Characterization of the gut microbiota in diabetes mellitus II patients with adequate and inadequate metabolic control.

OBJECTIVE: The objective of this study was to characterize the composition of the gut microbiota in type 2 Diabetes Mellitus (T2DM) patients with adequate and inadequate metabolic control, and its relationship with fiber consumption. RESULTS: A total of 26 patients with type 2 diabetes mellitus (T2DM) were enrolled, of which 7 (26.9%) cases had adequate metabolic control (HbA1c < 7%) and 19 (73.1%) inadequate metabolic control (HbA1c ≥ 7%). It was observed that among patients with controlled T2DM, 2 (28.6%) cases presented good intake of fiber and 5 (71.4%) cases a regular intake. In contrast, in patients with uncontrolled T2DM, 13 (68.4%) patients reported a regular intake and 6 (31.6%) a poor intake. In relation to the identification of the gut microbiota, both groups presented a similar characterization. There were differences in the population of bacteria identified in both groups, however, the results were not statistically significant. The most frequently identified bacteria in controlled and uncontrolled T2DM patients were Prevotella (71.4% vs 52.6%), followed by Firmicutes (71.4% vs 42.1%), Proteobacteria (71.4% vs 36.8%) and Bacteroidetes (57.1% vs 37.8%). On the other hand, Fusobacterium, Actinobacteria were not identified in either of the two groups of study.

Risk Factors Associated with Dengue Transmission and Spatial Distribution of High Seroprevalence in Schoolchildren from the Urban Area of Medellin, Colombia.

Dengue fever is an increasing health problem in tropical and subtropical regions. During 2010 in Medellin, the younger population presented a particularly high dengue incidence rate. This study estimated dengue virus (DENV) transmission in schoolchildren (aged 5-19 years) in Medellin from 2010 to 2012. A longitudinal serological survey (IgG) and spatial analysis were conducted to determine the distribution of DENV seroprevalence. A total of 4,385 schoolchildren participated for at least one year. Dengue seroprevalence significantly increased during the studied period (53.8% to 64.6%; p < 0.001). A significantly higher seroconversion rate was observed in 2010-2011 (16.8%) compared to 2011-2012 (7.8%). Multivariate regression analysis showed that the main factor associated with the seroprevalence was the aging. Furthermore, in 2010, patients with high socioeconomic status presented a lower risk. Predominant multitypic and DENV4 monotypic antibody responses were demonstrated. Geostatistical analysis evidenced a temporal clustering distribution of DENV seroprevalence in 2010. Population density and Ae. aegypti House Index were significantly correlated with the observed pattern. This study revealed high DENV transmission in schoolchildren determined as "sentinel population." High DENV risk was found in districts with combined poorly socioeconomic conditions and densest human and mosquito populations. These findings may allow to target population for effective prevention and vaccination campaigns.

Human Trypanosomiasis in the Eastern Plains of Colombia: New Transmission Scenario.

Characteristics of Trypanosoma cruzi infection were studied in a rural area of the eastern plains of Colombia. Using enzyme-linked immunosorbent assay and indirect fluorescent-antibody tests, the infection was determined in 11.6% of the inhabitants of 142 dwellings. During 6 months of community surveillance, in 42.3% dwellings, 609 triatomines were collected (597 Rhodnius prolixus and seven, three, one, and one of Panstrongylus geniculatus, Psammolestes arturi, Eratyrus mucronatus, and Triatoma maculata, respectively). Rhodnius prolixus was found in 80% peridomiciliary Attalea butyracea palms examined with baited traps, and its infection with T. cruzi was 30% and 38.5% in dwellings and palms, respectively. Trypanosoma cruzi was isolated in five of 35 triatomines and in one of 24 dogs. The blood of domestic and wild animals was identified in triatomines collected in the intradomicile and in palms. These results support the extension of the wild cycle of T. cruzi to human dwellings and the characterization of a new scenario for transmission in Colombia.

Comportamiento de las cifras de glucemia en pacientes diabéticos tipo 2 con la ingesta de dos desayunos con la misma cantidad de carbohidratos / Figures performance of glycemia in type 2 diabetic patients with intake of two breakfast with the same amount of carbohydrates

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[Dengue infection: A common cause of febrile syndrome in patients from Quibdó, Chocó, Colombia]. / Infección por dengue: una causa frecuente de síndrome febril en pacientes de Quibdó, Chocó, Colombia.

INTRODUCTION: Quibdó, a municipality in Chocó, has poor public services and weather and social conditions that favor dengue transmission. However, there are few studies about this problem in this district. OBJECTIVE: To determine the frequency of dengue infection in patients with acute febrile syndrome and to compare clinical features among dengue infected patients with other febrile diseases. MATERIALS AND METHODS: A cross-sectional study was conducted from January, 2008, to March, 2010. The study population comprised patients with febrile syndrome of seven or fewer days of evolution, recruited from hospitals in the town. Dengue diagnosis was made in serum samples by detection of IgM antibodies, NS1 antigen, reverse transcription polymerase chain reaction, and virus isolation. Clinical and laboratory information from the patients was obtained. RESULTS: During the study period, 469 patients with acute febrile syndrome were recruited, of whom 98.3% were Afro-descendant. Dengue fever was found in 28.4% of the cases. Four dengue serotypes were identified with DENV-1 predominance. The ages ranged from zero to 76 years. From all patients, 70.7% of cases were classified as dengue without warning signs. Nausea, vomiting, abdominal pain, cough, nasal congestion and sore throat were significantly more frequent in patients with another febrile disease. CONCLUSIONS: Active surveillance of the acute febrile syndrome allowed for the detection of undiagnosed cases of dengue; the observed frequency of this infection suggests that the study area has a high risk of dengue infection.

Concordancia de dos pruebas serológicas para el diagnóstico de la enfermedad de Chagas / Concordance of two serological tests for the diagnosis of Chagas disease

Objetivo Establecer la concordancia entre un Ensayo Inmunoenzimático Ligado a una Enima Casera (ELISA) y la Inmunofluorescencia Indirecta (IFI) para el diagnóstico de infección por T. cruzi empleando eluidos sanguíneos. Metodología Se realizó un estudio de evaluación de tecnología diagnóstica y muestreo de corte transversal a 650 habitantes de una zona endémica de Colombia. Se determinó el área bajo la curva de operador-receptor (del inglés ROC) y se usó la IFI estandarizada en eluidos sanguíneos como gold standard. Se estableció el punto de corte para el ELISA, así como la concordancia entre las lecturas. Resultados El ELISA presentó una concordancia de 0,99 (IC95 %: 0,989-0,992) entre las lecturas realizadas y una curva ROC de 0,9795. El punto de corte establecido fue 0,5 de absorbancia en la prueba de ELISA. 16,6 % fueron positivas para anticuerpos anti-T. cruzi por ELISA y 10,9 % por IFI. Conclusiones El ELISA mostró buena concordancia frente a IFI, por lo tanto es una buena elección diagnóstica para la población que vive en áreas remotas.

Objetive Establish the concordance between in-house ELISA and IIF for the diagnosis of infection with T. cruzi using blood eluates. Methodology A study of diagnostic technology evaluation and cross-sectional sample of 650 residents of an endemic area of Colombia was conducted. It was determined the Receiver Operating Characteristic curve (ROC) and IIF was used as a gold standard. It was established the cutoff for the ELISA and the correlation between readings. Results The in-house ELISA it was an agreement of 0.99 (95 % CI: 0.989 to 0.992) between the two readings taken and the area for the ROC curve was 0.9795. The cutoff was set at 0.5 absorbance in the ELISA test. 16.6 % were positive by ELISA and 10.9 % by IIF. Conclusions The in-house ELISA showed good concordance compared to the IIF, so it is a good choice diagnostic for the population living in remote areas.

[Concordance of two serological tests for the diagnosis of Chagas disease]. / Concordancia de dos pruebas serológicas para el diagnóstico de la enfermedad de Chagas.

OBJECTIVE: Establish the concordance between in-house ELISA and IIF for the diagnosis of infection with T. cruzi using blood eluates. METHODOLOGY: A study of diagnostic technology evaluation and cross-sectional sample of 650 residents of an endemic area of Colombia was conducted. It was determined the Receiver Operating Characteristic curve (ROC) and IIF was used as a gold standard. It was established the cutoff for the ELISA and the correlation between readings. RESULTS: The in-house ELISA it was an agreement of 0.99 (95 % CI: 0.989 to 0.992) between the two readings taken and the area for the ROC curve was 0.9795. The cutoff was set at 0.5 absorbance in the ELISA test. 16.6 % were positive by ELISA and 10.9 % by IIF. CONCLUSIONS: The in-house ELISA showed good concordance compared to the IIF, so it is a good choice diagnostic for the population living in remote areas.

Análisis sociodemográfico y espacial de la transmisión de la tuberculosis en la ciudad de Armenia (Colombia) / Sociodemographic and spatial transmission of tuberculosis in the city of Armenia (Colombia)

La tuberculosis es uno de los problemas que demanda atención prioritaria en el municipio de Armenia, capital del departamento del Quindío (Colombia). En este estudio, se encontró que la población afectada, generalmente pertenece al género masculino (razón hombre: mujer 2:1) y en edad económicamente productiva (25-54 años). La mayoría de enfermos son del régimen subsidiado (40%) o no asegurados (26%) y viven en condiciones socioeconómicas críticas. Se encontraron diferencias significativas de carga de enfermedad en las tasas entre comunas: en unas localidades fueron de 10 y en otras de 30 casos por 100.000 habitantes, indicando heterogeneidad de la situación en la ciudad. El análisis geoespacial permite caracterizar y precisar los escenarios donde se deben concentrar las acciones prioritarias del programa de control de la tuberculosis.

Tuberculosis is an important public health problem that demands priority action in the city of Armenia (Colombia). In this study, we found that most cases of TB were males (ratio 2:1) and economically active population (25-54 years). TB patients had subvention health care (40%) or were uncovered by the national health insurance (26%), living in critical socioeconomic condi tions. Significant differences in the TB prevalence rate between town localities were found; in some zones were 10 and 30 cases per 100.000 inhabitants, indicating a heterogeneous situation. Spatial analysis might allow the definition and concentration of early actions in a region for the tuberculosis control.

ITS-RFLP- and RAPD-based genetic variability of Trypanosoma cruzi I, human and vector strains in Santander, Colombia.

Chagas disease is a severe public health problem in Latin-American countries. In Colombia, the predominance of Trypanosoma cruzi I has been described in the literature, with a broad heterogeneity between strains. However, most of the studies carried out centered on isoenzyme analysis, with a smaller number that focus on other molecular methods. In this report, we discuss the results of a molecular analysis of T. cruzi I strains, isolated from the domestic cycle, from the department of Santander, one of the territorial divisions where the prevalence of infection is highest. Internal transcribed spacer-restriction fragment length polymorphism and random amplification of polymorphic DNA were used to characterize 16 strains from human and vector (Triatominae) hosts. The data reveal a clustering based on the biological origin. Human and vector strains grouped separately; however, three vector strains clustered together with human strains. These results indicate that genetic differences exist in the strains that infect both hosts. We conclude that T. cruzi I populations in the domestic cycle of transmission of Chagas disease in Santander are heterogeneous and are composed of different clones. The epidemiological and biological implications are discussed.