Facilitators of peer leader retention within a Type 2 diabetes intervention trial for US Latinos/Hispanics of Mexican origin.

Peer support is effective in improving self-management behaviors and health outcomes among individuals with Type 2 diabetes. Volunteer peer support programs offer a cost-effective resource for diabetes self-management support; however, factors affecting the retention of volunteer peer leaders remain understudied. Herein, we examined factors associated with volunteer retention and satisfaction among 34 predominantly Mexican-origin peer leaders who assisted patients from a Federally Qualified Health Center located on the US/Mexico border with their diabetes management. Peer leaders completed surveys with open- and close-ended questions at baseline, 6 months and 12 months. Quantitative and qualitative data analyses were guided by the Volunteer Process Model. Using nonparametric Mann-Whitney U tests, self-efficacy as a peer leader at 6 months was most associated with interest to continue volunteering (P = 0.01), and satisfaction with support from the program at 12 months was most associated with interest to continue volunteering (P = 0.01). The qualitative data indicated that the relationship between the peer leaders and their patients was the primary factor for a satisfying volunteer experience. Future research should focus on increasing peer leaders' self-efficacy and satisfaction with program support and examine how organizations can support the development of the patient-peer relationship. Practitioners should consider appealing to volunteer peers' motivations to promote their retention.

Distribution of Burkholderia cepacia complex species isolated from industrial processes and contaminated products in Argentina.

Burkholderia cepacia complex (Bcc) members have clinical relevance as opportunistic pathogens in patients with cystic fibrosis and are responsible of numerous nosocomial infections. These closely related bacteria are also reported as frequent contaminants of industrial products. In this retrospective study, we use PCR and recA gene sequence analysis to identify at species level Bcc isolates recovered from massive consumption products and industrial processes in Argentina during the last 25 years. The sequences obtained were also compared with recA sequences from clinical Bcc isolates deposited in GenBank database. We detected Bcc in purified water and preserved products from pharmaceutics, cosmetics, household cleaning articles, and beverages industries. B. contaminans (which is prevalent among people with cystic fibrosis in Argentina) was the most frequent Bcc species identified (42% of the Bcc isolates studied). B. cepacia (10%), B. cenocepacia (5%), B. vietnamiensis (16%), B. arboris (3%), and the recently defined B. aenigmatica (24%) were also detected. Rec A sequences from all B. cepacia and most B. contaminans industrial isolates obtained in this study displayed 100% identity with recA sequences from isolates infecting Argentinean patients. This information brings evidence for considering industrial massive consumption products as a potential source of Bcc infections. In addition, identification at species level in industrial microbiological laboratories is necessary for a better epidemiological surveillance. Particularly in Argentina, more studies are required in order to reveal the role of these products in the acquisition of B. contaminans infections.

Experiencias y creencias de madres sobre la lactancia materna exclusiva en una región de México / Experiences and beliefs of mothers about exclusive breastfeeding in a region of Mexico

Objetivo: explorar las experiencias y creencias sobre la lactancia materna exclusiva de madres que acuden a consulta nutricional a un hospital público. Método: se llevó a cabo un estudio cualitativo en la ciudad de Soledad de Graciano Sánchez, México. Participaron 31 madres lactantes en cuatro grupos focales. Se realizó análisis de contenido convencional. Resultados: las participantes reconocen la lactancia materna como la alimentación ideal para sus hijos, no obstante, señalan carencias de información en materia de lactancia y abogan por una orientación más completa y veraz. Diversas circunstancias comprometen el amamantamiento y hacen la lactancia poco placentera en términos de sensación física. Las mujeres resaltan el papel de la madre y abuela como principal fuente de apoyo e información a diferencia del personal de salud. Consideraciones finales: la educación en lactancia humana debe fortalecerse. El personal sanitario debe incrementar su papel y presencia para promover la lactancia materna exclusiva.

Objetivo: explorar as experiências e crenças sobre a amamentação exclusiva de mães que chegam a um hospital público para consulta nutricional. Método: um estudo qualitativo foi realizado na cidade de Soledad de Graciano Sánchez, no México. 31 mães lactantes participaram de quatro grupos focais. A análise do conteúdo convencional foi realizada. Resultados: os participantes reconhecem a amamentação como a dieta ideal para seus filhos, no entanto, apontam a falta de informação sobre a amamentação e defendem uma orientação mais completa e verdadeira. Diversas circunstâncias comprometem a amamentação e tornam a amamentação desagradável em termos de sensação física.As mulheres destacam o papel da mãe e da avó como principal fonte de apoio e informação, diferentemente do pessoal de saúde. Considerações finais: a educação em lactação humana deve ser fortalecida. O pessoal de saúde deve aumentar seu papel e presença para promover o aleitamento materno exclusivo.

Objective: explore the experiences and beliefs about exclusive breastfeeding of mothers who come to a public hospital for nutritional consultation. Methods: a qualitative study was carried out in the city of Soledad de Graciano Sánchez, Mexico. 31 lactating mothers participated in four focus groups. Analysis of conventional content was carried out. Results: the participants recognize breastfeeding as the ideal diet for their children, however, they point out the lack of information on breastfeeding and they advocate a more complete and truthful orientation. Various circumstances compromise breastfeeding and make breastfeeding unpleasant in terms of physical sensation. Women highlight the role of the mother and grandmother as the main source of support and information unlike the health personnel. Final consideration: the education in human lactation should be strengthened. Health personnel should increase their role and presence to promote exclusive breastfeeding.

Toe Brachial Pressure Index as Alternative Method to Correlate Arteriosclerotic Disease in Type 2 Diabetes.

AIM: To investigate the association between the ankle brachial pressure index and toe brachial pressure index with the findings of carotid Doppler ultrasonography in patients with diabetes and coronary ischaemic disease. METHODS AND RESULTS: The objective was to evaluate the relationship between insulin resistance and serum homocysteine in subjects with polycystic ovarian syndrome (PCOS). CONCLUSION: We studied 81 type 2 diabetic patients, with established cardiovascular disease, consecutively admitted to our outpatient clinic in the Division of Diabetes of La Paz Hospital. We collected clinic and demographic data, ABI and TBI were measured and at the same time a carotid Doppler ultrasound was performed. Multiple linear regression analysis was used to investigate the association of ABI and TBI with carotid disease. We found a negative correlation between TBI and internal carotid artery peak systolic velocity (ICA PSV) (r = -0,300, p= 0,007), common carotid artery resistance index (CCA RI) (r = -0,232, p= 0,038) and intima-media thickness (IMT) (r -0,236, p=0,035). Toe blood pressure and ICA PSV showed an inverse association (r=- 0,226, p=0,042). Adjusting for clinical and demographic characteristic, only low TBI index is associated with a higher ICA PSV.

Cervical cancer cells suppress effector functions of cytotoxic T cells through the adenosinergic pathway.

BACKGROUND: The expression of CD73 in tumor cells plays a significant role in the production of adenosine (Ado) that suppresses antitumor effector cells. METHODS: In this study we analyzed the capability of HPV-positive (HPV+) cervical cancer (CeCa) cell lines CaSki, SiHa, HeLa, and RoVa; and HPV-negative (HPV-) cell lines C33A and ViBo to produce Ado and inhibit effector functions of CD8+ T cells. RESULTS: HPV+ CeCa cells expressed significantly higher levels of CD73 in the membrane (p<0.01) than HPV- CeCa cells and this expression was associated with the production of larger amounts of Ado (>400µM) compared to HPV-CeCa cells (<200µM) in the presence of AMP, as well asa stronger inhibition of (>50%) proliferation, activation, and cytotoxic activity of CD8+ T cells via interaction with A2A adenosine receptor. We also provide evidence that silenced E6/E7 expression in CeCa cells, strongly reduced its CD73 expression level and its capability to generate Ado. CONCLUSION: This results suggest that HPV infection, which is associated with more than 99% of CeCa cases, may present an increased constitutive expression of CD73 in cervical neoplasia to contribute to the suppression of the immune response mediated by the production of large amounts of Ado.

Desarrollo embrionario del pargo colorado Lutjanus colorado (Jordan & Gilbert, 1882) / Embryonic development of pargo colorado Lutjanus colorado (Jordan & Gilbert, 1882)

El pargo colorado (Lutjanus colorado) es una especie con un alto valor comercial en el mercado mexicano, con potencial para su cultivo. Hasta la fecha no existen estudios sobre su reproducción, cultivo larvario y engorda en cautiverio. El presente trabajo es el primer reporte sobre la descripción a detalle del desarrollo embrionario de la especie bajo condiciones de cultivo. Los huevos fertilizados viables del pargo colorado son pelágicos, esféricos, transparentes y con una sola gota de aceite. Midieron 0,77±0,09 mm de diámetro y la gota de aceite 0,14±0,01 mm. La primera división ocurrió a las 0,05 horas post fertilización (HPF). La eclosión se llevó a cabo a las 17,22 HPF bajo las condiciones del presente estudio. Las larvas recién eclosionadas midieron 1,8±0,1 mm de longitud total (LT). El desarrollo embrionario de esta especie fue similar a la descrita para especies de la misma familia. Los resultados del presente estudio aportan información básica para iniciar el desarrollo de la biotecnología para la producción de semilla de esta especie a escala comercial.

The Colorado snapper (Lutjanus colorado) is one of the most commercially important fish species in México and it is considered a suitable candidate for culture. Until now, no research has been carried out on its reproduction, larviculture and fattening in captivity. This study is the first description of embryonic development of this species under controlled conditions. Fertilized eggs of Colorado snapper are pelagic, spherical and transparent and contain one drop of oil. Eggs measured 0.77±0.09 mm and the drop of oil 0.14±0.01 mm. First cell division occurred at 0.05 h post-fertilization (HPF), hatching at 17.22 HPF under the above described conditions. Larvae total length (LT) was 1.8±0.1 mm. Embryonic development of this species was similar to other lutjanidae species. These results provide basic information for developing the necessary biotechnology for commercial seed production of the Colorado snapper.

Effects of refractive index changes on four-wave mixing bands in Er-doped photonic crystal fibers pumped at 976 nm.

An experimental study of the effects of an auxiliary 976 nm pump signal on the four-wave mixing parametric bands generated with a 1064 nm pump in a normal dispersion Er-doped photonic crystal fiber is presented. The four-wave mixing signal and idler bands shift to shorter and longer wavelengths, respectively, with increasing 976 nm pump power. It is shown that the wavelength-dependent resonant refractive index change in the erbium-doped core under 976 nm pumping is at the origin of the effect.

Valor predictivo del índice tobillo-brazo, el índice dedo-brazo y la presión arterial del dedo en el paciente con diabetes / Predictive value of ankle brachial index, toe brachial index and toe arterial pressure in patients with diabetes

Introducción: La enfermedad vascular periférica es muy frecuente en pacientes con diabetes. Objetivos: Evaluar, en el paciente diabético, la utilidad del índice tobillo-brazo, el índice dedo-brazo y la presión arterial del dedo para predecir el riesgo de aparición de un evento vascular en las extremidades inferiores. Material y métodos: Se evaluaron 123 pacientes diabéticos. Se midieron el índice tobillo-brazo (ITB), el índice dedo-brazo (IDB) y la presión arterial (PA) del primer dedo del pie. Se compararon los valores medios de los parámetros en los pacientes con y sin evento. Se analizó su valor predictivo y la contribución independiente de cada uno. Resultados: Los valores medios de ITB, IDB y PA en el primer dedo fueron menores en los pacientes con evento vascular. La isquemia por ITB, la isquemia por IDB y el menor valor de PA en el primer dedo aumentaron el riesgo de presentar un evento vascular. Se demostraron, como predictores independientes, la isquemia por ITB y la PA del dedo. Conclusiones: Se demuestra la utilidad del IDB, el ITB y la PA del dedo a la hora de predecir el mayor riesgo de aparición de un evento vascular en las extremidades inferiores en el paciente con diabetes, presentando un valor predictivo independiente el ITB y la PA del dedo (AU)

Introduction: Patients with diabetes have a higher frequency of vascular peripheral disease. Objective: To evaluate, in patients with diabetes, the usefulness of the ankle brachial index, the toe brachial index and the toe blood pressure to predict the risk of later appearance of a vascular event in lower extremities. Material and methods: We measured the ankle brachial index (ITB), the toe brachial index (IDB) and the toe blood pressure in 123 patients with diabetes. We compared the mean value of these parameters between patients with and without vascular event. We analyzed the predictive value of this parameters and the independent contribution of each one of them. Results: The mean value of ITB, IDB and toe blood pressure were signifi cantly lower in patients who had a vascular event. The patients with ischemia by ITB, ischemia by IDB and with lower value of toe blood pressure have an increased risk of presenting a vascular event. Only ischemia by ankle brachial index and toe blood pressure were independent predictors of later appearance of a vascular event. Conclusions: The usefulness of ankle brachial index, toe brachial index and toe blood pressure to predict a vascular event in patients with diabetes had been demonstrated. In addition, ankle brachial index and toe arterial pressure have and independent predictive value (AU)

La automonitorización glucémica en los pacientes con diabetes tipo 2 no tratados con insulina, ¿es una técnica apropiada para todos los pacientes? / Capillary blood glucose monitoring in non-insulin treated patients with type 2 diabetes. Is that technique appropriate for all patients?

No hay un criterio unánime en la literatura médica acerca del beneficioque aporta el autoanálisis glucémico en el control metabólico(valorado por la HbA1c) en los pacientes diabéticos no tratados coninsulina. Nuestra experiencia en el seguimiento de un grupo pequeñode pacientes que, tras sufrir un episodio coronario, se incorporana un programa educativo parece que se decanta a favor del autoanálisis,observándose una mejoría más importante en la HbA1c deaquellos pacientes que lo realizan. Sin embargo, entre los profesionalessí existe unanimidad respecto a la necesidad de sistematizarmétodos de enseñanza adaptados a programas concretos que demuestrenempíricamente su eficacia.Los programas de educación terapéutica en diabetes incorporan el autoanálisisglucémico como una herramienta de apoyo para el aprendizaje,pues permite a las personas comprender, asumir y, sobre todo,experimentar la relación directa entre sus hábitos de vida y sus glucemias.De esta manera, desarrollan habilidades y estrategias que les permitenel autocontrol del tratamiento, tanto en alimentación como en larealización de ejercicio físico, o en los cambios en la medicación oral

There is no unanimous consensus in medical literature regarding the benefits of glucose self-monitoring in the metabolic control (evaluatedaccording to the HbA1c) in patients with non-insulin treated diabetes.Our experience in the follow-up of a small group of patients that, aftersuffering a coronary episode, joined an educational programme wouldappear to support the process of self-monitoring, fi nding a more significant improvement in the HbA1c of those patients who followed theprogramme. Nevertheless, there is unanimous consensus among professionalsregarding the need to systematise teaching methods adaptedto specifi c programmes that empirically prove its effectiveness.The therapeutic education programmes on diabetes include glucoseself-monitoring as a support tool for patient education, since it helpspeople to understand, to come to terms with and, above all, to experience,the direct relationship between their lifestyle habits and theirblood sugar levels. Like that, they develop skills and strategies thatmake it possible for them to self-monitor the treatment, both in termsof diet as well as physical exercise, or in terms of changes in the oral medication (AU)

Effect of hypo- and hypersaline conditions on osmolality and Na+/K+-ATPase activity in juvenile shrimp (Litopenaeus vannamei) fed low- and high-HUFA diets.

Fatty acid composition of cellular membranes can modify permeability and can modulate the activity of Na(+)/K(+)-ATPase. Although highly unsaturated fatty acids (HUFA) improve survival and osmoregulatory capacity to low salinities in penaeid shrimp, the possible mechanisms have not been established. For this purpose the influence of HUFA supplementation in diet (2.9 vs. 34% HUFA proportion to total fatty acids) on osmoregulatory responses of juvenile Litopenaeus vannamei submitted to an acute (15 h) or chronic exposure (21 days), to low (5 g L(-1)) and high salinities (50 g L(-1)) was analyzed. Shrimp fed the high-HUFA diet, had higher concentration of main HUFA (20:5n-3 and 22:6n-3) in polar lipids of gills. Osmotic pressure in hemolymph was significantly affected by salinity in acute (640, 751, 847 mOsm/kg for 5, 30 and 50 g L(-1), respectively), and chronic exposure (645, 713, 814 mOsm/kg), but variations between them were small compared to environmental salinity (206, 832, 1547 mOsm/kg), indicating that osmoregulation was achieved in a matter of hours. An increase in Na(+)/K(+)-ATPase activity was observed only after a chronic exposure to low salinity. Free amino acids (FAA), mainly alanine and arginine, were higher at 30 (control) and 50 g L(-1) in accordance to their role as organic osmolites. Neither osmotic pressure, Na(+)/K(+)-ATPase activity, nor FAA was affected by HUFA supplementation. However, higher water content in gills of shrimp exposed to low salinities was counteracted by increased HUFA content, which could be a result of changes in water permeability of gills. The osmoregulatory capacity of penaeid shrimp to low and high salinities was achieved within 15 h of acclimation and did not depend on HUFA supplementation in the diet.

Characterization of the reactivity of a silica derived from acid activation of sepiolite with silane by 29Si and 13C solid-state NMR.

The mechanism of the reaction between a silica sample coming from acid treatment of sepiolite (denominated Silsep) and an organosilane, namely bis(triethoxysilylpropyl)tetrasulfane (TESPT), has been evaluated by solid state NMR spectroscopy, being compared with the silanization reaction of a commercial silica. The effect of the silane concentration and temperature on the course of the reaction was considered. Experimental results indicate that the silanization reaction is more effective in the case of Silsep, favoring both the reaction of silane molecules with the filler surface and the reaction between neighboring silane molecules. This different behavior is attributed to structural factors, moisture, and number of acid centers on silica surface. Environmental scanning electron microscopy (ESEM) was used to deposit micrometric water drops on the surface of these samples and to evaluate the proportion and distribution of the organophylization process.

Adaptación de la tasa basal frente a dosis elevadas de corticoides en mujer con diabetes pregestacional, embarazo gemelar y tratamiento con infusión subcutánea continua de insulina (ISCI) / Adaptation of the basal rate against elevated glucocorticoid doses in a woman suffering pregestational diabetes, twin pregnancy and therapy with continuous subcutaneous insulin infusion

El tratamiento con corticoides puede alterar el control metabólico de las mujeres gestantes con diabetes. El caso que se presenta corresponde al de una mujer con diabetes pregestacional en tratamiento con ISCI que, tras la inyección de 2 dosis de 12 mg betametasona vía im (cada 12 h) para maduración del pulmón fetal, necesitó una adaptación de la tasa basal de insulina de la bomba de infusión. La tasa basal de insulina fue modificada en todos los periodos previamente programados, triplicando las tasas después de aplicada la primera dosis de corticoides durante las 24 h siguientes, duplicándolas el segundo día y aumentando 0,1 UI/hora el tercer y cuarto días. El incremento de insulina que supuso la nueva pauta fue de 39,5 UI/24 h el primer día, 19,75 UI/24 h el segundo, y 2,4 UI/24 h el tercer y cuarto días. Los valores de glucemia media logrados en los 4 días siguientes de las inyecciones de corticoides fueron 152, 99, 108, y 116 mg/dl (65-206), encontrándose más del 75% de las mediciones en un rango aceptable de entre 60 a 140 mg/dl. Falta saber si los buenos resultados obtenidos son reproducibles en el resto de gestantes con diabetes tipo 1 que sigan terapia con ISCI

Corticoid treatment can alter the metabolic control of pregnant women with diabetes. The reported case describes a woman with pregestational diabetes under CSII therapy, who needed an adaptation of basal rate of the insulin pump after the i.m. injection of two doses of 12 mg beclametasone (t.i.d) administered to accelerate fetal lung maturation. The basal rate was modified in each of the previously programmed periods, increasing all of them three times during the first 24 h, twice during the second day, and 0.1 IU./h the third and the forth following days. The insulin increment was the first day 39.5 IU./24 h, the second day 19.75 IU./24 h, and 2.4 IU./24 h the ensuing third and forth days. Mean blood glucose values were achieved these days were 152, 99, 108 and 116mg/dl (range 65-206), being more than 75% of determinations in an acceptable range between 60-140 mg/dl. Our recommendation needs also to be confirmed in other type 1 diabetic women treated with CSII who receive corticoids during pregnancy

Risk factors of breast cancer in Mexican women.

OBJECTIVE: To investigate the association between family history (FH) of neoplasia, gyneco-obstetric factors and breast cancer (BC) in a case-control study. In cases, to analyze those variables in relation with early onset of BC, the manner of detection (self-examination, prompted by pain, or casual), the size of tumor, and the elapsed time to seek medical attention. MATERIAL AND METHODS: Data from 151 prevalent BC cases and 235 age-matched controls were analyzed by multiple logistic regression, to assess the influence of BC risk factors. RESULTS: Ten per cent of patients and 1% of controls had first-degree relatives (FDR) with BC. Family history of FDR with BC (OR, 11.2; 95% CI 2.42-51.92) or with gastric or pancreatic cancer (OR, 17.7; 95% CI 2.2-142.6) was associated with BC risk. Breastfeeding at or under 25 years of age was protective against BC (OR, 0.40; 95% CI 0.24-0.66). The manner of tumor detection did not influence its size at the time of diagnosis. CONCLUSIONS: Our study confirms that FH of BC and/or of gastric or pancreatic carcinoma are risk factors for BC, while lactation at 25 years of age or earlier is protective.

Health education goes Hollywood: working with prime-time and daytime entertainment television for immunization promotion.

This article presents an entertainment education strategy used to influence Hollywood prime-time and daytime television programs to add storylines on the importance of immunizations to their shows. Rather than giving information about immunizations to show producers, directors, actors, and writers, we furnished "log lines" and true stories about immunizations that could be used to inspire scripts that included immunization themes. By working through personal contacts within the entertainment television industry's closed system of networks, we were able to gain entree and some airtime for our campaign agenda. Embedded messages aired on eight popular shows in the 1996-1997 broadcast season, with five scheduled to air in the 1997-1998 season. These efforts were evaluated qualitatively, focusing on issues of personal networks, content of aired messages, and comparative costs for paid airtime. The strategy developed can be adapted for a range of entertainment education interventions.

Phenylacetic acid as a phytotoxic compound of corn pollen.

Phenylacetic acid (PAA), one of the phytotoxic compounds in corn (Zea mays) pollen, was identified by GC-MS and by direct comparison with a pure commercial sample of PAA. Bioassays were carried out by testing whole pollen, methylene chloride extract of the pollen, and pure PAA on germination and radical growth ofAmaranthus leucocarpus andEchinochloa crusgalli. The effect of corn pollen was compared with that ofZea mexicana (Teosinte), one of the wild relatives of cultivated maize.