Discrepancias entre los datos ofrecidos por la Secretaría de Salud y la Organización Mundial de la Salud sobre tuberculosis en México, 1981-1998 Inconsistencies between reports from the World Health Organization and the Ministry of Health

OBJETIVO: Describir las tendencias de la morbilidad y mortalidad de la tuberculosis en México, entre 1981 y 1998, comparando datos de la Secretaría de Salud y de la Organización Mundial de la Salud. MATERIAL Y MÉTODOS: Se analizó el número de casos y tasas notificados y la tendencia de la enfermedad en los últimos años. Se calculó la incidencia de casos nuevos de tuberculosis bacilíferos mediante el riesgo anual de infección tuberculosa, con lo que se estimó el porcentaje de detección de casos bacilíferos en 1997-1998. RESULTADOS: El número de casos de tuberculosis emitido por la Organización Mundial de la Salud supera al notificado por la Secretaría de Salud, discrepancia que se ha reducido. Los casos bacilíferos se han mantenido entre 1993-1998 y se estimó una detección de 66 y de 26% en 1997 y 1998, respectivamente (para un Riesgo Anual de Infección Tuberculosa de 0.5%). La mortalidad se redujo 6.7% cada año entre 1990 y 1998 mientras que se observó un aumento de casos nuevos, lo que implica la persistencia de la transmisión de la infección entre la población. CONCLUSIONES: Hay discrepancia entre el número de casos de tuberculosis ofrecido por la Secretaría de Salud y la Organización Mundial de la Salud. De acuerdo con las estimaciones por el Riesgo Anual de Infección Tuberculosa se deja de detectar un número considerable de casos bacilíferos.<br>OBJECTIVE: To describe the tuberculosis morbidity and mortality trends in Mexico, by comparing the data reported by the Ministry of Health (MH) and the World Health Organization (WHO) between 1981 and 1998. MATERIAL AND METHODS: The number of cases notified in the past few years, their rates, and the trends of the disease in Mexico were analyzed. The incidence of smear-positive pulmonary tuberculosis was estimated for 1997 and 1998 with the annual tuberculosis infection risk (ATIR), to estimate the percentage of bacilliferous cases in 1997-1998. RESULTS: WHO reported more tuberculosis cases for Mexico than the MH. However, this difference has decreased throughout the years. The notification of smear-positive cases remained stable during 1993-1998. The estimated percentages of detection were 66% for 1997 and 26% for 1998 (based on ATIR of 0.5%). Tuberculosis mortality decreased gradually (6.7% per year) between 1990 and 1998, whereas the number of new cases increased, suggesting the persistence of disease transmission in the population. CONCLUSIONS: Inconsistencies between case notifications from national data and WHO were considerable, but decreased progressively during the study period. According to ATIR estimations, a considerable number of infectious tuberculosis cases are not detected

Discrepancias entre los datos ofrecidos por la Secretaría de Salud y la Organización Mundial de la Salud sobre tuberculosis en México, 1981-1998

Objetivo. Describir las tendencias de la morbilidad y mortalidad de la tuberculosis en México, entre 1981 y 1998, comparando datos de la Secretaría de Salud y de la Organización Mundial de la Salud. Material y métodos. Se analizó el número de casos y tasas notificados y la tendencia de la enfermedad en los últimos años. Se calculó la incidencia de casos nuevos de tuberculosis bacilíferos mediante el riesgo anual de infección tuberculosa, con lo que se estimó el porcentaje de detección de casos bacilíferos en 1997-1998. Resultados. El número de casos de tuberculosis emitido por la Organización Mundial de la Salud supera al notificado por la Secretaría de Salud, discrepancia que se ha reducido. Los casos bacilíferos se han mantenido entre 1993-1998 se estimó una detección de 66 y de 26% en 1997 y 1998, respectivamente (para un Riesgo Anual de Infección Tuberculosa de 0.5%). La mortalidad se redujo 6.7% cada año entre 1990 y 1998 mientras que se observó un aumento de casos nuevos, lo que implica la persistencia de la transmisión de la infección entre la población. Conclusiones. Hay discrepancia entre el número de casos de tuberculosis ofrecido por la Secretaría de Salud y la Organización Mundial de la Salud. De acuerdo con las estimaciones por el Riesgo Anual de Infección Tuberculosa se deja de detectar un número considerable de casos bacilíferos. El texto completo en inglés de este artículo está disponible en: http:// www.insp.mx/salud/index.htm

CD161 Expression Defines a Th1/Th17 Polyfunctional Subset of Resident Memory T Lymphocytes in Bronchoalveolar Cells

<div><p>Alveolar resident memory T cells (T_RM) comprise a currently uncharacterized mixture of cell subpopulations. The CD3⁺CD161⁺ T cell subpopulation resides in the liver, intestine and skin, but it has the capacity for tissue migration; however, the presence of resident CD3⁺CD161⁺ T cells in the bronchoalveolar space under normal conditions has not been reported. Bronchoalveolar cells (BACs) from healthy volunteers were evaluated and found that 8.6% (range 2.5%-21%) of these cells were CD3⁺ T lymphocytes. Within the CD3⁺ population, 4.6% of the cells (2.1–11.3) expressed CD161 on the cell surface, and 74.2% of the CD161⁺CD3⁺ T cells expressed CD45RO. The number of CD3⁺CD161⁺ T cells was significantly lower in the bronchoalveolar space than in the blood (4.6% of BACs vs 8.4% of peripheral blood mononuclear cells (PBMCs); P<0.05). We also found that 2.17% of CD4⁺ T lymphocytes and 1.52% of CD8⁺ T lymphocytes expressed CD161. Twenty-two percent of the alveolar CD3⁺CD161⁺ T lymphocytes produced cytokines upon stimulation by PMA plus ionomycin, and significantly more interferon gamma (IFN-γ) was produced compared with other cytokines (P = 0.05). Most alveolar CD3⁺CD161⁺ T cells produced interleukin-17 (IL-17) and IFN-γ simultaneously, and the percentage of these cells was significantly higher than the percentage of CD3⁺CD161⁻ T cells. Moreover, the percentage of alveolar CD3⁺CD161⁺ T lymphocytes that produced IFN-γ/IL-17 was significantly higher than those in the peripheral blood (p<0.05). In conclusion, Th1/Th17-CD3⁺CD161⁺ T_RM could contribute to compartment-specific immune responses in the lung.</p></div

CD161 expression in CD3⁺ T lymphocytes from BAL fluid or PBMCs.

<p>BACs or PBMCs were stained with anti-human CD3 and CD161. (A) Representative flow cytometry analysis plots. The CD3⁺ cells in the SSC vs CD3 plot were selected, and the CD3⁺CD161⁺ cells were selected by gating on the CD161 vs CD3 plot or single histogram plot set according to appropriate isotype controls. (B) The box plot shows the percentages of CD3⁺CD161⁺ T lymphocytes in BACs and PBMCs from healthy volunteers; n = 10. P values were generated using the Mann-Whitney test with the GraphPad prism software.</p

Functional profile of CD3⁺CD161⁺ and CD3⁺CD161^- alveolar lymphocytes.

<p>(A) Representative plots of flow cytometry analysis performed by selecting CD3⁺CD161⁺ or CD3⁺CD161^- cells from the CD161 vs CD3 double plot or single histogram plot according to appropriate isotype control and evaluating the percentage of cytokine-producing cells within these gates. (B) Bar graphs representing the percentages of alveolar CD3⁺CD161⁺ and CD3⁺CD161^- cells producing IFN-γ (n = 7), IL-4, IL-17 and TNF-α; n = 4. P values were generated using the Mann-Whitney test.</p

Functional profile of CD3⁺CD161⁺ T lymphocytes.

<p>(A) BACs or PBMCs were cultured with PMA plus ionomycin in the presence of BFA for 6 h and then stained with anti-human CD3 and CD161. Intracellular cytokine production was evaluated using anti IFN-γ, TNF-α, IL-4 and IL-17 antibodies, and representative plots from flow cytometry analysis performed by first selecting the CD3⁺CD161⁺ cells by gating on the CD161 vs CD3 plot or single histogram plot set according to appropriate isotype controls and then evaluating the percentage of cytokine-producing cells within these gates. (B) Horizontal bars indicate the mean proportions of CD3⁺CD161⁺ cells producing IFN-γ n = 7), TNF-α, IL-4 and IL-17; n = 4. P values were generated using the Kruskal-Wallis test followed by Dunn's Multiple Comparison between BACs and PBMCs.</p

Where Brain, Body and World Collide

The production cross section of electrons from semileptonic decays of beauty hadrons was measured at mid-rapidity (|y| &lt; 0.8) in the transverse momentum range 1 &lt; pt &lt; 8 Gev/c with the ALICE experiment at the CERN LHC in pp collisions at a center of mass energy sqrt{s} = 7 TeV using an integrated luminosity of 2.2 nb^{-1}. Electrons from beauty hadron decays were selected based on the displacement of the decay vertex from the collision vertex. A perturbative QCD calculation agrees with the measurement within uncertainties. The data were extrapolated to the full phase space to determine the total cross section for the production of beauty quark-antiquark pairs