Risk Factors for SARS-CoV-2 Infection, Pneumonia, Intubation, and Death in Northeast Mexico.

Despite the social distancing and mobility restriction measures implemented for susceptible people around the world, infections and deaths due to COVID-19 continued to increase, even more so in the first months of 2021 in Mexico. Thus, it is necessary to find risk groups that can benefit from more aggressive preventive measures in a high-density population. This is a case-control study of suspected COVID-19 patients from Nuevo León, Mexico. Cases were: (1) COVID-19-positive patients and COVID-19-positive patients who (2) developed pneumonia, (3) were intubated and (4) died. Controls were: (1) COVID-19-negative patients, (2) COVID-19-positive patients without pneumonia, (3) non-intubated COVID-19-positive patients and (4) surviving COVID-19-positive patients. ≥ 18 years of age, not pregnant, were included. The pre-existing conditions analysed as risk factors were age (years), sex (male), diabetes mellitus, hypertension, chronic obstructive pulmonary disease, asthma, immunosuppression, obesity, cardiovascular disease, chronic kidney disease and smoking. The Mann-Whitney U tests, Chi square and binary logistic regression were used. A total of 56,715 suspected patients were analysed in Nuevo León, México, with 62.6% being positive for COVID-19 and, of those infected, 14% developed pneumonia, 2.9% were intubated and 8.1% died. The mean age of those infected was 44.7 years, while of those complicated it was around 60 years. Older age, male sex, diabetes, hypertension, and obesity were risk factors for infection, complications, and death from COVID-19. This study highlights the importance of timely recognition of the population exposed to pre-existing conditions to prioritise preventive measures against the virus.

Comorbidities and antimicrobial resistance in urological outpatients with positive urine culture / Resistencia bacteriana y comorbilidades presentes en pacientes urológicos ambulatorios con urocultivos positivos

Background: The urinary tract infections are the third cause of infections in Mexico. The inappropriate use of antibiotic has generated the presence of multidrugresistant bacteria. Objective: To identify the bacterial resistance patterns of the hospital and to detect the present comorbidities that can modify the evolution of urinary tract infection for proper empirical management. Methods: Non-comparative cross-sectional study, positive urine cultures were reviewed in the period from December 2015 to May 2016, in outpatients of urology in the hospital. The obtained growth, bacterial resistance and the comorbidities of each patient were analyzed. Results: 190 urine cultures were included. The most frequent bacterium was Escherichia coli. Greater general antibiotic resistance was detected to ceftazidime (91.5%), quinolones (> 65%) and trimethoprim / sulfamethoxazole (58%). The general multiresistance was 66.3%. The antibiotics that showed greater sensitivity were: amikacin, imipenem, nitrofurantoin, meropenem and piperacillin / tazobactam. The most frequent comorbidities were diabetes mellitus, previous use of antibiotics for urinary tract infection and prostatic hyperplasia. Conclusion: In patients with urinary tract infection in the hospital, the empirical use of nitrofurantoin and amikacin is recommended. Quinolones and trimethoprim / sulfamethoxazole have a high resistance index.

Introducción: las infecciones de vías urinarias son la tercera causa de morbilidad por infecciones en México. El uso indiscriminado de antibióticos ha generado la aparición de bacterias multiresistentes. Objetivo: identificar los patrones de resistencia bacteriana del hospital y detectar las comorbilidades presentes que pueden alterar el curso de una infección urinaria, para el manejo empírico adecuado. Métodos: estudio transversal no comparativo, se revisaron los urocultivos positivos en el período diciembre de 2015 a mayo de 2016, en pacientes ambulatorios de urología del hospital. Se analizó crecimiento obtenido, resistencia bacteriana y las comorbilidades de cada paciente. Resultados: se incluyeron 190 urocultivos. La bacteria más frecuente fue Escherichia coli. Se detectó mayor resistencia antibiótica general a ceftazidima (91.5%), quinolonas (> 65%) y trimetoprim/sulfametoxazol (58%). La multirresistencia general fue de 66.3%. Los antibióticos que demostraron mayor sensibilidad fueron: amikacina, imipenem, nitrofurantoína, meropenem y piperacilina/tazobactam. Las comorbilidades más frecuentes fueron diabetes mellitus, uso previo de antibióticos para infección de vías urinarias e hiperplasia prostática. Conclusiones: en los pacientes con infección de vías urinarias del hospital, se recomienda el uso empírico de nitrofurantoína y amikacina. Las quinolonas y el trimetoprim/sulfametoxazol tienen un alto índice de resistencia.

Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries.

An analysis of the adoption of secondary preventive behaviors is significant in regions with disparities in mammography use and breast cancer survival. Therefore, we determined the cognitive factors and the degree to which they differentiate stages of change in mammography among Mexican women. We also compared the decisional balance performance at Mexico, Switzerland, South Korea, and the USA. A cross-sectional study was designed for women in the stages of precontemplation (n = 240), contemplation (n = 243), action (n = 205), maintenance (n = 311), and relapse (n = 348). We only considered those ≥40 years with no cancer history. We measured the pros, cons, and self-efficacy, among other components. The decisional balance was estimated, and the result was transformed into T-scores. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with multinomial logistic regression using precontemplation as the reference group. The decisional balance distinguished stages partially: in contemplation, the OR was 1.26 (95%CI 1.08, 1.47) and in maintenance, 1.34 (95%CI 1.13, 1.59); in action and relapse, the statistical significance was marginal (p < 0.10). The decisional balance T-score performance registered variations among countries. Additionally, the effect of self-efficacy progressively ascended from contemplation to action and maintenance (OR = 1.29 [95%CI 1.05, 1.58], 1.53 [95%CI 1.20, 1.96], and 2.48 [95%CI 1.82, 3.39], respectively). Furthermore, risk perception and severity did not have an effect on stages of change among Mexican women. Recognition of what provokes action in a population is a key factor in the efficacy of screening programs. Variations among countries highlight the necessity for importance of investigating cognitive determinants for mammography in specific areas.

An acidic sphingomyelinase Type C activity from Mycobacterium tuberculosis.

Sphingomyelinases (SMases) catalyze the hydrolysis of sphingomyelin to ceramide and phosphorylcholine. Sphingolipids are recognized as diverse and dynamic regulators of a multitude of cellular processes mediating cell cycle control, differentiation, stress response, cell migration, adhesion, and apoptosis. Bacterial SMases are virulence factors for several species of pathogens. Whole cell extracts of Mycobacterium tuberculosis strains H37Rv and CDC1551 were assayed using [N-methyl-(14)C]-sphingomyelin as substrate. Acidic Zn(2+)-dependent SMase activity was identified in both strains. Peak SMase activity was observed at pH 5.5. Interestingly, overall SMase activity levels from CDC1551 extracts are approximately 1/3 of those of H37Rv. The presence of exogenous SMase produced by M. tuberculosis during infection may interfere with the normal host inflammatory response thus allowing the establishment of infection and disease development. This Type C activity is different from previously identified M. tuberculosis SMases. Defining the biochemical characteristics of M. tuberculosis SMases helps to elucidate the roles that these enzymes play during infection and disease.

Actividad de una esfingomielinasa ácida tipo C producida por Mycobacterium tuberculosis / An acidic sphingomyelinase Type C activity from Mycobacterium tuberculosis

Sphingomyelinases (SMases) catalyze the hydrolysis of sphingomyelin to ceramide and phosphorylcholine. Sphingolipids are recognized as diverse and dynamic regulators of a multitude of cellular processes mediating cell cycle control, differentiation, stress response, cell migration, adhesion, and apoptosis. Bacterial SMases are virulence factors for several species of pathogens. Whole cell extracts of Mycobacterium tuberculosis strains H37Rv and CDC1551 were assayed using [N-methyl-14C]-sphingomyelin as substrate. Acidic Zn2+-dependent SMase activity was identified in both strains. Peak SMase activity was observed at pH 5.5. Interestingly, overall SMase activity levels from CDC1551 extracts are approximately 1/3 of those of H37Rv. The presence of exogenous SMase produced by M. tuberculosis during infection may interfere with the normal host inflammatory response thus allowing the establishment of infection and disease development. This Type C activity is different from previously identified M. tuberculosis SMases. Defining the biochemical characteristics of M. tuberculosis SMases helps to elucidate the roles that these enzymes play during infection and disease.

Las esfingomielinasas (SMasas) catalizan la hidrólisis de esfingomielina a ceramida y fosforilcolina. Los esfingolípidos son reconocidos como reguladores diversos y dinámicos de una multitud de procesos celulares que median en el control del ciclo celular, la diferenciación, la respuesta al estrés, la migración celular, la adhesión y la apoptosis. Las esfingomielinasas bacterianas son factores de virulencia reconocidos en varias especies de patógenos. En este trabajo se analizaron los extractos de células enteras de las cepas de Mycobacterium tuberculosis H37Rv y CDC1551 utilizando [N-metil-14C]-esfingomielina como sustrato. Se identificó actividad de SMasa-ácida dependiente de zinc en ambas cepas. La actividad máxima se observó a pH 5.5. Curiosamente, los niveles de actividad de SMasa generados a partir de extractos de la cepa CDC1551 son aproximadamente un tercio de los de la cepa H37Rv. La presencia de una SMasa exógena producida por M. tuberculosis durante la infección puede interferir con la respuesta inflamatoria del huésped, permitiendo así el establecimiento de la infección y el desarrollo de la enfermedad. Esta actividad tipo C es distinta de las actividades previamente reportadas para M. tuberculosis. Definir las características bioquímicas de las esfingomielinasas de M. tuberculosis ayudará a dilucidar el papel que desempeñan estas enzimas durante la infección y la enfermedad.

[Knowledge transfer for STI/HIV/AIDS prevention among adolescents]. / Transferencia del conocimiento para la prevención de ITS/VIH/SIDA en adolescents

BACKGROUND: The transfer of knowledge is a crucial process for the functioning and continuation of training programs. The aim of this study was to determine how the transfer process works for the program JUVENIMSS and the factors that relate to the transfer of knowledge. METHODS: The study design was correlational, involving 122 health professionals. The Scale for the Measurement of Implementation Components was used. To analyze descriptive statistical data, overall index, instrument subscales, Kolmogorov-Smirnov goodness-of-fit test, and correlations were used. RESULTS: The average age of the professionals involved in the program was 37 years (standard deviation n = 10.5), with a predominance of females (84 %), and 48 % social workers. Knowledge transfer for the prevention of STI / HIV / AIDS among adolescents is correlated with administrative support, administrative personnel management, leadership, training, supervision / technical support and performance evaluation. CONCLUSIONS: Knowledge transfer showed areas of opportunity that should be considered by decision-makers to promote the implementation and continuation of preventive programs to prevent risky sexual behavior among adolescents.

Introducción: la transferencia del conocimiento es un proceso trascendental para la funcionalidad y mantenimiento de los programas de formación. El objetivo de este trabajo fue determinar cómo opera el proceso de transferencia del programa JUVENIMSS y los factores que se relacionan con la transferencia del conocimiento. Métodos: el diseño del estudio fue correlacional, participaron 122 profesionales de salud. Se utilizó la Escala de Medición de los Componentes de Implementación. Para el análisis de los datos se usó estadística descriptiva, índice global y de las subescalas del instrumento, prueba de bondad de ajuste de Kolmogorov-Smirnov y correlaciones. Resultados: el promedio de edad de los profesionales que participan en el programa fue 37 años (Desviación estándar = 10.5), predominó el sexo femenino (84 %), el 48 % fueron trabajadores sociales. La transferencia del conocimiento para la prevención de ITS/VIH/SIDA en adolescentes se correlacionó con apoyo administrativo, gestión del personal administrativo, liderazgo, entrenamiento, supervisión/asistencia técnica y evaluación del desempeño. Conclusiones: la transferencia del conocimiento mostró áreas de oportunidad que deben ser consideradas por los tomadores de decisiones para favorecer la implementación y el mantenimiento de los programas preventivos para prevenir conductas sexuales de riesgo en los adolescentes.

[Prevalence of overweight and obesity in children from Monterrey, Nuevo León]. / Prevalencia de sobrepeso y obesidad en niños de Monterrey, Nuevo León.

BACKGROUND: Pediatric obesity is a major health problem around the globe. It has increased in the last decades up to 30 % (in 2010). The aim of this study was to establish the prevalence of overweight and obesity in children from zero to 14 years from three family medicine units and one school. METHODS: A prospective study of prevalence, which included children of both sexes who assisted to three family medicine units and a junior high school. We assessed the somatometry and compared it in accordance to the World Health Organization 2006-2007 references and standards. RESULTS: The overall overweight and obesity prevalence in 1624 children was 45.5 % (15.5 % of overweight and 29.9 % of obesity, respectively). A total of 354 of 840 women (42.1 %) and 385 of 784 men (49 %) had overweight and obesity (p < 0.05). In both sexes, we did not observed a difference in overweight (15.7, women; 15.4, men). However, with regards to obesity, women showed 26.4 versus 33.6 of men (p < 0.05). We observed only one family unit with major obesity prevalence, which probably had an initial overestimation. CONCLUSIONS: We found one of the highest prevalences of overweight and obesity in children at a national level: up to 45 % in a state of Mexican northwestern. Obesity doubled overweight, and it was almost 10 % higher in men than in women.

INTRODUCCIÓN: la obesidad infantil es un problema de salud pública mundial y se ha incrementado en forma alarmante en las últimas décadas hasta en 30 % en el 2010. El objetivo de este estudio fue establecer la prevalencia de sobrepeso y obesidad en niños de cero a 14 años de tres unidades de medicina familiar (UMF). MÉTODOS: estudio prospectivo, de prevalencia, que incluyó a niños de ambos sexos que acudieron a tres UMF y una escuela primaria. Se evaluó la somatometría y se comparó de acuerdo con estándares y referencias de crecimiento de la Organización Mundial de la Salud (OMS) 2006-2007. RESULTADOS: la prevalencia de sobrepeso y obesidad en todo el grupo fue de 45.5 % en los 1624 niños de 0 a 14 años (15.5 %, sobrepeso; 29.9 %, obesidad). Un total de 354 de 840 mujeres (42.1 %) y 385 de 784 hombres (49 %) tuvieron sobrepeso u obesidad (p < 0.05). En las mujeres no se observó diferencia en cuanto a sobrepeso en relación con los hombres (15.7 frente a 15.4 %), pero sí en relación con la obesidad: 26.4 frente a 33.6 % (p < 0.05). Solo se observó una de las UMF con mayor prevalencia de obesidad, lo que probablemente se relacione con un sesgo de sobrerregistro. Conclusiones: se encontró una de las prevalencias de sobrepeso y obesidad infantiles más altas reportadas a nivel nacional, hasta en 45 %, en un estado del noreste mexicano. La obesidad fue dos a uno mayor al sobrepeso y casi 10 % mayor en hombres que en mujeres.

[Ageneses of the gallbladder: revision of the literature and a case reported]. / Agenesia vesicular: reporte de caso.

BACKGROUND: ageneses of the gallblander (AGB) is an infrequent congenital malformation. It was described by Lemery in 1701, for the first time. Until today, it has been described 400 cases worldwide. The objective was to present a case of AGB and review the literature. CLINICAL CASE: female of 61 years who was attended for relating colic pain, intensive and persistent in right upper abdomen during two days, accompanied of heartburn and nausea; relaxed abdomen with light pain to deep palpation in right abdomen, without peritoneal irritability. The lab showed Hb 12,8 g/dL, Hct. 40,04 %, WBC 5090/mL, PlT 266000 mL, direct bilirubin 0.3 mg/dL, bilirubin indirect 0.5 mg/dL, PT 7.4 g/dL, ALB 4 g/dL, glucose 107 md/dL, urea 36 md/dL. Abdominal echography showed intrahepatic and extrahepatic bilary tract without evidence of dilation, and partially identified gallbladder. The diagnosis of gallbladder agenesis was established by cholangiography. CONCLUSIONS: the case presented symptoms specific of gallbladder disease without blockage of the liver as it is described in the literature. The cholangiography and CT revealed absence of gallbladder disease and corroborated diagnosis of vesicular agenesis.