Mutational Dynamics Related to Antibiotic Resistance in M. tuberculosis Isolates from Serial Samples of Patients with Tuberculosis and Type 2 Diabetes Mellitus.

Genetic variation in tuberculosis is influenced by the host environment, patients with comorbidity, and tuberculosis-type 2 diabetes mellitus (TB-T2DM) and implies a higher risk of treatment failure and development of drug resistance. Considering the above, this study aimed to evaluate the influence of T2DM on the dynamic of polymorphisms related to antibiotic resistance in TB. Fifty individuals with TB-T2DM and TB were initially characterized, and serial isolates of 29 of these individuals were recovered on day 0 (diagnosis), 30, and 60. Genomes were sequenced, variants related to phylogeny and drug resistance analyzed, and mutation rates calculated and compared between groups. Lineage X was predominant. At day 0 (collection), almost all isolates from the TB group were sensitive, apart from four isolates from the TB-T2DM group showing the mutation katG S315T, from which one isolate had the mutations rpoB S450L, gyrA A90G, and gyrA D94G. This pattern was observed in a second isolate at day 30. The results provide a first overview of the dynamics of mutations in resistance genes from individuals with TB-T2DM, describing an early development of resistance to isoniazid and a rapid evolution of resistance to other drugs. Although preliminary, these results help to explain the increased risk of drug resistance in individuals with TB and T2DM.

[Risk factors for metabolic dysfunction-associated fatty liver disease in the Hispanic-Mexican population.] / Factores de riesgo de la enfermedad hepática grasa asociada a disfunción metabólica en población hispano-mexicana.

OBJECTIVE: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a poor attended disease, which has gained attention due the elevated number of cases in countries as Mexico, where the incidence is the number 4th globally. MAFLD develops in obese or overweighted individuals and is characterized by triglycerides accumulation in the liver, this condition can develop to hepatocellular carcinoma. It has been observed that MAFLD depends on the genetics and lifestyle. Due to the high prevalence of this disease among Hispanic population, we focused on this study in the characteristics and prevalence of MAFLD in Mexican patients. METHODS: In this study were included 572 overweighted and obese patients, who underwent a screening analysis using the fatty liver index (IHG), clinical parameters were analysed, demographic and comorbidities. Frequency of variables were obtained, and the data were analysed by Chi-square test or Fisher test, odd ratio (OR) and binary logistic regression. RESULTS: A MALFD prevalence of 37% were obtained, where the history of familiar obesity, paracetamol usage, carbohydrate and fat intake are shown to be risk factors. It was found that high blood pressure, central obesity and hypertriglyceridemia were also associated to the MAFLD development. On the other hand, physical exercise was a protector factor. CONCLUSIONS: Our results show the necessity to study the MAFLD causalities in Mexican patients, focused on the paracetamol intake.

OBJETIVO: La enfermedad hepática grasa asociada a disfunción metabólica (MAFLD) es una enfermedad poco considerada, que ha recibido atención debido al número de casos en países como México, donde ocupa el 4º lugar mundial de incidencia. La MAFLD se desarrolla en personas con sobrepeso u obesidad y se caracteriza por la acumulación de triglicéridos en el hígado, donde puede evolucionar hacia carcinoma hepatocelular. Se ha observado que la MAFLD depende de la genética y del estilo de vida. Tomando en cuenta la alta prevalencia de MAFLD en la población hispana, nos enfocamos en este trabajo en estudiar la prevalencia y características relacionadas con esta enfermedad en pacientes mexicanos. METODOS: En este estudio se incluyeron 572 pacientes con sobrepeso u obesidad, a los cuales se les realizó un análisis de cribado mediante el índice de hígado graso (IHG), se analizaron parámetros clínicos, demográficos y comorbilidades. Se obtuvieron frecuencias de las variables y se analizaron los datos mediante chi cuadrado o exacta de Fisher, razón de momios (OR) y regresión logística binaria. RESULTADOS: Se obtuvo una prevalencia del 37% de MAFLD, donde la historia familiar de obesidad, el uso de paracetamol, así como el consumo de carbohidratos y grasas fueron factores de riesgo para su desarrollo. Se encontró que la hipertensión arterial, la obesidad visceral y la hipertrigliceridemia también estaban asociados al desarrollo de la MAFLD. Por otro lado, el ejercicio fue un factor protector. CONCLUSIONES: Nuestros resultados ponen de manifiesto la necesidad de realizar estudios relacionados con las causalidades de la MAFLD en los pacientes mexicanos, principalmente en el uso del paracetamol.

Efficacy of nutrition therapy with food rich in methionine for treating nonalcoholic fatty liver / Eficacia de la terapia nutricional con alimentos ricos en metionina para el tratamiento de hígado graso no alcohólico

Non-Alcoholic Fatty Liver disease (NAFLD) can lead to Non Alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. The treatment for NAFLD involves modification of caloric intake and physical activity. NAFLD has a pro-oxidant nature; therefore, it is logical to suppose that the antioxidant methionine can be used as a treatment for this disease. Aim. This study aimed to evaluate the effect of high-methionine dietary therapy on patients with NAFLD. Materials and methods. A randomized clinical study was conducted over three months. In this study, 121 NAFLD patients participated, and the age of the participants was ≥ 20 years (experimental group included 56 and control group 65), all of whom were randomized and matched by sex, recluted from the ISSSTE hospital in Xalapa, Mexico. The patients were instructed to consume food to cover the recommended methionine daily doses, and the daily amount consumed was calculated. Methionine effect was measured as NAFLD regression and quality of life improvement. Results. Nutritional therapy induced NAFLD regression and diminished central fat accumulation, blood pressure, and the fatty liver index. Some parameters, such as liver enzymes, did not changed. The quality of life of patients improved after treatment. Conclusions. In this study, we show a hepatoprotective effect induced only in three months of chances in the diet, thus, a longer diet may generate more relevant benefits in the resistant parameters of our study(AU)

La enfermedad del hígado graso no alcohólico (NAFLD) puede conducir a la esteatohepatitis no alcohólica (NASH), la cirrosis y el cáncer de hígado. El tratamiento para NAFLD es la modificación de la ingesta calórica y la actividad física. Debido a que NAFLD tiene una naturaleza pro-oxidante; es lógico suponer que el antioxidante metionina puede utilizarse en el tratamiento de esta enfermedad. Objetivo. el presente trabajo evaluó el papel de la terapia nutricional con alimentos ricos en metioninaen pacientes con NAFLD. Materiales y Métodos. Se realizó un ensayo clínico aleatorizado durante tres meses. Participaron en el estudio 121 pacientes con NAFLD con edad ≥ 20 años (56 en el grupo experimental y 65 en el control), todos aleatorizados y pareados por sexo, reclutados de la Clínica Hospital ISSTE en la ciudad de Xalapa, México, en el año 2015. Se instruyó a los pacientes en consumir los alimentos hasta completar la dosis diaria recomendada de metioninay se calculó la cantidad diaria consumida. Su efecto se midió como la regresión de NAFLD y la mejora de la calidad de vida. Resultados. La terapia nutricional retrocedió NAFLD; disminuyó la acumulación de grasa central, la presión arterial y el índice de hígado graso. Algunos parámetros, como las enzimas de la función hepática, no se modificaron con el tratamiento. Otro parámetro fue la mejora de la calidad de vida de los pacientes tratados. Conclusiones. En este trabajo mostramos un impacto hepatoprotector producido con tan solo tres meses de cambios en la dieta, por lo que una dieta más prolongada podría generar beneficios aún más significativos en los parámetros resistentes en nuestro protocolo(AU)

Factores de riesgo de la enfermedad hepática grasa asociada a disfunción metabólica en población hispano-mexicana / Risk factors for metabolic dysfunction-associated fatty liver disease in the Hispanic-Mexican population

FUNDAMENTOS: La enfermedad hepática grasa asociada a disfunción metabólica (MAFLD) es una enfermedad poco considerada,que ha recibido atención debido al número de casos en países como México, donde ocupa el 4º lugar mundial de incidencia. La MAFLDse desarrolla en personas con sobrepeso u obesidad y se caracteriza por la acumulación de triglicéridos en el hígado, donde puedeevolucionar hacia carcinoma hepatocelular. Se ha observado que la MAFLD depende de la genética y del estilo de vida. Tomando encuenta la alta prevalencia de MAFLD en la población hispana, nos enfocamos en este trabajo en estudiar la prevalencia y características relacionadas con esta enfermedad en pacientes mexicanos. MÉTODOS: En este estudio se incluyeron 572 pacientes con sobrepeso u obesidad, a los cuales se les realizó un análisis de cribadomediante el índice de hígado graso (IHG), se analizaron parámetros clínicos, demográficos y comorbilidades. Se obtuvieron frecuenciasde las variables y se analizaron los datos mediante chi cuadrado o exacta de Fisher, razón de momios (OR) y regresión logística binaria. RESULTADOS: Se obtuvo una prevalencia del 37% de MAFLD, donde la historia familiar de obesidad, el uso de paracetamol, así comoel consumo de carbohidratos y grasas fueron factores de riesgo para su desarrollo. Se encontró que la hipertensión arterial, la obesidadvisceral y la hipertrigliceridemia también estaban asociados al desarrollo de la MAFLD. Por otro lado, el ejercicio fue un factor protector. CONCLUSIONES: Nuestros resultados ponen de manifiesto la necesidad de realizar estudios relacionados con las causalidades dela MAFLD en los pacientes mexicanos, principalmente en el uso del paracetamol.(AU)

BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a poor attended disease, which has gained at-tention due the elevated number of cases in countries as Mexico, where the incidence is the number 4 th globally. MAFLD developsin obese or overweighted individuals and is characterized by triglycerides accumulation in the liver, this condition can develop tohepatocellular carcinoma. It has been observed that MAFLD depends on the genetics and lifestyle. Due to the high prevalence of thisdisease among Hispanic population, we focused on this study in the characteristics and prevalence of MAFLD in Mexican patients. METHODS: In this study were included 572 overweighted and obese patients, who underwent a screening analysis using the fatty liverindex (IHG), clinical parameters were analysed, demographic and comorbidities. Frequency of variables were obtained, and the data wereanalysed by Chi-square test or Fisher test, odd ratio (OR) and binary logistic regression. RESULTS: A MALFD prevalence of 37% were obtained, where the history of familiar obesity, paracetamol usage, carbohydrate andfat intake are shown to be risk factors. It was found that high blood pressure, central obesity and hypertriglyceridemia were alsoassociated to the MAFLD development. On the other hand, physical exercise was a protector factor. CONCLUSIONS: Our results show the necessity to study the MAFLD causalities in Mexican patients, focused on the paracetamol intake.(AU)

[Adaptation and validation of EMPODERA-TB to evaluate empowerment of patients with pulmonary tuberculosisAdaptação e validação do instrumento EMPODERA-TB para avaliar o empoderamento em pacientes com tuberculose pulmonar]. / Adaptación y validación del instrumento EMPODERA-TB para evaluar el empoderamiento en pacientes con tuberculosis pulmonar.

Objective: Adapt and validate EMPODERA-TB in order to measure empowerment of patients with pulmonary tuberculosis (TB). Methods: An instrument initially designed to measure empowerment of patients with chronic diseases was adapted and validated to measure empowerment of patients with tuberculosis. The items applicable to patients with tuberculosis were selected and adapted. Validation was performed using exploratory and confirmatory factor analysis, and internal consistency was determined using Cronbach's alpha coefficient, based on data from a sample of 49 patients of Mexican origin diagnosed with pulmonary tuberculosis. Results: The instrument comprised 19 items grouped into three dimensions: knowledge acquisition, information-sharing skills, and decision-making skills. Acceptable goodness-of-fit was observed (SRMR: 0.124; CD: 0.999); internal consistency for the three dimensions was 0.878, 0.879, and 0.808, respectively, and for the instrument overall it was 0.885. Conclusions: The instrument showed acceptable goodness-of-fit and adequate internal consistency, making it possible to measure empowerment of patients with pulmonary tuberculosis. This instrument will be useful in TB clinical practice and epidemiology in Spanish-speaking Latin American countries. It will allow implementation of strategies that improve knowledge and adherence to treatment, interactions with patients or individuals at risk of infection, and development of prevention strategies.

Objetivo: Adaptar e validar o instrumento EMPODERA-TB para medir o empoderamento em pacientes com tuberculose pulmonar. Métodos: Um instrumento elaborado inicialmente para medir o empoderamento em pacientes com doenças crônicas foi adaptado e validado para medir o empoderamento em pacientes com tuberculose. Para tanto, foram selecionados e adaptados os itens aplicáveis aos pacientes com tuberculose. A validação foi realizada por meio de análise fatorial exploratória e confirmatória, e a consistência interna foi analisada por meio do coeficiente alfa de Cronbach, com base em dados de uma amostra de 49 pacientes de origem mexicana com diagnóstico de tuberculose pulmonar. Resultados: O instrumento foi composto por 19 itens, agrupados em três dimensões: aquisição de conhecimento, habilidade de compartilhar informações e habilidade para a tomada de decisão. Observou-se um ajuste aceitável (SRMR: 0,124; CD: 0,999), enquanto a consistência interna para as dimensões foi de 0,878, 0,879 e 0,808, respectivamente, e para o instrumento como um todo foi de 0,885. Conclusões: O instrumento apresentou índices de bondade de ajuste aceitáveis e consistência interna adequada; portanto, permite mensurar o empoderamento em pacientes com tuberculose pulmonar. Este instrumento será útil para a prática clínica e epidemiológica da tuberculose nos países latino-americanos de língua espanhola, e permitirá a implementação de estratégias que melhorem o conhecimento e a adesão ao tratamento, bem como a interação com pacientes ou indivíduos em risco de contágio e, portanto, o estabelecimento de estratégias de prevenção.

Adaptación y validación del instrumento EMPODERA-TB para evaluar el empoderamiento en pacientes con tuberculosis pulmonar

[RESUMEN]. Objetivo. Adaptar y validar el instrumento EMPODERA-TB para medir el empoderamiento en pacientes con tuberculosis pulmonar. Métodos. Se adaptó y validó un instrumento, diseñado inicialmente para medir el empoderamiento en pacien- tes con enfermedades crónicas, para medir el empoderamiento en pacientes con tuberculosis. Para ello, se seleccionaron y adaptaron los ítems aplicables a los pacientes con tuberculosis. La validación se realizó mediante análisis factorial exploratorio y confirmatorio, y la consistencia interna mediante el coeficiente alfa de Cronbach, con base en los datos de una muestra de 49 pacientes de origen mexicano con diagnóstico de tuberculosis pulmonar. Resultados. El instrumento se integró por 19 ítems agrupados en tres dimensiones: adquisición de conoci- mientos, habilidades para compartir información y para la toma de decisiones. Se observó un ajuste aceptable (SRMR: 0,124; CD: 0,999), mientras que la consistencia interna para las dimensiones fue de 0,878; 0,879 y 0,808, respectivamente, y para el instrumento completo fue de 0,885. Conclusiones. El instrumento mostró índices de ajuste de bondad aceptables y consistencia interna adecuada, por lo que permite medir el empoderamiento en pacientes con tuberculosis pulmonar. Este instru- mento será de utilidad en la práctica clínica y epidemiología de tuberculosis en países latinoamericanos de habla hispana, y permitirá implementar estrategias que mejoren el conocimiento y el apego al tratamiento, así como la interacción con pacientes o individuos en riesgo de contagio y, con ello, establecer estrategias de prevención.

[ABSTRACT]. Objective. Adapt and validate EMPODERA-TB in order to measure empowerment of patients with pulmonary tuberculosis (TB). Methods. An instrument initially designed to measure empowerment of patients with chronic diseases was adapted and validated to measure empowerment of patients with tuberculosis. The items applicable to patients with tuberculosis were selected and adapted. Validation was performed using exploratory and confirmatory factor analysis, and internal consistency was determined using Cronbach's alpha coefficient, based on data from a sample of 49 patients of Mexican origin diagnosed with pulmonary tuberculosis. Results. The instrument comprised 19 items grouped into three dimensions: knowledge acquisition, informa- tion-sharing skills, and decision-making skills. Acceptable goodness-of-fit was observed (SRMR: 0.124; CD: 0.999); internal consistency for the three dimensions was 0.878, 0.879, and 0.808, respectively, and for the instrument overall it was 0.885. Conclusions. The instrument showed acceptable goodness-of-fit and adequate internal consistency, making it possible to measure empowerment of patients with pulmonary tuberculosis. This instrument will be useful in TB clinical practice and epidemiology in Spanish-speaking Latin American countries. It will allow implementa- tion of strategies that improve knowledge and adherence to treatment, interactions with patients or individuals at risk of infection, and development of prevention strategies.

[RESUMO]. Objetivo. Adaptar e validar o instrumento EMPODERA-TB para medir o empoderamento em pacientes com tuberculose pulmonar. Métodos. Um instrumento elaborado inicialmente para medir o empoderamento em pacientes com doenças crônicas foi adaptado e validado para medir o empoderamento em pacientes com tuberculose. Para tanto, foram selecionados e adaptados os itens aplicáveis aos pacientes com tuberculose. A validação foi realizada por meio de análise fatorial exploratória e confirmatória, e a consistência interna foi analisada por meio do coeficiente alfa de Cronbach, com base em dados de uma amostra de 49 pacientes de origem mexicana com diagnóstico de tuberculose pulmonar. Resultados. O instrumento foi composto por 19 itens, agrupados em três dimensões: aquisição de conhe- cimento, habilidade de compartilhar informações e habilidade para a tomada de decisão. Observou-se um ajuste aceitável (SRMR: 0,124; CD: 0,999), enquanto a consistência interna para as dimensões foi de 0,878, 0,879 e 0,808, respectivamente, e para o instrumento como um todo foi de 0,885. Conclusões. O instrumento apresentou índices de bondade de ajuste aceitáveis e consistência interna adequada; portanto, permite mensurar o empoderamento em pacientes com tuberculose pulmonar. Este instrumento será útil para a prática clínica e epidemiológica da tuberculose nos países latino-americanos de língua espanhola, e permitirá a implementação de estratégias que melhorem o conhecimento e a adesão ao tratamento, bem como a interação com pacientes ou indivíduos em risco de contágio e, portanto, o estabelecimento de estratégias de prevenção.

Generation and persistence of S1 IgG and neutralizing antibodies in post-COVID-19 patients.

BACKGROUND: Antibody-mediated immune response plays an important role in protection against reinfection. In the case of SARS-CoV-2 infection, the maximum duration of antibody response is still unknown. In this work, the generation of neutralizing  antibodies (NAbs) and IgG antibodies against the S1 subunit (S1 IgG ) of SARS-CoV-2 and their possible duration were determined through decay models. METHODS: 132 participants with SARS-CoV-2 infection were classified according to the severity of the disease. Seroconversion and persistence of S1 IgG antibodies and NAbs were determined by ELISA, samples were taken at two different times post-infection and duration of those antibodies was estimated using Linear Mixed Models (LMMs). RESULTS: The highest amount of S1 IgGs antibodies was associated with age (41 years or older), greater severity of COVID-19 and male gender. NAbs production was associated with the same variables, except for age. The percentage of NAbs decay is higher in the asymptomatic group (P = 0.033), while in S1 IgG antibodies decay, no statistical difference was found between the 4 severity groups. An exponential decay model was built by using a LMM and similarly, two dispersion regions where constructed. The duration of S1 IgG antibodies was 744 days (668-781) for first region and 744 days (453-1231) for the second. Regarding NAbs, an adaptative LMM was used to model a logistic function, determining a duration of 267 days (215-347). CONCLUSION: Humoral immunity to SARS-CoV-2 infection depends on the severity of the disease, gender and age. This immune response could be long-lasting as for other coronaviruses.

Adaptación y validación del instrumento EMPODERA-TB para evaluar el empoderamiento en pacientes con tuberculosis pulmonar / Adaptation and validation of EMPODERA-TB to evaluate empowerment of patients with pulmonary tuberculosis / Adaptação e validação do instrumento EMPODERA-TB para avaliar o empoderamento em pacientes com tuberculose pulmonar

RESUMEN Objetivo. Adaptar y validar el instrumento EMPODERA-TB para medir el empoderamiento en pacientes con tuberculosis pulmonar. Métodos. Se adaptó y validó un instrumento, diseñado inicialmente para medir el empoderamiento en pacientes con enfermedades crónicas, para medir el empoderamiento en pacientes con tuberculosis. Para ello, se seleccionaron y adaptaron los ítems aplicables a los pacientes con tuberculosis. La validación se realizó mediante análisis factorial exploratorio y confirmatorio, y la consistencia interna mediante el coeficiente alfa de Cronbach, con base en los datos de una muestra de 49 pacientes de origen mexicano con diagnóstico de tuberculosis pulmonar. Resultados. El instrumento se integró por 19 ítems agrupados en tres dimensiones: adquisición de conocimientos, habilidades para compartir información y para la toma de decisiones. Se observó un ajuste aceptable (SRMR: 0,124; CD: 0,999), mientras que la consistencia interna para las dimensiones fue de 0,878; 0,879 y 0,808, respectivamente, y para el instrumento completo fue de 0,885. Conclusiones. El instrumento mostró índices de ajuste de bondad aceptables y consistencia interna adecuada, por lo que permite medir el empoderamiento en pacientes con tuberculosis pulmonar. Este instrumento será de utilidad en la práctica clínica y epidemiología de tuberculosis en países latinoamericanos de habla hispana, y permitirá implementar estrategias que mejoren el conocimiento y el apego al tratamiento, así como la interacción con pacientes o individuos en riesgo de contagio y, con ello, establecer estrategias de prevención.

ABSTRACT Objective. Adapt and validate EMPODERA-TB in order to measure empowerment of patients with pulmonary tuberculosis (TB). Methods. An instrument initially designed to measure empowerment of patients with chronic diseases was adapted and validated to measure empowerment of patients with tuberculosis. The items applicable to patients with tuberculosis were selected and adapted. Validation was performed using exploratory and confirmatory factor analysis, and internal consistency was determined using Cronbach's alpha coefficient, based on data from a sample of 49 patients of Mexican origin diagnosed with pulmonary tuberculosis. Results. The instrument comprised 19 items grouped into three dimensions: knowledge acquisition, information-sharing skills, and decision-making skills. Acceptable goodness-of-fit was observed (SRMR: 0.124; CD: 0.999); internal consistency for the three dimensions was 0.878, 0.879, and 0.808, respectively, and for the instrument overall it was 0.885. Conclusions. The instrument showed acceptable goodness-of-fit and adequate internal consistency, making it possible to measure empowerment of patients with pulmonary tuberculosis. This instrument will be useful in TB clinical practice and epidemiology in Spanish-speaking Latin American countries. It will allow implementation of strategies that improve knowledge and adherence to treatment, interactions with patients or individuals at risk of infection, and development of prevention strategies.

RESUMO Objetivo. Adaptar e validar o instrumento EMPODERA-TB para medir o empoderamento em pacientes com tuberculose pulmonar. Métodos. Um instrumento elaborado inicialmente para medir o empoderamento em pacientes com doenças crônicas foi adaptado e validado para medir o empoderamento em pacientes com tuberculose. Para tanto, foram selecionados e adaptados os itens aplicáveis aos pacientes com tuberculose. A validação foi realizada por meio de análise fatorial exploratória e confirmatória, e a consistência interna foi analisada por meio do coeficiente alfa de Cronbach, com base em dados de uma amostra de 49 pacientes de origem mexicana com diagnóstico de tuberculose pulmonar. Resultados. O instrumento foi composto por 19 itens, agrupados em três dimensões: aquisição de conhecimento, habilidade de compartilhar informações e habilidade para a tomada de decisão. Observou-se um ajuste aceitável (SRMR: 0,124; CD: 0,999), enquanto a consistência interna para as dimensões foi de 0,878, 0,879 e 0,808, respectivamente, e para o instrumento como um todo foi de 0,885. Conclusões. O instrumento apresentou índices de bondade de ajuste aceitáveis e consistência interna adequada; portanto, permite mensurar o empoderamento em pacientes com tuberculose pulmonar. Este instrumento será útil para a prática clínica e epidemiológica da tuberculose nos países latino-americanos de língua espanhola, e permitirá a implementação de estratégias que melhorem o conhecimento e a adesão ao tratamento, bem como a interação com pacientes ou indivíduos em risco de contágio e, portanto, o estabelecimento de estratégias de prevenção.

Potential Protection of Pre-Existent Antibodies to Human Coronavirus 229E on COVID-19 Severity.

The causes of the broad spectrum of severity in COVID-19 are unknown. A protective effect through humoral immunity from previous infections by viruses of the SARS-CoV-2 family could explain a mild form of this disease. This study aimed to address whether the presence of antibodies against human seasonal coronaviruses (HCoVs) could prevent severe manifestations of COVID-19. A cross-sectional study was carried out in 165 participants. The presence of pre-existent antibodies against the seasonal HCoV-OC43, HCoV-HKU1, HCoV-229E, and HCoV-NL63 were detected. From all of the seasonal HCoVs studied, it was only found that being seropositive to HCoV-229E presented an association (p = 0.012) with developing mild clinical symptoms of COVID-19 or being asymptomatic. Multinomial regression analysis showed that being seropositive to HCoV-229E is associated with mild or moderate clinical symptoms for COVID-19. Statistical analysis also showed that being female is associated with being asymptomatic for SARS-CoV-2 infection or developing mild COVID-19. A subgroup analysis taking only seropositive to HCoV-229E revealed that females are more likely to develop asymptomatic SARS-CoV-2 infection (OR = 27.242, 95% CI 2.092-354.706, p = 0.012). Our results suggest that previous infections by HCoV-229E could prevent more serious clinical manifestations of COVID-19, but these are not the only variables that influence this event.

Secondary school students' perceptions of a mobile application design for smoking prevention.

INTRODUCTION: Our research was based on the BUS model, which provides guidelines for developing mobile applications for health. This model is supported by theories of behavior change, user-centered design, and social marketing. This study aimed to determine secondary school students' perceptions of a mobile application design for smoking prevention. METHODS: In 2018, qualitative research was conducted in three secondary schools located in the central part of the state of Veracruz, Mexico. Focus groups were established to explore beliefs about smoking and mobile phone use. The sketch technique was used to identify the characteristics for the mobile application. RESULTS: The students' perception of smoking allowed us to determine behaviors that can be changed: 1) associating cigarettes with a distraction from problems can be prevented; 2) peer and family pressure as a trigger to starting smoking can be avoided; and 3) tobacco use can be disassociated from being popular. Regarding the design of the mobile application prototype, an entertaining game with levels to help teenagers stay active was proposed. CONCLUSIONS: Games for health can help modify user behavior and even positively influence their values. The final product was the prototype for the 'No le entres' (don't jump in) application. An important finding was that adolescents living in both urban and rural settings use mobile phones similarly.

Evaluación del efecto de una intervención en WhatsAPP para pacientes hipertensos / Avaliação do efeito de uma intervenção no whatsapp para pacientes com hipertensão / Assessment of the effect of a whatsapp based intervention for patients with high blood pressure

Objetivo: Evaluar el efecto de una intervención utilizando WhatsApp dirigida a personas con hipertensión arterial en Xalapa, Veracruz, México. Material y Métodos: Se diseñó un ensayo clínico controlado aleatorizado, se reclutaron 40 pacientes hipertensos en cada grupo. Se desarrollaron 65 elementos en WhatsApp considerando las Behaviour Change Techniques. Las variables que se consideraron fueron tanto sociodemográficas, antropométricas, clínicas, adherencia terapéutica y conocimientos sobre hipertensión arterial. Para el tratamiento de las pérdidas se realizó un análisis por intención de tratar. Resultados: En el grupo experimental, el cambio que se observó estuvo relacionado con la modificación en la alimentación y en la realización de ejercicio, lo que contrasta con quienes solo recibían el tratamiento habitual. Discusión: El recibir información por WhatsApples motiva e impulsa a cuidarse. Se recomienda replicar este tipo de intervenciones en poblaciones diferentes o con otras enfermedades.

Objective: To assess the effect of an intervention using Whatsapp aimed at people with high blood pressure in Xalapa, Veracruz, Mexico. Material and Methods: A randomized controlled clinical trial was designed; 40 patients with high blood pressure were recruited in each group. Considering Behavior Change Techniques, 65 elements were developed and distributed via WhatsApp. Different variables were considered: anthropometric, physiological, clinical, therapeutic adherence and knowledge about hypertension, among them. An intention-to-treat analysis was carried out for the treatment of losses. Results: In the experimental group, the observed change was related to modifications in eating habits and exercise, contrasting with those subjects who only received the usual treatment. Discussion: Receiving information via WhatsApp motivates and makes patients take care of themselves. It is recommended to reproduce this type of intervention in different populations or with other diseases

Objetivo: Avaliar o efeito de uma intervenção usando WhatsApp dirigida em pessoas com hipertensão em Xalapa, Veracruz, México. Material e Métodos: Um ensaio clínico controlado randomizado foi desenhado, 40 pacientes hipertensos foram recrutados em cada grupo. 65 elementos foram desenvolvidos no WhatsApp considerando as Behaviour Change Techniques. As variáveis consideradas foram: sociodemográficas, antropométricas, clínicas, adesão terapêutica e conhecimento sobre hipertensão arterial. Para o tratamento das perdas, foi realizada uma análise de intenção de tratar. Resultados: Na turma experimental, a mudança observada foi relacionada à modificação na alimentação e à atividade física, o que contrasta com aqueles que receberam apenas o tratamento usual. Discussão: Receber informações através do WhatsApp motiva e incentiva o autocuidado. Recomenda-se replicar este tipo de intervenção em diferentes populações ou com outras doenças

Acreditación y resultados de la educación médica en México / Accreditation and results from medical education in Mexico

OBJETIVO: Saber si los programas de educación médica reconocidos por su calidad tienen mejores resultados en el Examen Nacional de Aspirantes a Residencias Médicas. MATERIAL Y MÉTODOS: Se analizan los resultados del Consejo Mexicano para la Acreditación de la Educación Médica (programas acreditados, programas no acreditados y programas sin acreditación) y los de los Comités Interinstitucionales para la Evaluación de la Educación Superior (programas con y sin nivel 1) según el Examen Nacional de Aspirantes a Residencias Médicas (2016). RESULTADOS: Tanto en el número de programas con promedio general aprobatorio, como en la probabilidad de ser seleccionado y en el promedio general del examen, los programas con reconocimiento tienen mejores resultados. Sin embargo, en el 37% de los programas hay contraposición entre reconocimiento y resultados. CONCLUSIONES: En general, los programas con reconocimiento tienen mejores resultados. Hay que justipreciar la importancia de estos para el otorgamiento de los reconocimientos a la calidad

OBJECTIVE: To determine whether the medical education programs recognised for their quality achieve better results in the National Medical Residency Examination. MATERIAL AND METHODS: An analysis was performed on the results from the Mexican Council for Accrediting Medical Education (accredited programs, non-accredited programs and programs with no accreditation), as well as from the Inter-institutional Committee on Evaluating Higher Education (Level 1 or No Level 1 Programs) according to the National Medical Residency Examination for Candidates (2016). RESULTS: Recognised programs achieve better results as regards the possibility to be admitted, as well as the mean scores. However, there is an evident difference between the results and the recognition in 37% of the programs. CONCLUSIONS: In general, the recognised programs get better results. Thus, their importance has to be appraised in order to recognise quality

Validación del test de Fagerström para adiccióna la nicotina (FTND) / Validation of Fagerström Test forNicotine Dependence (FTND / Validação do teste de Fagerström paradependência à nicotina (FTND)

Introducción. El tabaquismo es causa de enfermedad respiratoria y factor de riesgo de enfermedades cardiovasculares, cáncer y otras enfermedades. Las intervenciones desarrolladas están orientadas al conocimiento del tabaquismo en fumadores, orientando un diagnóstico basado en la utilización de diversas pruebas que se han convertido en instrumento de evaluación, lo cual ha generado la necesidad de conocer las propiedades psicométricas de las pruebas utilizadas. Objetivo. Validación del test de Fagerström para adicción a la nicotina. Materiales y métodos. Se llevó a cabo un estudio transversal y descriptivo de evaluación de tecno-logía diagnóstica, y muestreo no probabilístico por conveniencia. Se incluyó una población de 200 fumadores activos de la Universidad de Boyacá. Se evaluaron seis preguntas que conforman el test, mediante la prueba de esfericidad de Bartlett, Kaiser-Meyer-Olkin y alfa de Cronbach. Resultados. La prueba de esfericidad de Bartlett resultó estadísticamente significativa, lo cual sugiere la existencia de correlaciones dentro de la matriz de seis preguntas. La prueba de comunalidad es de utilidad en la determinación de los grupos o los factores que se describen en el test para establecer la adicción física a la nicotina. La variación total explicable de las seis preguntas que corresponden a la versión corta del test de Fagerström dio cuenta del 47,7 % de variabilidad. Conclusiones. Las propiedades psicométricas del test permiten su utilización en el diagnóstico de tabaquismo según la adicción a la nicotina del fumador, sin presentar diferencias en la comprensión por parte de los fumadores y teniendo resultado fiables.

Introduction: smoking causes respiratory disease and is a risk factor for cardiovascular disease, cancer, and other pathologies. The interventions carried out are directed toward the knowledge of smoking habit oriented to a diagnosis, based on the use of various tests that have become an assessment tool. This has generated the need to know the psychometric properties of the test used. Objective: To validate the Fagerström Test for Nicotine Dependence. Materials and Methods: It was carried out a descriptive cross-sectional study of assessment of diag-nostic technology. Non-probability-convenience sampling with two hundred active smokers, at the University of Boyacá, was selected. Bartlett's test of sphericity, Kaiser-Meyer-Olkin, and Cronbach's alpha were also conducted to evaluate the six questions that constitute the test. Results: Bartlett's test of sphericity was statistically significant, suggesting the existence of correla-tions within the matrix of six questions. Commonality test is useful in determining groups or factors described in the test to establish the physical addiction to nicotine. The explicable total variation of the six questions corresponding to the short version of the Fagerström Test accounted for 47.7% of variability. Conclusions: The psychometric properties of the test allow its use in the diagnosis of smoking habit according to the nicotine addiction, with no differences in understanding by smokers and shows reliable results

ntrodução. O tabagismo é responsável pelas doenças respiratórias e fator de risco de doenças cardiovasculares, câncer e outras doenças. As Intervenções realizadas são orientados para o conhe-cimento do tabagismo em fumantes, dirigindo um diagnóstico baseado no uso de vários testes que tornaram-se em ferramenta de avaliação, o que gerou a necessidade de conhecer as propriedades psicométricas dos testes utilizados. Objetivo: Validação do teste de Fagerström para dependência à nicotina Materiais e Métodos: Foi realizado um estudo descritivo transversal de avaliação a tecnologia de diagnóstico, e a amostragem de conveniência não probabilística. Foi incluída uma população de 200 fumantes ativos da Universidade de Boyacá. Foram avaliadas seis perguntas que compõem o teste, mediante o teste de esfericidade de Bartlett, Kaiser-Meyer-Olkin e alfa de Cronbach. Resultados. O teste de esfericidade do Bartlett foi estatisticamente significativo, sugerindo a existência de correlações dentro da matriz das seis perguntas. O teste de comunalidade é útil na determinação dos grupos ou dos fatores que sã descritos no teste para estabelecer a dependência física à nicotina. A variação total explicável das seis perguntas correspondentes à versão curta do teste de Fagerström foi responsável por 47,7% da variabilidade. Conclusões: As propriedades psicométricas do teste, permitem seu uso no diagnóstico de tabagismo, dependendo da dependência à nicotina do fumante, sem apresentar diferenças na compressão por parte dos fumantes e tendo resultados confiáveis.

[mSalUV: a new mobile messaging system for diabetes control in Mexico]. / mSalUV: un nuevo sistema de mensajería móvil para el control de la diabetes en México.

OBJECTIVE: Design and develop a mobile messaging system called mSalUV, which reminds patients with type 2 diabetes about taking their medication and attending appointments and promotes healthy lifestyles, and explore patient opinion regarding use of the system. METHODS: The study had three stages: 1) design and development of mSalUV; 2) design and development of text messages; and 3) exploration of patient opinion regarding use of mSalUV. RESULTS: The mSalUV system was created and around 40 text messages were designed. A total of 1 850 messages were sent during the 45 day intervention. Patients thought that mSalUV helped them to treat their disease and that it was easy to use, they were inclined to continue using the system in the future, and people close to them (family members and support networks) supported them using it. Furthermore, they perceived the system as "someone that cared about them." CONCLUSIONS: The results suggest that a system such as mSalUV would be well accepted by its potential users; in this case, people with type 2 diabetes. This presents a very interesting scenario that will enable taking advantage of new technologies for health. Further research is needed to evaluate the system's efficiency and effectiveness.

mSalUV: un nuevo sistema de mensajería móvil para el control de la diabetes en México / mSalUV: a new mobile messaging system for diabetes control in Mexico

OBJETIVO: Diseñar y desarrollar un sistema de mensajería móvil llamado mSalUV, que permita recordar a pacientes con diabetes mellitus tipo 2 la toma de medicación y la asistencia a citas y que promueva estilos de vida saludables, así como explorar su opinión con respecto al uso del sistema. MÉTODOS: Se consideraron tres etapas: la primera incluyó el diseño y desarrollo de mSalUV. La segunda abarcó el diseño y construcción de los mensajes de texto. La tercera exploró la opinión de los usuarios con respecto al uso de mSalUV. RESULTADOS: Se obtuvo el sistema mSalUV, además se diseñaron alrededor de 40 mensajes de texto. Durante los 45 días del período de intervención se envió un total de 1 850 mensajes. Los usuarios opinaron que mSalUV los ayudaba en el tratamiento de su enfermedad, que era de fácil uso, mostraron una actitud favorable para continuar su uso en el futuro, además de que las personas cercanas a ellas (familiares y redes de apoyo), estaban de acuerdo en que lo utilizaran. Por otra parte, percibieron al sistema como "alguien que los quería". CONCLUSIONES: Los resultados presentados nos sugieren que un sistema como mSalUV sería bastante aceptado por los posibles usuarios, en este caso, personas con diabetes mellitus tipo 2. Esto nos plantea un escenario muy interesante que permitirá aprovechar a las nuevas tecnologías en beneficio de la salud. Se requieren más investigaciones para evaluar la eficacia y efectividad del sistema.

OBJECTIVE: Design and develop a mobile messaging system called mSalUV, which reminds patients with type 2 diabetes about taking their medication and attending appointments and promotes healthy lifestyles, and explore patient opinion regarding use of the system. METHODS: The study had three stages: 1) design and development of mSalUV; 2) design and development of text messages; and 3) exploration of patient opinion regarding use of mSalUV. RESULTS: The mSalUV system was created and around 40 text messages were designed. A total of 1 850 messages were sent during the 45 day intervention. Patients thought that mSalUV helped them to treat their disease and that it was easy to use, they were inclined to continue using the system in the future, and people close to them (family members and support networks) supported them using it. Furthermore, they perceived the system as "someone that cared about them." CONCLUSIONS: The results suggest that a system such as mSalUV would be well accepted by its potential users; in this case, people with type 2 diabetes. This presents a very interesting scenario that will enable taking advantage of new technologies for health. Further research is needed to evaluate the system's efficiency and effectiveness.