An epidemiological analysis of TB trends in native and migrant populations, New Mexico, 1993-2021.

To analyze the epidemiological, demographic, clinical, laboratory, radiographic and treatment outcome trends in non-US-born individuals with TB in New Mexico.We retrospectively analyzed TB data from New Mexico TB surveillance system from (1993-2021), comparing variables between non-US-born and US-born individuals.Of the 1,512 TB cases, 876 (56.5%) were non-US-born and 653 (43.3%) were US-born. The incidence rate among non-US-born patients declined from 15.3/100,000 (1993) to 7.8/100,000 (2021) (54.6% reduction), while among US-born patients it declined from 3.3/100,000 (1993) to 0.5/100,000 (2021) (84.8% reduction). The majority of non-US-born individuals were from Mexico (n = 482, 73.5%). Non-US-born were typically younger adults (median age: 54 vs. 61), predominantly male (64.8% vs. 59.4%), less likely to consume excess alcohol and have extrapulmonary TB. However, they were more likely to exhibit resistance to standard TB drugs (P < 0.01). Non-US-born individuals were less likely to die (7.8% vs. 15.4%), but more likely to be lost to follow-up (P < 0.007). Treatment by providers outside the Department of Health was associated with noncompletion (OR 0.18, 95% CI 0.09-0.35; P < 0.001).These results highlight the need for a detailed understanding of the impact of migration on TB epidemiology and the development of tailored interventions to improve treatment outcomes..

Schistosoma mansoni cathepsin D1: Biochemical and biophysical characterization of the recombinant enzyme expressed in HEK293T cells.

Schistosomes express a variety of aspartyl proteases (APs) with distinct roles in the helminth pathophysiology, among which degradation of host haemoglobin is key, since it is the main amino acid source for these parasites. A cathepsin D-like AP from Schistosoma mansoni (SmCD1) has been used as a model enzyme for vaccine and drug development studies in schistosomes and yet a reliable expression system for readily producing the recombinant enzyme in high yield has not been reported. To contribute to further advancing the knowledge about this valuable antischistosomal target, we developed a transient expression system in HEK 293T mammalian cells and performed a biochemical and biophysical characterization of the recombinant enzyme (rSmCD1). It was possible to express a recombinant C-terminal truncated form of SmCD1 (rSmCD1ΔCT) and purify it with high yield (16 mg/L) from the culture supernatant. When analysed by Size-Exclusion Chromatography and multi-angle laser light scattering, rSmCD1ΔCT behaved as a dimer at neutral pH, which is unusual for cathepsins D, turning into a monomer after acidification of the medium. Through analytical ultrancentrifugation, the dimer was confirmed for free rSmCD1ΔCT in solution as well as stabilization of the monomer during interaction with pepstatin. The mammalian cell expression system used here was able to produce rSmCD1ΔCT with high yields allowing for the first time the characterization of important kinetic parameters as well as initial description of its biophysical properties.

Descriptive observational study on early functional recovery and postoperative pain in knee joint replacement surgery. / Estudio observacional descriptivo sobre recuperación funcional temprana y dolor postoperatorio en cirugía de reemplazo articular de rodilla.

INTRODUCTION: The management of postoperative pain in joint replacement surgery represents a challenge. Therefore, the advent of new strategies in the management of pain such as local infiltration analgesia (LIA) and the adductor canal block, allowed an adequate postoperative pain control and early rehabilitation of the patient in total knee arthroplasty. MATERIALS AND METHODS: A descriptive, observational and longitudinal study of a prospective cohort of patients operated by the group of joint replacements between September 29, 2017 and November 30, 2017 was conducted. They were evaluated with the analog pain scale for postoperative pain at 5 different times (1:Upon leaving recovery; 2:On the first postoperative day; 3:Before initiating in-hospital physical therapy; 4:At the end of physical therapy, and 5:Upon departure from the clinic). RESULTS: Of the 141 patients operated on, 70.9% of the patients were managed with LIA and 29.1% with adductor canal block. There were no differences between groups in postoperative pain assessment during the 5 different times (P≥.45). DISCUSSION: Our results indicate that LIA and the adductor canal blockade demonstrated the same efficacy for the control of postoperative pain and rehabilitation.

Prevalence of Strongylida nematodes associated with African Snail, Achatina fulica, in Valle del Cauca, Colombia / Prevalencia de parásitos nematodos Strongylidos asociados al Caracol africano, Achatina fulica, en el Valle del Cauca, Colombia

ABSTRACT Objectives. To establish the presence and prevalence of Strongylida nematode parasites in Achatina fulica in the Valle del Cauca, especially of nematodes that are potentially pathogenic for humans. Materials and methods. A. fulica individuals were collected in nine cities of the Valle del Cauca, Colombia. Direct visual examination was used to identify A. fulica parasites. Nematodes were separated from tissue or collected from mucus, washed in saline solution, and fixed in a hot AFA solution. Samples were mounted in glycerine and observed under the microscope. Results. The general nematode parasite prevalence was 35% in 2013. The city with highest prevalence during 2013 was Cartago (60%), following by Buenaventura (42.9%) and Cali (33%), while during 2014 were Cali (30%) and Buenaventura (30%). The Strongylida nematodes registered were classified in three genera: Angiostrongylus (14.7% prevalence), Aelurostrongylus (2.6%), and Strongyluris (2.6%). The city with highest positive records of Angiostrongylus was Cali during 2014 and Aelurostrongylus was Buenaventura during 2013. Strongyluris genus was recorded only in Cali during 2013, with a prevalence of 11%. Of the nine evaluated cities, five has presence of Angiostrongylus. Conclusions. Three genera of Strongylida nematode were recorded associated with A. fulicas specimens in the Valle del Cauca during 2013 and 2014. Therefore, the role that A. fulica and native mollusk species could be playing in the life cycle of these parasites at the local level should not underestimated.

RESUMEN Objetivos. Establecer la presencia y prevalencia de parásitos nematodos Strongylida en Achatina fulica en el Valle del Cauca, especialmente los nematodos que son potencialmente patogénicos para los humanos. Materiales y métodos. Individuos de A. fulica fueron colectados en nueve ciudades del Valle del Cauca, Colombia. Los nematodos fueron identificados mediante inspección directa de los individuos, estos se separaron de los tejidos y el mucus, luego, los nematodos se lavaron en solución salina, y fijaron en solución AFA caliente. Se montaron placas en glicerina para observar al microscopio. Resultados. La prevalencia general de parásitos nematodos fue 35% en 2013. La ciudad con mayor prevalencia durante 2013 fue Cartago (60%), seguido de Buenaventura (42.9%) y Cali (33%), mientras que en 2014 fue Cali (30%) y Buenaventura (30%). Los nematodos Strongylida registrados fueron clasificados en tres géneros: Angiostrongylus (prevalencia 14.7%), Aelurostrongylus (2.6%), y Strongyluris (2.6%). La ciudad con la mayor cantidad de positivos para Angiostrongylus fue Cali durante 2014 y Buenaventura con Aelurostorngylus para el 2013. El género Strongyluris solo se reportó en Cali durante 2013, con una prevalencia del 11%. En cinco de las nueves ciudades evaluadas se registró la presencia de Angiostrongylus. Conclusiones. Tres géneros de nematodos Strongylida se reportaron en individuos de A. fulica en el Valle del Cauca durante 2013 y 2014. Por lo tanto, no debe subestimarse el papel de A. fulica y las especies de moluscos nativas en el ciclo de vida de estos parásitos.

Schistosoma mansoni: molecular characterization of Alkaline Phosphatase and expression patterns across life cycle stages.

Here we describe the cloning and characterization of the Schistosoma mansoni Alkaline Phosphatase (SmAP), previously identified in the tegument of adult worms. SmAP encodes a complete sequence composed of 536 amino acids containing an N-terminal signal peptide, five N-glycosylation sites, and a GPI anchor signal, similar to that described for mammalian orthologs. Real-time RT-PCR and Western blot experiments suggest a rapid translation as soon as cercariae are transformed into schistosomula. Immunolocalization analysis shows that the protein is widely distributed in the worm tissues, with increased concentration in the vitelline glands of female parasites. Furthermore, the surface localization of this enzyme was quantitatively supported by its enzymatic activity in live ex vivo or cultured parasites throughout the life cycle stages. The fact that cercariae accumulate large amounts of SmAP mRNA, which rapidly translates into protein upon schistosomula transformation, indicates it may have an important role in host invasion.

Comparación de la reformas de los sistemas de salud en Colombia y Costa Rica en su dimensión política / Political dimension of the reform of the systems of health of Colombia and Costa Rica

OBJETIVO: analizar la dimensión política de la reforma de los sistemas de salud de Colombia y Costa Rica en el período de 1990-2009. METODOLOGIA: se realizó una investigación utilizando la metodología de comparación entre países (Cross National). Se hizo un manejo sistemático de datos comparados de Colombia y Costa Rica, buscando semejanzas y diferencias entre los dos países. RESULTADOS: se evidenció la similitud que existe en la conformación político administrativa de los dos países objeto de análisis; igualmente, se pudo observar que, en gran medida, la dirección y la implementación que toman las reformas de los sistemas de salud están altamente condicionadas por la participación de la sociedad civil en el proceso de reforma, así como por las directrices impartidas por organismos financieros internacionales. CONCLUSIONES: Colombia tiene un sistema de aseguramientomixto regulado, vinculado al mercado y al sector privado. Costa Rica, en cambio,tiene un Sistema Público Integrado, ligado a los fines del Estado, de corte eminentemente universalista, apoyado por los actores civiles como pilar fundamental, quienes avalan o rechazan las decisiones sobre las reformas del sector salud, con escasa participación del sector privado. La rectoría la asume el Estado a través del Ministerio de Salud, el cual protege y vela por el cumplimiento de los derechos y genera políticas para elevar el nivel de salud de la población, de modo que redunde en mejores niveles de vida.

OBJECTIVE: to analyze the political dimension of the reform of the health systems of Colombia and Costa Rica over the period 1990 to 2009. METHODOLOGY: we conducted an investigation using the methodology of comparison between countries (Cross National). There was a systematic use of comparative data from Colombia and Costa Rica, looking for similarities and differences between the two countries. RESULTS: it was showed the similarity in the political and administrative establishment of the two States under review, also we could see that much of the course and implement reforms that make health systems are highly conditioned by the participation of civil society in the reform process, as well as the guidelines issued by international financial organizations. CONCLUSIONS: Colombia has a mixed insurance system regulated and market-linked private sector. Costa Rica has instead integrated public system, linked for the purposes of the state, eminently universal, supported by civilian actors as a fundamental pillar who endorse or reject the decisions on health sector reforms, with limited involvement of private sector. The rectory is assumed by the State through the Ministry of Health, which protects and enforces the rights and creates policies to increase the level of health of the population so that results in improved living standards.

Schistosoma mansoni Molecular characterization of Alkaline Phosphatase and expression patterns across life cycle stages

Here we describe the cloning and characterization of the Schistosoma mansoni Alkaline Phosphatase(SmAP), previously identified in the tegument of adult worms. SmAP encodes a complete sequence composedof 536 amino acids containing an N-terminal signal peptide, five N-glycosylation sites, and a GPIanchor signal, similar to that described for mammalian orthologs. Real-time RT-PCR and Western blotexperiments suggest a rapid translation as soon as cercariae are transformed into schistosomula. Immunolocalizationanalysis shows that the protein is widely distributed in the worm tissues, with increased concentration in the vitelline glands of female parasites. Furthermore, the surface localization of thisenzyme was quantitatively supported by its enzymatic activity in live ex vivo or cultured parasites throughout the life cycle stages. The fact that cercariae accumulate large amounts of SmAP mRNA, which rapidly translates into protein upon schistosomula transformation, indicates it may have an important role in host invasion.

Videophone utilization as an alternative to directly observed therapy for tuberculosis.

To demonstrate whether the use of videophone technology is an effective alternative method to direct observation of tuberculosis (TB) medication administration, a retrospective chart review and data analysis were performed on records for 57 patients with active TB in two Washington state counties who utilized videophone technology for the administration of medications from 2002 through 2006. A total of US$139,546 was saved in staff salaries, benefits and travel costs. The average cost savings per patient was US$2448. The use of videophone technology is a cost-effective alternative to in-home directly observed administration of TB medication.

Concentraciones sanguíneas de zinc en embarazadas con partos prematuros / Embarrassed sanguineous zinc concentrations in with premature childbirths

con el objetivo de evaluar la relación entre el comportamiento del zinc durante el embarazo y algunas variables estudiadas en embarazadas que tuvieron partos prematuros, se hizo un estudio de corte trasversal en 60 gestantes cuyos hijos nacieron entre las semanas 27 y 36, en la ciudad de Medellín, Colombia. La concentración media del metal y su error estándar fueron 7,33 ± 0,23 mg/L; no se observó una correlación entre los valores encontrados y la edad gestacional. Las gestantes sanas tuvieron una concentración media de zinc de 7,20 ± 0,25 mg/L, la cual fue significativamente menor que la de quienes tuvieron niños con crecimiento restringido, p = 0,03, pero similar a la de las que sufrieron hipertensión inducida, embarazos múltiples, fetos malformados o recibieron esteroides para la maduración pulmonar fetal. El percentil 75 de la curva de valores del zinc se estableció en 8,6 mg/L, y quienes se ubicaron por encima del mismo tuvieron un número significativamente mayor de fetos de sexo femenino, p = 0,011, y una tendencia no significativa a tener más fetos con restricción del crecimiento, p = 0,07. Las ubicadas por debajo del percentil 25, o sea de 6,2 mg/L, mostraron también tendencias no significativas a un número mayor de embarazos gemelares, p = 0,05 y de fetos malformados, p = 0,08. Los hallazgos de la muestra estudiada sugieren que puede existir asociación entre las concentraciones de zinc y efectos fetales importantes que se deben verificar en estudios posteriores que incluyan poblaciones mayores. Es llamativa la relación entre un zinc materno alto y el sexo femenino del feto, la cual podría estar indicando el efecto de factores hormonales específicos.Palabras claves: zinc, embarazo, parto prematuro.

Quantitative proton MRS predicts outcome after traumatic brain injury.

OBJECTIVE: To determine whether proton MRS (1H-MRS) neurochemical measurements predict neuropsychological outcome of patients with traumatic brain injury (TBI). BACKGROUND: Although clinical indices and conventional imaging techniques provide critical information for TBI patient triage and acute care, none accurately predicts individual patient outcome. METHODS: The authors studied 14 patients with TBI soon after injury (45+/-21 days postinjury) and again at 6 months (172+/-43 days) and 14 age-, sex-, and education-matched control subjects. N-acetylaspartate (NAA), creatine, and choline were measured in normal-appearing occipitoparietal white and gray matter using quantitative 1H-MRS. Outcome was assessed with the Glasgow Outcome Scale (GOS) and a battery of neuropsychological tests. A composite measure of neuropsychological function was calculated from individual test z-scores probing the major functional domains commonly impaired after head trauma. RESULTS: Early NAA concentrations in gray matter predicted overall neuropsychological performance (r = 0.74, p = 0.01) and GOS (F = 11.93, p = 0.007). Other metabolite measures were not related to behavioral function at outcome. CONCLUSION: 1H-MRS provides a rapid, noninvasive tool to assess the extent of diffuse injury after head trauma, a component of injury that may be the most critical factor in evaluating resultant neuropsychological dysfunction. 1H-MRS can be added to conventional MR examinations with minimal additional time, and may prove useful in assessing injury severity, guiding patient care, and predicting patient outcome.

Conceptos básicos de investigación en psiquiatría y salud mental / Basics of research in psychiatry and mental health

Se presentan algunos aspectos generales relacionados con el diseño y la ejecución de una investigación y con la publicación de sus resultados. El artículo empieza con la descripción de los componentes de un proyecto de investigación y luego revisa los diseños de uso mas frecuente. Mas adelante examina los aspectos básicos del uso de instrumentos de medición y ofrece pautas para la recolección y el procesamiento de los datos y para la selección e interpretación de las pruebas estadísticas. Finalmente, presenta los elementos básicos para la elaboración de manuscritos con destino a las revistas científicas...

Some general aspects related to the design and implementation of researc programs and the publication of its results are presented. The article begins with the description of the components of a researc project and afterwards reviews the more frequently used instruments, guidelines for the recollection and processing of data and the selection and interpretation of statistical test. At the end, basic elements for the development of papers for science journals are presented...

Reversal of inhibitory pathways in neutrophils by protein kinase antagonists: a rational approach to the restoration of depressed cell function?

Neutrophil functions are sensitive to both stimulatory and inhibitory pathways. For example, the endogenous hormones histamine, prostaglandin E1, adenosine, and catecholamine were found to inhibit the oxidant responses of human neutrophils by formyl peptide to 6.2, 16.8, 11.4, and 15.4%, respectively, of the initial response. The inhibition of cell function is mimicked by dibutyryl cAMP and forskolin, consistent with a pathway involving cAMP and an A kinase. Because of likely roles of kinases in both stimulatory and inhibitory pathways, we evaluated the potential for regulating either pathway by kinase inhibitors. Preincubation of intact neutrophils with membrane-permeable but nonspecific protein kinase antagonists blocked the isoproterenol-mediated inhibition of superoxide generation. The isoquinoline sulfonamides H-7, H-8, and H-9 at 100 microM reversed inhibition to 60.1, 66.6, and 70.9%, respectively, of the response of control cells. H-9 also antagonized the inhibition of superoxide production induced by other agents that regulate intracellular cAMP (prostaglandin E1, histamine, adenosine, forskolin, and dibutyryl cAMP). A synthetic peptide used as a specific but impermeable protein kinase A antagonist restored superoxide production inhibited by isoproterenol and cAMP up to 70% in electroporated cells. A small number of proteins are targets of cAMP-dependent phosphorylation in electroporated cells, and phosphorylation is inhibited in the presence of the peptide inhibitor. Taken together, these data show that a peptide inhibitor and isoquinoline sulfonamides reverse the inhibition of the respiratory burst in neutrophils evoked by the inhibitory pathways. Drugs that reverse the effect of endogenous inhibitors of neutrophil activation (by restoring cell function) have important therapeutic implications in restoring cell functions in patients whose cell functions are depressed under physiological conditions.