Prevalence of Drug-Resistant Tuberculosis in HIV-Positive and Diabetic Patients in Sinaloa, Mexico: A Retrospective Cross-Sectional Study.

Tuberculosis (TB) is a disease caused by the bacillus Mycobacterium tuberculosis (MTB). Human immunodeficiency virus (HIV) infection and type 2 diabetes mellitus (T2DM) are among the main risk factors for the development of TB and increase the risk of drug-resistant TB developing (DR-TB). The aim of this study was to estimate the prevalence of DR-TB in patients with HIV or T2DM in Sinaloa, Mexico. This was an observational and cross-sectional study. The analysis was conducted using the clinical data of patients registered on the National Epidemiological Surveillance System for TB (SINAVE/PUI-TB) platform with a presumed diagnosis of TB during 2019 to 2021 in Sinaloa, Mexico. The prevalence of DR-TB was estimated in HIV and T2DM patients, as well as the odds ratios for their sociodemographic variables, using the Chi-square test. There were 2, 4, and 4 TB-HIV cases and 2, 6, and 9 TB-T2DM cases during 2019, 2020, and 2021, respectively, whereas there were 2 and 1 DRTB-HIV and DRTB-T2DM cases, respectively. The results indicated that the WHO guidelines for DR-TB were not properly applied to this high-risk population. Hence, the appropriate application of guidelines for TB and DR-TB detection in these patients needs to be immediately implemented by the State health system.

Synthesis and molecular docking studies of imines as α-glucosidase and α-amylase inhibitors.

Imine functionality is found in many compounds with important biological activity. Thus, the development of novel synthetic approaches for imines is important. In this work, it is propose an easy, eco-friendly and straightforward synthesis pathway of aryl imines under microwave irradiation catalyzed by Alumina-sulfuric acid. In addition, the in vitro enzymatic inhibition, antioxidant activity and molecular docking studies were performed. The aryl imines were isolated with yields in the range of 37-94%. All aryl imines synthesized were evaluated for in vitro inhibitory potential against α-glucosidase and α-amylase enzymes and the results exhibited that the most of the compounds displayed inhibitory activity against both enzymes. The (E)-1-(4-nitrophenyl)-N-(pyridin-2-yl)methanimine (3d) was 1.15-fold more active than acarbose against α-amylase whilst the (E)-1-phenyl-N-(pyridin-2-yl)methanimine (3c) displayed similar activity that acarbose against α-glucosidase. The molecular docking studies in α-glucosidase and α-amylase reveal that aryl imines mainly establish an H-bond with the R2-subtituent and hydrophobic interactions with the R1-subtituent. The docking analysis reveals these synthetic aryl imines 3d-i interact in same active site than acarbose drug in both enzymes.

Recomendaciones nutricionales para el personal de salud y el personal esencial expuesto a la COVID-19 en Latinoamérica / Nutritional Recommendations for Healthcare and Essential Personnel Exposed to COVID-19 in Latin America

Estas recomendaciones se basan en la evidencia científica actual derivada de meta-análisis y revisiones sistemáticas sobre nutrición y prevención de infecciones respiratorias causadas por los virus SARS-CoV, MERS-CoV o influenza, similares en su estructura al SARS-CoV-2. Están dirigidas al personal en la primera línea de atención de salud y al personal que presta servicios esenciales a la comunidad, con alto riesgo de infección por la COVID-19. Estas personas usan equipo de protección personal, cumplen largos turnos laborales, en ocasiones bajo condiciones extremas, lo que puede llevar a descanso insuficiente, alto nivel de estrés, depresión, pobre calidad en la alimentación y deshidratación. Todos estos factores influyen negativamente en el sistema inmune y podrían conllevar un mayor riesgo de infección. Una ingesta adecuada de micronutrientes y otros compuestos bioactivos es esencial para el desempeño óptimo del sistema inmune. Existe evidencia moderada que avala la suplementación, en forma individual, con vitamina C (2 000 mg), vitamina D (1 000-2 000 UI) y zinc (≤ 40 mg) en la prevención de infecciones respiratorias en adultos. No se encontró evidencia suficiente para avalar la suplementación con vitamina A, niacina, ácido fólico, B12, omega 3, probióticos y polifenoles, aunque si se recomienda el consumo de alimentos ricos en estos nutrientes para apoyar al sistema inmune. Se recomienda al personal seguir la recomendación de consumir 5 porciones/día (400 g) de frutas y vegetales/hortalizas, mantenerse hidratado y limitar la cafeína. No hay evidencia del consumo de alimentos alcalinos para prevenir infecciones. Estas recomendaciones son particularmente importantes durante la pandemia(AU)

These recommendations are based on current scientific evidence obtained through meta-analysis and systematic reviews on nutrition and the prevention of respiratory infections related to SARS-CoV, MERS-CoV or influenza, similar in structure to SARS-CoV-2. They are aimed at primary health care personnel and to those who provide essential services to the community and are, consequently, at high risk of COVID-19 infection. These individuals wear personal protective equipment, work long shifts, sometimes under extreme conditions, which can lead to insufficient rest, high stress levels, depression, poor nutrition and dehydration. Together, these factors have a negative impact on the immune system and could result in an increased risk of infection. An adequate intake of micronutrients and other bioactive compounds is essential for optimal immune performance. There is moderate evidence supporting supplementation, individually, with vitamin C (2 000 mg), vitamin D (1 000-2 000 IU) and zinc (≤40 mg) for the prevention of respiratory infections in adults. Insufficient evidence was found to support supplementation with vitamin A, niacin, folic acid, B12, omega 3, probiotics and polyphenols; however, the consumption of foods rich in these nutrients is recommended to support immune function. It is recommended that workers follow the recommendation of consuming 400 g/day of fruits and vegetables, remain hydrated and limit caffeine. There is no scientific evidence supporting the consumption of alkaline foods to prevent infections. The aforementioned recommendations are particularly relevant during the pandemic(AU)

Recomendaciones de micronutrientes para grupos vulnerables en contexto de desnutrición, durante la pandemia de COVID-19 en Latinoamérica / Micronutrient recommendations for vulnerable groups in context of undernutrition, during the COVID-19 pandemic in Latin America

La crisis por COVID-19 (SARS-CoV-2) puede convertirse en una catástrofe alimentaria para Latinoamérica, aumentando las personas que padecen hambre de 135 a 265 millones, especialmente en Venezuela, Guatemala, Honduras, Haití y El Salvador, que ya enfrentaban crisis económicas y sanitarias. Este manuscrito presenta la posición de un grupo de expertos latinoamericanos sobre las recomendaciones de consumo y/o suplementación con vitamina A, C, D, zinc, hierro, folatos y micronutrientes múltiples, en contextos de desnutrición, para grupos vulnerables: mujeres embarazadas y lactantes, niñas y niños menores de 5 años y adultos mayores. Las recomendaciones buscan disminuir el impacto potencial que tendrá COVID-19 en el estado nutricional, durante la pandemia. La posición surge de la discusión de dichos expertos con base a la revisión de evidencia científica actual para estos grupos vulnerables. Está dirigida a tomadores de decisiones, encargados de políticas públicas, personal de salud y organismos de la sociedad civil. Después de la lactancia materna y una dieta suficiente en cantidad y calidad, la suplementación con los micronutrientes presentados, puede contribuir a prevenir y tratar enfermedades virales, reforzar el sistema inmune y reducir complicaciones. La lactancia materna con medidas de higiene respiratoria, el suministro de múltiples micronutrientes en polvo para niños desde los 6 meses hasta los 5 años y el aporte de hierro y folatos o micronutrientes múltiples para la embarazada, son estrategias comprobadas y eficaces que deben seguirse implementando en tiempos de COVID-19. Para los adultos mayores la suplementación con vitamina C, D y zinc puede estar indicada(AU)

The COVID-19 crisis (SARS-CoV-2) might transform into a food catastrophe in Latin America and would increase the number of people suffering from hunger from 135 to 265 million, particularly in Venezuela, Guatemala, Honduras, Haiti and El Salvador, already facing economic and health crises. This manuscript presents the position of a group of Latin American experts in nutrition for establishing the recommendations for consumption and / or supplementation with vitamin A, C, D, zinc, iron, folates and multiple micronutrients, in undernutrition contexts, for vulnerable population of pregnant and lactating women, children under 5 years and the elderly. The recommendations seek to decrease the potential impact that COVID-19 will have on nutritional status during the pandemic. The position arises from the discussion of the experts based on the review of current scientific evidence for these vulnerable groups. It aims to reach stakeholders, public policy makers, health personnel and civil society organizations. Only after breastfeeding and a sufficient diet in terms of quantity and quality, a supplementation with the micronutrients mentioned above can help prevent and treat viral diseases, strengthen the immune system and even reduce complications. Breastfeeding with respiratory hygiene measures, the provision of multiple micronutrients powders for children from 6 moths to 5 years of age and the supply of iron and folates or multiple micronutrients tablets for pregnant women are proven and effective strategies that must continue to be implemented during COVID-19 pandemic. For older adults, supplementation with vitamin C, D and zinc might be indicated(AU)

Indicadores bioquímicos del estado nutricional en adolescentes pre-universitarios de Caracas / Biochemical indicators of the nutritional status of pre-university adolescents of Caracas

Con el propósito de evaluar el estado nutricional de un grupo de adolescentes de la ciudad de Caracas, Venezuela, se realizó un estudio transversal y descriptivo, en 94 estudiantes de educación media de instituciones oficiales, con edades entre 15 y 18 años, sin historia de patologías. Con el consentimiento de los representantes, se tomó una muestra de sangre para determinar hemoglobina y hematocrito, glucosa, triglicéridos, colesterol total y fraccionado, hierro, ferritina, así como las vitaminas A y E. Adicionalmente se registró el peso y la talla para determinar el IMC. Se encontró en los adolescentes un 17% de sobrepeso, 12% de obesidad y un 4% de déficit nutricional. El 5% de los adolescentes presentó anemia, mientras que 10% y 17% presentaron valores bajos de hierro y ferritina sérica respectivamente, indicando que una fracción de la población tenía un pobre estado nutricional respecto al hierro. Dicha deficiencia fue mayor en el sexo femenino (28%). El 18% presentó valores bajos de vitamina E, y un 16% valores bajos de colesterol en HDL. En general el estudio detectó un grupo de adolescentes con sobrepeso así como con deficiencias nutricionales. A pesar de ser una población joven, el 33% presentó al menos 1 factor de riesgo cardiovascular, sugiriendo un riesgo potencial en la edad adulta.

The nutritional status of 94 apparently healthy high school students (15 to 18 years old), entering a pre-university course at the Universidad Simón Bolívar was evaluated. After a written consent of their representatives was obtained, the weight and height of these students was measured and a blood sample was collected. Hematocrit and haemoglobin were determined in whole blood whereas circulating glucose, triglycerides, total and fractionated cholesterol, iron, ferritin as well as vitamins A and E were determined in the serum. The results showed that according to BMI cut off points, 17% of the students were overweight, 12% were obese and only 4% showed evidence of nutritional deficit. Anemia affected 5% of the adolescents whereas 10% and 17% had low circulating iron and ferritin respectively. Low levels of iron status indicators reached 28% in the females. In addition, 18% had low vitamin E levels. In general, the students showed no risk of cardiovascular disease however, 16% of the population had low levels of HDL and despite their young age 33% had at least one risk factor, suggesting a potential risk at an older age. The study showed that among these adolescents there was a group exhibiting overweight as well as signs of nutritional deficiencies.

[Diagnosis and treatment of methylmalonic aciduria: a case report]. / Diagnóstico y tratamiento de la aciduria metilmalónica: a propósito de un caso.

The methylmalonic aciduria is an organic acidemia, inherited as autosomic recessive trait, caused by a deficiency of the methylmalonyl-CoA mutase, or by defects in the biosynthesis of the cofactor adenosylcobalamin. Regarding the enzymatic defect, there are two forms: mut(o) with no detectable enzymatic activity and mut(-) with reduced activity. Its clinical presentation may vary from a severe neonatal form with acidosis and death, up to a progressive chronic form. Here we describe the case of a four year-old boy, with diagnosis of methylmalonyl-CoA mutase deficiency type mut(-) with an acute presentation. Molecular analysis of MUT gene identified two mutations c.607G>A (G203R) and c.2080C>T (R694W), later confirmed in the parents. The aim of this report is to highlight the importance of including the organic acid analysis in urine among the first line exams in acutely and severely ill children with undefined etiology. The definitive diagnosis is important because it may allow a specific treatment and a favorable evolution to prevent the secuelae.

Diagnóstico y tratamiento de la aciduria metilmalónica: a propósito de un caso / Diagnosis and treatment of methylmalonic aciduria: a case report

La aciduria metilmalónica es una acidemia orgánica, autosómica recesiva, causada por la deficiencia de la metilmalonil CoA-mutasa, o por defectos en la biosíntesis del cofactor adenosilcobalamina. Del defecto enzimático, existen dos formas: mut (o) sin actividad enzimática y mut (-) con actividad reducida. Su presentación clínica puede variar desde una forma neonatal grave con acidosis y muerte, hasta una forma crónica progresiva. A continuación se describe el caso de un niño de 4 años de edad, con deficiencia de metilmalonil-CoA mutasa tipo mut (-), que se presentó en forma aguda. El estudio molecular del gen MUT mostró 2 mutaciones c.607G>A (G203R) y c.2080C > T(R694W), confirmadas posteriormente en los padres. El objetivo de este reporte es destacar la importancia de indicar el análisis de ácidos orgánicos en orina entre los estudios de primera línea, en todo niño con un cuadro clínico de presentación aguda y severamente enfermo, sin etiología definida. Por otra parte, se desea resaltar que el diagnóstico oportuno y definitivo es importante ya que permite iniciar un tratamiento específico, lograr una evolución favorable y prevenir las secuelas.

Reanimación cardiopulmonar en pediatría: evaluación de causas de error en situaciones de emergencia / Cardiopulmonary recsucitation in pediatric: evaluation of causes of mistake in emergence situations

El presente trabajo tuvo como objetivos evaluar los conocimientos que tienen los pediatras que usualmente manejan el paro cardiarespiratorio (PPCR) en nuestros hospitales, sobre maniobras básicas, dosificación de drogas de primera línea y escogencia de equipo de reanimación cardiopulmonar (RCP) en situaciones hipotéticas de PCR en niños de diferentes edades; e identificar las causas más frecuentes de error, y si el retraso en emitir una respuesta es un factor importante. En la sección de RCP básica, se contestó correctamente 43,62 por ciento de las preguntas. Se observó un mal desempeño en la dosificación de adrenalina, atropina y joules para desfibrilar