Effect of confinement by SARS-CoV-2 on the degree of steatohepatitis in university students from Reynosa, Tamaulipas

Introduction: Healthy lifestyles are relevant for several diseases, steatohepatitis, although little known, is common in young people. There are reasons to be concerned about homebound college youth who are at risk for steatohepatitis. By restricting the mobility of the population, the risk factors for weight gain and the intake of calorie-dense foods increase, which are elements associated with steatohepatitis. Objective: To determine the effect of confinement during the COVID-19 pandemic on the degree of steatohepatitis by comparing transient elastography results taken before and after confinement. Method: Longitudinal study. A sample of 114 young university students of random sex was included. The transient elastography technique (FibroScan) was implemented, determining the degrees of steatosis and hepatic fibrosis by performing the test before and after the confinement of the participants. Student´s t-test was used to analyse the differences in the degrees of steatohepatitis before and after confinement. Results: the degrees of steatosis during the first sampling were S0 (52.6%), S1 (14.9%), S2 (5.3%) and S3 (27.2%) (m = 250.89, DE= ± 56.91), in the second sampling were presented S0 (56.1%), S1 (13.2%), S2 (5.3%) and S3 (5.4%) (m = 243.81, DE = ± 52.330), the relation of both samples was (p = 0.131). The results in the degrees of fibrosis in the first sampling were F0 (91.4%), F1 (6.1%). F2 (2.6%) (m= 4.80, DE = ±1.11), in the second F1 (95.6%), F2 (3.5) and F2 (0.9%) (m = 4.33, DE = ±1.16) and the relation of the two sampling was (p= 0.000). Conclusions: The degrees of hepatic fibrosis presented significant changes, on the other hand, steatosis tends to decrease, but the change is not significant, however, it is necessary to investigate with third variables to detect other factors involved in the changes

Differential Role of Type 2 Diabetes as a Risk Factor for Tuberculosis in the Elderly versus Younger Adults

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age becoming non-significant in the elderly. Findings were validated using TB surveillance data. T2D in the elderly (vs. T2D in younger individuals) was characterized by better glucose control (e.g., lower hyperglycemia or HbA1c), lower insulin resistance, more sulphonylureas use, and features of less inflammation (e.g., lower obesity, neutrophils, platelets, anti-inflammatory use). We posit that differences underlying glucose dysregulation and inflammation in elderly vs. younger adults with T2D, contribute to their differential association with TB. Studies in the elderly provide valuable insights into TB-T2D pathogenesis, e.g., here we identified insulin resistance as a novel candidate mechanism by which T2D may increase active TB risk

Consenso experto en tiempos de COVID-19: aplicaciones del método Delphi en materia de salud [Expert consensus in times of COVID-19: health applications of the Delphi method]

La epidemia de COVID-19 ha modificado la cultura de la comunicación. La solución para los problemas de salud puede ser asertiva cuando es consensuada. El método Delphi es una herramienta de consenso que emplea rondas de listas de preguntas para recopilar información del conocimiento de un panel de expertos que analizan planteamientos y posibles soluciones a problemas. Se basa en la premisa de que, con la libertad del anonimato, la inteligencia combinada mejora el juicio individual y captura la opinión colectiva experta. El proceso del método es muy flexible, pues las rondas de preguntas pueden realizarse de manera presencial o remota. En este artículo se describe cómo implementar el método Delphi convencional en tiempos de confinamiento, y se analizan la utilidad y las limitaciones del método para su uso por expertos en salud para la resolución de problemas de tratamiento, diagnóstico o administrativos. Las tecnologías actuales para recolectar los datos permiten gran flexibilidad en el formato de los cuestionarios y facilitan la recopilación de la opinión experta. Gracias a su adaptabilidad, el método Delphi se está convirtiendo en una estrategia popular que involucra los ámbitos cualitativo y cuantitativo. - The COVID-19 epidemic has led to changes in the culture of communication. The solution to health problems is assertive when it is consensual. The Delphi method, a tool for agreement, uses rounds of question lists to gather information from the ­knowledge of a panel of experts who discuss approaches and possible solutions to problems. It is based on the premise that, with the freedom of anonymity, combined intelligence improves individual judgment and captures collective expert opinion. The process of the method is very flexible since the rounds of questions can be carried out in person or remotely. In this article, we describe how to implement the conventional Delphi method in times of confinement, analyze the usefulness and limitations of the method for use by health experts to solve treatment, diagnostic or administrative problems. Current technologies for collecting data allow great flexibility in the format of questionnaires and facilitate the collection of expert opinion. Thanks to its adaptability, the Delphi method is becoming a popular strategy that involves both qualitative and quantitative domains

Differential Role of Type 2 Diabetes as a Risk Factor for Tuberculosis in the Elderly versus Younger Adults

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age becoming non-significant in the elderly. Findings were validated using TB surveillance data. T2D in the elderly (vs. T2D in younger individuals) was characterized by better glucose control (e.g., lower hyperglycemia or HbA1c), lower insulin resistance, more sulphonylureas use, and features of less inflammation (e.g., lower obesity, neutrophils, platelets, anti-inflammatory use). We posit that differences underlying glucose dysregulation and inflammation in elderly vs. younger adults with T2D, contribute to their differential association with TB. Studies in the elderly provide valuable insights into TB-T2D pathogenesis, e.g., here we identified insulin resistance as a novel candidate mechanism by which T2D may increase active TB risk