Seroprevalence of Trypanosoma cruzi among children from Veracruz, Mexico: Epidemiological baseline for a control model based on Chagas disease active transmission / Seroprevalencia de Trypanosoma cruzi en niños de Veracruz, México: línea epidemiológica de base para un modelo de control fundamentado de la transmisión activa de la enfermedad de Chagas.

Introduction. In 2021, the Secretaría de Salud de México and the Pan American Health Organization launched an initiative to interrupt intra-domiciliary vector transmission of Trypanosoma cruzi based on the prevalence of Chagas disease in children. The Mexican State of Veracruz was leading this initiative. Objective. To estimate the seroprevalence of T. cruzi infection among children under 15 years of age from rural areas of Veracruz, México. Materials and methods. We identified eight localities of high priority from the Municipality of Tempoal, Veracruz, for baseline serology. Blood samples were collected on filter paper from 817 individuals between June and August 2017, for screening with a third-generation enzyme immunoassay. Reactive cases were confirmed by indirect hemagglutination, enzyme-linked immunosorbent assay, and indirect immunofluorescence tests on peripheral blood serum samples. We calculated seroprevalence and 95% confidence intervals (CI). Results. We confirmed Chagas disease cases in children under 15 years of age with a seroprevalence of 1,9% (95 % CI = 1,12-3,16) in the localities of Citlaltepetl, Cornizuelo, Cruz de Palma and Rancho Nuevo. Conclusions. These results indicate recent transmission of T. cruzi in these communities and allow to establish an epidemiological baseline for the design and implementation of a model focused on geographical areas with active transmission to advance toward the elimination of intra-domiciliary vector transmission of this parasite in Mexico.

Introducción. En el 2021, la Secretaría de Salud de México y la Organización Panamericana de la Salud lanzaron una iniciativa para interrumpir la transmisión vectorial intradomiciliaria de Trypanosoma cruzi, fundamentada en la prevalencia de la enfermedad de Chagas en la población infantil. El estado mexicano de Veracruz fue el pionero de esta iniciativa. Objetivo. Estimar la seroprevalencia de infección por T. cruzi en menores de 15 años de localidades rurales de Veracruz, México. Materiales y métodos. Se identificaron ocho localidades prioritarias para la serología basal del municipio de Tempoal, Veracruz. Entre junio y agosto de 2017, se recolectaron muestras de sangre en papel filtro de 817 individuos para su tamizaje mediante un inmunoensayo enzimático de tercera generación. Los casos reactivos del tamizaje se confirmaron mediante pruebas de hemaglutinación indirecta, ensayo de inmunoabsorción ligado a enzimas e inmunofluorescencia indirecta en muestras de suero. Se calculó la seroprevalencia y su intervalo de confianza (IC) del 95 %. Resultados. En las localidades de Citlaltépetl, Cornizuelo, Cruz de Palma y Rancho Nuevo se confirmaron casos de la enfermedad de Chagas en menores de 15 años con una seroprevalencia de 1,9 % (IC 95 % = 1,12-3,16). Conclusiones. Los resultados indican que estas comunidades presentan transmisión reciente de T. cruzi y permiten establecer una línea epidemiológica de base para el diseño e implementación de un modelo dirigido a aquellas áreas geográficas con transmisión activa. Se espera que dicho modelo contribuya a la eliminación de la transmisión vectorial intradomiciliaria del tripanosomátido en México.

Comparative Genomics of Pseudomonas aeruginosa Strains Isolated from Different Ecological Niches.

The Pseudomonas aeruginosa genome can change to adapt to different ecological niches. We compared four genomes from a Mexican hospital and 59 genomes from GenBank from different niches, such as urine, sputum, and environmental. The ST analysis showed that high-risk STs (ST235, ST773, and ST27) were present in the genomes of the three niches from GenBank, and the STs of Mexican genomes (ST167, ST2731, and ST549) differed from the GenBank genomes. Phylogenetic analysis showed that the genomes were clustering according to their ST and not their niche. When analyzing the genomic content, we observed that environmental genomes had genes involved in adapting to the environment not found in the clinics and that their mechanisms of resistance were mutations in antibiotic resistance-related genes. In contrast, clinical genomes from GenBank had resistance genes, in mobile/mobilizable genetic elements in the chromosome, except for the Mexican genomes that carried them mostly in plasmids. This was related to the presence of CRISPR-Cas and anti-CRISPR; however, Mexican strains only had plasmids and CRISPR-Cas. blaOXA-488 (a variant of blaOXA50) with higher activity against carbapenems was more prevalent in sputum genomes. The virulome analysis showed that exoS was most prevalent in the genomes of urinary samples and exoU and pldA in sputum samples. This study provides evidence regarding the genetic variability among P. aeruginosa isolated from different niches.

Clinical and Virological Features of SARS-CoV-2 Variants during the Four Waves of the Pandemic in the Mexican Southeast.

We conducted a retrospective study using a population of patients who were hospitalized at Dr. Juan Graham Casasus Hospital in Villahermosa (Tabasco, Mexico) and had a positive RT-PCR test for SARS-CoV-2 between June 2020 and January 2022. We analyzed all medical records, including demographic data, SARS-CoV-2 exposure history, underlying comorbidities, symptoms, signs at admission, laboratory findings during the hospital stay, outcome, and whole-genome sequencing data. Finally, the data were analyzed in different sub-groups according to distribution during waves of the COVID-19 pandemic regarding Mexican reports from June 2020 to January 2022. Of the 200 patients who tested positive via PCR for SARS-CoV-2, only 197 had samples that could be sequenced. Of the samples, 58.9% (n = 116) were males and 41.1% (n = 81) females, with a median age of 61.7 ± 17.0 years. Comparisons between the waves of the pandemic revealed there were significant differences in the fourth wave: the age of patients was higher (p = 0.002); comorbidities such as obesity were lower (p = 0.000), while CKD was higher (p = 0.011); and hospital stays were shorter (p = 0.003). The SARS-CoV-2 sequences revealed the presence of 11 clades in the study population. Overall, we found that adult patients admitted to a third-level Mexican hospital had a wide range of clinical presentations. The current study provides evidence for the simultaneous circulation of SARS-CoV-2 variants during the four pandemic waves.

Mental Health Disorders and Coping Strategies in Healthcare Workers during the COVID-19 Pandemic: An Analytical Cross-Sectional Study in Southeastern Mexico.

Mental health disorders are relatively common in the general population and were already an important issue for the healthcare sector before COVID-19. COVID-19, being a worldwide crucial event and evidently a great stressor has increased both the prevalence and incidence of these. Therefore, it is evident that COVID-19 and mental health disorders are closely related. Moreover, several coping strategies exist to endure said disorders such as depression and anxiety, which are used by the population to confront stressors, and healthcare workers are not the exception. This was an analytical cross-sectional study, conducted from August to November 2022, via an online survey. Prevalence and severity of depression, anxiety, and stress were assessed via the DASS-21 test, and coping strategies were assessed via the CSSHW test. The sample consisted of 256 healthcare workers and of those, 133 (52%) were males with a mean age of 40.4 ± 10.35, and 123 (48%) were females with a mean age of 37.28 ± 9.33. Depression was prevalent in 43%, anxiety in 48%, and stress in 29.7%. Comorbidities were a significant risk factor for both depression and anxiety with an OR of 10.9 and 4.18, respectively. The psychiatric background was a risk factor for depression with an OR of 2.17, anxiety with an OR of 2.43, and stress with an OR of 3.58. The age difference was an important factor in the development of depression and anxiety. The maladaptive coping mechanism was prevalent in 90 subjects and was a risk factor for depression (OR of 2.94), anxiety (OR of 4.46) and stress (OR of 3.68). The resolution coping mechanism was a protective factor for depression (OR of 0.35), anxiety (OR of 0.22), and stress (OR of 0.52). This study shows that mental health disorders are highly prevalent among healthcare workers in Mexico and that coping strategies are associated with their prevalence. It also implies that not only occupations, age, and comorbidities might affect mental health, but also the way patients confront reality and the behavior and decisions they take towards stressors.

Prevalence and Risk Factors of Adverse Effects and Allergic Reactions after COVID-19 Vaccines in a Mexican Population: An Analytical Cross-Sectional Study.

Vaccinations have helped to control the COVID-19 pandemic; however, few studies focus on the adverse effects and allergic reactions of these vaccines and fewer have a scope in the Latin American population. The objective of this study was to assess the associations between vaccinations, sex, age, allergic reactions, and adverse effects. This was an analytical cross-sectional study conducted between 1 July and 1 October 2022. The sample consisted of 443 surveyed participants, with a total of 1272 COVID-19 vaccine doses. Seven vaccines (Pfizer BioNTech, Oxford-AstraZeneca, CanSino, Moderna, Johnson and Johnson, Sinovac, and Sputnik V) were evaluated. A total of 12.6% of those surveyed had at least one allergic reaction posterior to vaccination, and females had a greater chance of developing one (p < 0.001, OR 3.1). The most common allergic reaction was chest pain, and Pfizer-BioNTech and Oxford-AstraZeneca were associated with the onset of allergic reactions (p < 0.005). A total of 54.6% of those surveyed developed adverse effects, the most common of which were myalgia, fever, cephalea, asthenia or adynamia, and arthralgia; moreover, older age was associated with the onset of adverse effects (p < 0.5). This study concludes that the BNT162b2 (Pfizer BioNTech) and ChAdOX1 nCOV-19 (Oxford-AstraZeneca) vaccines are strongly associated with the onset of allergic reactions, with ORs of 1.6 (CI 95%, 1.18 to 2.3) and 1.87 (CI 95%, 1.35 to 2.6), respectively. In addition, females have a greater chance of developing allergic reactions associated with COVID-19 vaccinations, and there was a relation found between older age and a greater prevalence of comorbidities, adverse effects after vaccination, and COVID-19 infection after vaccination.

Side effects of the Pfizer BioNTech vaccine in health workers of a hospital in the southeast of Mexico.

INTRODUCTION: The goal of this study was to evaluate the side effects of application of the Pfizer BioNTech vaccine on the workers at a Mexican hospital. METHODOLOGY: A cross-sectional study was carried out, in which 1351 workers from a tertiary care center in the Mexican southeast were included. Sociodemographic data, comorbidities, and side effects after the Pfizer BioNTech vaccine were obtained through an online survey. The variables were analyzed through descriptive statistics. The presence or absence of side effects was analyzed through the Chi-square test or t-test, as appropriate. The result was considered statistically significant at p < 0.05. RESULTS: A total of 1351 health workers participated in the online survey. The mean age was 37.8 ± 10.9 years and 56.4% were women. Among them, 8.2% suffered from high blood pressure. In addition, 76.7% manifested pain in the application area. The presence of side effects was associated with the female gender (p < 0.01). Side effects were more prevalent in younger age (37.2 ± 10.7) than older age (41.5 ± 10.8) (p < 0.01). There was no association with the presence of comorbidities (p > 0.05). CONCLUSIONS: The data suggest that pain in the application area is the most frequent side effect among workers in a Mexican hospital who received the Pfizer BioNTech vaccine against COVID-19. In addition, we observed sialorrhea as a side effect in the studied population and this had not previously been reported. The highest number of adverse events occurred between 24 to 72 hours after application.

A Plasmid Carrying blaIMP-56 in Pseudomonas aeruginosa Belonging to a Novel Resistance Plasmid Family.

blaIMP and blaVIM are the most detected plasmid-encoded carbapenemase genes in Pseudomonas aeruginosa. Previous studies have reported plasmid sequences carrying blaIMP variants, except blaIMP-56. In this study, we aimed to characterize a plasmid carrying blaIMP-56 in a P. aeruginosa strain isolated from a Mexican hospital. The whole genome of P. aeruginosa strain PE52 was sequenced using Illumina Miseq 2 × 150 bp, with 5 million paired-end reads. We characterized a 27 kb plasmid (pPE52IMP) that carried blaIMP-56. The phylogenetic analysis of RepA in pPE52IMP and 33 P. aeruginosa plasmids carrying resistance genes reported in the GenBank revealed that pPE52IMP and four plasmids (pMATVIM-7, unnamed (FDAARGOS_570), pD5170990, and pMRVIM0713) were in the same clade. These closely related plasmids belonged to the MOBP11 subfamily and had similar backbones. Another plasmid (p4130-KPC) had a similar backbone to pPE52IMP; however, its RepA was truncated. In these plasmids, the resistance genes blaKPC-2, blaVIM variants, aac(6')-Ib4, blaOXA variants, and blaIMP-56 were inserted between phd and resolvase genes. This study describes a new family of plasmids carrying resistance genes, with a similar backbone, the same RepA, and belonging to the MOBP11 subfamily in P. aeruginosa. In addition, our characterized plasmid harboring blaIMP-56 (pPE52IMP) belongs to this family.

El desafío del Hospital Regional de alta especialidad "Dr. Juan Graham Casasús" ante la nueva pandemia de SARS-CoV-2: la ocupación hospitalaria / The challenge of the high speciality Hospital "Dr. Juan Graham Casasus" in the face of the new SARS-CoV-2 pandemic: the bed occupancy

Al inicio de la pandemia en México, el Hospital Regional de Alta Especialidad "Dr. Juan Graham Casasús" contaba con 156 camas para la atención de pacientes críticos por sintomatología correspondiente a COVID-19, para abordar esto, se incrementó en un 50% la capacidad hospitalaria durante el periodo crítico. En los primeros 6 meses de pandemia se brindó atención a cerca del 60% de la población de la región que requirió atención especializada por COVID-19 pero a pesar de los resultados se concluye que COVID-19 representa un importante desafío en el sureste de México. Sobre la base de los resultados actuales se evidencia la necesidad de integrar la detección del SARS-CoV-2 de manera rutinaria reconociendo una nueva normalidad en un hospital de tercer nivel en Tabasco, México

At the beginning of the pandemic in Mexico, the "Dr. Juan Garaham Casasús" Hospital had 156 beds for the care of critical patients due to symptoms corresponding to COVID-19. To address this, hospital capacity increased by 50% during the critical period. In the first six months of the pandemic, care was provided to about 60% of the population in the region that required specialized care for COVID-19, still despite the results, it concluded that COVID-19 represents a challenge in the southeast of Mexico and based on the current results, it is evident the need to integrate the detection of SARS-CoV-2 routinely, recognizing a new normal in a tertiary hospital in Tabasco, Mexico.

Isobolographic analysis of antinociceptive effect of ketorolac, indomethacin, and paracetamol after simultaneous peripheral local and systemic administration.

This study was designed to characterize the type of interaction (subadditive, additive, or synergistic) after simultaneous administration by two different routes (intraperitoneal plus peripheral local) of the same nonsteroidal anti-inflammatory drugs (NSAID) ketorolac and indomethacin or paracetamol. The antinociceptive effects of locally or intraperitoneally delivery of NSAIDs or paracetamol, and the simultaneous administration by the two routes at fixed-dose ratio combination were evaluated using the formalin test. Pain-related behavior was quantified as the number of flinches of the injected paw. Isobolographic analysis was used to characterize the interaction between the two routes. ED30 values were estimated for individual drugs, and isobolograms were constructed. Ketorolac, indomethacin, or paracetamol and fixed-dose ratio combinations produced a dose-dependent antinociceptive effect in the second but not in the first phase of the formalin test. The analysis of interaction type after simultaneous administration by the two routes the same NSAID or paracetamol (on basis of their ED30), revealed that the simultaneous administration of ketorolac or paracetamol was additive and for indomethacin was synergistic. Since the mechanisms underlying the additive effect of ketorolac or paracetamol and the synergistic effect of indomethacin were not explored; it is possible that the peripheral and central mechanism is occurring at several anatomical sites. The significance of these findings for theory and pain pharmacotherapy practice indicates that the combination of one analgesic drug given simultaneously by two different administration routes could be an additive or it could lead to a synergistic interaction.

Spontaneous Pneumomediastinum in nCOVID-19 infection: a case report / Pneumomediastino espontáneo en la infección por nCOVID-19: un reporte de caso

Spontaneous pneumomediastinum (SP) is a clinical entity characterized by the presence of interstitial air in the mediastinum. The purpose of this study was to further examine a rare SP case in a 60-year-old male, with COVID-19. In conclusion, SP is an uncommon complication in COVID-19, and the recognition of clinical characteristics is crucial since early identification plays a significant role in the maintenance or recovery of the disease..(Au)

El neumomediastino espontáneo (NE) es una entidad clínica caracterizada por la presencia de aire intersticial en el mediastino. El propósito de este estudio fue examinar más a fondo un caso raro de NE en un hombre de 60 años con COVID-19. En conclusión, el NE es una complicación poco común de COVID-19 y el reconocimiento de las características clínicas es crucial, ya que su identificación temprana juega un papel importante en el mantenimiento y recuperación de la enfermedad..(Au)

Features of patients that died for COVID-19 in a hospital in the south of Mexico: A observational cohort study.

BACKGROUND: Due to the wide spread of SARS-CoV2 around the world, the risk of death in individuals with metabolic comorbidities has dangerously increased. Mexico has a high number of infected individuals and deaths by COVID-19 as well as an important burden of metabolic diseases; nevertheless, reports about features of Mexican individuals with COVID-19 are scarce. The aim of this study was to evaluate demographic features, clinical characteristics and the pharmacological treatment of individuals who died by COVID-19 in the south of Mexico. METHODS: We performed an observational study including the information of 185 deceased individuals with confirmed diagnoses of COVID-19. Data were retrieved from medical records. Categorical data were expressed as proportions (%) and numerical data were expressed as mean ± standard deviation. Comorbidities and overlapping symptoms were plotted as Venn diagrams. Drug clusters were plotted as dendrograms. RESULTS: The mean age was 59.53 years. There was a male predominance (60.1%). The mean hospital stay was 4.75 ± 4.43 days. The most frequent symptoms were dyspnea (88.77%), fever (71.42%) and dry cough (64.28%). Present comorbidities included diabetes (60.63%), hypertension (59.57%) and obesity (43.61%). The main drugs used for treating COVID-19 were azithromycin (60.6%), hydroxychloroquine (53.0%) and oseltamivir (27.3%). CONCLUSIONS: Mexican individuals who died of COVID-19 had shorter hospital stays, higher frequency of shortness of breath, and higher prevalence of diabetes than individuals from other countries. Also, there was a high frequency of off-label use of drugs for their treatment.

Calidad de vida relacionada con la salud en pacientes trasplantados de córnea de un hospital de tercer nivel / Quality of life in adult patients after the cornea transplant in a third level hospita

Introducción: La grave limitación funcional que conlleva la ceguera o debilidad visual concede al trasplante de córnea un alto valor social, económico y humano. La calidad de vida relacionada con la salud se puede considerar como un indicador de calidad asistencial. Objetivo: Determinar la calidad de vida en pacientes adultos después del trasplante de córnea en un hospital de tercer nivel. Método: Con aprobación ética, se realizó un estudio transversal en pacientes trasplantados de córnea de 2012 a 2016. Se analizaron variables sociodemográficas, calidad de vida relacionada con la salud (SF-36) y agudeza visual en el ojo trasplantado (movimiento de manos, recuento de dedos y test de Snellen). Se aplicaron la prueba de ji cuadrado, el test de Kruskal-Wallis y el test de Wilcoxon; se consideró significativa una p < 0.05. Resultados: Se incluyeron 60 pacientes de 17 a 89 años de edad receptores de trasplante de córnea. El motivo de trasplante más frecuente fue por queratocono (n = 36). El 60% (n = 36) tuvieron buena visión después del trasplante y se hallaron diferencias significativas entre la agudeza visual del ojo trasplantado preoperatoria y posoperatoria (p = 0.000). La calidad de vida fue buena en el 86.67% de la muestra. Las dimensiones de la calidad de vida fueron mayores a medida que mejoró la agudeza visual (p < 0.05). Conclusiones: El seguimiento a pacientes trasplantados de córnea es indispensable para evaluar los resultados de la atención médica.

Introduction: The severe functional limitation that blindness or visual weakness entails gives a high social, economic and human value to corneal transplantation. The quality of life related to health can be considered as an indicator of quality of care. Objective: To determine the quality of life in adult patients, after the cornea transplant in a third level hospital. Method: With ethical approval, a cross-sectional survey was carried out in patients transplanted from the cornea from 2012 to 1016. Sociodemographic variables, quality of life related to health (SF-36) and visual acuity (hand movement, counting of fingers and Snellen test). Chi-square test, Kruskal-Wallis test, Wilcoxon test and p < 0.05 were considered significant. Results: We included 60 patients from 17 to 89 years of age, transplanted from the cornea. The most frequent reason for transplant was keratoconus (n = 36). Sixty percent (n = 36) had good vision after transplantation and significant differences were found between visual acuity before and after surgery (p = 0.000). The quality of life was good in 86.67% of the sample. The dimensions of quality of life were greater as visual acuity improved (p < 0.05). Conclusions: The follow-up of patients transplanted from the cornea is essential to evaluate the results of medical care

Metformin: A Prospective Alternative for the Treatment of Chronic Pain.

Metformin (biguanide) is a drug widely used for the treatment of type 2 diabetes. This drug has been used for 60 years as a highly effective antihyperglycemic agent. The search for the mechanism of action of metformin has produced an enormous amount of research to explain its effects on gluconeogenesis, protein metabolism, fatty acid oxidation, oxidative stress, glucose uptake, autophagy and pain, among others. It was only up the end of the 1990s and beginning of this century that some of its mechanisms were revealed. Metformin induces its beneficial effects in diabetes through the activation of a master switch kinase named AMP-activated protein kinase (AMPK). Two upstream kinases account for the physiological activation of AMPK: liver kinase B1 and calcium/calmodulin-dependent protein kinase kinase 2. Once activated, AMPK inhibits the mechanistic target of rapamycin complex 1 (mTORC1), which in turn avoids the phosphorylation of p70 ribosomal protein S6 kinase 1 and phosphatidylinositol 3-kinase/protein kinase B signaling pathways and reduces cap-dependent translation initiation. Since metformin is a disease-modifying drug in type 2 diabetes, which reduces the mTORC1 signaling to induce its effects on neuronal plasticity, it was proposed that these mechanisms could also explain the antinociceptive effect of this drug in several models of chronic pain. These studies have highlighted the efficacy of this drug in chronic pain, such as that from neuropathy, insulin resistance, diabetic neuropathy, and fibromyalgia-type pain. Mounting evidence indicates that chronic pain may induce anxiety, depression and cognitive impairment in rodents and humans. Interestingly, metformin is able to reverse some of these consequences of pathological pain in rodents. The purpose of this review was to analyze the current evidence about the effects of metformin in chronic pain and three of its comorbidities (anxiety, depression and cognitive impairment).

Evaluación de los métodos utilizados para el diagnóstico de vaginosis bacteriana en el Hospital Regional ISSSTE Puebla / Evaluation of methods used for the diagnosis of bacterial vaginosis in the Hospital Regional ISSSTE Puebla

Resumen La vaginosis bacteriana (VB) es una alteración frecuente de la microbiota vaginal en mujeres en edad reproductiva. El diagnóstico puede ser efectuado aplicando criterios clínicos o por la evaluación de los morfotipos bacterianos presentes en la tinción de Gram realizada a la secreción vaginal o mediante procedimientos microbiológicos, los cuales se desarrollaron como una alternativa al diagnóstico clínico, reemplazándolo paulatinamente. El objetivo del presente trabajo fue determinar la efectividad de los métodos de Amsel e Ison-Hay, para el diagnóstico de vaginosis bacteriana, empleando el método de Nugent como estándar. En este estudio se analizaron 305 muestras de secreción vaginal de pacientes del Hospital Regional ISSSTE Puebla. Las muestras se procesaron y analizaron para el diagnóstico de VB, siguiendo las recomendaciones de los métodos de Amsel, Nugent e Ison-Hay. El análisis de los resultados indicó un 12.8 % por Nugent, 31.1 % de VB por el método de Amsel y 36.7 % por Ison-Hay; sugiriendo que ambas técnicas muestran una alta tasa de falsos positivos. La sensibilidad para el método de Amsel e Ison-Hay fue de 97.44 %, la especificidad fue de 78.57 % y 72.18 % para Amsel e Ison-Hay, respectivamente. En conclusión, dado a los resultados obtenidos y a las mínimas diferencias entre los métodos analizados, se recomienda realizar los criterios de Amsel, seguidos de la observación de la tinción de Gram del flujo vaginal para la valoración de la microbiota por el método de Ison-Hay, para tener un mejor diagnóstico de VB, cuando no se emplea el método de Nugent.

Abstract Bacterial vaginosis (BV) is a frequent alteration of the vaginal microbiota in women of reproductive age. The diagnosis can be made by applying clinical criteria or by the evaluation of bacterial morphotypes present in Gram stain performed to vaginal secretion or by microbiological procedures, which were developed as an alternative to clinical diagnosis, gradually replacing it. The objective of this work was to determine the effectiveness of the Amsel and Ison-Hay methods, used for the diagnosis of bacterial vaginosis using the Nugent method as a standard. In this study, 305 samples of vaginal discharge from patients of the ISSSTE Puebla Regional Hospital were analyzed. The samples were processed and analyzed for the diagnosis of BV following the recommendations of the Amsel, Nugent and Ison-Hay methods. The analysis of the results indicated 12.8 % by Nugent, 31.1 % of BV by the Amsel method and 36.7 % by Ison-Hay; suggesting that both techniques show a high rate of false positives. The sensitivity for the Amsel and Ison-Hay method was 97.44 %, the specificity was 78.57 % and 72.18 % for Amsel and Ison-Hay, respectively. In conclusion, given the results obtained and the minimal differences between the analyzed methods, it is recommended to perform the Amsel criteria, followed by the observation of Gram staining of the vaginal flow for the assessment of the microbiota by the Ison-Hay method, to have a better diagnosis of BV, when the Nugent method is not used.

Antinociceptive effects of ceftriaxone in formalin-induced nociception.

Ceftriaxone (CFX) is a ß-lactam antibiotic with analgesic properties. However, its role in the formalin-induced nociception remains unknown. The purpose of this study was to investigate the antinociceptive effect of CFX in the 1% formalin test in rats. Formalin induced a typical nociceptive response (flinching behavior) of two phases. Local peripheral pretreatment (20 min) with CFX (400-800 µg/paw) slightly attenuated the flinching behavior in phase 2, but not phase 1. Acute intraperitoneal pretreatment (20 min) also reduced phase 2 of the formalin test. In both cases, CFX induced a dose-dependent antinociception. We also tested the effect of CFX 1 day after its administration and in two schedules of repeated administration. One-day pretreatment with CFX (50-400 mg/kg, ip) induced a dose-dependent antinociceptive effect in formalin-treated rats. Repeated administration (daily during 3 or 7 days) with CFX (50-400 mg/kg, ip) diminished formalin-induced nociception. Results suggest that local or systemic as well as single or repeated administration of CFX reduces formalin-induced nociception.

Calidad de vida en los pacientes con DM-2: Un estudio transversal en el sureste mexicano / Quality of life in patients with DM-2: A cross-sectional study in the Mexican southeast

La diabetes es una enfermedad crónica y compleja con demandas y desafíos que influyen en la calidad de vida relacionada a la salud. Objetivo: determinar la calidad de vida en los pacientes con diabetes mellitus tipo 2 que acuden a los servicios médicos de la UJAT durante el periodo junio- julio del 2017. Métodos: se realizó un estudio transversal en 80 sujetos con diagnóstico de diabetes mellitus tipo 2 que acuden a un primer nivel de atención en el sureste mexicano. Se diseñó un instrumento y se obtuvieron datos sociodemográficos, de calidad de vida, antropométrica, bioquímica y clínica. Las variables fueron analizadas a través de estadística descriptiva, además, se utilizó la prueba de Chi cuadrado para explorar asociación entre variables categóricas y para variables continuas la prueba de T, considerando los estadísticamente significativos los resultados de p<0,05. Resultados: la media de edad de los pacientes estudiados fue 57,8 años. El dominio de la calidad de vida principalmente afectado fue energía, funcionamiento sexual y movilidad, y los factores que tuvieron efecto sobre la calidad de vida fueron la escolaridad, las comorbilidades, la polifarmacia, el índice de masa corporal y la hiperglucemia. Discusión: los pacientes con diagnóstico de diabetes mellitus tipo 2 que acuden a un primer nivel institucional del sureste mexicano están principalmente afectados en 3 dominios: energía y movilidad, ansiedad y preocupación y funcionamiento sexual.

Diabetes is a chronic and complex disease with demands and challenges that influence the quality of life - related to health. Objective: To determine the quality of life in patients with type 2 diabetes in the first level of care in Tabasco, during June- July 2017. Methods: A cross-sectional study was carried out in 102 subjects with type 2 diabetes. An instrument collected sociodemographic, quality of life, anthropometric, biochemical, and clinical data. The variables analyzed through descriptive statistics, also, the Chi-square test to explore the association between categorical variables, and for continuous variables, the T-test. Finally, considering the statistically significant results of p <0,05. Results: The mean age of patients included was 57,8 years old. The domain of the quality of life principally affected were energy-mobility, anxiety-concern, and sexual function, and the factors that affected the quality of life were education, comorbidi-ties, polypharmacy, body mass index, and hyperglycemia. Discussion: Patients with type 2 diabetes in the first institutional level in the Mexican south are principally affected in three domains: energy-mobility, anxiety-concern, and sexual function.

Perfil clínico-epidemiológico de las defunciones por influenza con antecedente de vacunación oportuna, México 2010-2018.

INTRODUCTION: Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective -vaccination prevents the occurrence of serious cases and decreases mortality. OBJECTIVE: To describe deaths from influenza with a history of timely vaccination, from the 2010 to the 2018 season in Mexico. METHOD: Cross-sectional, descriptive study where the Influenza Epidemiological Surveillance System database was used. RESULTS: From 2010 to 2018, 65 vaccinated individuals died from influenza, from which 55% of cases (n = 36) were due to type A (H1N1), 51% (n = 33) were females, median age was 57 years, 21 % (n = 14) did not meet the operational definition of influenza-like illness or severe acute respiratory infection, 83% (n = 54) had at least one comorbidity, with the most common being diabetes mellitus and hypertension (32% each); 55% (n = 36) of deaths received antiviral treatment and only 8% (n = 5) had no comorbidities and received treatment with oseltamivir. CONCLUSIONS: Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.

INTRODUCCIÓN: Las epidemias de influenza son de mayor riesgo en los extremos de la vida y en personas con comorbilidades. La vacunación efectiva previene la aparición de casos graves y disminuye la mortalidad. OBJETIVO: Describir las defunciones por influenza en México con antecedente de vacunación oportuna, de 2010 a 2018. MÉTODO: Estudio transversal descriptivo en el que se utilizó la base de datos del Sistema de Vigilancia Epidemiológica de Influenza. RESULTADOS: De 2010 a 2018 fallecieron por influenza 65 personas con vacunación, 55 % (n = 36) de las cuales por tipo A (H1N1), 51 % (n = 33) del sexo femenino, la mediana de edad fue de 57 años, 21 % (n = 14) no cumplía la definición operacional de enfermedad tipo influenza o infección respiratoria aguda grave, 83 % (n = 54) tenía al menos una comorbilidad; las comorbilidades más frecuentes fueron diabetes mellitus e hipertensión arterial (32 % cada una); 55 % (n = 36) recibió tratamiento antiviral y solo 8 % (n = 5) no presentaba comorbilidades y tenía tratamiento con oseltamivir. CONCLUSIONES: Las defunciones por influenza con vacunación oportuna representan un porcentaje muy bajo del total. La vacunación contra influenza ha sido una estrategia de prevención específica que disminuye la carga de la enfermedad.

Clinical-epidemiological profile of deaths from influenza with a history of timely vaccination, Mexico 2010-2018

Introduction: Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective vaccination prevents the occurrence of serious cases and decreases mortality. Objective: To describe deaths from influenza with a history of timely vaccination, from the 2010 to the 2018 season in Mexico. Method: Cross-sectional, descriptive study where the Influenza Epidemiological Surveillance System database was used. Results: From 2010 to 2018, 65 vaccinated individuals died from influenza, from which 55% of cases (n = 36) were due to type A (H1N1), 51% (n = 33) were females, median age was 57 years, 21 % (n = 14) did not meet the operational definition of influenza-like illness or severe acute respiratory infection, 83% (n = 54) had at least one comorbidity, with the most common being diabetes mellitus and hypertension (32% each); 55% (n = 36) of deaths received antiviral treatment and only 8% (n = 5) had no comorbidities and received treatment with oseltamivir. Conclusions: Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.

Feasibility of feeding Aedes aegypti mosquitoes on dengue virus-infected human volunteers for vector competence studies in Iquitos, Peru.

BACKGROUND: Transmission of dengue virus (DENV) from humans to mosquitoes represents a critical component of dengue epidemiology. Examinations of this process have generally been hampered by a lack of methods that adequately represent natural acquisition of DENV by mosquitoes from humans. In this study, we assessed artificial and natural blood feeding methods based on rates of DENV infection and dissemination within mosquitoes for use in a field-based epidemiological cohort study in Iquitos, Peru. METHODOLOGY/PRINCIPAL FINDINGS: Our study was implemented, stepwise, between 2011 and 2015. Participants who were 5 years and older with 5 or fewer days of fever were enrolled from ongoing clinic- and neighborhood-based studies on dengue in Iquitos. Wild type, laboratory-reared Aedes aegypti were fed directly on febrile individuals or on blood collected from participants that was either untreated or treated with EDTA. Mosquitoes were tested after approximately 14 days of extrinsic incubation for DENV infection and dissemination. A total of 58 participants, with viremias ranging from 1.3 × 10(2) to 2.9 × 10(6) focus-forming units per mL of serum, participated in one or more feeding methods. DENV infection and dissemination rates were not significantly different following direct and indirect-EDTA feeding; however, they were significantly lower for mosquitoes that fed indirectly on blood with no additive. Relative to direct feeding, infection rates showed greater variation following indirect-EDTA than indirect-no additive feeding. Dissemination rates were similar across all feeding methods. No differences were detected in DENV infection or dissemination rates in mosquitoes fed directly on participants with different dengue illness severity. CONCLUSIONS/SIGNIFICANCE: Our study demonstrates the feasibility of using direct and indirect feeding methods for field-based studies on vector competence. Direct mosquito feeding is preferable in terms of logistical ease, biosecurity, and reliability.

Clinical-epidemiological profile of deaths from influenza with a history of timely vaccination, Mexico 2010-2018.

INTRODUCTION: Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective vaccination prevents the occurrence of serious cases and decreases mortality. OBJECTIVE: To describe deaths from influenza with a history of timely vaccination, from the 2010 to the 2018 season in Mexico. METHOD: Cross-sectional, descriptive study where the Influenza Epidemiological Surveillance System database was used. RESULTS: From 2010 to 2018, 65 vaccinated individuals died from influenza, from which 55% of cases (n = 36) were due to type A (H1N1), 51% (n = 33) were females, median age was 57 years, 21 % (n = 14) did not meet the operational definition of influenza-like illness or severe acute respiratory infection, 83% (n = 54) had at least one comorbidity, with the most common being diabetes mellitus and hypertension (32% each); 55% (n = 36) of deaths received antiviral treatment and only 8% (n = 5) had no comorbidities and received treatment with oseltamivir. CONCLUSIONS: Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.