Latent Tuberculosis Infection in a Migrant Agricultural Community in Baja California, Mexico

The objectives were to estimate the prevalence and identify correlates of latent tuberculosis infection (LTBI) among residents of a migrant agricultural community in San Quintín, Baja-California, Mexico. Residents completed a questionnaire and had their blood tested for LTBI using the QuantiFERON®-TB Gold In-Tube (QFT) assay. Among 133 participants, 39.8% (95% CI 31.5–48.7%) tested QFT-positive. Having crossed the U.S.-Mexican border since living in San Quintin (P = 0.03), consuming unpasteurized milk (P = 0.02) and receiving health care at IMSS-Oportunidades in the last 6 months (P = 0.03) were independently associated with QFT-positivity. High LTBI prevalence in this community emphasizes the need for TB education and LTBI treatment for its residents. Association with travel to the U.S. suggests the potential for TB transmission across borders. Higher QFT-positivity among those consuming unpasteurized milk could indicate M. bovis infection, previously reported among Mexican migrants living in U.S. border cities

Air Travel and Venous Thromboembolism: A Systematic Review

CONTEXT: Despite multiple attempts to document and quantify the danger of venous thromboembolism (VTE) following prolonged travel, there is still uncertainty about the magnitude of risk and what can be done to lower it. OBJECTIVES: To review the methodologic strength of the literature, estimate the risk of travel-related VTE, evaluate the efficacy of preventive treatments, and develop evidence-based recommendations for practice. DATA SOURCES: Studies identified from MEDLINE from 1966 through December 2005, supplemented by a review of the Cochrane Central Registry of Controlled Trials, the Database of Abstracts of Reviews of Effects, and relevant bibliographies. STUDY SELECTION: We included all clinical studies that either reported primary data concerning travel as a risk factor for VTE or tested preventive measures for travel-related VTE. DATA EXTRACTION AND ANALYSIS: Two reviewers reviewed each study independently to assess inclusion criteria, classify research design, and rate methodologic features. The effect of methodologic differences, VTE risk, and travel duration on VTE rate was evaluated using a logistic regression model. DATA SYNTHESIS: Twenty-four published reports, totaling 25 studies, met inclusion criteria (6 case-control studies, 10 cohort studies, and 9 randomized controlled trials). Method of screening for VTE [screening ultrasound compared to usual clinical care, odds ratio (OR) 390], outcome measure [all VTE compared to pulmonary embolism (PE) only, OR 21], duration of travel (<6 hours compared to 6–8 hours, OR 0.011), and clinical risk (“higher” risk travelers compared to “lower,” OR 3.6) were significantly related to VTE rate. Clinical VTE after prolonged travel is rare [27 PE per million flights diagnosed through usual clinical care, 0.05% symptomatic deep venous thrombosis (DVT) diagnosed through screening ultrasounds], but asymptomatic thrombi of uncertain clinical significance are more common. Graduated compression stockings prevented travel-related VTE (P < 0.05 in 4 of 6 studies), aspirin did not, and low-molecular-weight heparin (LMWH) showed a trend toward efficacy in one study. CONCLUSIONS: All travelers, regardless of VTE risk, should avoid dehydration and frequently exercise leg muscles. Travelers on a flight of less than 6 hours and those with no known risk factors for VTE, regardless of the duration of the flight, do not need DVT prophylaxis. Travelers with 1 or more risk factors for VTE should consider graduated compression stockings and/or LMWH for flights longer than 6 hours

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all &gt;0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

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Entomology and Plant Patholog

Marcelina

Woman looking off to her left gold and silver ornamental decoration.https://digitalcommons.usf.edu/osterweil/2052/thumbnail.jp

Coleção Tópica: Avanços no conhecimento hidrogeológico do Haiti Para recuperação e desenvolvimento

International audienceHaiti's groundwater resources are poorly understood and scarcely researched, despite their importance as the principal source for water supply. The knowledge gap and its role of inhibiting informed relief, recovery and investments in development are described, along with an update on progress towards the UN Sustainable Development Goals. This essay leads a topical collection of seven articles that advance hydrogeological knowledge of Haiti. Additional data, research and monitoring are identified as urgently needed for the nation's sustainable development. Keywords Water security • Groundwater development • Groundwater management • Groundwater and society • Haiti This article is part of the topical collection "Advancements in hydrogeological knowledge of Haiti for recovery and development" * James K.Resumen Los recursos hídricos subterráneos de Haití son poco conocidos y apenas investigados, a pesar de su importancia como fuente principal de suministro de agua. Se describen las deficiencias en el conocimiento y su papel de obstáculo para el suministro de información, la recuperación y las inversiones en el desarrollo, junto con una actualización del progreso hacia los Objetivos de Desarrollo Sostenible de la ONU. Este ensayo encabeza una colección temática de siete artículos que hacen avanzar el conocimiento hidrogeológico de Haití. Se identifican los datos, la investigación y el monitoreo adicionales que se necesitan con urgencia para el desarrollo sostenible de la nación.Résumé Les ressources en eaux souterraines en Haïti sont mal comprises et font rarement l’objet de recherches, malgré leur importance en tant que principale source d’approvisionnement en eau. Le manque de connaissances et son caractère d’inhibition d’aides, de relance et d’investissements dans le développement sont décrits, ainsi qu’une mise à jour des avancées de la mise en œuvre des objectifs de développement durable des Nations Unies. Cet essai introduit une collection thématique de sept articles qui font progresser les connaissances hydrogéologiques d’Haïti. Des données, des recherches et un suivi supplémentaires sont identifiés comme étant urgemment nécessaires pour le développement durable de la nation.Resumo Os recursos hídricos subterrâneos do Haiti são pouco conhecidos e pouco pesquisados, apesar de sua importância como principal fonte de abastecimento de água. A lacuna de conhecimento e seu papel de inibir ajuda informada, recuperação e investimentos em desenvolvimento são descritos, juntamente com uma atualização sobre o progresso em direção aos Objetivos de Desenvolvimento Sustentável da ONU. Este ensaio lidera uma coleção tópica de sete artigos que promovem o conhecimento hidrogeológico do Haiti. Dados adicionais, pesquisa e monitoramento são identificados como urgentemente necessários para o desenvolvimento sustentável da nação