Neglected Tropical Diseases outside the Tropics

Neglected Tropical Diseases (NTDs) have been targeted due to their prevalence and the burden of disease they cause globally, but there has been no significant focus in the literature on the subject of NTDs as a group in immigrants and travelers, and no specific studies on the emerging phenomenon of imported NTDs. We present the experience of a Tropical Medicine Unit in a major European city, over a 19-year period, describing and comparing NTDs diagnosed amongst immigrants, travelers and travelers visiting friends and relatives (VFRs). NTDs were diagnosed outside tropical areas and occurred more frequently in immigrants, followed by VFR travelers and then by other travelers. The main NTDs diagnosed in immigrants were onchocerciasis, Chagas disease and ascariasis; most frequent NTDs in travelers were schistosomiasis, onchocerciasis and ascariasis, and onchocerciasis and schistosomiasis in VFRs. Issues focusing on modes of transmission outside endemic areas and how eradication programs for some NTDs in endemic countries may have an impact in non-tropical Western countries by decreasing disease burden in immigrants, are addressed. Adherence to basic precautions such as safe consumption of food/water and protection against arthropod bites could help prevent many NTDs in travelers

Imported Infectious Diseases in Mobile Populations, Spain

Health screening of immigrant populations is needed to ensure early diagnosis and treatment

Epidemiology of injuries in elite male and female futsal: a systematic review and meta-analysis

The main purpose of this study was to conduct a systematic review and meta-analysis quantifying the incidence of injuries in futsal players. A systematic search was conducted using MEDLINE, PubMed, Web of Science and Scopus databases and subsequently six studies (14 cohorts) were selected. Two reviewers independently extracted data and assessed trial quality and risk of bias using the Strengthening the Reporting of Observational Studies in Epidemiology statement and Newcastle Ottawa Scale, respectively. Quality of evidence was also determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Separate meta-analyses for male and female players were conducted using a Poisson random-effect regression model approach. The overall and match incidence rates in elite male futsal players were 6.8 (95% CI = 0.0 – 15.2) and 44.9 (95% CI = 17.2 – 72.6) injuries/1000 hours of exposure. Pooled training injury rate in male players was not calculated due to the lack of studies reporting training injuries in this cohort. For females, an overall, training and match incidence rates of 5.3 (95% CI = 3.5 - 7), 5.1 (95% CI = 2.7 - 7.6) and 10.3 (95% CI = 0.6 - 20.1) injuries/1000 hours of exposure were reported. In males, match incidence rate in International tournaments was 8.5 times higher than in national leagues (77.2 [95% CI = 60.0 - 94.5] vs 9.1 [95% CI = 0.0 – 19.3] for international tournaments and national leagues, respectively). Elite male and female futsal players are exposed to a substantial risk of sustaining injuries, especially during matches

Epidemiology of injuries in professional football: A systematic review and meta-analysis

Objective: We performed a systematic review and meta-analysis of epidemiological data of injuries in professional male football. Method: Forty-four studies have reported the incidence of injuries in football. Two reviewers independently extracted data and assessed trial quality using the STROBE statement and Newcastle Ottawa Scale. Studies were combined in a pooled analysis using a Poisson random effects regression model. Results: The overall incidence of injuries in professional male football players was 8.1 injuries/1000 hours of exposure. Match injury incidence (36 injuries/1000 hours of exposure was almost ten times higher than training injury incidence rate (3.7 injuries/1000 hours of exposure). Lower extremity injuries had the highest incidence rates (6.8 injuries/1000 hours of exposure). The most common type of injury was muscle/tendon (4.6 injuries/1000 hours of exposure), which were frequently associated with traumatic incidents. Minor injuries (1-3 days of time loss) were the most common. The incidence rate of injuries in the top 5 European professional leagues was not different to that of the professional leagues in other countries (6.8 vs. 7.6 injuries/1000 hours of exposure, respectively). Conclusions: Professional male football players have a substantial risk of sustaining injuries, especially during matches

Pharmacogenetics of Metformin Transporters Suggests No Association with Therapeutic Inefficacy among Diabetes Type 2 Mexican Patients

Mexico has been under official epidemiological alert due to diabetes since 2016. This study presents new information on the frequency and variants of metformin transporters OCT1, OCT2, OCT3, ABCB1, and CYP2C9 variants as well. It also reports the association with HbA1c control on 103 DMT2 patients. They were genotyped through real-time PCR (TaqMan assays) and grouped according to treatment: metformin and metformin + glibenclamide. Metformin plasmatic levels were determined through mass spectrometry. The analysis of HbA1c showed statistical significance across genotypes in polymorphisms rs72552763 (p = 0.022), rs622342 (p = 0.009), rs1128503 (p = 0.021), and rs2032582 (p = 0.009) within the monotherapy group. Bivariate analysis found no association between any polymorphism and HbA1c control. Two logistic regression models accounted for two diplotypes in OCT1 and ABCB1, including statistically significant covariates. The first model yielded significance in age (p = 0.026), treatment period [p = 0.001], BMI ≥ 25 kg/m2 (p = 0.043), and combined therapy (p < 0.001). There was no association with GAT/GAT of rs72552763 or A/A rs622342 in OCT1. The second model yielded significance in age (p = 0.017), treatment period (p = 0.001), BMI ≥ 25 kg/m2 (p = 0.042), and combined therapy (p < 0.001), finding no association with C/C of rs1128503 or G/G of rs2032582 in ABCB1. Our multinomial logistic regression results may benefit future predictive analyses in diabetic populations

All-particle cosmic ray energy spectrum measured by the HAWC experiment from 10 to 500 TeV

We report on the measurement of the all-particle cosmic ray energy spectrum with the High Altitude Water Cherenkov (HAWC) Observatory in the energy range 10 to 500 TeV. HAWC is a ground based air-shower array deployed on the slopes of Volcan Sierra Negra in the state of Puebla, Mexico, and is sensitive to gamma rays and cosmic rays at TeV energies. The data used in this work were taken from 234 days between June 2016 to February 2017. The primary cosmic-ray energy is determined with a maximum likelihood approach using the particle density as a function of distance to the shower core. Introducing quality cuts to isolate events with shower cores landing on the array, the reconstructed energy distribution is unfolded iteratively. The measured all-particle spectrum is consistent with a broken power law with an index of $-2.49\pm0.01$ prior to a break at $(45.7\pm0.1$) TeV, followed by an index of $-2.71\pm0.01$. The spectrum also respresents a single measurement that spans the energy range between direct detection and ground based experiments. As a verification of the detector response, the energy scale and angular resolution are validated by observation of the cosmic ray Moon shadow's dependence on energy.Comment: 16 pages, 11 figures, 4 tables, submission to Physical Review