Prevalence of Latent Tuberculosis Infection (LTBI) in Mexican Patients With Rheumatoid Arthritis (RA).

INTRODUCTION: Patients with rheumatoid arthritis (RA) are at increased risk of developing tuberculosis, and even more so if they receive biological agents. In Mexico, the prevalence of latent tuberculosis infection (LTBI) in RA diagnosed by interferon-gamma release assay (IGRA) is largely unknown. The objective was to determine LTBI prevalence and the associated risk factors in rheumatoid arthritis patients. METHODS: A cross-sectional study was performed comprising 82 patients with RA who attended the rheumatology service at a second-level hospital. Demographic characteristics, comorbidity, Bacillus Calmette-Guerin (BCG) vaccination and smoking history, type of treatment, disease activity and functional capacity were investigated. The Disease Activity Score 28 and the Health Assessment Questionnaire-Disability Index were applied for the estimate of RA activity and functional capacity. Further information was compiled from the electronic medical records and personal interviews. LTBI was determined by QuantiFERON TB Gold Plus (QIAGEN, Germantown, USA). RESULTS: Prevalence of LTBI was 14% (95% confidence interval (CI): 8.6% to 23.9%). Factors associated with LTBI were history of smoking (odds ratio (OR) = 6.63 95% CI 1.01 to 43.3) and disability score (OR = 7.19 95%CI 1.41 to 36.6). CONCLUSIONS: The prevalence of LTBI in Mexican patients with RA was 14%. Our results suggest prevention of smoking and functional incapacity could reduce the risk of LTBI. Further research could endorse our results.

SLCO1B1 and SLC10A1 polymorphism and plasma rifampin concentrations in patients with co-morbidity tuberculosis-diabetes mellitus in Baja California, Mexico.

Rifampicin is one of the most important drugs for the treatment of tuberculosis (TB). Polymorphisms in SLCO1B1 and SLC10A1 genes are associated with impaired transporter function of drug compounds such as rifampicin. The relationship between genetic variation, clinical comorbidities, and rifampicin exposures in TB patients has not been completely elucidated. The aim of this study was to investigate the prevalence of SLCO1A1 and SLCO1B1 polymorphisms in TB and TB-DM patients and to determine their relationship with rifampicin pharmacokinetics on patients from México. Blood samples were collected in two hospitals in Baja California, Mexico from February through December 2017. Sampling included 19 patients with TB, 11 with T2DM and 17 healthy individuals. Polymorphisms genotype rs2306283, rs11045818, rs11045819, rs4149056, rs4149057, rs72559746,rs2291075 and rs4603354 of SLCO1B1 and rs4646285 and rs138880008 of SLC10A1 were analyzed by Sanger's sequencing. None of the SLCO1B1 and SLC10A1 variants were significantly associated with rifampicin Cmax. TB and T2DM patients with suboptimal Cmax rifampicin levels showed wild alleles in rs11045819 and rs2291075 in SLCO1B1 SLC10A1 and SLC10A1. This is the first study to analyze SLC10A1 and SLCO1B1 polymorphisms in TB and TB-T2DM patients and healthy individuals in Mexico. Further research to confirm and extend these findings is necessary.

Adaptación y validación del instrumento EMPODERA-TB para evaluar el empoderamiento en pacientes con tuberculosis pulmonar / Adaptation and validation of EMPODERA-TB to evaluate empowerment of patients with pulmonary tuberculosis / Adaptação e validação do instrumento EMPODERA-TB para avaliar o empoderamento em pacientes com tuberculose pulmonar

RESUMEN Objetivo. Adaptar y validar el instrumento EMPODERA-TB para medir el empoderamiento en pacientes con tuberculosis pulmonar. Métodos. Se adaptó y validó un instrumento, diseñado inicialmente para medir el empoderamiento en pacientes con enfermedades crónicas, para medir el empoderamiento en pacientes con tuberculosis. Para ello, se seleccionaron y adaptaron los ítems aplicables a los pacientes con tuberculosis. La validación se realizó mediante análisis factorial exploratorio y confirmatorio, y la consistencia interna mediante el coeficiente alfa de Cronbach, con base en los datos de una muestra de 49 pacientes de origen mexicano con diagnóstico de tuberculosis pulmonar. Resultados. El instrumento se integró por 19 ítems agrupados en tres dimensiones: adquisición de conocimientos, habilidades para compartir información y para la toma de decisiones. Se observó un ajuste aceptable (SRMR: 0,124; CD: 0,999), mientras que la consistencia interna para las dimensiones fue de 0,878; 0,879 y 0,808, respectivamente, y para el instrumento completo fue de 0,885. Conclusiones. El instrumento mostró índices de ajuste de bondad aceptables y consistencia interna adecuada, por lo que permite medir el empoderamiento en pacientes con tuberculosis pulmonar. Este instrumento será de utilidad en la práctica clínica y epidemiología de tuberculosis en países latinoamericanos de habla hispana, y permitirá implementar estrategias que mejoren el conocimiento y el apego al tratamiento, así como la interacción con pacientes o individuos en riesgo de contagio y, con ello, establecer estrategias de prevención.

ABSTRACT Objective. Adapt and validate EMPODERA-TB in order to measure empowerment of patients with pulmonary tuberculosis (TB). Methods. An instrument initially designed to measure empowerment of patients with chronic diseases was adapted and validated to measure empowerment of patients with tuberculosis. The items applicable to patients with tuberculosis were selected and adapted. Validation was performed using exploratory and confirmatory factor analysis, and internal consistency was determined using Cronbach's alpha coefficient, based on data from a sample of 49 patients of Mexican origin diagnosed with pulmonary tuberculosis. Results. The instrument comprised 19 items grouped into three dimensions: knowledge acquisition, information-sharing skills, and decision-making skills. Acceptable goodness-of-fit was observed (SRMR: 0.124; CD: 0.999); internal consistency for the three dimensions was 0.878, 0.879, and 0.808, respectively, and for the instrument overall it was 0.885. Conclusions. The instrument showed acceptable goodness-of-fit and adequate internal consistency, making it possible to measure empowerment of patients with pulmonary tuberculosis. This instrument will be useful in TB clinical practice and epidemiology in Spanish-speaking Latin American countries. It will allow implementation of strategies that improve knowledge and adherence to treatment, interactions with patients or individuals at risk of infection, and development of prevention strategies.

RESUMO Objetivo. Adaptar e validar o instrumento EMPODERA-TB para medir o empoderamento em pacientes com tuberculose pulmonar. Métodos. Um instrumento elaborado inicialmente para medir o empoderamento em pacientes com doenças crônicas foi adaptado e validado para medir o empoderamento em pacientes com tuberculose. Para tanto, foram selecionados e adaptados os itens aplicáveis aos pacientes com tuberculose. A validação foi realizada por meio de análise fatorial exploratória e confirmatória, e a consistência interna foi analisada por meio do coeficiente alfa de Cronbach, com base em dados de uma amostra de 49 pacientes de origem mexicana com diagnóstico de tuberculose pulmonar. Resultados. O instrumento foi composto por 19 itens, agrupados em três dimensões: aquisição de conhecimento, habilidade de compartilhar informações e habilidade para a tomada de decisão. Observou-se um ajuste aceitável (SRMR: 0,124; CD: 0,999), enquanto a consistência interna para as dimensões foi de 0,878, 0,879 e 0,808, respectivamente, e para o instrumento como um todo foi de 0,885. Conclusões. O instrumento apresentou índices de bondade de ajuste aceitáveis e consistência interna adequada; portanto, permite mensurar o empoderamento em pacientes com tuberculose pulmonar. Este instrumento será útil para a prática clínica e epidemiológica da tuberculose nos países latino-americanos de língua espanhola, e permitirá a implementação de estratégias que melhorem o conhecimento e a adesão ao tratamento, bem como a interação com pacientes ou indivíduos em risco de contágio e, portanto, o estabelecimento de estratégias de prevenção.

Whole genome characterization, and geographical distribution of M. tuberculosis in central region of Veracruz, Mexico

ABSTRACT The purpose of this work was to perform by Whole Genomic Sequencing (WGS) a characterization of tuberculosis isolates circulating in the central region of Veracruz, Mexico, and to determine its geographical distribution. The genome of 25 clinical isolates of tuberculosis patients, recovered from central zone of Veracruz, Mexico, were sequenced and the information obtained was used to characterize lineage, prediction of drug resistance, identification of clonal complexes, and finally correlated with the geolocalization data. Isolates analyzed were included into seven L4 sublineages, most frequent was X3; X1 (4.1.1.3) in 35%. rpoBSer450Leu polymorphism was the most frequently found variant. Sublineage Haarlem (4.1.2) had the widest distribution, found in five municipalities. Of the of two clonal complexes found, the most abundant included eight isolates, with X3/X1 lineage, placed in two municipalities. Combination of WGS and geographic information system was very useful for the identification of sublineages, clonal complexes, and their geographical dispersion with important implications in the epidemiological surveillance and clinical control of TB.

Diversidad genética de Mycobacterium tuberculosis circulando en la jurisdicción V de Jalapa, Veracruz, México / Genetic diversity of Mycobacterium tuberculosis circulating in the jurisdiction V from Jalapa, Veracruz, Mexico

ANTECEDENTES: El estado de Veracruz se ubica en el sureste de México y presenta una alta prevalencia de tuberculosis (TBC) y drogo resistencia. Sin embargo, la composición de los genotipos circulantes es poco conocida. OBJETIVO: Caracterizar la diversidad genética de la TBC en la jurisdicción sanitaria V del estado de Veracruz. MÉTODOS: Estudio transversal realizado en aislados clínicos de pacientes con TBC residentes de la jurisdicción V. Se determinó la sensibilidad a medicamentos de primera línea. La genotipificación se realizó mediante espoligotipificación y MIRU-VNTR 15 loci. RESULTADOS: Entre los 74 aislados analizados se observó resistencia a un fármaco en 44 (59%) aislados. Linaje L4 (EuroAmericano) se presentó en 73 aislados. Se identificaron cinco sublinajes; H (40%), T (22%), LAM (16%), X (13%) y U (7%). El 32% de los aislados se agrupó mediante su espoligotipo y 40% en 10 complejos clonales. CONCLUSIONES: Es la primera descripción sobre la estructura genética de TBC en la región central de Veracruz. La diversidad de genotipos podría contribuir a su dispersión en la región. Esta información será útil para el desarrollo de intervenciones y reducir el impacto de TBC en la población.

BACKGROUND: The state of Veracruz is placed in southeastern Mexico and has a high prevalence of tuberculosis (TB) and drug resistance. Nevertheless, the composition of circulating genotypes in the central region of the state is partially known. AIM: To characterize the genetic diversity of TB in the sanitary jurisdiction V of the state of Veracruz. METHODS: A cross-sectional study was conducted among clinical isolates from patients with TB living in the jurisdiction V, in Jalapa Ver., Mexico. Sensitivity to first-line drugs was determined, and genotyping was performed by spoligotyping and MIRU-VNTR 15 loci. RESULTS: Among the 74 isolates analyzed, resistance to one drug was observed in 44 isolates. L4 (EuroAmerican) was the major lineage identified. Five sublineages were the most abundant; H (40%), T (22%), LAM (16%), X (13%) and U (7%). Only 32% of the isolates were clustered by spoligotype and 40% were placed in ten clonal complexes. CONCLUSIONS: This is the first description of the genetic structure of TB in the central region of Veracruz. The diversity of genotypes could contribute to its dispersion. This information will be useful for the development of interventions to reduce the impact of TB in the population.

IgG Antibodies Generation and Side Effects Caused by Ad5-nCoV Vaccine (CanSino Biologics) and BNT162b2 Vaccine (Pfizer/BioNTech) among Mexican Population.

SARS-CoV-2 has rapidly generated a pandemic. Vaccines are currently being rolled out to control the viral spread and prevent deaths. Emergency vaccines, using new platforms, have been approved. Their effectiveness, safety and immunogenicity in different populations are not fully known. This study aimed to discover the immunogenicity of the messenger ribonucleic acid (mRNA) BNT162b2 and adenovirus vector Ad5-nCoV vaccines through IgG antibody generation against subunit 1 of protein S (S1 IgG) and assess the side effects of the vaccines. A total of 115 vaccinated people were included, 61 of whom received the BNT162b2 vaccine, while 54 received Ad5-nCoV. Measurements of S1 IgG antibodies were carried out using the enzyme-linked immunosorbent assay (ELISA) technique. The BNT162b2 vaccine generated S1 IgG antibodies in 80.3% of the participants after the first dose. The number of seropositive participants increased to 98.36% with the administration of the second dose. The Ad5-nCoV vaccine generated S1 IgG antibodies in 88.89% of those vaccinated. Women generated more antibodies when administered either vaccine. There were no serious adverse effects from vaccination. In conclusion, not all participants had detectable S1 IgG antibodies. The Ad5-nCoV vaccine presented the most seronegative cases. The studied vaccines were shown to be safe.

Nanopartículas como transportadores de fármacos: una herramienta prometedora contra la tuberculosis / Nanoparticles as drug transporters: a promising tool against tuberculosis

RESUMEN La Organización Mundial de la Salud (OMS) ubica a la tuberculosis (TB) como uno de los problemas de salud más preocupantes en la actualidad, y señala que se requieren de acciones novedosas para controlar su expansión y, de esta manera, alcanzar una de las metas establecidas en los Objetivos de Desarrollo Sostenible: reducir para 2030 la morbilidad e incidencia de TB. Para lograr este objetivo, está claro que las herramientas empleadas actualmente para su diagnóstico y tratamiento ya no son las adecuadas. En este sentido, es necesario desarrollar nuevos medicamentos y vacunas, así como novedosos procedimientos de administración de fármacos que generen una mejor respuesta, disminuyan el tiempo y optimicen los tratamientos. La nanotecnología ha incorporado en los últimos años un gran número de nuevas herramientas que incrementan considerablemente, la diversidad de mecanismos para la administración de tratamientos antituberculosos. Dicho esto, la presente revisión describe brevemente el estado actual de la farmacorresistencia en TB, así como las características generales de las nanopartículas que están evaluándose como herramientas para transportar antibióticos antituberculosos.

ABSTRACT The World Health Organization (WHO) places Tuberculosis (TB) as one of the most important health problems today. According to the WHO, this disease requires novel actions to control its expansion and, in this way, achieve one of the goals established in the sustainable development goals: to reduce TB morbidity and incidence by 2030 and regain control. To achieve this goal, the tools currently used for diagnosis and treatment are no longer adequate. In this sense, it is necessary to develop new drugs and vaccines, as well as novel drug administration procedures that generate a better response, reduce times, and optimize treatments. Nanotechnology has incorporated in recent years a considerable number of new tools that significantly increase the diversity of mechanisms for the administration of anti-tuberculosis drugs. Therefore, the present review briefly describes the current state of drug resistance in tuberculosis, as well as the general characteristics of nanoparticles being evaluated as tools to transport new antibiotics against tuberculosis.

Nanopartículas como transportadores de fármacos: una herramienta prometedora contra la tuberculosis / Nanoparticles as drug transporters: a promising tool against tuberculosis

RESUMEN La Organización Mundial de la Salud (OMS) ubica a la tuberculosis (TB) como uno de los problemas de salud más preocupantes en la actualidad, y señala que se requieren de acciones novedosas para controlar su expansión y, de esta manera, alcanzar una de las metas establecidas en los Objetivos de Desarrollo Sostenible: reducir para 2030 la morbilidad e incidencia de TB. Para lograr este objetivo, está claro que las herramientas empleadas actualmente para su diagnóstico y tratamiento ya no son las adecuadas. En este sentido, es necesario desarrollar nuevos medicamentos y vacunas, así como novedosos procedimientos de administración de fármacos que generen una mejor respuesta, disminuyan el tiempo y optimicen los tratamientos. La nanotecnología ha incorporado en los últimos años un gran número de nuevas herramientas que incrementan considerablemente, la diversidad de mecanismos para la administración de tratamientos antituberculosos. Dicho esto, la presente revisión describe brevemente el estado actual de la farmacorresistencia en TB, así como las características generales de las nanopartículas que están evaluándose como herramientas para transportar antibióticos antituberculosos.

ABSTRACT The World Health Organization (WHO) places Tuberculosis (TB) as one of the most important health problems today. According to the WHO, this disease requires novel actions to control its expansion and, in this way, achieve one of the goals established in the sustainable development goals: to reduce TB morbidity and incidence by 2030 and regain control. To achieve this goal, the tools currently used for diagnosis and treatment are no longer adequate. In this sense, it is necessary to develop new drugs and vaccines, as well as novel drug administration procedures that generate a better response, reduce times, and optimize treatments. Nanotechnology has incorporated in recent years a considerable number of new tools that significantly increase the diversity of mechanisms for the administration of anti-tuberculosis drugs. Therefore, the present review briefly describes the current state of drug resistance in tuberculosis, as well as the general characteristics of nanoparticles being evaluated as tools to transport new antibiotics against tuberculosis.

Association of polymorphisms at -174 in IL-6, and -308 and -238 in TNF-α, in the development of tuberculosis and type 2 diabetes mellitus in the Mexican population.

Polymorphisms at -176 in IL-6, and -238 and -308 in TNF-α have been described as risk factors for developing tuberculosis (TB) and type 2 diabetes mellitus (T2DM). However, it is not known how these changes influence the development of TB-T2DM comorbidity. The objective of this work was therefore to analyze the impact of these polymorphisms in the Mexican population. This is a cross-sectional study of cases and controls in which polymorphisms at -174 in IL-6, -238 and -308 in TNF-α were identified in healthy subjects, those with TB, T2DM and carriers of the comorbidity, each group consisted of 30 individuals. Descriptions of the population, frequency of genotypes and risk association were calculated, and a reduction of multifactorial dimensionality between groups (MDR) was determined. Genotype 174 G/G-of IL-6 was observed in 78% of individuals, while -308 G/G and -238 G/G of TNF-α occurred in 90% and 91% of individuals, respectively. The -174 G/G IL-6 in individuals with T2DM increased five-fold (p = .02) the risk of developing the comorbidity. The MDR analysis showed that the association of -174 G/G IL-6 and -308 G/G TNF-α in healthy individuals increased the risk of developing the comorbidity up to six-fold (p = .019), while in individuals with T2DM, this risk augmented 14-fold (p = .0002). The -174 G/G IL-6 genotype increases the risk of developing comorbidity in the T2DM population and this risk is raised when associated with -308 G/G TNF-α. These findings have implications for understanding the epidemiological dynamics of the TB-T2DM comorbidity, promoting prevention strategies and inhibiting the development of this co-morbidity.

Viral coinfection in acute respiratory infection in Mexican children treated by the emergency service: A cross-sectional study.

BACKGROUND: Acute respiratory infections (ARIs) cause illness. Children under five years of age are highly vulnerable to these infections. Viral coinfection or multiple viral infection is a variable that can have a significant impact on the evolution of these diseases. METHODS: This cross-sectional study was carried out in Mexican children (under five years of age) who had an ARI and who were treated by an emergency service in a hospital in Guadalajara, Jalisco, Mexico. The viral etiology, as well as the presence of multiple viral infections, was determined. A structured questionnaire was used to obtain demographic and clinical information. Odds ratio (OR) was calculated, and univariate and multivariate analyses using logistic regression were performed. RESULTS: In the study population, metapneumovirus (hMPV) was the most frequent virus (22%), followed by adenovirus (hAD) (16%), respiratory syncytial virus (RSV) (14%), rhinovirus (hRV) (12%), bocavirus (hBoV) (9%), influenza virus (IF) (7%), and parainfluenza (PIF) (4%). The frequency of viral coinfections was 31.62%, and multiple logistic regression analysis revealed that hMPV, RSV, PIF, and hBoV were independently associated with multiple viral infection. No difference was found in the clinical manifestation of children with simple and multiple infections. Simple hMPV infection was associated with patients who presented with severe ARI. Using a multivariate analysis, we found that overcrowding is associated with coinfection when the viral etiology was hRV (OR = 2.56, 95% confidence interval (CI) 1.07 to 6.13), IF (OR = 2.56, 95% CI 1.07 to 6.13), PIF (OR = 2.96, 95% CI 1.15 to 7.65), hAD (OR = 2.56, 95% CI 1.07 to 6.13), and hBoV (OR = 2.9, 95% CI 1.14 to 7.34). CONCLUSIONS: Viral coinfections are frequent in children requiring treatment by an emergency service. However, the severity of ARI is similar to that of children with a simple infection. The hMPV is common and may confer a significant disease burden in the Mexican population. Finally, overcrowding is a housing characteristic that favors the development of coinfections.

[Proposal of a five MIRU-VNTR panel to screen clinical isolates of Mycobacterium tuberculosis in Mexico]. / Propuesta de un panel MIRU-VNTR 5 para el tamizaje de aislamientos clínicos de Mycobacterium tuberculosis en México.

INTRODUCTION: Tuberculosis is a public health problem across Mexico. This paper aims to select a panel, with a minimum number of repetitive elements (MIRU-VNTR) for genotypic characterization of Mycobacterium tuberculosis (M. tuberculosis) clinical isolates. METHOD: In this study, a full panel of 24 MIRU-VNTR loci was used to discriminate 65 clinical isolates of M. tuberculosis from three different geographical regions of Mexico. Those loci with the highest discriminatory power were subsequently selected. RESULTS: The panel, including five loci, was obtained by selecting the highest values of allelic diversity among the genotypes obtained. The dendrogram, generated by the panel MIRU-VNTR 5, showed a high discriminatory power with 65 unique genotype profiles and formed clusters according to the geographical region of origin. CONCLUSIONS: The panel MIRU-VNTR 5 can be useful for characterizing clinical isolates of M. tuberculosis in Mexico.

Characterisation of pks15/1 in clinical isolates of Mycobacterium tuberculosis from Mexico

Tuberculosis (TB) is an infectocontagious respiratory disease caused by members of the Mycobacterium tuberculosis complex. A 7 base pair (bp) deletion in the locus polyketide synthase (pks)15/1 is described as polymorphic among members of the M. tuberculosis complex, enabling the identification of Euro-American, Indo-Oceanic and Asian lineages. The aim of this study was to characterise this locus in TB isolates from Mexico. One hundred twenty clinical isolates were recovered from the states of Veracruz and Estado de Mexico. We determined the nucleotide sequence of a ± 400 bp fragment of the locus pks15/1, while genotypic characterisation was performed by spoligotyping. One hundred and fifty isolates contained the 7 bp deletion, while five had the wild type locus. Lineages X (22%), LAM (18%) and T (17%) were the most frequent; only three (2%) of the isolates were identified as Beijing and two (1%) EAI-Manila. The wild type pks15/1 locus was observed in all Asian lineage isolates tested. Our results confirm the utility of locus pks15/1 as a molecular marker for identifying Asian lineages of the M. tuberculosis complex. This marker could be of great value in the epidemiological surveillance of TB, especially in countries like Mexico, where the prevalence of such lineages is unknown.

Epidemiologic investigation of tuberculosis in a Mexican population from Chihuahua State, Mexico: a pilot study.

Tuberculosis (TB) and its co-morbid conditions have become a burden on global health economies. It is well understood that susceptibility of the host to TB infection/disease is influenced by both genetic and environmental factors and their interactions. The aims of this pilot case-control study are to characterize the sociodemographic and environmental factors related to active TB disease (TB/case) and latent TB infection (LTBI/control) status, and to identify risk factors associated with progression from LTBI to TB. We recruited 75 cases with TB (mean age=46.3y; females=41%) and 75 controls with LTBI (mean age=39.0y; females=37%), from the Mestizo population of Cuidad Juárez, Mexico. In addition to the determination of case/control status, information on environmental variables was collected (e.g., socioeconomic status, smoking, alcohol consumption, substance abuse, nutritional status, household demographics, medical histories and presence of type 2 diabetes [T2DM]). The data were analyzed to identify the environmental correlates of TB and LTBI using univariate and multivariate statistical approaches. Following multivariate logistic regression analysis, TB was associated with poor nutrition, T2DM, family history of TB, and non-Chihuahua state of birth. These preliminary findings have relevance to TB control at the Mexico-United States border, and contribute to our future genetic study of TB in Mexicans.

Co-infection and risk factors of tuberculosis in a Mexican HIV+ population / Coinfecção e fatores de risco de tuberculose em uma população Mexicana com HIV+

INTRODUCTION: The situation of tuberculosis (TB) is being modified by the human immunodeficiency virus (HIV), which is increasing the occurrence of new cases and the generation of drug resistant strains, affecting not only the people infected with HIV, but also their close contacts and the general population, conforming a serious public health concern. However, the magnitudes of the factors associated to this co-infection differ considerably in relation to the population groups and geographical areas. METHODS: In order to evaluate the prevalence and risk factors for the co-infection of tuberculosis (TB) in a population with human immunodeficiency virus (HIV+) in the Southeast of Mexico, we made the analysis of clinical and epidemiological variables and the diagnosis of tuberculosis by isolation of mycobacteria from respiratory samples. RESULTS: From the 147 HIV+ individuals analyzed, 12 were culture positive; this shows a prevalence of 8 percent for the co-infection. The only variable found with statistical significance for the co-infection was the number of CD4-T < 200 cells/mm³, OR 13 (95 percent, CI 2-106 vs 12-109). CONCLUSIONS: To our knowledge this is the first report describing the factors associated with tuberculosis co -infection with HIV in a population from Southern Mexico. The low number of CD4 T-cells was the only variable associated with the TB co-infection and the rest of the variables provide scenarios that require specific and particular interventions for this population group.

INTRODUÇÃO: A situação da tuberculose (TB) foi modificada pelo vírus da imunodeficiência humana (HIV). Com isso, aumentou-se a ocorrência de novos casos de TB e a geração de cepas resistentes à droga, afetando não só as pessoas infectadas com HIV, mas também seus contatos próximos e da população em geral, gerando um sério problema de saúde pública. No entanto, a magnitude dos fatores associados à esta coinfecção diferem consideravelmente em relação aos grupos populacionais e áreas geográficas. MÉTODOS: Para avaliar a prevalência da comorbilidade e fatores de risco da coinfecção de tuberculose (TB) em uma população com o vírus da imunodeficiência humana (VIH+) no sudeste do México, nós fizemos a análise das variáveis clínicas e epidemiológicas e de isolamento da micobactérias através de cultura de amostras respiratórias. RESULTADOS: A partir de 147 indivíduos HIV+ analisados, 12 foram positivos na cultura, o que mostra uma prevalência de 8 por cento para a coinfecção. A única variável com significância estatística encontrada para a coinfecção foi o número de células CD4-T<200 células/mm³, OR 13 (95 por cento, CI 2-106 vs 12-109). CONCLUSÕES: Ao nosso conhecimento este é o primeiro relatório que descreve os fatores associados à coinfecção de tuberculose com HIV em uma população do sudeste do Mexico. O baixo número de células T CD4+ foi à única variável associada com a coinfecção por TB no resto das variáveis, proporcionando situações que exigem intervenções específicas e particulares para este grupo populacional.

Expression of matrix metalloproteinases 2 and 9 in human gastric cancer and superficial gastritis.

AIM: To assess expression of matrix metalloproteinases 2 (MMP2) and MMP9 in gastric cancer, superficial gastritis and normal mucosa, and to measure metalloproteinase activity. METHODS: MMP2 and MMP9 mRNA expression was determined by quantitative real-time polymerase chain reaction. Normalization was carried out using three different factors. Proteins were analyzed by quantitative gelatin zymography (qGZ). RESULTS: 18S ribosomal RNA (18SRNA) was very highly expressed, while hypoxanthine ribosyltransferase-1 (HPRT-1) was moderately expressed. MMP2 was highly expressed, while MMP9 was not detected or lowly expressed in normal tissues, moderately or highly expressed in gastritis and highly expressed in cancer. Relative expression of 18SRNA and HPRT-1 showed no significant differences. Significant differences in MMP2 and MMP9 were found between cancer and normal tissue, but not between gastritis and normal tissue. Absolute quantification of MMP9 echoed this pattern, but differential expression of MMP2 proved conflictive. Analysis by qGZ indicated significant differences between cancer and normal tissue in MMP-2, total MMP-9, 250 and 110 kDa bands. CONCLUSION: MMP9 expression is enhanced in gastric cancer compared to normal mucosa; interpretation of differential expression of MMP2 is difficult to establish.

Conocimiento y actitudes sobre tuberculosis en personal médico de Veracruz, México / Knowledge and attitudes about tuberculosis in medical staff from Veracruz, Mexico

Antecedentes: La tuberculosis (TB) es una enfermedad infecciosa responsable de ocho millones de casos y tres millones de muertos cada año. De acuerdo a la Organización Mundial de la Salud, el conocimiento y la actitud del personal médico sobre la enfermedad se ubica como un elemento importante para el correcto desarrollo de los programas de lucha contra la TB, con especial énfasis en países de economías emergentes. Es por lo anterior que el objetivo del este trabajo es evaluar los conocimientos y actitudes en personal médico de Veracruz, México. Metodología: Se encuestó a una muestra representativa de médicos que laboran en una institución pública, identificando edad, género, especialidad médica y antigüedad. El conocimiento de TB se consideró en cinco apartados (enfermedad, diagnóstico, tratamiento, prevención y normativo), que integrados mostraron el conocimiento global; se compararon las variables del médico y el conocimiento mediante pruebas t y x ². Resultados: De los 220 médicos encuestados, solo 38 (17%) obtuvieron una evaluación global adecuada; por apartados, 142 (65%) mostraron conocimiento adecuado en prevención y 40 (18%) en enfermedad. No se observaron diferencias entre los niveles de conocimiento y las variables analizadas. El 70% de los médicos refieren a la TB como un tema poco importante en el total de sus actividades, e identificamos que el enfoque que se da a la enfermedad esté orientado hacia la prevención. Conclusión: Se observó un bajo conocimiento global; sin embargo, se ubicaron los apartados que deberían ser reforzados para generar un mejor entendimiento y en consecuencia un cambio de actitud hacia la enfermedad. [Aguilar-Nájera MJ, Cortés-Salazar CS, Zenteno-Cuevas R. Conocimiento y actitudes sobre tuberculosis en personal médico de Veracruz, México. MedUNAB 2008; 11: 213-217].

Background: Tuberculosis (TB) is an infectious disease responsible of 8 millions of cases and 3 millions of deaths each year. According to the World Health Organization, the knowledge and attitude of the medical staff about the disease is considered a very important element for the correct development of the fight programs against TB, with special emphasis in emerging countries. The main goal of this work is to evaluate the knowledge and attitudes of medical staff from Veracruz, Mexico. Methods: A representative sample of physicians that works in a public institution were survey, identifying age, gender, medical specialty and years of service. TB knowledge was evaluated by 5 issues (disease, diagnosis, treatment, prevention, and normative), that integrated show the global knowledge. The variables from the physicians and knowledge were compared by t and X² test. Results: From 220 surveyed physicians, only 38 (17%) obtain an adequated global evaluation; by issues, 142 (65%) show an adequate knowledge in prevention, and only 40 (18%) in disease. No differences were observed between the knowledge level and the variables analyzed. Beside 70% of the doctors mention that the TB is an aspect with minimal transcendence in all their activities; additionally, we found their focus to TB is more oriented to prevention. Conclusion: We identified the issues of TB that need to be reinforced in order to induce in the doctors a better understanding of illness and, in consequence, a change of attitude toward TB. [Aguilar-Nájera MJ, Cortés-Salazar CS, Zenteno-Cuevas R. Knowledge and attitudes about tuberculosis in medical staff from Veracruz, Mexico. MedUNAB 2008; 11:213-217].

Identification of potential B cell epitope determinants by computer techniques, in hemagglutinin-neuraminidase from the porcine rubulavirus La Piedad Michoacan.

Hemagglutinin-neuraminidase (HN) from porcine rubulavirus La Piedad Michoacan (RvpLPM) is one of the most antigenic proteins known, and is responsible for virus-host cell interaction. We analyzed the amino acid sequence of HN, using computer-assisted techniques to identify B cell epitopes. From a pool of 18 possible antigenic peptides, we evaluated the antigenicity of the 2 peptides with the highest scores and the 1 with lowest score. Antibodies from RvpLPM-infected pigs recognized the synthesized HN-A, HN-B, and HN-R peptides (optical density [OD]: 0.33 +/- 0.02 for HN-A, 0.20 +/- 0.02 for HN-B, and 0.07 +/- 0.01 for HN-R); bovine serum albumin-coupled HN-A and HN-B induced rabbit anti-RvpLPM antibodies (OD: 0.39 +/- 0.01 for HN-A and 0.35 +/- 0.02 for HN-B). Loop 5 from the outer membrane protein, OmpC, from Salmonella typhi was replaced with HN-B; this protein was then expressed in Escherichia coli UH302. BALB/c mice were challenged intraperitoneally or orogastrically with the fusion protein expressed in E. coli and murine antibodies obtained from both types of administration inhibited virus-hemagglutinating activity, as did the antibodies from RvpLPM-infected swine. These results suggest that HN-A and HN-B are peptides involved in RvpLPM cell carbohydrate recognition, and could therefore be considered potential targets for vaccine and diagnostic procedures development.

Tuberculosis y la importancia de incorporar nuevas metodologías diagnósticas / Tuberculosis and the importance of incorporating new diagnostic methodologies

La tuberculosis (TB) continúa siendo considerada como una de las enfermedades infecto-contagiosas de mayor impacto en la salud pública y requiere, de acuerdo con la Organización Mundial de la Salud (OMS), una atención inmediata a nivel global. Los objetivos de esta breve revisión son los de considerar las condiciones epidemiológicas de la enfermedad, describir los sistemas tradicionales y las nuevas técnicas de diagnóstico, y su posibilidad de aplicación en programas de combate contra la que es considerada como la peste blanca: la tuberculosis

Neumonitis inducida por el rubulavirus porcino / Pneumonitis induced by pork rubulavirus

Introducción: El rubulavirus porcino es un virus miembro de la familia Paramixoviridae, subfamilia paramixovirinae y género Rubulavirus. Este virus posee gran homología en la secuencia de nucleótidos y aminoácidos con los virus de las paperas, virus símicos y virus de la parinfluenza 2 y 4. El rubulavirus porcino es responsable de la enfermedad del ojo azul que afecta a cerdos de todas las edades y provoca alteraciones reproductivas, neurológicas y respiratorias. Objetivo: En el presente trabajo identificamos las principales lesiones pulmonares que provoca la infección experimental de cerdos con el rubulavirus porcino. Materiales y métodos: Los animales fueron inoculados por vía intranasal y sacrificados en diferentes tiempos postinfección. En cada tiempo postinfección se analizaron las lesiones macroscópicas y microscópicas, se determinó el título de anticuerpos, y se realizó el aislamiento viral de diversos tejidos. Resultados: Se demostró que el rubulavirus porcino induce una neumonitis intersticial con un infiltrado mononuclear, características de infecciones ocasionadas por paramoxovirus como el virus de las paperas o el virus del sarampión. El aislamiento viral fue mayor en el día cinco postinfección, de manera interesante se logró recuperar el virus principalmente en la tonsila, tráquea y pulmón. Discusión: Con base en estos resultados, este artículo propone a este virus como un modelo experimental para estudiar la patología y respuesta inmune en infecciones causadas por paramixovirus

Proteínas pulmonares asociadas a sustancias con actividad surfactante7 / Pulmonary proteins associated to substances with surfactant activity

La ausencia de surfactantes pulmonares trae como consecuencia el incremento de la tensión superficial a lo largo del epitelio alveolar, provocando un colapso alveolar y la lisis de las células epiteliales. Este proceso culmina con la aparición de un síndrome de insuficiencia respiratoria, que es la causa principal de morbimortalidad en niños prematuros. Recientemente, la aplicación de mezclas de agentes surfactantes con fines terapéuticos ha constituido un gran apoyo para la terapia respiratoria, ya que permite una evolución más rápida de los niños que padecen este síndrome. Por todo esto, resulta de gran importancia el conocimiento más detallado de la función, el metabolismo y la regulación de la expresión genética de las proteíinas surfactantes, para el diseño de nuevas y mejores estrategias terapéuticas para combatir este síndrome