Effect of Insulin Resistance on Abdominal Obesity, Liver Fat Infiltration, and Body Mass Index in Youngsters.

AIM: Evaluate insulin resistance (IR) as a mediator of the effect of body fat distribution on liver fat infiltration and stiffness (LSt) in young adults using structural equation modeling (SEM). METHODS: We invited 500 first year students from two universities and evaluated their family history to determine the risk for cardiometabolic disease. Of these, 174 students (age 19 ± 1 years) were assessed for total body fat percentage (BF%), LSt, fat infiltration (Coefficient attenuated parameter CAP), and serum biochemical analysis. We performed a mediation analysis using two different structural equation models to determine the relationship between BMI, BF%, abdominal obesity (AO), IR, LSt, and fat infiltration using standardized ß coefficients. The symbol "->" means "explains/causes". RESULTS: Model#1 supported that mediation analysis and had a better fit than the direct effect. AO->IR (b = 0.62, p = 0.005), AO->CAP (b = 0.63, p <0.001), and CAP->IR (b = 0.23, p = 0.007), with negligible effect of BMI on CAP and IR. Model#2 showed direct effect of BMI on LSt was a better fit than mediation. BMI->LSt (b = 0.17, p = 0.05) but no effect AO->LSt. Interestingly, LSt->IR (b = 0.18, p = 0.001), but bi-directional IR->LSt (b = 0.23, p = 0.001). CONCLUSIONS: AO and BMI in young adults have differential phenotypic effects on liver CAP and LSt. Visceral fat had a direct effect on IR and CAP. Meanwhile, BMI was associated with LSt. Our findings shed light on the complex interplay of factors influencing liver stiffness, particularly in young individuals. Further research is needed to elucidate the precise mechanisms underlying these associations and their implications for liver health.

Clinical Efficacy of SARS-CoV-2 Vaccination in Hemodialysis Patients.

Introduction: The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, there are currently limited data on the clinical efficacy of vaccinations in the hemodialysis population. Methods: A national multicenter observational cohort was performed in Chile to evaluate the clinical efficacy of anti-SARS-CoV-2 vaccination in end-stage renal disease patients on chronic hemodialysis from February 2021 to August 2021. In addition, the BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines were evaluated. The efficacy of vaccination in preventing SARS-CoV-2 infection, hospitalizations, and deaths associated with COVID-19 was determined. Results: A total of 12,301 patients were evaluated; 10,615 (86.3%) received a complete vaccination (2 doses), 490 (4.0%) received incomplete vaccination, and 1196 (9.7%) were not vaccinated. During follow-up, 1362 (11.0%) patients developed COVID-19, and 150 died (case fatality rate: 11.0%). The efficacy of the complete vaccination in preventing infection was 18.1% (95% confidence interval [CI]:11.8-23.8%), and prevention of death was 66.0% (95% CI:60.6-70.7%). When comparing both vaccines, BNT162b2 and CoronaVac were effective in reducing infection and deaths associated with COVID-19. Nevertheless, the BNT162b2 vaccine had higher efficacy in preventing infection (42.6% vs. 15.0%) and deaths (90.4% vs. 64.8%) compared to CoronaVac. Conclusion: The results of our study suggest that vaccination against SARS-CoV-2 in patients on chronic hemodialysis was effective in preventing infection and death associated with COVID-19.

Looking for Crumbs in the Obesity Forest: Anti-obesity Interventions and Obesity-Associated Cardiometabolic Traits in the Mexican Population. History and Systematic Review With Meta-Analyses.

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthesizes the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without an inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, covering alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting metabolism-associated traits such as BMI, weight, waist circumference, triglycerides, glucose, among others. Only the studies with at least 3 months of treatment were included in the meta-analyses in order to reduce placebo effects. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43 national, and 2 multinational-collaborative studies. Most of the national studies had small sample sizes, and the implemented strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium-to-high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like pure water instead of sweet beverages decrease triglycerides and systolic blood pressure. Dark chocolate showed the highest effect for BMI and high blood pressure, and treatment with insulin increased weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different cardiometabolic associated traits, which should be analyzed in detail in the population living near the Mexico-U.S. border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020221436, identifier: CRD42020221436.

Species abundance and temporal variation of arbovirus vectors in Brownsville, Texas / Abundancia de especies y variación temporal de los vectores de arbovirus en Brownsville, Texas

The recent outbreaks of the dengue fever and West Nile viruses and the looming threats of the Zika and chikungunya viruses highlight the importance of establishing effective, proactive arboviral surveillance in communities at high risk of transmission, such as those on the Texas– Mexico border. Currently, there are no approved human vaccines available for these mosquito-borne diseases, so entomological control and case management are the only known methods for decreasing disease incidence. The principal vectors, which include Culex quinquefasciatus, Aedes aegypti, and Ae. Albopictus, all have an established presence in South Texas. The public health response to most arbovirus outbreaks in the region has been reactionary rather than proactive. However, after the 2005 dengue outbreak and subsequent fatality, the City of Brownsville Public Health Department began collecting data on mosquito vector abundance and incidence. The objective of this study was to describe the various species of mosquitoes found in vector surveillance in Brownsville, Texas, during 2009–2013; quantify their prevalence; and identify any associations with temporal or weather-related variations. The results confirm a significant mosquito population in Brownsville in late winter months, indicating a high risk of arbovirus transmission in South Texas year-round, and not just until November, previously considered the end date of arbovirus season by state health services. The data from Brownsville’s surveillance program can help characterize local vector ecology and facilitate more proactive mitigation of future arboviral threats in South Texas.

Los últimos brotes de los virus del dengue y del Nilo Occidental y la inminente amenaza del virus del Zika y el chikunguña ponen de relieve la importancia de instaurar un sistema eficaz y proactivo de vigilancia de los arbovirus en las comunidades expuestas a un riesgo alto de transmisión, como las ubicadas en la frontera entre Texas y México. Actualmente no se dispone de ninguna vacuna humana aprobada contra estas enfermedades transmitidas por mosquitos, de manera que el control entomológico y el manejo de los casos son los únicos métodos conocidos para reducir la incidencia de estas enfermedades. Está comprobada la presencia de los princi-pales vectores, entre los que se cuentan las especies Culex quinquefasciatus, Aedes aegypti y Ae. albopictus, en la zona sur de Texas. La respuesta de salud pública a la mayoría de los brotes de arbovirus en la región ha sido reactiva en lugar de proactiva. Sin embargo, después del brote de dengue registrado en el 2005 y dada su letalidad, el Departamento de Salud Pública de la Ciudad de Brownsville empezó a recopilar datos sobre la abundancia de los mosquitos vectores y la incidencia de las enfermedades que transmi-ten. El objetivo de este estudio fue describir las diversas especies de mos-quitos encontrados mediante la vigilancia de vectores realizada en Brownsville (Texas) entre los años 2009 y 2013, cuantificar su prevalencia y determinar si hay alguna relación con las variaciones temporales o climáti-cas. Los resultados confirman que Brownsville tiene una población signifi-cativa de mosquitos en los últimos meses del invierno, lo que indica un alto riesgo de transmisión de arbovirus en la zona sur de Texas durante todo el año y no solo hasta noviembre, mes en el que los servicios de salud del estado solían considerar que culminaba la temporada de arbovirus. Los datos del programa de vigilancia de Brownsville pueden ayudar a caracte-rizar la ecología local de los vectores y propiciar una mitigación más proac-tiva de las futuras amenazas arbovirales en la zona sur de Texas.

Organic Compounds Detected in Deciduous Teeth: A Replication Study from Children with Autism in Two Samples.

Biological samples are an important part of investigating toxic exposures and disease outcomes. However, blood, urine, saliva, or hair can only reflect relatively recent exposures. Alternatively, deciduous teeth have served as a biomarker of early developmental exposure to heavy metals, but little has been done to assess organic toxic exposures such as pesticides, plastics, or medications. The purpose of our study was to determine if organic chemicals previously detected in a sample of typically developing children could be detected in teeth from a sample of children with autism. Eighty-three deciduous teeth from children with autism spectrum disorders (ASD) were chosen from our tooth repository. Organic compounds were assessed using liquid chromatography tandem mass spectrometry and gas chromatography methods. Consistent with a prior report from Camann et al., (2013), we have demonstrated that specific semivolatile organic chemicals relevant to autism etiology can be detected in deciduous teeth. This report provides evidence that teeth can be useful biomarkers of early life exposure for use in epidemiologic case-control studies seeking to identify differential unbiased exposures during development between those with and without specific disorders such as autism.

Socioeconomic context and the food landscape in Texas: results from hotspot analysis and border/non-border comparison of unhealthy food environments.

PURPOSE: The purpose of this paper is to describe the food landscape of Texas using the CDC's Modified Retail Food Environment (mRFEI) and to make comparisons by border/non-border. METHODS: The Modified Retail Food Environment index (mRFEI (2008)) is an index developed by the CDC that measures what percent of the total food vendors in a census track sell healthy food. The range of values is 0 (unhealthy areas with limited access to fruits and vegetables) to (100-Healthy). These data were linked to 2010 US Census socioeconomic and ethnic concentration data. Spatial analysis and GIS techniques were applied to assess the differences between border and non-border regions. Variables of interest were mRFEI score, median income, total population, percent total population less than five years, median age, % receiving food stamps, % Hispanic, and % with a bachelor degree. RESULTS: Findings from this study reveal that food environment in Texas tends to be characteristic of a "food desert". Analysis also demonstrates differences by border/non-border location and percent of the population that is foreign born and by percent of families who receive food stamps. CONCLUSIONS: Identifying the relationship between socioeconomic disparity, ethnic concentration and mRFEI score could be a fundamental step in improving health in disadvantage communities, particularly those on the Texas-Mexico border.

Concerns about contraceptive side effects among young Latinas: a focus-group approach.

To identify perceptions and attitudes about contraceptive side effects in young, low-income Latina adolescents through focus-group conversations. We conducted seven focus-group discussions with Latino females in an outpatient clinic and community setting. Qualitative methodology was used to analyze data. Participants were recruited from the outpatient gynecology clinic at the University of Illinois at Chicago, and from the Easter Seals Day Care Center. Women were recruited if they were Latino and between the ages of 18 and 26 years (N = 40). Participants cited both perceptions of side effects as well as personal experience with side effects as reasons for not using or discontinuing the use of contraception. Women also demonstrated incorrect knowledge about contraception, and tended to value anecdotal information over information from health professionals. These factors led to reliance on less-effective methods of contraception, placing participants at risk for unintended pregnancy. Concern about side effects, fear of health consequences and misinformation were identified as barriers to effective contraceptive use in young, low-income Latinas. Providers caring for this population should address potential concerns about side effects of contraception as well as assess patients' understanding in light of cultural and language barriers.

Aspectos electrocardiográficos y ecocardiográficos de la miocardiopatía hipertrófica en edad pediátrica / Electrocardiography and echocardiography in juvenily hypertrophic myocardiopathy

La miocardiopatía hipertrófica (MCH) es una alteración heterogénea de causas múltiples, caracterizada por hipertrofia asimétrica del ventrículo izquierdo y/o derecho e histopatológicamente por desorganización de las fibras miocárdicas. Con la finalidad de conocer sus características electrocardiográficas y ecocardiográficas en pacientes en edad pediátrica, se realizó un estudio retrolectivo de 1986 a 1995. Se encontraron 24 casos con MCH: 15 fueron del sexo femenino y 8 del masculino con edad promedio de 6 años (1 mes a 17 años). En 6 casos había antecedentes familiares de MCH. Las manifestaciones clínicas fueron: disnea (71 por ciento); síncope (42 por ciento) y palpitaciones (42 por ciento). A la exploración física, en todos los pacientes existió soplo aórtico de tipo expulsivo, soplo regurgitante mitral en 42 por ciento y signos de insuficiencia cardiaca global en 54 por ciento. La radiografía de tórax evidenció cardiomegalia en 71 por ciento e hipertensión venocapilar en 42 por ciento. Las alteraciones electrocardiográficas más frecuentes fueron: prolongación del tiempo de inicio de la deflexión intrinsicoide en las derivaciones correspondientes a la región afectada, Q limpias y más o menos profundas en aVF, aVL, V5 y V6 y trastornos del ritmo de tipo supraventricular en 11 enfermos (46 por ciento) con y sin insuficiencia cardiaca. Por ecocardiograma bidimensional, se confirmó la existencia de hipertrofia anteroseptal en los 24 pacientes. El tratamiento fue médico en el 83 por ciento y quirúrgico en los restantes. Se observó una mortalidad del 17 por ciento. La MCH es un padecimiento raro en la edad pediátrica, la mortalidad se incrementa con la presencia de insuficiencia cardiaca y trastornos del ritmo. El tratamiento debe individualizarse.

A case of pleomorphic lipoma of the hypopharynx

Se describe aquí el primer caso de un lipoma pleomórfico de la faringe en un hombre de 69 años quien acudió por disfagia y tos de 12 años de evolución. En la laringo-faringoscopía se observó una neoplasia submucosa de color amarillo, polipoide y de límites bien definidos. En la tomografía era hipodensa y midió 3 cm. Histológicamente estuvo compuesta por tejido adiposo maduro, bandas de tejido conectivo y células gigantes pleomórficas, algunas con aspecto en roseta. No se observaron lipoblastos ni mitosis. Seis meses después de la resección no hubo evidencia de recurrencia