicrobianos y aumentar el riesgo de fracaso terapéutico. La obesidad y la adolescencia modifican de forma significativa el curso clínico de la NAC, incrementando su gravedad y dificultando su manejo. Un aspecto en discusión es que la mayoría de los estudios agrupa amplias franjas etarias pediátricas sin analizar de forma diferenciada al subgrupo adolescente, lo que limita la comprensión de sus particularidades clínicas. En esta revisión se evalúa la información disponible para evaluar si la confluencia de obesidad y adolescencia podrían configurar un perfil clínico distintivo, caracterizado por particularidades fisiológicas y metabólicas que amerita ser explorado en futuras investigaciones específicamente dirigidas a este grupo etario.
Read moreTransmisión vertical en embarazadas infectadas por virus de inmunodeficiencia humana en servicio de atención integral
Introducción: La Transmisión Vertical (TV) del Virus de la Inmunodeficiencia Humana (VIH) constituye la causa principal de transmisión del virus en menores de 15 años. Se define la TV del VIH, como la entidad clínica infecciosa del paso del VIH de una mujer embarazada infectada a su hijo durante el período de la gestación, el trabajo de parto, o durante la lactancia. Objetivo: Describir las características de la transmisión vertical en gestantes infectadas por el virus de la inmunodeficiencia humana, de enero 2019 a diciembre 2021 en el Hospital Escuela (HE). Métodos: Estudio descriptivo retrospectivo. La muestra fue de 42 gestantes infectadas por VIH que asistieron al Servicio Atención Integral (SAI) del HE. Se revisaron expedientes clínicos registrando información sobre características sociodemográficas y clínicas de las pacientes. Los resultados se presentaron en frecuencias y porcentajes de las variables estudiadas. Resultado: el 100% (42) de las madres conocían el diagnóstico de ser VIH positivo, 79% fueron diagnosticadas previo al embarazo, 100% en tratamiento antirretroviral (ARV), 43% con carga viral no detectable, 81% finalizó su embarazo vía cesárea, 55% fueron categorizados como alto riesgo, 52% recibió terapia antirretroviral (ARV) por 4 semanas, incidencia de TV de VIH fue de 2.4%, 1 de los 42 pacientes Discusión: La solicitud de una prueba para el diagnóstico de VIH en control prenatal debe realizarse de forma rutinaria, implementándose cesárea electiva, omisión de lactancia materna y tratamiento ARV prenatal a la culminación del embarazo y en recién nacido para la reducción la transmisión vertical.
Read moreDevelopment of Biodegradable Bioplastic from Banana Pseudostem Cellulose
Banana pseudostem is an abundant lignocellulosic residue with potential for value-added applications. This study evaluated five banana varieties to determine their suitability for bioplastic production, with Williams showing the highest cellulose yield (26.99% ± 0.23). Cellulose extracted from this variety was combined with corn-starch (1:1 w/w) to synthesize a bioplastic through gelatinization and lyophilization. FTIR confirmed effective removal of lignin and hemicellulose from the pseudostem and evidenced new hydrogen-bond interactions between cellulose and starch through O–H band shifts (3335 → 3282 cm−1). SEM revealed a porous laminar morphology with cellulose particles (40–52 µm) embedded within the starch matrix. DSC analysis showed that the bioplastic exhibits an intermediate thermal profile between its components, while mechanical compression increased the endothermic transition temperature (from 69 °C to 85 °C) and reduced molecular mobility. Tensile testing demonstrated that compression markedly improved mechanical performance, increasing tensile strength from 0.094 MPa to 0.69 MPa and density from 110 to 638.7 kg/m3. These findings indicate that cellulose–starch bioplastics derived from banana pseudostem possess favorable structural, thermal, and mechanical characteristics for short-use applications. The approach also contributes to the valorization of agricultural waste through biodegradable material development.
Read moreBarriers and Facilitators Associated With Delays in the Diagnosis and Treatment of Lupus: A Qualitative Study of Patients and Rheumatologists in the Central American and Caribbean Region.
Timely diagnosis, treatment, and delays in systemic lupus erythematosus (SLE) remain underexplored in the Central America and Caribbean (CAC) region. The objective was to describe and analyze patient-level and health care system-level barriers and facilitators associated with diagnostic and therapeutic delays in SLE, based on experiences of patients and rheumatologists from 6 countries in the CAC region. A qualitative study was conducted in Cuba, the Dominican Republic, Guatemala, Honduras, Nicaragua, and Panama. Patients and rheumatologists were purposively recruited. Data were collected through in-depth interviews and focus groups. Thematic analysis was conducted. A total of 46 patients and 40 rheumatologists participated. Barriers and facilitators were grouped into 4 themes. Patient-related and context-related delays reflected disease interpretation and health-seeking behaviors: mild or nonspecific manifestations and self-medication delayed care, whereas visible symptoms and a family history of autoimmunity facilitated timely consultation. Health care system-related delay encompassed 3 themes: (a) accessibility-financial precarity, geographic barriers, and medication costs delayed care, though social support and universal coverage (Cuba) facilitated treatment; (2) technical and cultural competence-insufficient provider training and misdiagnoses hindered timely care, while trustful rheumatologist-patient relationships improved adherence; (3) health resources-shortages of specialists, diagnostic tests, and medications were major obstacles. Delays in SLE care in CAC are predominantly driven by systemic rather than patient-level factors. Strengthening health system capacity, expanding rheumatology services, and fostering culturally sensitive care are essential to reducing inequities and improving outcomes.
Read moreDistribution and natural history of an onverlooked mammal, Neogale frenata (Mustelidae, Carnivora) in Honduras
Neogale frenata, the long-tailed weasel, has the widest distribution of any mustelid in the Western Hemisphere; however, it remains poorly known in Central America. This study confirms the presence of N. frenata in three protected areas of Honduras: El Chile Biological Reserve, Misoco Biological Reserve, and La Tigra National Park. Our research involved the use of camera traps and an occasional capture using a Sherman trap, resulting in both photographic and physical evidence of the species in La Tigra National Park. Based on our review, the distribution of the weasel has been updated, confirming its presence in eight departments of Honduras. Although it may be a species with an underestimated distribution due to the difficulty of identifying and capturing it through various methodologies, it could be widely distributed throughout the country. The photographs presented here constitute the first scientific evidence of the species in Honduras.
Read moreGenDivRange: A global dataset of geo-referenced population genetic diversity across species ranges
The spatial distribution of genetic diversity within a species’ range reflects its past demographic history, and its knowledge is essential to better understand the limits of species ranges and to predict range shifts in response to a changing environment. We present GenDivRange, a unified dataset of published geo-referenced estimates of genetic diversity for 1,109 species, each represented by at least five populations placed on their range maps estimated from Global Biodiversity Information Facility (GBIF) observations. A total of 19,173 populations across the globe and from most major taxa, covering terrestrial, freshwater, and marine organisms, are included. At least one of the three genetic diversity estimates is available for each study: expected heterozygosity, Nei’s gene diversity, or allelic richness, mostly estimated from microsatellite markers. Additionally, the dataset contains the detailed taxonomy, biome, breeding, and adult habitat of each species.
Read moreA mammal dilemma? Description of interspecific relationships in two threatened cacti from northern Honduras