A numbers game: Mosquito-based arbovirus surveillance in two distinct geographic regions of Latin America.

Aedes mosquitoes, as vectors of medically important arthropod-borne viruses (arboviruses), constitute a major public health threat that requires entomological and epidemiological surveillance to guide vector control programs to prevent and reduce disease transmission. In this study, we present the collaborative effort of one year of mosquito-based arbovirus surveillance in two geographically distinct regions of Latin America (Nicaragua and Ecuador). Adult female mosquitoes were collected using backpack aspirators in over 2,800 randomly selected households (Nicaragua, Ecuador) and 100 key sites (Nicaragua) from eight distinct communities (Nicaragua: 2, Ecuador: 6). A total of 1,358 mosquito female pools were processed for RNA extraction and viral RNA detection using real-time RT-PCR. Ten positive dengue virus (DENV) pools were detected (3 in Nicaragua and 7 in Ecuador), all of which were found during the rainy season and matched the serotypes found in humans (Nicaragua: DENV-1 and DENV-4; Ecuador: DENV-2). Infection rates ranged from 1.13 to 23.13, with the Nicaraguan communities having the lowest infection rates. Our results demonstrate the feasibility of detecting DENV-infected Aedes mosquitoes in low-resource settings and underscore the need for targeted mosquito arbovirus sampling and testing, providing valuable insights for future surveillance programs in the Latin American region.

Diabetes and the fabkin complex: A dual-edged sword.

The Fabkin complex, composed of FABP4, ADK, and NDPKs, emerges as a novel regulator of insulin-producing beta cells, offering promising prospects for diabetes treatment. Our approach, which combines literature review and database analysis, sets the stage for future research. These findings hold significant implications for both diabetes treatment and research, as they present potential therapeutic targets for personalized treatment, leading to enhanced patient outcomes and a deeper comprehension of the disease. The multifaceted role of the Fabkin complex in glucose metabolism, insulin resistance, anti-inflammation, beta cell proliferation, and vascular function underscores its therapeutic potential, reshaping diabetes management and propelling advancements in the field.

Design and Characterization of Ocular Inserts Loaded with Dexamethasone for the Treatment of Inflammatory Ophthalmic Disease.

The short precorneal residence time of ophthalmic drops is associated with their low absorption; therefore, the development of ocular inserts capable of prolonging and controlling the ophthalmic release of drugs is an interesting option in the design and development of these drugs. A surface response design was developed, specifically the Central Composite Design (CCD), to produce ophthalmic films loaded with Dexamethasone (DEX) by the solvent evaporation method having experimental levels of different concentrations of previously selected polymers (PVP K-30 and Eudragit RS100.). Once optimization of the formulation was obtained, the in vivo test was continued. The optimal formulation obtained a thickness of 0.265 ± 0.095 mm, pH of 7.11 ± 0.04, tensile strength of 15.50 ± 3.94 gF, humidity (%) of 22.54 ± 1.7, mucoadhesion strength of 16.89 ± 3.46 gF, chemical content (%) of 98.19 ± 1.124, release of (%) 13,510.71, and swelling of 0.0403 ± 0.023 g; furthermore, in the in vivo testing the number and residence time of PMN cells were lower compared to the Ophthalmic Drops. The present study confirms the potential use of polymeric systems using PVPK30 and ERS100 as a new strategy of controlled release of ophthalmic drugs by controlling and prolonging the release of DEX at the affected site by decreasing the systemic effects of the drug.

Dengue severity by serotype in 19 years of pediatric clinical studies in Nicaragua.

Background: Dengue virus, a major global health threat, consists of four serotypes (DENV1-4) that cause a range of clinical manifestations from mild to severe and potentially fatal disease. Methods: This study, based on 19 years of data from the Pediatric Dengue Cohort Study and Pediatric Dengue Hospital-based Study in Managua, Nicaragua, investigates the influence of serotype and immune status on dengue severity. Study participants 6 months to 17 years old were followed during their hospital stay or as ambulatory patients, with dengue cases confirmed by molecular, serological, and/or virological methods. Results: We enrolled a total of 14071 participants, of whom 2954 (21%) were positive for DENV infection. Of 2425 cases with serotype result by RT-PCR, 541 corresponded to DENV1, 996 to DENV2, 718 to DENV3 and 170 to DENV4. Severe disease was more prevalent among secondary DENV2 and DENV4 cases, while similar disease severity was observed in both primary and secondary DENV1 and DENV3 cases. According to the 1997 World Health Organization (WHO) severity classification, both DENV2 and DENV3 had a higher proportion of severe disease compared to other serotypes, whereas DENV3 had the greatest percentage of severity under the WHO-2009 classification. DENV2 was associated with pleural effusion and low platelet count, while DENV3 correlated with both hypotensive and compensated shock. Conclusions: These findings emphasize the critical need for a dengue vaccine with balanced efficacy against all four serotypes, particularly as existing vaccines show variable efficacy by serotype and immune status, posing challenges for comprehensive protection, particularly in dengue-naïve individuals.

Patient and caregiver perceptions of the possibility of home blood transfusions.

BACKGROUND: Patients with hematologic malignancies (HM) often develop transfusion dependence. The patient and caregiver burdens associated with the need for frequent transfusions are high. Home blood transfusions has the potential to reduce these burdens, but is not widely practiced in the United States. We designed a qualitative study to evaluate the patient and caregiver perceptions of the potential for a home blood transfusion program. STUDY DESIGN AND METHODS: Eligible patients included Adult (≥18 years) patients who were English speaking and met the definition for transfusion dependence within 3 months of study enrollment. We identified and interviewed eligible participants (patients and caregivers), using a semi-structured interview guide to elicit patient perceptions of the acceptability, barriers, and benefits related to home blood product transfusions. Interviews were audio recorded and transcribed. Results were imported into NVivo 12 (version 12; QSR International, Burlington, VT) for coding and analysis. RESULTS: We recruited participants until we reached thematic saturation, which occurred at 29 participants (20 patients, 9 caregivers). Among the 20 patient participants, nine had MDS (45%) and 11 had acute leukemia (55%). Most of the patients (60%) reported getting one transfusion per week. Four themes emerged when the participants discussed their perception regarding the potential of a home blood transfusion program: (1) current in-person experience, (2) caregiver burden, (3) perceptions of home blood transfusions, and (4) interest in participating in a home blood transfusion program. CONCLUSION: The concept of home blood transfusions was well received and further research to study its implementation is warranted.

Primary exposure to Zika virus increases risk of symptomatic dengue virus infection with serotypes 2, 3, and 4 but not serotype 1.

Infection with any of the four dengue virus serotypes (DENV1-4) can protect against or enhance subsequent dengue depending on pre-existing antibodies and the subsequent infecting serotype. Additionally, primary infection with the related flavivirus Zika virus (ZIKV) has been shown to increase DENV2 disease. Here, we measured how prior DENV and ZIKV immunity influenced risk of disease caused by all four serotypes in a pediatric Nicaraguan cohort. Of 3,412 participants in 2022, 10.6% experienced symptomatic DENV infections caused by DENV1 (n=139), DENV4 (n=133), DENV3 (n=54), DENV2 (n=9), or an undetermined serotype (n=39). Longitudinal clinical and serological data were used to define infection histories, and generalized linear and additive models adjusted for age, sex, time since the last infection, cohort year, and repeat measurements were used to predict disease risk. Compared to flavivirus-naïve participants, primary ZIKV infection increased disease risk of DENV4 (relative risk = 2.62, 95% confidence interval: 1.48-4.63) and DENV3 (2.90, 1.34-6.27) but not DENV1 (1.20, 0.72-1.99). Primary DENV infection or a DENV followed by ZIKV infection also increased DENV4 risk. We re-analyzed 19 years of cohort data and demonstrated that prior flavivirus-immunity and pre-existing antibody titer differentially affected disease risk for incoming serotypes, increasing risk of DENV2 and DENV4, protecting against DENV1, and protecting at high titers but enhancing at low titers against DENV3. We thus find that prior ZIKV infection, like prior DENV infection, increases risk of certain DENV serotypes. Cross-reactivity among flaviviruses should be carefully considered when assessing vaccine safety and efficacy.

GWAS of random glucose in 476,326 individuals provide insights into diabetes pathophysiology, complications and treatment stratification.

Conventional measurements of fasting and postprandial blood glucose levels investigated in genome-wide association studies (GWAS) cannot capture the effects of DNA variability on 'around the clock' glucoregulatory processes. Here we show that GWAS meta-analysis of glucose measurements under nonstandardized conditions (random glucose (RG)) in 476,326 individuals of diverse ancestries and without diabetes enables locus discovery and innovative pathophysiological observations. We discovered 120 RG loci represented by 150 distinct signals, including 13 with sex-dimorphic effects, two cross-ancestry and seven rare frequency signals. Of these, 44 loci are new for glycemic traits. Regulatory, glycosylation and metagenomic annotations highlight ileum and colon tissues, indicating an underappreciated role of the gastrointestinal tract in controlling blood glucose. Functional follow-up and molecular dynamics simulations of lower frequency coding variants in glucagon-like peptide-1 receptor (GLP1R), a type 2 diabetes treatment target, reveal that optimal selection of GLP-1R agonist therapy will benefit from tailored genetic stratification. We also provide evidence from Mendelian randomization that lung function is modulated by blood glucose and that pulmonary dysfunction is a diabetes complication. Our investigation yields new insights into the biology of glucose regulation, diabetes complications and pathways for treatment stratification.

Examining health care access disparities in Hispanic populations with peripheral artery disease and diabetes.

INTRODUCTION: This study investigated disparities in health care access for Hispanic adults with diabetes and peripheral artery disease (PAD) who are at risk of lower-extremity amputation and other cardiovascular morbidities and mortalities. METHODS: We utilized the health care access survey data from the All of Us research program to examine adults (⩾ 18 years) with either diabetes and/or PAD. The primary associations evaluated were: could not afford medical care and delayed getting medical care in the past 12 months. Multivariable logistic regression models were used to assess the association of Hispanic ethnicity and survey responses, adjusting for age, sex, income, health insurance, and employment status. RESULTS: Among 24,104 participants, the mean age was 54.9 years and 67% were women. Of these, 8.2% were Hispanic adults. In multivariable analysis, Hispanic adults were more likely to be unable to afford seeing a health care provider, and receiving emergency care, follow-up care, and prescription medications (p < 0.05) than non-Hispanic adults. Furthermore, Hispanic adults were more likely to report being unable to afford medical care due to cost (odds ratios [OR] 1.72, 95% CI 1.50-1.99), more likely to purchase prescription drugs from another country (OR 2.20, 95% CI 1.69-2.86), and more likely to delay getting medical care due to work (OR 1.46, 95% CI 1.22-1.74) and child care (OR 1.80, 95% CI 1.35-2.39) issues than non-Hispanic White adults. CONCLUSION: The Hispanic population with diabetes and PAD faces substantial barriers in health care access, including a higher likelihood of delaying medical care and being unable to afford it.

Perceived importance and interest in research by Chilean primary care providers.

BACKGROUND: Primary care providers (PCPs) are relevant stakeholders for primary care research (PCR). OBJECTIVE: We report the perceived importance and interest in PCR of a national sample of Chilean PCPs. METHODS: We conducted a cross-sectional study targeting Chilean PCPs. An electronic survey assessing perceived relevance of PCR, research training and experience, training interests, and demographics was disseminated through emails and WhatsApp messages. Descriptive statistics were used to summarize data. Logistic regression models were used to estimate adjusted probabilities and 95% confidence intervals for high interest in PCR, high interest in using research methods, and high interest in receiving research training, and predictors of these outcomes. RESULTS: A total of 387 providers completed the online survey. Only 26.4% of PCPs had research experience as a principal or co-investigator. However, most clinicians perceived PCR as very important (92.5%) and were interested in using research methods (90.7%) and receiving training (94.3%). There were no statistically significant differences in these perceptions between provider's discipline, role, sex, age, and geographical location after adjusting for covariates. CONCLUSIONS: Despite few Chilean PCPs have research training, a large majority perceive it as important, are interested in using it in their practice and would like to receive training.

Size structure of the coral Stylophora pistillata across reef flat zones in the central Red Sea.

Demographic analyses offer insight into the state of a population. Here, we surveyed different reef flat zones (exposed, midreef and sheltered) of six reefs over a cross-shelf gradient to characterize the population structure of Stylophora pistillata, a coral species which dominates reef flats in the central Red Sea. Phototransects were conducted at each reef flat zone, and the density of S. pistillata, the planar area of each colony, and the occurrence of partial mortality were calculated using the program ImageJ. Each colony was also assigned a color morph (yellow, purple or mixed colors). Density and mean size were extremely variable, both among reef flat zones and reefs, but overall, both metrics were lower on the midshelf reefs. The yellow color morph accounted for nearly 90% of colonies surveyed and dominated most reef flats assessed, with the exception of one site where 81% of colonies were purple morphs. There were no spatial trends in the percentage of colonies suffering partial mortality, but overall there is a positive correlation with size class and proportion of colonies with partial mortality. Despite few trends emerging from assessing individual parameters, a PERMANOVA analysis revealed differences among reef flat zones in most of the reefs, highlighting the importance of multivariate analysis. The data presented here serve as a baseline for monitoring and may identify possible future demographic changes to this important coral species in a region increasingly affected by bleaching events.

Cryptic in vitro ubiquitin ligase activity of HDMX towards p53 is probably regulated by an induced fit mechanism.

HDMX and its homologue HDM2 are two essential proteins for the cell; after genotoxic stress, both are phosphorylated near to their RING domain, specifically at serine 403 and 395, respectively. Once phosphorylated, both can bind the p53 mRNA and enhance its translation; however, both recognize p53 protein and provoke its degradation under normal conditions. HDM2 has been well-recognized as an E3 ubiquitin ligase, whereas it has been reported that even with the high similarity between the RING domains of the two homologs, HDMX does not have the E3 ligase activity. Despite this, HDMX is needed for the proper p53 poly-ubiquitination. Phosphorylation at serine 395 changes the conformation of HDM2, helping to explain the switch in its activity, but no information on HDMX has been published. Here, we study the conformation of HDMX and its phospho-mimetic mutant S403D, investigate its E3 ligase activity and dissect its binding with p53. We show that phospho-mutation does not change the conformation of the protein, but HDMX is indeed an E3 ubiquitin ligase in vitro; however, in vivo, no activity was found. We speculated that HDMX is regulated by induced fit, being able to switch activity accordingly to the specific partner as p53 protein, p53 mRNA or HDM2. Our results aim to contribute to the elucidation of the contribution of the HDMX to p53 regulation.

Angiotensin II Inhibits Insulin Receptor Signaling in Adipose Cells.

Angiotensin II (Ang II) is a critical regulator of insulin signaling in the cardiovascular system and metabolic tissues. However, in adipose cells, the regulatory role of Ang II on insulin actions remains to be elucidated. The effect of Ang II on insulin-induced insulin receptor (IR) phosphorylation, Akt activation, and glucose uptake was examined in 3T3-L1 adipocytes. In these cells, Ang II specifically inhibited insulin-stimulated IR and insulin receptor substrate-1 (IRS-1) tyrosine-phosphorylation, Akt activation, and glucose uptake in a time-dependent manner. These inhibitory actions were associated with increased phosphorylation of the IR at serine residues. Interestingly, Ang II-induced serine-phosphorylation of IRS was not detected, suggesting that Ang II-induced desensitization begins from IR regulation itself. PKC inhibition by BIM I restored the inhibitory effect of Ang II on insulin actions. We also found that Ang II promoted activation of several PKC isoforms, including PKCα/ßI/ßII/δ, and its association with the IR, particularly PKCßII, showed the highest interaction. Finally, we also found a similar regulatory effect of Ang II in isolated adipocytes, where insulin-induced Akt phosphorylation was inhibited by Ang II, an effect that was prevented by PKC inhibitors. These results suggest that Ang II may lead to insulin resistance through PKC activation in adipocytes.

Biomechanics Assessment of Kinematic Parameters of Low-Sprint Start in High-Performance Athletes Using Three Dimensional Motion Capture System

ABSTRACT In a sprint start, the athlete takes up a position with their hands just behind a line, arms vertical, feet generally placed about a shoe length apart, and the hips rising above the line of the head. Mistakes in this position influence the execution of the low-sprint start, and can drastically influence the initial running speed and acceleration achieved by the athlete. Common mistakes occur due to the misconception that athletes must also lean forward, bringing the shoulders ahead of their hands and putting pressure on them. A standard approach to identify sprint start mistakes is to use a stick or weighted string to drop down from the shoulders. The effective implementation of this approach depends on the coach's experience and remains a significant challenge. In this study, a three-dimensional motion capture system with the Vicon® Plug-in-Gait model was used to characterize the kinematic parameters that influence the execution of low-sprint start in six high-performance athletes. The main kinematic parameters are reaction time, stride length, and stride time. The obtained results demonstrate the potential utility of a three-dimensional motion capture system to assess the kinematic parameters of low-sprint start in high-performance athletes.

Regulation of miRNAs Expression by Mutant p53 Gain of Function in Cancer.

The p53 roles have been largely described; among them, cell proliferation and apoptosis control are some of the best studied and understood. Interestingly, the mutations on the six hotspot sites within the region that encodes the DNA-binding domain of p53 give rise to other very different variants. The particular behavior of these variants led to consider p53 mutants as separate oncogene entities; that is, they do not retain wild type functions but acquire new ones, namely Gain-of-function p53 mutants. Furthermore, recent studies have revealed how p53 mutants regulate gene expression and exert oncogenic effects by unbalancing specific microRNAs (miRNAs) levels that provoke epithelial-mesenchymal transition, chemoresistance, and cell survival, among others. In this review, we discuss recent evidence of the crosstalk between miRNAs and mutants of p53, as well as the consequent cellular processes dysregulated.

Violencia laboral entre el personal de enfermería y su relación con la calidad del cuidado en hospitales públicos / Workplace Violence among Nursing Staff and Their Relationship with the Quality of Care in Public Hospitals

Introducción: La violencia laboral entre el personal de enfermería en hospitales constituye un problema de salud pública, afectando de manera indirecta la calidad del cuidado. Objetivo: Determinar la relación de violencia laboral entre el personal de enfermería y la calidad del cuidado en hospitales públicos. Métodos: Estudio descriptivo correlacional y transversal, realizado en dos hospitales públicos de México durante agosto y septiembre de 2017. La muestra fue de 161 enfermeros y 117 pacientes. Se utilizaron el Barómetro Cisneros y el Caring Assessment Instrument para medir las variables de interés; se obtuvieron medias, desviación estándar y frecuencias para datos descriptivos, el coeficiente de correlación de Spearman y coeficientes de Contingencia y Chi cuadrada para determinar la relación. Resultados: Predominó el sexo femenino (85,70 por ciento), con una media de edad de 35,67 años, 45,90 por ciento), trabajaban en el turno nocturno, 79,40 por ciento), de los participantes refirió no haber experimentado violencia laboral, la evaluación inequitativa fue la estrategia de violencia laboral más frecuente. Respecto a los pacientes, más de la mitad reportó calidad en el cuidado. El Coeficiente de Correlación de Spearman no mostró significancia estadística (p > 0,05). Conclusión: El personal de enfermería no se encuentra familiarizado con la conceptualización de violencia laboral, por lo que es probable que la mayoría la haya experimentado y por temor a represalias, no la reportara(AU)

Introduction: Workplace violence among nursing personnel in hospitals constitutes a public health problem, indirectly affecting the quality of care. Objective: To determine the relationship of workplace violence among nursing staff and the quality of care in public hospitals. Methods: á Descriptive, correlational and cross-sectional study was carried out in two public hospitals in Mexico from August to September 2017. The sample consisted of 161 nurses and 117 patients. We used Cisneros Barometer and the Caring Assessment Instrument to measure the variables of interest; means, standard deviation and frequencies were obtained for descriptive data, Spearman's correlation coefficient and Contingency coefficients and Chi squared to determine the relationship. Results: Female predominated (85.70 percent)), with a mean age of 35.67 years, 45.90 percent worked the night shift, 79.40 percent),),of the participants referred not having experienced workplace violence, inequitable evaluation was the most frequent workplace violence strategy. Regarding patients, more than 50 percent), reported quality of care. The Spearman Correlation Coefficient did not show statistical significance (p> 0.05). Conclusion: Nursing staff are not familiar with the conceptualization of workplace violence, so it is likely that the majority have experienced it, but did not report it, for fear of reprisals(AU)

Transporters, TBC1D4, and ARID5B Variants to Explain Glycated Hemoglobin Variability in Patients with Type 2 Diabetes.

INTRODUCTION: Genetic variants could aid in predicting antidiabetic drug response by associating them with markers of glucose control, such as glycated hemoglobin (HbA1c). However, pharmacogenetic implementation for antidiabetics is still under development, as the list of actionable markers is being populated and validated. This study explores potential associations between genetic variants and plasma levels of HbA1c in 100 patients under treatment with metformin. METHODS: HbA1c was measured in a clinical chemistry analyzer (Roche), genotyping was performed in an Illumina-GSA array and data were analyzed using PLINK. Association and prediction models were developed using R and a 10-fold cross-validation approach. RESULTS: We identified genetic variants on SLC47A1, SLC28A1, ABCG2, TBC1D4, and ARID5B that can explain up to 55% of the interindividual variability of HbA1c plasma levels in diabetic patients under treatment. Variants on SLC47A1, SLC28A1, and ABCG2 likely impact the pharmacokinetics (PK) of metformin, while the role of the two latter can be related to insulin resistance and regulation of adipogenesis. CONCLUSIONS: Our results confirm previous genetic associations and point to previously unassociated gene variants for metformin PK and glucose control.

Apoyo en redes sociales y factores de riesgo de sobrepeso y obesidad en adolescentes / Social network support and risk factors for obesity and overweight in adolescents

Objetivo: Determinar la relación entre el apoyo social en redes sociales y factores de riesgo de sobrepeso u obesidad, tomando en cuenta estilos de vida saludable y barreras percibidas en adolescentes. Método: Estudio descriptivo y correlacional de corte transversal con adolescentes de una preparatoria pública de Nuevo León, México. Se realizaron mediciones antropométricas para obtener el índice de masa corporal, conductuales para barreras percibidas en alimentación saludable y actividad física, además de estilos de vida saludables. Resultados: Participaron 188 adolescentes, predominó el sexo masculino con 55,9%. La edad media fue de 16,1 años. El 52,1% tuvo sobrepeso, menos de la mitad de los adolescentes reportó contar con sus amigos en redes sociales (37,8%). El 52% de los participantes con exceso de peso necesita cambios en su alimentación y la mayoría reportó actividad física baja (82,7%). Se observa una correlación entre apoyo social en redes sociales y barreras percibidas de actividad física en adolescentes con exceso de peso (r2 0,144; p < 0,05). Conclusiones: La mayoría de los adolescentes no llevan una dieta adecuada ni realizan actividad física recomendada, una de las principales causas es la falta de motivación como barrera percibida. Las redes sociales constituyen una herramienta para que el personal de enfermería coadyuve en la promoción de la salud y lleve a cabo intervenciones dirigidas a prevenir la enfermedad en un contexto global en transición hacia lo digital.(AU)

Aim: To determine the relationship between social support in social networks and risk factors of overweight and obesity including healthy lifestyles and perceived barriers in adolescents. Method: Descriptive and cross-sectional study with adolescents from a public high school in Nuevo León, Mexico. Anthropometric measurements were determined to obtain body mass index, behavioural measurements for perceived barriers to healthy eating and physical activity, as well as healthy lifestyles. Results: A total of 188 adolescents participated, male sex predominated at 55.9%, mean age was 16.1 years. From them, 52.1% were overweight, less than half of the adolescents reported having friends on social networks (37.8%); 52% of overweight participants need changes in their diet and the majority reported low physical activity (82.7%). There is a correlation between social support in social networks and perceived barriers to physical activity in overweight adolescents (r2 0.144; p < 0.05). Conclusions: Most of the adolescents do not have an adequate diet or perform recommended physical activity, one of the main causes is lack of motivation as a perceived barrier. Social networks represent a tool for nursing staff to promote health and develop interventions aimed at preventing disease in a global context in digital transition.(AU)

Factors associated with influenza vaccination acceptance in Mexican healthcare workers: A multicenter cross-sectional study.

Adherence of healthcare workers (HCWs) to influenza vaccination is far from optimal despite its being the most effective intervention for preventing influenza. In order to evaluate factors associated with influenza vaccination acceptance among Mexican HCWs during the 2017-2018 influenza season, a multicenter cross-sectional study spanning public and private hospitals was conducted. Participants were consecutively invited to answer a self-administered questionnaire. A total of 1513 out of 1553 questionnaires were evaluated. The median age of the participants was 32 (26-44) years and 65.8% were women. Nurses and physicians comprised 53.0% of the surveyed population. Total self-reported adherence to influenza vaccination among HCWs during the 2017-2018 season was 63.5% and varied across participating hospitals (P < 0.001). Factors positively associated with influenza vaccination were incremental doses of influenza vaccine received within the last 5 years (aOR = 1.94, 95% CI = 1.78-2.10), City 3 (aOR = 1.62, 95% CI = 1.19-2.20) and City 1 (aOR = 1.39, 95% CI = 1.02-1.91), whereas factors negatively associated were lack of a previous dose of influenza vaccine (aOR = 0.03, 95% CI = 0.01-0.08) and unawareness of the vaccination campaign (aOR = 0.57, 95% CI = 0.44-0.72). Lack of information and poor communication were barriers identified by both vaccinated and unvaccinated personnel. This study concluded that adherence to influenza vaccination in Mexican HCWs is suboptimal and that the factors associated with receipt of influenza vaccine are similar to those reported in other studies.

Asociación entre obesidad y tasa de filtración glomerular en población con hipertensión arterial / Association between obesity and glomerular filtration rate in a population with arterial hypertension

Introducción: La obesidad tiene consecuencias para el sistema de salud por su asociación con la morbimortalidad y la afectación de la calidad de vida. A nivel individual genera proteinuria y glomeruloesclerosis, que aceleran la disminución de la filtración glomerular.Objetivo:Determinar la asociación entre obesidad y tasa de filtración glomerular en población con hipertensión arterial.Material y método:Estudio descriptivo de corte transversal, que analizó la obesidad y filtración glomerular en 3.197 pacientes con hipertensión arterial de una institución de primer nivel de atención. Se revisaron historias clínicas obteniendo variables sociodemográficas, antropométricas, parámetros clínicos, y clasificación de la enfermedad renal crónica.Resultados:La población tuvo un promedio de edad de 64±12,47 años, y en su mayoría fueron del sexo femenino (70,58%). La prevalencia de obesidad grado I fue (26,11%), grado II (9,63%) y grado III (4,56%). Los obesos tuvieron una mediana de la tasa de filtrado glomerular superior comparado con los no obesos, pero dicha diferencia solo fue observada en los estadios de ERC I y II.Conclusión:Existe asociación entre obesidad e incremento de la tasa de filtrado glomerular solamente en estadios I y II. El perímetro abdominal, la tensión arterial no controlada y el LDL fueron variables que influyen en el promedio de la tasa de filtrado glomerular, pero tienen un comportamiento diferente por grado de enfermedad renal crónica. (AU)

Introduction: Obesity has consequences for the health system due to the association with morbidity and mortality and the effect on quality of life. At the individual level, obesity generates proteinuria and glomerulosclerosis that accelerate the decrease in glomerular filtration.Objective:To determine the association between obesity and glomerular filtration rate in a population with arterial hypertension.Methodology:A descriptive cross-sectional study that analyzed obesity and glomerular filtration in 3,197 patients with arterial hypertension from a first-level care institution. Medical records were reviewed obtaining sociodemographic and anthropometric variables, clinical parameters, and classification of chronic kidney disease.Results:The population had an average age of 64 years (SD 12.47), and the majority were female (70.58%). The prevalence of obesity grade I was (26.11%), grade II (9.63%) and grade III (4.56%). Obese had a median rate of glomerular filtration superior compared to non-obese, but this difference was observed only in stages I and grade II grade.Conclusion:There is an association between obesity and an increase in the glomerular filtration rate only in stages I and II. Abdominal circumference, uncontrolled blood pressure and LDL were variables that influence the average glomerular filtration rate, having a different behavior by degree of chronic kidney disease. (AU)