Food insecurity, gestational weight gain and gestational diabetes in the National Children's Study, 2009-2014.

BACKGROUND: Household food insecurity (HFI) and gestational diabetes mellitus (GDM) are both common during pregnancy, yet it is unknown if these two factors are related. We aimed to determine the independent and joint associations between HFI, gestational weight gain (GWG) and GDM among pregnant women in the USA. METHODS: We used data from 592 women in the National Children's Study, Initial Vanguard Study from 2009 to 2014. HFI was assessed using the Household Food Security Survey Module at the first study visit; GDM was assessed through questionnaires and medical chart review. Logistic regression models were used to investigate the exposures of HFI, GWG and their joint effect on GDM. RESULTS: Among participants, 20.1% were marginally food secure or food insecure and 7.4% were diagnosed with GDM. The elevated unadjusted association between HFI and GDM was attenuated after adjustment (aOR: 1.12; 95%CI: 0.47, 2.66). There was an elevated risk of GDM associated with inadequate GWG, (aOR: 2.42; 95%CI: 0.97, 6.00), but results were imprecise. There were no statistically significant associations in the joint exposure analysis. CONCLUSION: The relationship between HFI and GDM is mostly explained by other covariates, but there is some evidence that inadequate GWG is a possible risk factor for GDM.

The value of using seasonality and meteorological variables to model intra-urban PM2.5 variation.

A yearlong air monitoring campaign was conducted to assess the impact of local temperature, relative humidity, and wind speed on the temporal and spatial variability of PM2.5 in El Paso, Texas. Monitoring was conducted at four sites purposely selected to capture the local traffic variability. Effects of meteorological events on seasonal PM2.5 variability were identified. For instance, in winter low-wind and low-temperature conditions were associated with high PM2.5 events that contributed to elevated seasonal PM2.5 levels. Similarly, in spring, high PM2.5 events were associated with high-wind and low-relative humidity conditions. Correlation coefficients between meteorological variables and PM2.5 fluctuated drastically across seasons. Specifically, it was observed that for most sites correlations between PM2.5 and meteorological variables either changed from positive to negative or dissolved depending on the season. Overall, the results suggest that mixed effects analysis with season and site as fixed factors and meteorological variables as covariates could increase the explanatory value of LUR models for PM2.5.

Genetic evidence of enzootic leishmaniasis in a stray canine and Texas mouse from sites in west and central Texas.

We detected Leishmania mexicana in skin biopsies taken from a stray canine (Canis familiaris) and Texas mouse (Peromyscus attwateri) at two ecologically disparate sites in west and central Texas using polymerase chain reaction (PCR). A single PCR-positive dog was identified from a sample of 96 stray canines and was collected in a peri-urban area in El Paso County, Texas. The PCR-positive P. attwateri was trapped at a wildlife reserve in Mason County, Texas, from a convenience sample of 20 sylvatic mammals of different species. To our knowledge, this represents the first description of L. mexicana in west Texas and extends the known geographic range of the parasite to an area that includes the arid Chihuahuan Desert. Our finding of L. mexicana in P. attwateri represents a new host record and is the first description of the parasite in a wild peromyscid rodent in the United States.

Household food insecurity and antepartum depression in the National Children's Study.

PURPOSE: The purpose of this study was to determine the association between household food insecurity (HFI) and elevated antepartum depressive symptoms (EADS) in the National Children's Study, 2009-2014, as well as standardize our results to the U.S. pregnant population. METHODS: HFI was collected at participants' baseline visits using the U.S. Household Food Security Survey Module; antepartum depression symptoms were collected twice during pregnancy using the Center for Epidemiologic Study Depression scale. Generalized estimating equations for binary outcomes were used to estimate the association between HFI and EADS. Inverse probability weighting was used to generalize the effect to the U.S. population using the National Health and Nutrition Examination Survey. RESULTS: Among 746 participants, 20.6% were food insecure. Women who were food insecure were 3.39 times (95% confidence interval: 1.73, 6.62) as likely to report EADS compared with women who were food secure. This estimate was marginally strengthened in a weighted analysis (odds ratio: 3.68; 95% confidence interval: 1.43, 9.43). CONCLUSIONS: This study suggests that women who are food insecure are at a greater risk of EADS, and HFI should be evaluated when assessing antepartum depression.

The epidemiology of cutaneour leishmaniasis / The epidemiology of cutaneous leishmaniasis

An epidemiologic survey was conducted in an area of sutrolical rainforest in Northwest Ecuador with followin objectives; (1) to determine the prevalencie of cutaneous leishmaniasis (CL), (2) to identify the leishmania species cusing human disease, (3) to investigate the major CL clinical manifestations, (4) to study cellular and humoral inmune response indicators, and (5) to identify risk factors associated with the disease, Half of the 466 subjects had laboratory and clinical evidencie of either current (14 for cent) or piror disease (33 for cent). Subjects with c urrent disease had an average of 2.6+-1.9 lesions with a mean size of 8.4 +-19.4 cms. The parasite species isolated from subject lesions were: Leismania guyanesis (63 for cent. L. panamensis (33 for cent) and L. brazilensis (4 for cent). Subjects with CL exhibited the highest serum IgG an IgM concentrations (p<0.0001). Lesion number (t=2.9, p=0.007) and size (t=3.8, p=0.0004) was predictive or serum IgG levels. The Montenegro skin test induration size was correlated positively with ulcer number (t=2.2, p=0.038). Age<5 yrs (AOR=1.5, 95 for cent C.I.=0.48-2.35), adult male gender (AOR=2.8.95 for centC.I.=1.1-7.8), and wood and/or cane exterior house walls (AOR=1.8,95 for cent CI=1.4-2.5) were associated with an increased for CL. In contrast, electric home lighting was associated with decreased risk (AOR=0.7, 95 for cent CI=0.4-2.3). The results suggest that it may be possible to modify a portion of the risk for CL by making changes in the housing evironment which may help to reduce the amount of contact with the vector...

Ethnomedical Knewledge, Attitudes, and treatment practices related to cutaneous leishmaniasis in an endemic Ecuadorian population

La leishmaniasis cutanea (LC) es una zoonosis que representa un problema de salud publica en el Ecuador, al igual que en la mayoría de países latinoamericanos. Sin embargo, existe poca información sobre los conocimientos etnomedicos y prácticas terapéuticas en esta enfermedad. Se realizaron dos estudios en los que se investigó el uso de los tratamientos para la LC en una área endémica de Ecuador. alrededor del 80 por ciento de los adultos mencionaron al menos un tipo de tratamiento tradicional o convencional para la LC. De los 175+ métodos terapéuticos especificados, una tercera parte correspondió al uso tópico de hierbas, leche o resina de árboles, frutas, u otras plantas autoctonas. Los otros métodos incluyen antibióticos, varios ácidos, productos químicos, polvos, pomadas, lacas, productos derivados del petróleo, agua u objetos calientes y varios productos animales. Menos del 25 por ciento mencionó al Glucantimer, el tratamiento convencional que se usa actualmente en LC. La mayoría de estos métodos son probablemente inocuos; sin embargo, algunos de ellos como ácidos, agentes cáusticos y metales calientes incrementan la lesión y dan como resultado cicatrices más grandes y profundas en relación a la que causa la ulcera de la LC. En forma adicional, la aplicación de sustancias como el cloro, gasolina, mercurio y plomo en las úlceras abiertas pueden ser carciongénicas o causar defectos en los fetos de mujeres em barazadas. Es importante considerar que varios de estos métodos tradicionales pueden tener valor terapéutico, entre los que se pueden mencionar el agua caliente y las plantas que contienen alcaloides, terpenos y otros componenetes naturales con actividad antiprotozoaria; por consiguiente, su valor potencial debe ser investigado como alternativas terapéuticas en la LC.

Validéz de la prueba cutánea de montenegro en una área endémica de leishmaniasis cutánea Borbón-Esmeraldas

El estudio es predominantemente en población negra del norte de la provincia de Esmeraldas, zona rural, área tropical al noroeste de Ecuador (n=276). Ante la presencia de diversas especies o subespecies de leishmania, surge la necesidad de standarizar éste método diagnóstico como es el Test Cutáneo de Montenegro. En un primer grupo de 138 pacientes se aplica tres pruebas a concentraciones de 3x10, 6x10, 12.5x10. En el segundo protocolo con 138 pacientes, se aplica cuatro pruebas con parásito fraccionado a una concentración standarizada de 6x10 de los que predominan en la zona: brasiliensis, panamensis y amazonensis, más una dosis asociada. Al igual que en otros estudios de la zona, se determina que la concentración de mayor sensibilidad y especificidad es la de 6x10...