Maintenance of Self-Care Activities During COVID-19 Lockdown in Patients with Type 2 Diabetes That Received a Comprehensive Care Program Training.

Introduction: In 2020, several countries established a global emergency state. Lockdowns restricted people's lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown. Methods: Patients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18-70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters. Results: A total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment. Conclusion: A multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.

A diagnostic model for overweight and obesity from untargeted urine metabolomics of soldiers.

Soldiers in active military service need optimal physical fitness for successfully carrying out their operations. Therefore, their health status is regularly checked by army doctors. These inspections include physical parameters such as the body-mass index (BMI), functional tests, and biochemical studies. If a medical exam reveals an individual's excess weight, further examinations are made, and corrective actions for weight lowering are initiated. The collection of urine is non-invasive and therefore attractive for frequent metabolic screening. We compared the chemical profiles of urinary samples of 146 normal weight, excess weight, and obese soldiers of the Mexican Army, using untargeted metabolomics with liquid chromatography coupled to high-resolution mass spectrometry (LC-MS). In combination with data mining, statistical and metabolic pathway analyses suggest increased S-adenosyl-L-methionine (SAM) levels and changes of amino acid metabolites as important variables for overfeeding. We will use these potential biomarkers for the ongoing metabolic monitoring of soldiers in active service. In addition, after validation of our results, we will develop biochemical screening tests that are also suitable for civil applications.

Prediction of incident hypertension and arterial stiffness using the non-insulin-based metabolic score for insulin resistance (METS-IR) index.

Hypertension is associated with insulin resistance (IR), metabolic syndrome (MS), and arterial stiffness. Non-insulin-based IR indexes were developed as tools for metabolic screening. Here, we aimed to evaluate the novel non-insulin-based Metabolic Score for IR (METS-IR) index for the prediction of incident hypertension and arterial stiffness evaluated using pulse wave velocity (PWV) analysis, compared with other non-insulin-based IR indexes. We evaluated two populations, a cross-sectional evaluation of high-risk individuals (n = 305) with a wide range of metabolic comorbidities and dyslipidemia in whom PWV measurement was performed and a 3-year prospective cohort of normotensive individuals (N = 6850). We observed a positive correlation between METS-IR and PWV in the cross-sectional cohort, which was higher compared with other non-insulin-based fasting IR indexes; furthermore, PWV values >75th percentile were associated with the upper tercile of METS-IR values. In the prospective cohort, we observed an increased risk for incident hypertension for the upper METS-IR tercile (METS-IR ≥ 46.42; HR: 1.81, 95% CI: 1.41-2.34), adjusted for known cardiovascular risk factors, and observed that METS-IR had greater increases in the predictive capacity for hypertension along with SBP and the Framingham Hypertension Risk Prediction Model compared with other non-insulin-based IR indexes. Therefore, METS-IR is a novel non-insulin-based IR index which correlates with arterial stiffness and is a predictor of incident hypertension, complementary to previously validated risk prediction models.

Development and validation of a predictive model for incident type 2 diabetes in middle-aged Mexican adults: the metabolic syndrome cohort.

BACKGROUND: Type 2 diabetes mellitus (T2D) is a leading cause of morbidity and mortality in Mexico. Here, we aimed to report incidence rates (IR) of type 2 diabetes in middle-aged apparently-healthy Mexican adults, identify risk factors associated to ID and develop a predictive model for ID in a high-risk population. METHODS: Prospective 3-year observational cohort, comprised of apparently-healthy adults from urban settings of central Mexico in whom demographic, anthropometric and biochemical data was collected. We evaluated risk factors for ID using Cox proportional hazard regression and developed predictive models for ID. RESULTS: We included 7636 participants of whom 6144 completed follow-up. We observed 331 ID cases (IR: 21.9 per 1000 person-years, 95%CI 21.37-22.47). Risk factors for ID included family history of diabetes, age, abdominal obesity, waist-height ratio, impaired fasting glucose (IFG), HOMA2-IR and metabolic syndrome. Early-onset ID was also high (IR 14.77 per 1000 person-years, 95%CI 14.21-15.35), and risk factors included HOMA-IR and IFG. Our ID predictive model included age, hypertriglyceridemia, IFG, hypertension and abdominal obesity as predictors (Dxy = 0.487, c-statistic = 0.741) and had higher predictive accuracy compared to FINDRISC and Cambridge risk scores. CONCLUSIONS: ID in apparently healthy middle-aged Mexican adults is currently at an alarming rate. The constructed models can be implemented to predict diabetes risk and represent the largest prospective effort for the study metabolic diseases in Latin-American population.

Genome Sequence of Rhizobium jaguaris CCGE525T, a Strain Isolated from Calliandra grandiflora Nodules from a Rain Forest in Mexico.

We present the genome sequence of Rhizobium jaguaris CCGE525T, a nitrogen-fixing bacterium isolated from nodules of Calliandra grandiflora. CCGE525T belongs to Rhizobium tropici group A, represents the symbiovar calliandrae, and forms nitrogen-fixing nodules in Phaseolus vulgaris. Genome-based metrics and phylogenomic approaches support Rhizobium jaguaris as a novel species.

Dermatophytosis caused by Nannizzia nana in two siblings / Dermatofitosis causada por Nannizzia nana en dos hermanos

Background: Nannizzia nana is a zoophilic dermatophyte that affects animals like pigs, boars and, exceptionally, humans, in whom it causes tinea capitis, as well as tinea corporis and onychomycosis. Case report: Case 1. A previously healthy 8 year-old boy presented to our clinic with a 1-month evolution dermatosis that affected scalp, developing a pseudoalopecic tumor lesion with abundant seropurulent material. The patient had worked in a pig farm. Case 2. A previously healthy 6 year-old girl, sister of the aforementioned child, presented to our clinic with a dermatosis characterized by multiple erythematous-scaly plaques that affected her face, trunk and arms. N. nana was the fungus isolated on culture in both cases. The children were treated with oral griseofulvin and topical ketoconazole that led to clinical and mycological cures. Conclusions: N. nana dermatophytosis, although being rare in humans, can be treated as other cases of dermatophytosis

Antecedentes: Nannizzia nana es un dermatofito zoófilo que habitualmente afecta a animales, como el cerdo, el jabalí y, excepcionalmente, al ser humano, en el cual provoca tiña de la cabeza, tiña corporal y onicomicosis. Casos clínicos: Caso 1: niño sano de 8 años, con dermatosis de un mes de evolución que afectaba al cuero cabelludo con una lesión tumoral seudoalopécica y abundante material seropurulento. Como antecedente, el niño había trabajado en una granja porcina. Caso 2: niña sana de 6 años y hermana del niño del caso anterior, con dermatosis que le afectaba a la cara, el tronco y los brazos con numerosas placas eritematoescamosas. En ambos casos se aisló en cultivo Nannizzia nana. El tratamiento administrado a los niños fue griseofulvina por vía oral y ketoconazol tópico. Se consiguió la curación clínica y micológica. Conclusiones: Las dermatofitosis por N. nana, aunque son raras en el ser humano, pueden ser tratadas como otras dermatofitosis más habituales

Dermatophytosis caused by Nannizzia nana in two siblings.

BACKGROUND: Nannizzia nana is a zoophilic dermatophyte that affects animals like pigs, boars and, exceptionally, humans, in whom it causes tinea capitis, as well as tinea corporis and onychomycosis. CASE REPORT: Case 1. A previously healthy 8 year-old boy presented to our clinic with a 1-month evolution dermatosis that affected scalp, developing a pseudoalopecic tumor lesion with abundant seropurulent material. The patient had worked in a pig farm. Case 2. A previously healthy 6 year-old girl, sister of the aforementioned child, presented to our clinic with a dermatosis characterized by multiple erythematous-scaly plaques that affected her face, trunk and arms. N. nana was the fungus isolated on culture in both cases. The children were treated with oral griseofulvin and topical ketoconazole that led to clinical and mycological cures. CONCLUSIONS: N. nana dermatophytosis, although being rare in humans, can be treated as other cases of dermatophytosis.

Nodule bacteria from the cultured legume Phaseolus dumosus (belonging to the Phaseolus vulgaris cross-inoculation group) with common tropici phenotypic characteristics and symbiovar but distinctive phylogenomic position and chromid.

Phaseolus dumosus is an endemic species from mountain tops in Mexico that was found in traditional agriculture areas in Veracruz, Mexico. P. dumosus plants were identified by ITS sequences and their nodules were collected from agricultural fields or from trap plant experiments in the laboratory. Bacteria from P. dumosus nodules were identified as belonging to the phaseoli-etli-leguminosarum (PEL) or to the tropici group by 16S rRNA gene sequences. We obtained complete closed genomes from two P. dumosus isolates CCGE531 and CCGE532 that were phylogenetically placed within the tropici group but with a distinctive phylogenomic position and low average nucleotide identity (ANI). CCGE531 and CCGE532 had common phenotypic characteristics with tropici type B rhizobial symbionts. Genome synteny analysis and ANI showed that P. dumosus isolates had different chromids and our analysis suggests that chromids have independently evolved in different lineages of the Rhizobium genus. Finally, we considered that P. dumosus and Phaseolus vulgaris plants belong to the same cross-inoculation group since they have conserved symbiotic affinites for rhizobia.

[Trichomycosis (trichobacteriosis) capitis in an infant: Microbiological, dermoscopic and ultrastructural features]. / Tricomicosis (tricobacteriosis) en un infante: Aspectos microbiológicos, dermatoscópicos y ultraestructurales.

Trichomycosis is a superficial infection caused by Corynebacterium flavescens, which regularly affects axillary, and to a a lesser extent, pubic, scrotal and intergluteal, and exceptionally, head hairs or trichomycosis capitis (TC). This condition is characterised by the formation of bacterial nodules. Clinically, it can be confused with white piedra or pediculosis. The diagnosis is made by microscopic and dermoscopic observation and confirmed by culture. OBJECTIVE: To present a case of TC in an infant and illustrate the microscopic, dermoscopic, and ultrastructural characteristics. CLINICAL CASE: A 6 month-old boy, otherwise healthy, with multiple yellowish concretions on the hairs of the head. TC was confirmed by yellow fluorescence with Wood’s light; white-yellowish beads, like “rosaries of crystalline stones’’ were observed on dermoscopy, direct examination showed bacterial masses, and Corynebacterium flavescens was identified by culture. A superficial infection, without perforation of the hairs, was confirmed by electron microscopy. Treatment with fusidic acid for 3 weeks achieved a clinical and microbiological cure. CONCLUSION: TC is a rare condition that affects children, and tends to be mistaken for other diseases of the hair, such as pediculosis and mycotic infections.

Tricomicosis (tricobacteriosis) en un infante: aspectos microbiológicos, dermatoscópicos y ultraestructurales / Trichomycosis (trichobacteriosis) capitis in an infant: microbiological, dermoscopic and ultrastructural features

La tricomicosis es una infección superficial causada por Corynebacterium flavescens, que afecta por lo regular pelos axilares, en menor grado los púbicos, los escrotales e interglúteos y excepcionalmente los de la cabeza o tricomicosis capitis (TC). Esta infección se caracteriza por formación de nódulos pilosos. Clínicamente se confunde con infecciones como piedra blanca y pediculosis. El diagnóstico se realiza por microscopia y dermatoscopia de masas bacterianas y confirmado por cultivo. OBJETIVO: Presentar un caso de TC en un infante, y mostrar las características microscópicas, dermatoscópicas y ultraestructurales. CASO CLÍNICO: Niño sano de 6 meses de edad, con dermatosis que afectó los pelos de la cabeza en forma de múltiples nódulos-pilosos amarillentos. Se comprobó TC mediante fluorescencia amarilla a la luz de Wood; a la dermatoscopia se observaron cadenas blanco-amarillentas, como "rosarios de piedras cristalinas"; al examen directo se distinguieron masas bacterianas y al cultivo se identificó Corynebacterium flavescens. A la microscopia electrónica se observó infección superficial, sin perforación de los pelos. Se realizó tratamiento con aplicación de ácido fusídico por 3 semanas y se obtuvo curación clínica y microbiológica. CONCLUSIÓN: La TC es una entidad rara que se presenta en niños, y que suele confundirse con otros padecimientos del pelo como la pediculosis e infecciones micóticas.

Trichomycosis is a superficial infection caused by Corynebacterium flavescens, which regularly affects axillary, and to a a lesser extent, pubic, scrotal and intergluteal, and exceptionally, head hairs or trichomycosis capitis (TC). This condition is characterised by the formation of bacterial nodules. Clinically, it can be confused with white piedra or pediculosis. The diagnosis is made by microscopic and dermoscopic observation and confirmed by culture. OBJECTIVE: To present a case of TC in an infant and illustrate the microscopic, dermoscopic, and ultrastructural characteristics. CLINICAL CASE: A 6 month-old boy, otherwise healthy, with multiple yellowish concretions on the hairs of the head. TC was confirmed by yellow fluorescence with Wood’s light; white-yellowish beads, like "rosaries of crystalline stones" were observed on dermoscopy, direct examination showed bacterial masses, and Corynebacterium flavescens was identified by culture. A superficial infection, without perforation of the hairs, was confirmed by electron microscopy. Treatment with fusidic acid for 3 weeks achieved a clinical and microbiological cure. CONCLUSION: TC is a rare condition that affects children, and tends to be mistaken for other diseases of the hair, such as pediculosis and mycotic infections.

Setting the Lipid Component of the Diet: A Work in Process.

Some of the most relevant yet controversial issues in nutrition are those surrounding the guidelines on quality and quantity of dietary fat in the prevention and treatment of cardiovascular diseases and coronary heart diseases. Conflicting evidence questions the credibility of the previous dietary guidelines, particularly the quality of the evidence on which these recommendations were based. It is therefore important to explore the changes that have occurred in these guidelines and their influence on the adoption of different dietary patterns over time. In this review, we summarize the evolution of the fat component of the dietary guidelines, discuss controversial aspects, and highlight the areas in which additional evidence is still needed. Over the years, the scientific community has shown an obsession for calories in a diet instead of focusing on the quality of the food that makes up the diet. This is why certain authors have identified the importance of evaluating a diet focusing on diet patterns, rather than single isolated nutrients. This approach has been proposed in the most recent Dietary Guidelines for Americans.

Rhizobium grahamii sp. nov., from nodules of Dalea leporina, Leucaena leucocephala and Clitoria ternatea, and Rhizobium mesoamericanum sp. nov., from nodules of Phaseolus vulgaris, siratro, cowpea and Mimosa pudica.

Two novel related Rhizobium species, Rhizobium grahamii sp. nov. and Rhizobium mesoamericanum sp. nov., were identified by a polyphasic approach using DNA-DNA hybridization, whole-genome sequencing and phylogenetic and phenotypic characterization including nodulation of Leucaena leucocephala and Phaseolus vulgaris (bean). As similar bacteria were found in the Los Tuxtlas rainforest in Mexico and in Central America, we suggest the existence of a Mesoamerican microbiological corridor. The type strain of Rhizobium grahamii sp. nov. is CCGE 502(T) (= ATCC BAA-2124(T) = CFN 242(T) = Dal4(T) = HAMBI 3152(T)) and that of Rhizobium mesoamericanum sp. nov. is CCGE 501(T) (= ATCC BAA-2123(T) = HAMBI 3151(T) = CIP 110148(T) = 1847(T)).

Change in land use alters the diversity and composition of Bradyrhizobium communities and led to the introduction of Rhizobium etli into the tropical rain forest of Los Tuxtlas (Mexico).

Nitrogen-fixing bacteria of the Bradyrhizobium genus are major symbionts of legume plants in American tropical forests, but little is known about the effects of deforestation and change in land use on their diversity and community structure. Forest clearing is followed by cropping of bean (Phaseolus vulgaris) and maize as intercropped plants in Los Tuxtlas tropical forest of Mexico. The identity of bean-nodulating rhizobia in this area is not known. Using promiscuous trap plants, bradyrhizobia were isolated from soil samples collected in Los Tuxtlas undisturbed forest, and in areas where forest was cleared and land was used as crop fields or as pastures, or where secondary forests were established. Rhizobia were also trapped by using bean plants. Bradyrhizobium strains were classified into genospecies by dnaK sequence analysis supported by recA, glnII and 16S-23S rDNA IGS loci analyses. A total of 29 genospecies were identified, 24 of which did not correspond to any described taxa. A reduction in Bradyrhizobium diversity was observed when forest was turned to crop fields or pastures. Diversity seemed to recover to primary forest levels in secondary forests that derived from abandoned crop fields or pastures. The shifts in diversity were not related to soil characteristics but seemingly to the density of nodulating legumes present at each land use system (LUS). Bradyrhizobium community composition in soils was dependent on land use; however, similarities were observed between crop fields and pastures but not among forest and secondary forest. Most Bradyrhizobium genospecies present in forest were not recovered or become rare in the other LUS. Rhizobium etli was found as the dominant bean-nodulating rhizobia present in crop fields and pastures, and evidence was found that this species was introduced in Los Tuxtlas forest.

Oral geotrichosis: report of 12 cases.

Oral geotrichosis is an uncommon opportunistic infection caused by Geotrichum candidum, a habitual contaminant and component of the flora of various parts of the body. This communication reports both a 20-year retrospective study of clinically and mycologically proven cases of oral geotrichosis, and a prospective study of fungal oral flora in 200 individuals divided into two groups: normal individuals and individuals with associated conditions. Twelve patients with proven oral geotrichosis were included: 9 females and 3 males, with a mean age of 48.5 years; the associated conditions were diabetes mellitus (66.6%), leukemia, Hodgkin's lymphoma and HIV/AIDS infection. The oral geotrichoses showed three clinical varieties: pseudomembranous (75%), hyperplastic, and palatine ulcer. G. candidum was isolated in 11 cases and G. capitatum in one. Positive fungal cultures were obtained from the two groups, and 48% and 78% of cultures were positive, respectively, for Candida spp. In 2.8% and 6.33% of the cases, G. candidum was isolated, respectively, together with one strain of G. capitatum. Oral geotrichosis is an exceptional infection that clinically presents, and is treated, as oral candidiasis. G. candidum may be isolated from the oral flora of a small proportion of patients, either normal individuals or those with associated conditions.

Cytobrush-culture method to diagnose tinea capitis.

This is a comparative study to isolate the dermatophytes of tinea capitis using the cytobrush and comparing it versus the standard method. A prospective, observational, comparative trial of 178 probable cases of tinea capitis was conducted in two dermatological centers. Each patient underwent mycological tests that included direct exam with KOH and cultures with either of two methods: scraping the scalp to remove hair and cell debris, and the cytobrush. A total of 135 clinically and mycologically proven cases of tinea capitis were included; 119 were non-inflammatory and 16 inflammatory tinea. A total of 131 had a positive direct exam and subsequent primary isolation cultures were obtained in 135 cases. The main dermatophytes isolated were Microsporum canis (68%) and Trichophyton tonsurans (20%). A total of 115/135 (85.1%), were detected with the traditional method, with an average of 11.2 days until positive, while the number detected with the cytobrush was 132/135 (97.7%) with an average of 8.5 days until positive. The chi-square statistical method showed that the cytobrush culture was superior to the standard one with a chi-square of 5.078 (P = 0.025), with a statistically significant difference versus the standard method.

Vía aérea quirúrgica en el paciente politraumatizado / Surgical airway in the polywounded patient

Se realizó un estudio explicativo entre los resultados de la traqueotomía y la cricotiroidostomía (procederes quirúrgicos para abordar la vía aérea) en 80 pacientes politraumatizados que ingresaron en la unidad de Politraumas del Hospital Provincial Clínico Quirúrgico Docente Manuel Ascunce Domenech de la ciudad de Camagüey, desde enero de 1998 hasta diciembre de 1999. El objetivo fue analizar los resultados de la aplicación de ambas técnicas quirúrgicas en nuestro medio a los lesionados con traumatismo craneoencefálico grave. Al 60 % se le realizó traqueotomía y al 67, 5 % la cricotiroidostomía. La necesidad de una ventilación mecánica artificial prolongada más sepsis respiratoria fue el motivo de realización de la traqueotomía en 20 lesionados y de la cricotiroidostomía en 18 pacientes. Se observó un 27, 5 % de complicaciones con la realización de la traqueotomía con respecto al otro proceder donde sólo se encontró un 10 % de complicaciones. El resultado estético de la cicatriz fue considerado bueno en el 82, 5 % de los lesionados con la práctica de la cricotiroidostomía.

An explicative study among the results of tracheostomy and criothyroidostomy surgical preocedures for approaching the airway) in 80 polywounded patients who were admitted in polywounded unit at Manuel Ascunce Domenench Prov. Clinicalsurgical Hospital of Camagüey city, from january results in the application of both surgical techniques in our hospital; of those with severe craneo encephalic traumatism, tracheostomy was performed to 60 % and cricothyroidostomy to 67, 5 %. The need of mechanical artificial ventilation prolonged plus respiratory sepsis was the reason for carrying out tracheostomy in 20 wounded and cricothyroidostomy in 18 patients. It was observed 27, 5 % of caomplications with the performance of tracheostomy with respect to other procedure. It was found 10 % of complications. The aesthetic result was considered good in 82, 5 % of wounded with the practice of cricothyroidostomy. Results are compared with the said in the medical literature reviewed.

Regeneración osea guiada: comparación de membranas reabsorbibles fijadas con ciandacrilato vs minitornillos / Guided bone regeneration: comparison to using cyanoacrylate vs miniscrews for fixation of absorbable membranes

La osteopromoción fue desarrollada para el tratamiento de defectos óseos (patológicos o quirúrgicos) y mala unión de fracturas. Esto permite la regeneración del tejido por medio del proceso mesenquimal, que es la formación de tejido a partir de las células pluripotenciales del tejido mesenquimal, repitiendo bajo control epigenético y sistémico la misma secuencia del embrión. La capacidad de regeneración del mesenquimal depende del número y estado de las células. Las células del tejido fibroso, los osteoblastos y las células inflamatorias inhiben o estimulan estas células por medio de la secreción de factores. Los defectos óseos pequeños son rutinariamente tratados con regeneración tisular guiada o osteopromoción. La osteopromoción es el uso de membranas como barreras físicas para sellar una cavidad ósea en donde nuevo hueso es formado sin la previa formación de callo. Las membranas inpiden que otros tejidos interfieran con la formación del hueso. Los mismos defectos tratados sin membranas han mostrado una cicatrización lenta e incompleta. Las membranas usadas son de dos clases: no reabsorbibles y absorbibles. Las reabsorbibles no requieren de un procedimiento adicional para retirarlas, las no reabsorbibles pueden causar reabsorción ósea si no son retiradas. Los estudios de osteopromoción han logrado mejores resultados cuando las membranas son fijadas al hueso, así la fijación contribuye al éxito de la técnica. Los minitornillos han sido usados con eses propósito, pero también deben ser retirados. El cianoacrilato es un adhesivo quirúrgico.