Abstract: At the present time, climate change and antimicrobial resistance are considered as the most critical threats, affecting human, animal, plant, and environmental health. Although these terms may initially appear different, they are interconnected and share similarities in their causes (human interventions and natural cycles), health, and societal consequences. Climate change is associated through direct and indirect pathways with an increase in infectious diseases. Nonetheless, the association between global warming and antimicrobial resistance requires a comprehensive summary of evidence exploring it. Methods: A literature review was conducted to identify and describe the association between climate change and the rapid emergence and spread of antimicrobial resistance. The search was conducted in the following databases: PubMed, Web of Science, Scopus, Embase, Epistemonikos, and Google Scholar. The search period was restricted to articles published from January 2010 to June 2021. Additionally, a snowballing approach was conducted to identify any additional papers. Data extraction included study location, weather factors, environmental elements, antibiotics, and bacteria analysed, as well as the results. Results: 29 articles were included (ten literature or systematic reviews, eight experimental, six ecological, four observational, and one quasi-experimental). In terms of location, all the studies were conducted in countries between 35° and 75° north latitude. The results suggested some evidence of the effects of climate change (alterations in temperature, precipitation, and humidity) on the emergence and rapid spread of antimicrobial resistance in different environments (water, soil, cryosphere, and air). Temperature was described as a main effect of climate change that had effects on antibiotic resistance (increasing bacteria growth, altering metabolism, inducing crossprotection, and facilitating horizontal gene transfer between bacteria). Additionally, results also described the association between altered rain patterns and humidity and antimicrobial resistance, through the runoff of antibiotic molecules or the transport of antibiotic resistance mechanisms to other areas. Conclusions: This literature review has underscored the association between climate change and antimicrobial resistance. According to the results shown in the selected studies, the alterations in weather factors resulting from climate change have varying effects on the emergence and spread of antibiotic resistance. However, further research is imperative to decipher the complex interactions between other environmental processes, pollutants, patterns of antibiotic consumption, wastewater, animal migration, and regions below the latitudes covered in this literature review.

Abstract: Las lesiones cerebrales agudas (LCA) se asocian con altas tasas de mortalidad y malos resultados funcionales a largo plazo. La medición de biomarcadores del líquido cefalorraquídeo ventricular (vLCR) en pacientes con LCA puede ayudar a dilucidar algunas de las vías fisiopatológicas implicadas en el pronóstico de estos pacientes. Primero realizamos una búsqueda sistemática y una revisión descriptiva (Crit Care. 5 de agosto de 2021; 25 (1): 278; DOI: 10.1186/s13054-021-03698-z) donde concluimos que en pacientes con LCA, las concentraciones alteradas de biomarcadores proteicos en el vLCR relacionados con el daño citoesquelético, la inflamación, la apoptosis y el estrés oxidativo pueden predecir peores resultados neurológicos. Debido a estos resultados, realizamos un estudio de observación prospectivo (Neurocrit Care. 2022 Oct;37(2):463-470.doi:10.1007/s12028-022-01507-1.) donde concluimos que la expresión desregulada de la proteína en el vLCR diferenciaba entre LCA y no LCA. Luego realizamos otro estudio (J Neurosurg Anesthesiol. 27 de abril de 2023. doi:10.1097/ANA.0000000000000916.) donde concluimos que la expresión de patrones moleculares asociados al peligro (DAMP) específicos del vLCR se asociaba con un aumento de episodios de hipertensión intracraneal severa y muerte. Por último, en otro estudio observacional (Crit Care. 2023 Jun 24;27(1):249. doi: 10.1186/s13054-023-04538-y.), concluimos que las concentraciones de proteínas del vLCR después de una LCA eran un factor de riesgo para el desarrollo de enfermedades neurodegenerativas crónicas después de una LCA no traumática. Los hallazgos más importantes de esta tesis fueron que la respuesta proteómica después de una LCA es homogénea entre la LCA traumática y no traumática, involucra múltiples proteínas (DAMP) y puede estar asociada con enfermedades neurodegenerativas a largo plazo también en la LCA no traumática.