Impact of COVID-19 pandemic in the care of people living with HIV and cancer at an oncologic center in Mexico.

BACKGROUND: People living with HIV(PLWH) and cancer are among the most vulnerable patients and require constant access to medical services. We compared the characteristics of PLWH and cancer in Mexico, before and during the COVID-19 pandemic. METHODS: Patients admitted 1 year before (pre-pandemic) and 1 year after the start of the pandemic (pandemic) were included. Clinical characteristics, HIV-related variables, and 90-day mortality were compared. Data are described a proportions (N,%) and central tendency measures. A multiple regression model for variables associated with 90-day mortality was performed. RESULTS: Seventy-nine patients were seen in the pre-pandemic period; 92 during the pandemic. Main diagnoses were Kaposi Sarcoma and lymphoma. CD4+ cell count at diagnosis was lower during the pandemic: 81 cells/mm3 vs. 128 cells/mm3, p = .035. CD4+<100 cells/mm3 at first consultation increased from 41% to 58% during the pandemic (p = .041). Only BMI <20 kg/m2 was associated to death (aOR 8.27, 95%CI 1.74-39.25) (p = .008). The pandemic period was not associated with a higher 90-day mortality. CONCLUSIONS: PLWH and cancer presented to care with advanced disease overall. This was more pronounced during the pandemic period. Mortality was associated with AIDS-related variables regardless of study period. This underscores the need for strategies to maintain in-person access to health-care services for PLWH.

Relación entre Porphyromonas gingivalis y diabetes mellitus tipo 2: revisión sistemática exploratoria / Relationship between Porphyromonas gingivalis and Type 2 Diabetes Mellitus: Scoping review

Objetivo: analizar la relación entre Porphyromonas gingivalis y diabetes mellitus tipo 2, mediante una revisión sistemática exploratoria de la literatura científica publicada entre los años 2000 y 2019. Métodos: se utilizaron los siguientes términos MeSH: Porphyromonas gingivalis, diabetes mellitus type 2, periodontal disease, non insulin dependent diabetes. Se obtuvieron 346 resultados, de los cuales se seleccionaron 41 por título, se excluyeron 11 posterior a la lectura del abstract e introducción y 19 después de la lectura del texto completo. Finalmente, se incluyeron 11 artículos. Resultados: el lipopolisacárido de Porphyromonas gingivalis y su fimbria tipo II se relacionan con una mayor producción de citoquinas proinflamatorias como IL-6 y TNF-α, las cuales afectan las vías de señalización de la glucosa y se relacionan con insulinoresistencia. La dipeptidil peptidasa 4 de Porphyromonas gingivalis puede participar en la degradación de incretinas, lo cual afecta la producción de insulina en el huésped y promueve estados de hiperglicemia. El interactoma de Porphyromonas gingivalis puede superponerse con genes involucrados en resistencia a la insulina y diabetes mellitus tipo 2. Conclusión: según la evidencia científica publicada existen factores de virulencia y mecanismos por los cuales la Porphyromonas gingivalis influye en el desarrollo de insulinorresistencia y diabetes mellitus tipo 2.

Objective: To analyze the relationship between Porphyromonas gingivalis and Diabetes Mellitus Type 2 by reviewing the scientific literature published between 2000 and 2019. Methods: The following MeSH terms were used: Porphyromonas gingivalis, Diabetes Mellitus type 2, periodontal disease, non-insulin dependent diabetes. We obtained 346 results, of which 41 were selected by title, 11 were excluded after reading the abstract and introduction and 19 after reading the full text. Finally, 11 articles were included. Results: Porphyromonas gingivalis lipopolysaccharide and its type II fimbria are associated with increased production of proinflammatory cytokines such as IL-6 and TNF-α, which affect glucose signaling pathways and are related to insulin resistance. Porphyromonas gingivalis dipeptidyl peptidase 4 (PgDPP4) may participate in incretin degradation which affects host insulin production and promotes hyperglycemic states. The Porphyromonas gingivalis interactome may overlap with genes involved in insulin resistance and type 2 diabetes mellitus. Conclusion: According to published scientific evidence, there are virulence factors and mechanisms by which Porphyromonas gingivalis influences the development of insulin resistance and type 2 Diabetes Mellitus.

[Distribution and antifungal susceptibility of Candida clinical isolations coming from six health care centers in the metropolitan area of Caracas, Venezuela (years 2003-2005)]. / Distribución y sensibilidad a los antifúngicos de aislamientos clínicos de Candida en seis centros de salud del área metropolitana de Caracas, Venezuela (años 2003-2005).

The aim of this study was to investigate the frequency and antifungal susceptibility of Candida clinical isolations coming from patients with candidiasis in six health care centers of Caracas, Venezuela metropolitan area. The laboratory reports were retrospectively revised from January 2003 through August 2005. The isolated yeasts identification was carried out by conventional methods and antifungal susceptibility was evaluated by ATB-fungus (bioMérieux, France) and Etest (AB Biodisk, Solna, Sweden). One thousand nine hundred seventy seven (1.977) yeasts were studied and their susceptibility testing were carried out only in 1,414 of them. C. albicans was the most isolated yeast (46.7%) and none-albicans Candida-species represented more than half of the isolations (53.4%). All the isolated yeasts evaluated presented CMIs<1 microg/ml to anfotericina B and showed variable susceptibility percentages to fluconazole (91.5%), itraconazole (80%) and voriconazole (98.6%).

Distribución y sensibilidad a los antifúngicos de aislamientos clínicos de Candida en seis centros de salud del área metropolitana de Caracas, Venezuela (años 2003-2005) / Distribution and antifungal susceptibility of Candida clinical isolations coming from six health care centers in the metropolitan area of Caracas, Venezuela (years 2003-2005)

El objetivo de este estudio fue conocer la frecuencia y la sensibilidad a losantifúngicos de aislamientos clínicos de Candida provenientes de pacientescon candidiasis en seis centros de salud del área metropolitana de Caracas,Venezuela. Se revisaron retrospectivamente los informes de laboratorio desdeenero de 2003 hasta agosto de 2005. La identificación de las levadurasaisladas se realizó por los métodos convencionales y se evaluó lasusceptibilidad a los antifúngicos por los métodos ATB-Fungus (bioMérieux,Francia) y Etest (AB Biodisk, Solna, Suecia). Se aislaron 1.977 levaduras y a1.414 se les realizaron pruebas de sensibilidad. Candida albicans fue lalevadura aislada con más frecuencia (46,7%) y el resto de las especies deCandida representaron más de la mitad de los aislamientos (53,4%).Todas las levaduras evaluadas presentaron valores de CMI <1 mg/ml para laanfotericina B y porcentajes de sensibilidad variable al fluconazol (91,5%),itraconazol (80%) y voriconazol (98,6%)(AU)

The aim of this study was to investigate the frequency and antifungalsusceptibility of Candida clinical isolations coming from patients withcandidiasis in six health care centers of Caracas, Venezuela metropolitan area.The laboratory reports were retrospectively revised from January 2003 throughAugust 2005. The isolated yeasts identification was carried out byconventional methods and antifungal susceptibility was evaluated byATB-fungus (bioMérieux, France) and Etest (AB Biodisk, Solna, Sweden).One thousand nine hundred seventy seven (1,977) yeasts were studied andtheir susceptibility testing were carried out only in 1,414 of them. C. albicanswas the most isolated yeast (46.7%) and none-albicans Candida-speciesrepresented more than half of the isolations (53.4%). All the isolated yeastsevaluated presented CMIs <1 mg/ml to anfotericina B and showed variablesusceptibility percentages to fluconazole (91.5%), itraconazole (80%) andvoriconazole (98.6%)(AU)

Memoria / Memory

El documento presenta el desarrollo, resultado y presentaciones de cada uno los participantes de la reunión nacional de evaluación del decenio de salud de pueblos indígenas y comunidades Afrocaribes de Nicaragua, los temas abordados en la reunión fueron: Acuerdos internacionales y políticas nacionales, dentro de este tema se abordo "El parlamento indígena de América por la continuidad del decenio internacional de los pueblos indígenas; Derechos humanos de los pueblos indígenas y afrocaribeños en el decenio; Ley general de salud y su reglamento;asi como consideraciones en el marco de la autonimía