The re-emerging association between tuberculosis and diabetes: lessons from past centuries

The association between tuberculosis (TB) and diabetes mellitus (DM) had a common place in the literature up to the first half of the 20th century, but virtually disappeared with the discovery of insulin to treat DM and antibiotics to cure TB. In the late 1990s the literature began to re-emerge with the worldwide increase in type 2 DM, particularly in TB-endemic countries. Today, type 2 DM is the most prevalent comorbidity among TB patients and the World Health Organization considers it a threat to TB control. We summarize the literature on TB and DM up to the 1960s. Then we evaluate unique aspects of this comorbidity in older times, such as the frequent diabetic comas that suggest challenges for proper DM management as insulin was being implemented, or the absence of antibiotics to cure TB. Despite the unique aspects of each study period, the literature across times is consistent in key aspects of the association. Namely, a higher TB prevalence among DM (versus non-DM patients), the importance of glucose control and chronic DM on TB susceptibility and the higher risk of death among patients with the comorbidity. From the older literature, we can infer the likely contribution of type 1 DM to TB (in addition to type 2), regardless of their differing autoimmune or metabolic pathophysiology, respectively. Furthermore, in the older literature there was a notable reporting of DM development among TB patients, even though DM usually preceded TB. This observation deserves further epidemiological and basic studies to elucidate this intriguing aspect of the relationship between TB and DM

Additions to Dendrodacrys and outline of taxa with branched hyphidia in Dacrymycetes (Basidiomycota)

The genus Dendrodacrys is a monophyletic group that belongs to Dacrymycetes (Agaricomycotina, Basidiomycota) and accommodates species distinguished by strongly branched hyphidia in combination with 3-septate basidiospores. While the original circumscription mainly treated European taxa, here we shift the focus to tropical and sub-tropical material and uncover wider variation in morphology within Dendrodacrys. Still united by hyphidia shape and basidiospore septation, the genus is expanded with 10 taxa having pustulate, cerebriform, or stipitate basidiocarps of yellow to dark brown colours, cylindrical to ovoid basidiospores, and hyphal septa with or without clamps. Monophyly of the amended Dendrodacrys is confirmed with a phylogeny based on six markers (SSU, ITS, LSU, TEF1-α, RPB1, and RPB2). As a result, we describe two new species (De. laetum and De. rigoratum), transfer three existing species to Dendrodacrys (De. brasiliense, De. dendrocalami, and De. pezizoideum), and raise one variety to the species level (De. kennedyae ≡ Dacrymyces enatus var. macrosporus). In addition, we provide descriptions for the earlier combined De. paraphysatum and four new informal taxa. Lastly, we present illustrations, a character table, and an identification key that addresses all known dacrymycetes with branched hyphidia.Peer reviewe

DEVELOPING A TOOL USED FOR ASSESSING SUNSCREEN UTILIZATION AND SUN EXPOSURE

Introduction: Skin cancer incidence has increased within the last 40 years. It accounts to 1 in 3 cancer diagnoses worldwide. (1) Sunscreen serves as a protective barrier against the harmful effects of sun exposure such as skin cancer. (2) Despite the advantages of using sunscreen, studies suggest that it is being under-utilized. (3) The preliminary goal of this research is to develop, validate and standardize a questionnaire to assesses the sunscreen utilization of adolescents and adults in both Mexico and the United States along the Rio Grande Valley Methods A questionnaire in both English and Spanish has been developed to assess sunscreen utilization and sun exposure of the surveyees. We will perform face validity, reliability with test-retest approach, internal consistence with alpha Cronbach, intraclass correlation in clusters (i.e.: family, schools or clinics), sensitivity to detect contrasts The results of the survey will be analyzed using a 2k factorial design. Expected results: Using the 2k factorial design, we aim to assess the differences of sunscreen use amongst the following groups: Male versus female surveyees, adolescent versus adult surveyees and people residing in the United States versus residing in Mexico. The obtained statistics will help to calculate sample sizes in future studies. Future endeavors: Intervening with adolescents who do not utilize sunscreen well is something we look forward to partaking in: both locally and through policy change. After obtaining preliminary data with the questionnaire, we plan to do further studies regarding the relationship between circulating vitamin D levels, sun exposure, and sunscreen usage. Affiliations: 1. School of Medicine. UTRGV. Edinburg. Texas. 2. CEDIAMET, UMAN. Reynosa. Mexico. 3. Universidad Autonoma de Tamaulipas. Reynosa, Mexico. 4. Private practice. Laredo. Texas. 5. Population Health & Biostatistics. UTRGV. Harlingen. Texas

Familial chylomicronemia syndrome: A family case report in U.S./Mexico border by CEDIAMET

Primary familiar hyperchylomicronemia syndrome (FHS) is an extremely rare autosomal recessive condition. In 80% of cases is a result of a mutation in lipoprotein lipase, meanwhile, the 20% is a malfunctioning enzyme due to APOC2, APOA5, LMF1, or GP1HBP1. It is estimated FHS affects 3000 to 5000 individuals globally, with no correlation by sex or race. We are presenting a family with FHS in Reynosa, Mexico. The index patient was a male 36 years old who attended the CEDIAMET clinic after his 6th episode of acute pancreatitis. He has triglycerides 1300 mg/dl and CT scan with Balthazar C score. He suffered other five episodes of acute pancreatitis since 20 years old with serum triglycerides between 1,000 and 3,000 mg/dL. Each episode progressed in pain intensity and Balthazar score from A to C. The patient received treatment with bezafibrate and captopril because of hypertension. The physical exam shows eruptive xanthomas on his back, otherwise no other clinical relevant findings. He has a family history of recurrent pancreatitis in his father, and two older sisters (from a total of 3 sisters). This is the first case of FHS presented in RGV. To our knowledge, only one mutation in lipoprotein lipase had been described in Guanajuato, Mexico (Colima-Fausto 2017). The p.Gly188Glu mutation affects the lipid-binding region, leading to a complete loss of LPL function. We will research this case to determine if they have a mutation on any of the known genes and if negative, to sequence the regions for seeking new mutation on the U.S.-Mexico border. The common treatment for lowering triglycerides works small or not at all. Other conditions like hypothyroidism or Cushing were ruled out. A specialized exam is the post-heparin activation of lipoprotein lipase inadequate release of the enzyme. The dietary treatment includes a very low-fat diet (no more than 20 to 30 g fat/day), and avoiding alcohol. Plasmapheresis is an option for avoiding acute pancreatitis treatment. Recently, tiparvovec was discontinued in Europe (2007), and was the first gene therapy approved. Volanesorsen is another option that reduces triglycerides by 50 to 80%, currently in phase II and III trials

The intensity of physical activity improves cognitive performance among aging Americans

Background: Currently there is no pharmacological cure for Alzheimer’s disease and related dementias, physical activity (PA) has emerged as a promising approach. The optimal intensity of PA to improve cognitive health remains unknown. Therefore, this study aimed to evaluate associations between different durations and intensities of PA on performance across cognitive domains (executive function, processing speed, and memory) among aging Americans. Methods: 2377 adults aged ≥ 60 years from the cross-sectional National Health and Nutrition Examination Survey 2011-2014, were included. Linear regression in hierarchical blocks and the size of effect (η2) were analyzed with R software. Results: The mean age was 69.3±6.73, 50.86% females. Despite the attenuation of association following adjustments for covariates, participants who engaged in 3-6 hr/wk of vigorous- and \u3e 1 hr/wk of moderate-intensity PA performed significantly higher in executive function and processing speed tests compared to inactive peers (η2= 0.005 & 0.007 respectively, p \u3c 0.05). However, there was no clear dose-response relationship between the executive function and processing speed test scores and duration of weekly moderate-intensity PA. For the adjusted model, the effects of 1-3 hr/wk of vigorous-intensity PA became trivial for the delayed recall memory test scores (β=0.33; 95% CI: -0.01, 0.67; η2=0.002; p=0.56). Interestingly, higher handgrip strength and higher late-life body-mass-index were associated with a higher performance across all cognitive domains. Conclusion: Observed associations provide evidence linking habitual PA with superior cognition health among older adults. Furthermore, increased muscle strength and higher late-life adiposity may impact cognition and require further investigation

Relationship Between Cognitive Performance, Physical Activity, and Socio-Demographic/Individual Characteristics Among Aging Americans

Background: Physical activity (PA) has emerged as a promising approach to delay Alzheimer’s disease and related dementias, but the optimal intensity of PA to improve cognitive health remains unknown. Objective: To evaluate the association between duration and intensity of PA and cognitive domains (executive function, processing speed, and memory) in aging Americans. Methods: Linear regressions in hierarchical blocks for variable adjustment and the size of effect (η2) were analyzed by using the data of 2,377 adults (age = 69.3±6.7 years) from the NHANES 2011–2014. Results: Participants with 3–6 h/week of vigorous- and \u3e 1 h/week of moderate-intensity PA scored significantly higher in executive function and processing speed domains of cognition compared to inactive peers (η2 = 0.005 & 0.007 respectively, p \u3c 0.05). After adjustment, the beneficial effects of 1–3 h /week of vigorous-intensity PA became trivial for delayed recall memory domain test scores (η2 = 0.33; 95%CI: –0.01,0.67; η2 = 0.002; p = 0.56). There was no linear dose-response relationship between the cognitive test scores and weekly moderate-intensity of PA. Interestingly, higher handgrip strength and higher late-life body mass index were associated with a higher performance across all cognitive domains. Conclusion: Our study supports habitual PA with superior cognition health in some but not all domains among older adults. Furthermore, increased muscle strength and higher late-life adiposity may also impact cognition

The impact of an exercise program on selfefficacy in women with overweight and obesity

Introducción: En México la prevalencia combinada de sobrepeso y obesidad en mujeres es de 73%, problema de salud pública que se relaciona con las principales causas de muerte. Las principales estrategias se realizan a través de la práctica de ejercicio y alimentación saludable; sin embargo, no se ha tenido el impacto deseado; es necesario obtener indicadores cognitivos para fortalecer las estrategias de salud. Objetivo: Analizar el impacto de un programa de entrenamiento físico aeróbico gradual sobre el nivel de Autoeficacia (AE) para practicar ejercicio y dieta saludable en mujeres con sobrepeso y obesidad. Material y métodos: Se trató de un experimento en el que se incluyeron mujeres de 18 a 24 años con un IMC≥27. La muestra se conformó por 34 mujeres divididas en los grupos control y experimental (17 mujeres respectivamente), seleccionadas y asignadas mediante muestreo aleatorio. Las mediciones se realizaron mediante un inventario valido y confiable que mide la AE en dieta y ejercicio. La dosis de ejercicio fue calculada por la fórmula de Karvonen durante diez semanas de manera gradual y controlada. El estadístico utilizado fue un MANOVA de mediciones repetidas, se consideró un nivel de significancia <.05. Resultados: Posterior a la intervención se apreciaron cambios estadísticamente significativos, AE en ejercicio 40.3±4.0 vs. 35.8±5.4; y AE en dieta 85.8±10.5 vs. 78.8±10.7 (p<.05). Conclusiones: El ejercicio a la dosis establecida mejoró la condición de AE que favoreció la práctica de ejercicio y la dieta saludable en mujeres con sobrepeso y obesidad.Introduction: In Mexico, the combined prevalence of overweight and obesity in women is 73%, public health problem that is related to the leading causes of death. The main strategies are done through exercise and healthy eating; however, it has not had the desired impact; it is necessary to obtain cognitive indicators to strengthen health strategies. Objective: To analyze the impact of a gradual program of aerobic exercise training on the level of self-efficacy (AE) for exercise and healthy diet in overweight and obesity. Methods: This was an experiment in which women 18 to 24 years included, with a BMI≥27. The sample was composed of 34 women divided into control and experimental (17 women respectively), selected and assigned by random sampling groups. Measurements were made using a valid and reliable inventory that measures the AE in diet and exercise. The exercise dose was calculated by the Karvonen formula for 10 weeks in a gradual and controlled. The statistic used was a repeated measure MANOVA, a significance level <.05 was considered. Results: After the intervention statistically significant changes were observed, AE in 40.3 ± 4.0 vs. exercise 35.8 ± 5.4; AE and 85.8 ± 10.5 vs. diet 78.8 ± 10.7 (p <.05). Conclusions: Exercise at the target dose AE improved the condition that favored the practice of exercise and healthy diet in overweight and obesity

Alterations in Activation, Cytotoxic Capacity and Trafficking Profile of Peripheral CD8 T Cells in Young Adult Binge Drinkers

Background: Excess of alcohol consumption is a public health problem and has documented effects on the immune system of humans and animals. Animal and in vitro studies suggest that alcohol abuse changes CD8 T cell (CD8) characteristics, however it remains unknown if the CD8 profile of binge drinkers is different in terms of activation, trafficking and cytotoxic capacity. Aim: To analyze the peripheral CD8 cytotoxic capacity, activation and trafficking phenotypic profile of Mexican young adults with regard to alcohol consumption pattern. Methods: 55 Mexican young adults were stratified as Light (20), Intermediate (18) or Binge drinkers (17) according to their reported alcohol consumption pattern. Blood samples were obtained and hematic biometry and liver enzyme analysis were performed. Peripheral CD8 profile was established by expression of Granzyme B (GB), CD137, CD127, CD69, TLR4, PD1, CCR2, CCR4, CCR5 and CXCR4 by FACS. Data was analyzed by ANOVA, posthoc DMS and Tamhane, and principal component analysis (PCA) with varimax rotation, p\u3c0.05. Results: The Binge drinking group showed increased γGT together with increased expression of CD69 and reduced expression of TLR4, PD1, CCR2 and CXCR4 in peripheral CD8 cells. Other parameters were also specific to Binge drinkers. PCA established 3 factors associated with alcohol consumption: Early Activation represented by CD69 and TLR4 expression in the CD8 population; Effector Activation by CD69 expression in CD8 CD127(+)CD137(+) and CD8 CD25(+) CD137(+); and Trafficking by CXCR4 expression on total CD8 and CD8 GB(+)CXCR4(+), and CCR2 expression on total CD8. Binge drinking pattern showed low expression of Early Activation and Trafficking factors while Light drinking pattern exhibited high expression of Effector Activation factor. Conclusions: Alcohol consumption affects the immune phenotype of CD8 cells since binge drinking pattern was found to be associated with high CD69 and low TLR4, CXCR4 and CCR2 expression, which suggest recent activation, decreased sensitivity to LPS and lower migration capacity in response to chemokines SDF-1 and MCP-1. These results indicate that a binge-drinking pattern of alcohol consumption may induce an altered immune profile that could be related with liver damage and the increased susceptibility to infection reported to this behavior

Plan estratégico de inversión para pequeñas empresas comerciales de compra y venta de aparatos electrónicos y accesorios diversos de tecnología ubicadas en el municipio de San Salvador.

La elaboración de este trabajo de investigación, se ha efectuado para las pequeñas empresas dedicadas a la compra y venta de aparatos electrónicos y accesorios diversos de tecnología, con el fin de dar a conocer un plan estratégico de inversión que proporcione las respuestas adecuadas para determinar la factibilidad y viabilidad de ejecutar un proyecto de inversión, orientado al crecimiento de la participación en el mercado nacional. Un plan estratégico de inversión, es una descripción de una posibilidad de desarrollo de una empresa u organización que requiere de recursos humanos, técnicos y financieros. De acuerdo con el objetivo general del presente trabajo de investigación, se elaboraron los pasos a implementar en la creación de un nuevo proyecto, con el fin de maximizar la participación en el mercado nacional, considerando aumentar la demanda de sus productos y ampliar la cartera de clientes, partiendo de la interrogante ¿en qué medida se ve afectada la participación en el mercado nacional, de las pequeñas empresas comerciales dedicadas a la compra y venta de aparatos electrónicos y accesorios diversos de tecnología, al no contar con un plan estratégico de inversión? Para desarrollar el proceso de investigación de campo, se utilizó el instrumento de la encuesta desarrollando un cuestionario estructurado con veinticuatro preguntas cerradas, dirigido a los gerentes, propietarios, jefes de sucursal y contadores generales, según corresponda de las pequeñas empresas que pertenecen al sector en estudio. Además, se realizaron consultas en diferentes fuentes de información bibliográfica que contribuyeron en la preparación del trabajo de investigación. Los principales resultados obtenidos en el análisis de la información y el cruce de variables, permitió efectuar un diagnóstico y poder conocer la opinión del sector sujeto de estudio, siendo negocios rentables por contar con más tres años de estar compitiendo en el mercado nacional; en conclusión se determinó que no existe planificación estratégica, al no implementar herramientas financieras esto ocasiona un estancamiento de inversión que no les permite a las pequeñas empresas obtener mayores oportunidades en la buena gestión y el desarrollo en el mercado nacional; por ello, se presentó el desarrollo de un caso práctico dirigido a la apertura de una nueva sucursal en un centro comercial en el municipio de San Salvador