Disorders of Gut-brain Interaction on the US-Mexico Border: A Survey Using Rome IV Criteria.

BACKGROUND: Disorders of gut-brain interaction (DGBI) cause a substantial health burden. Herein we studied the prevalence and characteristics of DGBI and symptoms of bloating/distension in El Paso, Texas on the US-Mexico border, providing a unique opportunity to study the effects of acculturation. METHODS: Subjects from community centers completed the Rome IV questionnaire for DGBI, short acculturation scale for Hispanics questionnaire, and bloating/distention Pictograms. Data were presented as prevalence (95% CI) and compared using χ 2 . RESULTS: Of 216 participants, 197 (127 Hispanics, 90 with English acculturation) were included and 177 completed the Pictograms. Fifty-one [25.9% (20 to 32.6)] subjects fulfilled the criteria for at least one DGBI. Globus and functional dyspepsia were the most common upper DGBI, each in [3.0% (1.1 to 6.5)]. Unspecified functional bowel disorders [8.6% (5.1 to 13.5)], followed by functional abdominal bloating/distention [8.1% (4.7 to 12.9], and irritable bowel syndrome [6.1% (3.2 to 10.4] were the most common functional bowel disorder. Ninety-one (51.4%) reported bloating and/or distension with Pictograms; more frequently in those with DGBI (80.9% vs 40.8%, P < 0.001). Bloating and/or distension were reported by Pictograms in 30% of those not reporting it in the Rome IV Questionnaire. There were no differences based on acculturation or in Hispanics versus non-Hispanics. CONCLUSIONS: On the US-Mexico border, we found a lower prevalence of DGBI than in the US or Mexico. Functional abdominal bloating/distention was more prevalent on the US-Mexico border than in either country. Bloating/distension was more commonly reported with Pictograms than with verbal descriptors. There were no differences between Hispanics and non-Hispanics, suggesting shared environmental/acquired including dietary factors as the underlying mechanisms.

Hipoplasia del lóbulo hepático izquierdo asintomático, hallazgo transquirúrgico, tomográfico y patológico. Presentación de una rara entidad / Asymptomatic Hypoplasia of the Left Hepatic Lobe: Surgical Tomographic and Pathological Findings. Presentation of a Rare Entity

Resumen Antecedentes Las anomalías de la morfología hepática son raras, y se dividen en 2 categorías: las que resultan del desarrollo excesivo de tejido hepático, como el lóbulo de Riedel y otros lóbulos accesorios, y las de desarrollo deficiente del hígado, que incluyen agenesia, hipoplasia y aplasia de los lóbulos hepáticos. Presentación del caso Paciente del sexo masculino de 57 años de edad, sometido a plastia inguinal laparoscópica programada, donde se dio el hallazgo de hipoplasia hepática. Conclusión La hipoplasia hepática es poco frecuente, no presenta síntomas, ni repercusiones clínicas a largo plazo, suele ser un hallazgo incidental durante un estudio de imagen o durante un procedimiento quirúrgico abdominal.

Abstract Background: Abnormalities of liver morphology are rare, divided into two categories: those resulting from overgrowth of liver tissue, such as the Riedel lobe and other accessory lobes, and those with poor liver development include agenesis, hypoplasia and aplasia of the hepatic lobes. Presentation of the case 57-year-old man, subjected to laparoscopic programmed inguinal surgery, finding liver hypoplasia. Conclusions Hepatic hypoplasia is rare, has no symptoms or long-term clinical repercussions, is usually an incidental finding during an imaging study or during an abdominal surgical procedure.

Molecular identification of yeasts from the order Trichosporonales causing superficial infections.

BACKGROUND: The molecular reclassification of the order Trichosporonales placed the medically relevant Trichosporon species into three genera of the family Trichosporonaceae: Cutaneotrichosporon, Trichosporon, and Apiotrichum. From the clinical and epidemiological standpoint, it is important to identify any species of the family Trichosporonaceae because they present different antifungal susceptibility profiles. In Mexico, little is known about trichosporonosis etiology because the fungi are identified through phenotypic methods. AIMS: To identify at a molecular level 12 yeast isolates morfologically compatible with Trichosporon, obtained from patients with superficial infections. METHODS: The yeast isolates were obtained from patients with white piedra, onychomycosis, and hand and foot dermatomycosis, and were identified morphologically and genotypically (sequencing of the IGS1 region and phylogenetic analysis using the Maximum Likelihood Method). The phylogenetic analysis included 40 yeast sequences from the order Trichosporonales and one from Cryptococcus neoformans as outgroup. RESULTS: Based on the molecular analysis, we identified three (25%) Trichosporon inkin isolates, two (16.7%) Trichosporon asteroides, two (16.7%) Cutaneotrichosporon mucoides, and one each (8.3%) of Trichosporon aquatile, Trichosporon asahii, Apiotrichum montevideense, Cutaneotrichosporon cutaneum, and Cutaneotrichosporon jirovecii. CONCLUSIONS: The molecular characterization of the isolates showed a broad diversity of species within the order Trichosporonales, particularly among onychomycosis. It is essential to identify these yeasts at the species level to delve into their epidemiology.

Endoscopic pancreatic necrosectomy in the United States-Mexico border: A cross sectional study.

BACKGROUND: A recent expert panel issued recommendations about the technical aspects of direct endoscopic necrosectomy (DEN) for pancreatic walled-off necrosis (WON). However, significant technical heterogeneity still exists among endoscopists. AIM: To report the outcomes of our DEN technique and how it differs from a recent expert consensus statement and previous studies. METHODS: Medical records of patients with WON who underwent DEN from September 2016 - May 2019 were queried for the following information: Age, gender, ethnicity, etiology of acute pancreatitis, WON location and size, DEN technical information, adverse events (AEs) and outcomes. Adverse events were graded according to the American Society of Gastrointestinal Endoscopy Lexicon grading system. Technical success was defined as adequate lumen apposing metal stent (LAMS) deployment plus removal of ≥ 90% of necrosum. Clinical success was defined as complete resolution of WON cavity by imaging and resolution of symptoms at ≤ 3 months (mo) after last DEN. Data analysis was performed using mean and standard deviation for continuous variables, frequency and proportion for categorical variables, and median and range for interval data. RESULTS: A total of 21 patients underwent DEN. Most of them were Hispanic and their mean age was 51 ± 17 years. The majority of the collections were located in the body of the pancreas and the mean size was 13 cm ± 5 cm. The most common indication was persistent vomiting. Antibiotics were administered only in cases of infected necrosis. All LAMS were placed without radiological guidance, dilated the same day of deployment and removed after a mean of 27 ± 11 d. Routine cross-sectional imaging immediately after drainage was not performed. The mean interval between DEN sessions was 7 ± 4 d and the mean number of DEN/patient was 3 ± 2. Technical and clinical success rates were both 95%. AEs were seen in 5 patients and included: Sepsis (2), stent migration (1), stent maldeployment (1), perforation (1). The sensitivity and positive predictive value of an occluded LAMS leading to sepsis was 50% and 0.11 respectively. No fatalities were observed. CONCLUSION: Our DEN technique differed significantly from the one recommended by a recent expert panel and the one published in previous studies. Despite these differences excellent clinical outcomes were obtained.

COLORECTAL CANCER IN HISPANICS LIVING NEAR THE U.S.-MEXICO BORDER.

BACKGROUND: The incidence of colorectal cancer (CRC) in the US has declined. The decreasing trend is observed in non-Hispanic Whites, Blacks, and Hispanics. However, close analysis of the trends demonstrates that the decline among Hispanics is less than other races/ethnicities. We investigate the burden of CRC in Hispanics living near the U.S.-Mexico border, a subpopulation of Hispanics composed primarily of individuals of Mexican origin. OBJECTIVES: The objective of this study was to investigate and compare incidence rates of CRC in non-Hispanic Whites and Hispanics living in counties along the U.S.-Mexico border. METHODS: Data from the National Institutes of Health National Cancer Institute and State Cancer Profiles were analyzed to obtain CRC incidence rates (per 100,000 population) for persons ≥ 50 years of age residing in counties along the U.S.-Mexico border by race (non-Hispanic White and Hispanic) and gender from 2011 to 2015. RESULTS: Incidence rates of CRC in Hispanic men ≥ 50 years of age, living in counties along the U.S.-Mexico border, were higher than the national average for Hispanic men of similar age. In contrast, the incidence of CRC declined or remained stable in non-Hispanic Whites and women. CONCLUSIONS: Our study unveils a significant disparity in CRC incidence among Hispanics living near the U.S.-Mexico border, disproportionally affecting men ≥ 50 years of age. Socioeconomic and cultural/lifestyle factors are likely contributing to these disparities.

Colorectal cancer in hispanics living near the U.S. - Mexico Border

Background The incidence of colorectal cancer (CRC) in the US has declined. The decreasing trend is observed in non-Hispanic Whites, Blacks, and Hispanics. However, close analysis of the trends demonstrates that the decline among Hispanics is less than other races/ethnicities. We investigate the burden of CRC in Hispanics living near the U.S.–Mexico border, a subpopulation of Hispanics composed primarily of individuals of Mexican origin. Objectives The objective of this study was to investigate and compare incidence rates of CRC in non-Hispanic Whites and Hispanics living in counties along the U.S.–Mexico border. Methods Data from the National Institutes of Health National Cancer Institute and State Cancer Profiles were analyzed to obtain CRC incidence rates (per 100,000 population) for persons ≥ 50 years of age residing in counties along the U.S.–Mexico border by race (non-Hispanic White and Hispanic) and gender from 2011 to 2015. Results Incidence rates of CRC in Hispanic men ≥ 50 years of age, living in counties along the U.S.–Mexico border, were higher than the national average for Hispanic men of similar age. In contrast, the incidence of CRC declined or remained stable in non-Hispanic Whites and women. Conclusions Our study unveils a significant disparity in CRC incidence among Hispanics living near the U.S.–Mexico border, disproportionally affecting men ≥ 50 years of age. Socioeconomic and cultural/lifestyle factors are likely contributing to these disparities.

[Borrelia Infection in Latin America].

Lyme disease (LD) is a multisystemic inflammatory disease caused by pathogenic spirochetes, belonging to the genospecies complex Borrelia burgdorferi sensu lato (B.b.s.l.). Around the world, distinct species of Ixodes tick vectors transmit different species of Borrelia. Despite the rising recognition and occurrence of tick-borne disease in Latin America, serology has proven to be inconclusive in detecting suspected LD cases. Recently, new B.b.s.l. strains or new related species have been described in Brazil, Uruguay, and Chile. This could explain the lack of confirmatory tests, such as indeterminate Western blots (WBs) and polymerase chain reactions, in detecting suspected LD cases in this region of the world. Future studies will need to determine the extension of novel B.b.s.l. species infections in ticks, reservoirs, and humans in Latin America. The existence of these new Borrelia genomic species should prompt the development of innovative diagnostic and clinical approaches.

Nicotine craving questionnaire (CCN): psychometric properties on Mexican population / Cuestionario de Craving de Nicotina (CCN): propiedades psicométricas en población mexicana

Smoker's craving is one of the most important problems in tobacco cessation treatment. The aim of this study was to elaborate a self report questionnaire to assess smoking urge. Development process was carried out in two parts: construction of items using a natural modified semantic networks method. It was administered to 42 smokers; after that, the first version of the questionnaire was answered by 222 smokers. Internal consistency was obtained and an analysis of discrimination was conducted on the items; then, a factorial analysis with varimax rotation using principal components method was carried out, resulting in 12 items on three factors that explain 76% of the variance and 0.92 Chronbach's alpha.

El craving en fumadores es uno de los problemas principales del tratamiento del tabaquismo. El presente trabajo tuvo como objetivo la elaboración de un cuestionario de autorreporte del deseo de fumar. El proceso de desarrollo se llevó a cabo en dos etapas: construcción de reactivos por medio del método de redes semánticas naturales modificadas, el cual se aplicó a 42 fumadores; posteriormente se aplicó la primera versión del cuestionario a 222 fumadores. Se obtuvo la consistencia interna y se realizó un análisis de discriminación de reactivos; posteriormente se realizó un análisis factorial con rotación ortogonal con un método de componentes principales. Los resultados arrojaron 12 reactivos en tres factores, que explican 76% de la varianza total y un alfa de Chronbach=0.92.

Validation of a cocaine craving questionnaire (CCQ-G) in Mexican population / Cuestionario del craving (apetencia) de cocaína (CCQ-G) en población mexicana

This study aimed for the validation of the General Cocaine Craving Questionnaire (CCQ-G) in Mexican population. To achieve this, the scale was applied by interviewing 233 cocaine users, of which 214 met inclusion criteria for the final analysis. This study's inclusion criterion was: not having a psychotic episode and/or manic or depressive or cognitive damage that could impede adequate test solving. The sample consisted entirely of male participants, aged between 18 and 59 years (M = 27, SD = 9.2). All participants met DSM-IV-TR criteria for substance abuse and dependence. 83% of the sample were polydrug users, but reported cocaine as their main drug of use. 74.8% of the sample reported previously having attended treatment for cocaine dependence. At the time of the study, all of the sample was under residential treatment between their 4th and 12th week and was distributed in 5 different institutions whose treatment model is grounded in the philosophy of Alcoholics Anonymous. After factor analysis was performed, the model was adjusted to three factors. Factor 1 referred to intention to use cocaine, factor 2 expressed desire for cocaine consumption, and factor 3 referred to positive expectancies for cocaine consumption. The instrument showed good internal consistency with an α=.87.

El presente estudio tuvo como objetivo validar en la población mexicana la escala Cocaine Craving Questionnaire General (CCQ-G). Para conseguir tal objetivo, se entrevistó y aplicó la escala a una N = 233 consumidores de cocaína que decidieron participar voluntariamente en el estudio. Los criterios para ingresar al estudio fueron los siguientes: no sufrir un episodio psicótico, maniaco, depresivo o daño cognitivo que impidiera resolver adecuadamente la escala. La muestra estuvo constituida por participantes masculinos, que reunían los criterios del DSM-IV-TR para abuso y dependencia a sustancias, con edades comprendidas entre 18 y 59 años (M=27, SD=9.2). En el momento de las entrevistas estaban bajo tratamiento residencial entre la cuarta y duodécima semanas en cinco diferentes instituciones cuyo tratamiento se basa en el modelo de Alcohólicos Anónimos. El análisis factorial que se realizó señaló que el modelo se ajustaba a tres factores. El Factor 1 hacía referencia a la intención de uso de cocaína; el Factor 2 expresaba deseos de consumo de cocaína; el Factor 3 hacía referencia a las expectativas positivas del consumo de cocaína. El instrumento también mostró una adecuada consistencia interna con un α=.87.

Prenatal impairment of brain serotonergic transmission in infants.

OBJECTIVE: To evaluate whether the free fraction of L-tryptophan (L-Trp) and the N1/P2 component of the auditory evoked potentials (AEPs) are associated with impaired brain serotonin neurotransmission in infants with intrauterine growth restriction (IUGR). STUDY DESIGN: We measured free, bound, and total plasma L-Trp and recorded the N1/P2 component of AEP in a prospective, longitudinal, and comparative study comparing IUGR and control infants. RESULTS: Plasma free L-Trp was increased and the amplitude of N1/P2 component was significantly decreased in IUGR relative to control infants. The free fraction of L-Trp and N1/P2 component had a negative association. CONCLUSIONS: In newborns with IUGR, the changes in measured plasma free fraction of L-Trp and in the amplitude the N1/P2 component of the AEP suggest an inverse association between free L-Trp and components of the AEP. The changes observed in the free fraction of L-Trp and AEP may be causally associated with brain serotonergic activity in utero. In IUGR, epigenetic factors such as stress-induced disturbances in brain serotonin metabolism or serotonergic activity, identifiable by alterations in AEP, influence cerebral sensory cortex development and may be causally associated with serotonin-related disorders in adulthood.

N1/P2 component of auditory evoked potential reflect changes of the brain serotonin biosynthesis in rats.

It is known that L-tryptophan stimulates serotonin synthesis in the brain and serotonergic neuronal activity. Also, the N1/P2 component of auditory evoked potential (AEP) is a good indicator of this activity in the auditory cortex. In the present work, we examined the effect of the L-tryptophan administration on electric activity of the auditory cortex recorded as the N1/P2 component of the AEP in adult male rats. The effect of serotonergic agonists or antagonists was also tested. The results showed that indeed L-tryptophan was able to induce a drastic change in auditory cortex electric activity, reducing very significantly the amplitude of the N1/P2 component of the AEP. Quipazine maleate had a similar effect as L-tryptophan and the serotonergic antagonist spiperone induced an increase in the N1/P2 amplitude. These results show how an isolated nutrient is able to induce significant changes in brain auditory cortical function, through stimulation of serotonin synthesis. Besides, they add evidence about the important role of serotonergic neurotransmission modulating sensory cortical activity and that the N1/P2 component of AEPs represent a useful noninvasive indicator of brain serotonin tone.