Identification of the Genotypes Circulating in the Ecuadorian Population Infected with the Hepatitis C Virus (HCV).

Introduction: The hepatitis C virus (HCV) is responsible for 1.5 million new infections, and around 290 thousand deaths worldwide. 15 to 30% of the patients that go into a chronic phase of the disease will develop cirrhosis or hepatocellular carcinoma within 20 years and is the leading etiology for liver transplantation. HCV genetic characteristics display a remarkable genetic diversity, which divides HCV into 8 genotypes and 67 subgenotypes; the treatment and probability of chronic HCV depend on these genotypes and subgenotypes. In Ecuador, there is no available information regarding HCV genotypes and subgenotypes; therefore, this study aims to provide an overview of the main genotypes circulating in Ecuador. Methods: In a cross-sectional and descriptive study using the Ecuadorian Ministry of Health (MSP) registry of patients already diagnosed with Hepatitis C (HCV) between 2017 and 2019. From 51 patients identified by health ministry, blood samples from a total of 15 subjects (named HCV1 to HCV15) were collected using an appropriate venipuncture technique. Pandemic-related circumstances avoid reaching all patients identified by health ministry. Results: After the amplification of 11 samples from patients living in the Ecuadorian territory, the genotypes of HCV obtained were distributed as follows: 6 samples corresponding to subgenotype 2b (54.5%), 2 samples corresponding to subgenotype 1a (18.2%), 2 samples corresponding to subgenotype 4d (18.2%) and 1 corresponding to sample 1b (9.1%). Conclusion: These results represent the first epidemiological approach to genotype distribution in Ecuador, and it contributes to better management of patients. We emphasize the importance of the development of better strategies from the Healthcare Ministry of Ecuador (MSP) for the identification, treatment and tracking of HCV patients.

Effectiveness of a Lifestyle Change Program on Insulin Resistance in Yaquis Indigenous Populations in Sonora, Mexico: PREVISY.

To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆ = -0.91 and ∆ = -1.29, p ≤ 0.05) and the TyG index (∆ = -0.24 y ∆ = -0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆ = -3.32 and ∆ = -4.89, p ≤ 0.05) and the TyG index (∆ = -0.80 and ∆ = -0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes.

Network Science and Group Fusion Similarity-Based Searching to Explore the Chemical Space of Antiparasitic Peptides.

Antimicrobial peptides (AMPs) have appeared as promising compounds to treat a wide range of diseases. Their clinical potentialities reside in the wide range of mechanisms they can use for both killing microbes and modulating immune responses. However, the hugeness of the AMPs' chemical space (AMPCS), represented by more than 1065 unique sequences, has represented a big challenge for the discovery of new promising therapeutic peptides and for the identification of common structural motifs. Here, we introduce network science and a similarity searching approach to discover new promising AMPs, specifically antiparasitic peptides (APPs). We exploited the network-based representation of APPs' chemical space (APPCS) to retrieve valuable information by using three network types: chemical space (CSN), half-space proximal (HSPN), and metadata (METN). Some centrality measures were applied to identify in each network the most important and nonredundant peptides. Then, these central peptides were considered as queries (Qs) in group fusion similarity-based searches against a comprehensive collection of known AMPs, stored in the graph database StarPepDB, to propose new potential APPs. The performance of the resulting multiquery similarity-based search models (mQSSMs) was evaluated in five benchmarking data sets of APP/non-APPs. The predictions performed by the best mQSSM showed a strong-to-very-strong performance since their external Matthews correlation coefficient (MCC) values ranged from 0.834 to 0.965. Outstanding MCC values (>0.85) were attained by the mQSSM with 219 Qs from both networks CSN and HSPN with 0.5 as similarity threshold in external data sets. Then, the performance of our best mQSSM was compared with the APPs prediction servers AMPDiscover and AMPFun. The proposed model showed its relevance by outperforming state-of-the-art machine learning models to predict APPs. After applying the best mQSSM and additional filters on the non-APP space from StarPepDB, 95 AMPs were repurposed as potential APP hits. Due to the high sequence diversity of these peptides, different computational approaches were applied to identify relevant motifs for searching and designing new APPs. Lastly, we identified 11 promising APP lead candidates by using our best mQSSMs together with diversity-based network analyses, and 24 web servers for activity/toxicity and drug-like properties. These results support that network-based similarity searches can be an effective and reliable strategy to identify APPs. The proposed models and pipeline are freely available through the StarPep toolbox software at http://mobiosd-hub.com/starpep.

Terapia larval, una buena herramienta para el desbridamiento de úlceras complejas / Larval therapy, a good tool for the debridation of complex ulcers

Las úlceras afectan predominante-mente a los miembros inferiores. A nivel mundial representan un impor-tante problema sanitario, en cuanto a su prevalencia, gasto de recursos eco-nómicos y afectación socio funcional de los pacientes, que ven mermada en gran medida su calidad de vida y en ocasiones pueden ser precursoras de una pérdida de la extremidad. En nuestra práctica diaria dispone-mos un amplio abanico de opcio-nes de tratamiento con pomadas y apósitos con diferentes propiedades. Deberemos escoger el más adecua-do en cada caso, en función de la etiología de la úlcera, del aspecto de la misma o de la presencia o no de infección. Para el desbridamiento de úlceras difíciles y complejas la terapia larval resulta útil y efectiva cuando los medios habituales no han sido efectivos, favoreciendo y acelerando el proceso de limpieza de la úlcera con eliminación de la fibrina y del bio-film hasta favorecer su granulación. Pueden utilizarse en úlceras infecta-das con muy buenos resultados, su manejo es sencillo y bien tolerado por el paciente. (AU)

Ulcers predominantly affect the lower limbs. Worldwide, they rep-resent an important health prob-lem, in terms of their prevalence, expenditure of economic resources and socio-functional affectation of patients, who see their quality of life greatly diminished and can some-times be precursors of a loss of the limb.In our daily practice we have a wide range of treatment options to wound care with ointments and dressings with different properties. We must choose the most appropri-ate in each case, depending on the etiology of the ulcer, its appearance or the presence or absence of infec-tion. For the debridement of difficult and complex ulcers, larval therapy is useful and effective when the usual means have not been effective, fa-voring and accelerating the process of cleaning the ulcer with the elim-ination of fibrin and biofilm until it favors granulation. They can be used in infected ulcers with very good results, their handling is simple and well tolerated by the patient. (AU)

Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey.

BACKGROUND: The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico. METHODS: A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling. RESULTS: The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (ß = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (ß = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (ß = -0.14, p = 0.017) were associated with a lower BMI. CONCLUSIONS: The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.

Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study.

Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.

Carbapenem-Resistant Klebsiella pneumoniae: Microbiology Key Points for Clinical Practice.

Carbapenemase-producing Klebsiella pneumoniae strains (Cp-Kpn) represent a challenge for clinical practitioners due to their increasing prevalence in hospital settings and antibiotic resistance. Clinical practitioners are often overwhelmed by the extensive list of publications regarding Cp-Kpn infections, treatment, characteristics, identification, and diagnosis. In this perspective article, we provide key points for clinical practitioners to consider for improved patient management including identification of risk factors and strategies for treatment. Additionally, we also discuss genetic underpinnings of antibiotic resistance, implementation of an antimicrobial stewardship program (ASP), and use of automated systems for detection of Cp-Kpn. Collectively, implementation of such key points would enhance clinical practices through providing practical knowledge to health professionals worldwide.

Prevalence of prediabetes and modifiable factors in an ethnic group of Mexico: the Comcáac Project.

OBJECTIVE: To determine the prevalence of and modifiable factors associated with prediabetes in the Comcáac Indians. DESIGN: Cross-sectional study where prediabetes was defined using fasting plasma glucose, 2 h plasma glucose and glycated Hb (HbA1c). Physical, anthropometric and biochemical measurements, medical record, socio-economic, dietary and physical activity information were collected. The modifiable factors associated with prediabetes were assessed using multiple logistic regression. Settings Comcáac Indian communities of Punta Chueca and El Desemboque, Sonora, Mexico. SUBJECTS: Adults (n 227) aged 20 years or older. RESULTS: The sex- and age-adjusted prevalence (95 % CI) of prediabetes was 47·1 (40·8, 53·5) % in the overall population; age-adjusted prevalence was 47·3 (35·6, 59·0) % in men and 46·7 (39·1, 54·3) % in women. The modifiable factors associated with a risk of prediabetes (OR; 95 % CI) were light-intensity physical activity (per 1 h/week increase: 1·04; 1·01, 1·07) and insulin resistance (homeostasis model assessment of insulin resistance score >6·1 v. <4·1: 4·62; 1·37, 15·51). Increased consumption of a traditional dietary pattern based on fish and seafood, low-fat cereals, fruits and vegetables was a protective factor (0·49; 0·31, 0·79). All variables were modelled together and adjusted for age and sex. CONCLUSIONS: The high prediabetes prevalence found in the Comcáac community is alarming because it represents a large number of people who are at risk for type 2 diabetes. The identification of modifiable factors associated with prediabetes that are specific to this population may be useful for designing effective strategies to prevent prediabetes.

Nutrient-rich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial.

BACKGROUND: At present, it is unknown whether the use of nutrient-rich dairy proteins improves the markers of sarcopenia syndrome. Therefore, our proposal was to investigate whether adding 210 g of ricotta cheese daily would improve skeletal muscle mass, handgrip strength, and physical performance in non-sarcopenic older subjects. SUBJECTS AND METHODS: This was a single-blind randomized clinical trial that included two homogeneous, randomized groups of men and women over 60 years of age. Participants in the intervention group were asked to consume their habitual diet but add 210 g of ricotta cheese (IG/HD + RCH), while the control group was instructed to consume only their habitual diet (CG/HD). Basal and 12-week follow-up measurements included appendicular skeletal muscle mass (ASMM) by dual-energy X-ray absorptiometry, handgrip strength by a handheld dynamometer, and physical performance using the short physical performance battery (SPPB) and the stair-climb power test (SCPT). The main outcomes were relative changes in ASMM, strength, SPPB, and SCPT. RESULTS: ASMM increased in the IG/HD + RCH (0.6±3.5 kg), but decreased in the CG/HD (-1.0±2.6). The relative change between groups was statistically significant (P=0.009). The relative change in strength in both groups was negative, but the loss of muscle strength was more pronounced in CG/HD, though in this regard statistical analysis found only a tendency (P=0.07). The relative change in the balance-test scores was positive for the IG/HD + RCH, while in the CG/HD it was negative, as those individuals had poorer balance. In this case, the relative change between groups did reach statistical significance. CONCLUSION: The addition of 210 g of ricotta cheese improves ASMM and balance-test scores, while attenuating the loss of muscle strength. These results suggest that adding ricotta cheese to the habitual diet is a promising dietetic strategy that may improve the markers of sarcopenia in subjects without a pronounced loss of ASMM or sarcopenia.

Brote de sarampión en Barcelona. Características clínicas y epidemiológicas / Measles outbreak in Barcelona. Clinical and epidemiological characteristics

Introducción El sarampión es una enfermedad altamente contagiosa con reservorio humano exclusivo y frente a la que se dispone de una vacuna con virus atenuados que tiene una elevada efectividad. A partir de un caso importado se produce en Barcelona entre agosto de 2006 y julio de 2007 un brote de sarampión. El objetivo de este trabajo es describir las características clínicas y epidemiológicas de los pacientes atendidos en nuestro centro, de los que se obtuvo confirmación microbiológica. Métodos Estudio descriptivo y retrospectivo en el que se revisan las historias clínicas y los informes de urgencia de los pacientes diagnosticados de sarampión atendidos en nuestro centro durante el mencionado brote. Resultados De 130 declaraciones obligatorias se confirmó el sarampión en 99 casos (edad mediana de 12,4 meses (p25-p75: 9,6-14,4); el 51,4% eran varones). El 74,6% tenía entre 6 y 15 meses. En el 23,6% se documentó que habían recibido la vacuna triple vírica y en el 55,3% que existía un contacto previo conocido. Todos presentaron fiebre (media de 4,3 días [desviación estándar [DE]: 2,2] de evolución), el 82,7% presentaba exantema, el 60,2% presentaba manchas de Koplik y el 59,2% presentaba conjuntivitis. En el 35,7% se realizó alguna exploración complementaria. Las complicaciones más frecuentes fueron la otitis media aguda (20,4%) y la neumonía (15,3%). El 23,5% precisó ingreso hospitalario (estancia media de 6,6 días [DE: 3,6]).Conclusión La movilidad geográfica facilita la reaparición de las enfermedades de baja incidencia. Los lactantes entre 6 y 15 meses fueron el grupo de pacientes más afectados por el brote de sarampión. La gran mayoría de los casos se diagnosticaron con la clínica típica pero, a medida que avanzaba el brote, se diagnosticaron los pacientes con clínica menos específica gracias al contexto epidemiológico(AU)

Introduction Measles is an acute, highly contagious illness that affects humans, the only natural host. Although effective attenuated virus vaccines exist for this disease, outbreaks continue to occur in susceptible subgroups. From August 2006 to July 2007, an outbreak of measles occurred in the Barcelona (Spain) area, resulting from an imported case. The aim of this study was to describe the clinical and epidemiological characteristics of children with microbiologically confirmed measles diagnosed at our hospital. Methods Retrospective, descriptive study. The clinical histories and emergency records of children diagnosed with measles and evaluated at our hospital during the outbreak were analyzed. Results Of the 130 children with suspected measles evaluated, 99 cases were confirmed by laboratory tests. Median age at diagnosis was 12.4 months (25th–75th percentile: 9.6–14.4 months; 74.6% 6–15 months of age) and 51.4% were boys. Among the total, 23.6% of patients had been vaccinated against measles and 55.3% reported previous contact with a confirmed measles case. The most frequent symptoms/signs were fever (100%; mean evolution 4.3 days (standard deviation [SD]: 2.2 days), rash (82.7%), Koplik's spots (60.2%), and red eyes (59.2%). Complementary tests were performed in 35.7% of children. Most common complications were acute otitis media (20.4%) and pneumonia (15.3%). Among the total, 23.5% of patients were hospitalized for a mean duration of 6.6 days (SD: 3.6 days).Conclusion Geographical mobility facilitates the reappearance of diseases having a low incidence. Infants 6–15 months of age were the patient group most highly affected by the measles outbreak. Most cases were diagnosed with typical signs and symptoms of the infection, but as the outbreak advanced, patients were diagnosed based on less specific symptoms because of the epidemiological context (AU)

[Measles outbreak in Barcelona. Clinical and epidemiological characteristics]. / Brote de sarampión en Barcelona. Características clínicas y epidemiológicas.

INTRODUCTION: Measles is an acute, highly contagious illness that affects humans, the only natural host. Although effective attenuated virus vaccines exist for this disease, outbreaks continue to occur in susceptible subgroups. From August 2006 to July 2007, an outbreak of measles occurred in the Barcelona (Spain) area, resulting from an imported case. The aim of this study was to describe the clinical and epidemiological characteristics of children with microbiologically confirmed measles diagnosed at our hospital. METHODS: Retrospective, descriptive study. The clinical histories and emergency records of children diagnosed with measles and evaluated at our hospital during the outbreak were analyzed. RESULTS: Of the 130 children with suspected measles evaluated, 99 cases were confirmed by laboratory tests. Median age at diagnosis was 12.4 months (25th-75th percentile: 9.6-14.4 months; 74.6% 6-15 months of age) and 51.4% were boys. Among the total, 23.6% of patients had been vaccinated against measles and 55.3% reported previous contact with a confirmed measles case. The most frequent symptoms/signs were fever (100%; mean evolution 4.3 days (standard deviation [SD]: 2.2 days), rash (82.7%), Koplik's spots (60.2%), and red eyes (59.2%). Complementary tests were performed in 35.7% of children. Most common complications were acute otitis media (20.4%) and pneumonia (15.3%). Among the total, 23.5% of patients were hospitalized for a mean duration of 6.6 days (SD: 3.6 days). CONCLUSION: Geographical mobility facilitates the reappearance of diseases having a low incidence. Infants 6-15 months of age were the patient group most highly affected by the measles outbreak. Most cases were diagnosed with typical signs and symptoms of the infection, but as the outbreak advanced, patients were diagnosed based on less specific symptoms because of the epidemiological context.

[Trichophyton violaceum: an emerging pathogen]. / Trichophyton violaceum: un patógeno emergente.

Population changes taking place in recent years, such as more frequent travel to endemic areas, immigration, and international adoptions, have all contributed to a resurgence of certain pathogens in our geographical area. This is the case of Trichophyton violaceum. A retrospective review was made of all cases of superficial mycosis caused by T. violaceum in patients receiving in-hospital treatment during the years 2000 to 2006. This microorganism accounted for 18.5% of the 275 dermatophytes isolated during the above-mentioned period. In 96% of T. violaceum infections, the lesion manifested as tinea capitis, and all the patients were foreigners. We report in increase of tinea capitis caused by T. violaceum among pediatric patients that appears to be directly related to immigration.

Trichophyton violaceum: un patógeno emergente / Trichophyton violaceum: an emerging pathogen

Los cambios poblacionales (viajes a zonas endémicas, inmigración o adopciones internacionales) han contribuido al resurgimiento de ciertos patógenos en nuestra área geográfica, como ha ocurrido con Trichophyton violaceum. Se ha hecho una revisión retrospectiva de todas las micosis superficiales por T. violaceum durante los años 2000-2006, que representaron un 18,5% de los 275 dermatofitos aislados en el citado período. El 96% de estos pacientes eran extranjeros con diagnóstico de tinea capitis. Concluimos que el aumento de tinea capitis por T. violaceum en pacientes pediátricos está directamente relacionado con la inmigración (AU)

Population changes taking place in recent years, such as more frequent travel to endemic areas, immigration, and international adoptions, have all contributed to are surgence of certain pathogens in our geographical area. This is the case of Trichophyton violaceum. A retrospective review was made of all cases of superficial mycosis caused by T. violaceum in patients receivingin-hospital treatment during the years 2000 to 2006.This microorganism accounted for 18.5% of the 275 dermatophytes isolated during the above-mentioned period. In 96% of T. violaceum infections, the lesion manifested as tinea capitis, and all the patients were foreigners. We report in increase of tinea capitis caused by T. violaceum among pediatric patients that appears to be directly related to immigration (AU)

Cribado nasal del Staphylococcus aureus en una unidad de hemodialisis / No disponible

No disponible