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1.
Rev. Bras. Med. Fam. Comunidade (Online) ; 19(46): e-3678, 20241804.
Artículo en Inglés, Portugués | LILACS, Coleciona SUS | ID: biblio-1572887

RESUMEN

Introdução: Diabetes mellitus (DM) é uma doença crônica, não transmissível, cuja prevalência tem aumentado mundialmente. Seu manejo adequado na Atenção Primária à Saúde (APS) pode reduzir suas complicações e as internações por condições sensíveis à atenção primária. Objetivo: Comparar indicadores de qualidade da atenção a pessoas com diabetes atendidas na rede básica de saúde do Brasil e suas diferenças por região. Métodos: Com delineamento transversal, utilizaram-se dados dos Ciclos I e III do Programa de Melhoria do Acesso e da Qualidade (PMAQ). Os desfechos foram indicadores sintéticos, operacionalizados a partir de 24 variáveis: i) acesso; ii) disponibilidade de insumos e equipamentos em condições de uso; iii) disponibilidade de medicamentos em quantidade suficiente; iv) organização e gestão; v) cuidado clínico; e vi) relato de cuidado adequado. Foram calculadas as diferenças em pontos percentuais (p.p.) dos indicadores entre 2012 e 2018, e os dados foram estratificados por região. Resultados: No geral, houve uma melhora no cuidado à pessoa com DM na APS do Brasil e regiões entre as equipes participantes do PMAQ, entre 2012 e 2018. As prevalências de acesso, disponibilidade de insumos/equipamentos, medicamentos, oferta, organização e gestão apresentaram aumento de, no mínimo, 10 p.p. no período de 6 anos, mas podem melhorar. Conclusões: Considerando que a ocorrência de DM está aumentando no país, faz-se necessário maior investimento na estrutura dos serviços e em programas de educação permanente dos profissionais de saúde.


Introduction: Diabetes Mellitus (DM) is a non-communicable chronic disease whose prevalence has been increasing worldwide. Its adequate management in Primary Health Care (PHC) can reduce complications and hospitalizations for conditions sensitive to primary care. Objective: To compare quality indicators for the care of people with diabetes treated in the basic health network in Brazil and their differences by region. Methods: With a cross-sectional design, data from Cycles I and III of the PMAQ were used. The outcomes were synthetic indicators, operationalized from 24 variables: i) access; ii) availability of supplies and equipment in usable conditions; iii) availability of medications in sufficient quantities; iv) organization and management; v) clinical care; and vi ) report of adequate care. Differences in percentage points (p.p.) of the indicators between 2012 and 2018 were calculated, and the data were stratified by region. Results: Overall, there was an improvement in the care of people with DM in PHC in Brazil and regions among the teams participating in PMAQ, between 2012 and 2018. The prevalence of access, availability of supplies/equipment, medications, demand, organization, and management showed an increase of at least 10 p.p. within six years, but they can improve. Conclusions: Considering that the occurrence of DM is increasing in the country, greater investment is necessary in the structure of services and in continuing education programs for health professionals.


La Diabetes Mellitus es una enfermedad crónica no transmisible cuya prevalencia ha aumentado en todo el mundo. Su manejo adecuado en la Atención Primaria puede reducir sus complicaciones y las hospitalizaciones por afecciones sensibles a la Atención Primaria. Objetivo: comparar indicadores de calidad de la atención a personas con diabetes atendidas en la red básica de salud de Brasil y sus diferencias por región. Métodos: Con delineamiento transversal, se utilizaron datos de los Ciclos I y III del PMAQ. Los defectos fueron indicadores sintéticos, operacionalizados a partir de 24 variables: i) acceso, ii) disponibilidad de insumos y equipos en condiciones utilizables, iii) disponibilidad de medicamentos en cantidad suficiente, iv) organización y gestión, v) atención clínica y vi) reporte de atención adecuada. Se calcularon las diferencias en puntos porcentuales (p.p.) de los indicadores entre 2012 y 2018, y los datos se estratificaron por regiones. Resultados: En general, hubo una mejora en la atención a las personas con DM en APS en Brasil y regiones entre los equipos participantes en el PMAQ entre 2012 y 2018. La prevalencia del acceso, la disponibilidad de insumos/equipos, los medicamentos, el suministro, la organización y la gestión mostraron un aumento de al menos 10 p.p. en el periodo de seis años, pero pueden mejorar. Conclusiones: Considerando que la ocurrencia de DM está aumentando en el país, es necesario invertir más en la estructura de los servicios y en programas de educación continuada para los profesionales de salud.


Asunto(s)
Humanos , Atención Primaria de Salud , Diabetes Mellitus , Enfermedad Crónica , Indicadores de Calidad de la Atención de Salud
2.
HIV Res Clin Pract ; 25(1): 2411481, 2024 12.
Artículo en Inglés | MEDLINE | ID: mdl-39377112

RESUMEN

BACKGROUND: Diabetes affects 4.5% of people living with HIV in Mexico. This study aims to describe the diabetes cascade of care (DMC) in people with HIV in a tertiary center in Mexico City. METHODS: We conducted a single-center review of people with HIV aged over 18, using medical records of active people enrolled at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) HIV Clinic (HIVC). Our analysis focused on their last visit to describe the DMC, aiming to identify gaps in control goals. We included people who had a consultation within the 12 months preceding May 2020. RESULTS: Out of the 2072 active people, medical records were available for 2050 (98.9%). Among these, 326 people (15.9%) had fasting glucose (FG) abnormalities, of which 133 (40.7%) had diabetes. The prevalence of diabetes among people with HIV was of 6.4% (133/2050). Regarding the DMC, the following proportions of people achieved control goals: 133/133 (100%) received medical care in the last 12 months, 123/123 (100%) had blood pressure (BP) <140/90 mmHg, 73/132 (55.3%) had LDL cholesterol (c-LDL) <100 mg/dl, 63/132 (47.7%) had FG <130 mg/dl, 50/116 (43.1%) had glycosylated hemoglobin (HbA1c) <7%. ABC goals (HbA1c <7%, c-LDL <100 mg/dl, BP <140/90 mmHg) were met in 28/109 (25.6%) people. 126/133 (94%) people with HIV achieved HIV-viral load <50 copies/mL. CONCLUSIONS: Despite the high rate of viral suppression among people with HIV and diabetes, significant challenges remain in achieving comprehensive diabetes control. These findings highlight the need for targeted interventions to improve metabolic outcomes and the overall management of diabetes in people with HIV.


Asunto(s)
Diabetes Mellitus , Infecciones por VIH , Centros de Atención Terciaria , Humanos , México/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Infecciones por VIH/tratamiento farmacológico , Femenino , Masculino , Centros de Atención Terciaria/estadística & datos numéricos , Persona de Mediana Edad , Adulto , Diabetes Mellitus/epidemiología , Diabetes Mellitus/terapia , Prevalencia , Glucemia/análisis , Estudios Retrospectivos
3.
Washington, D.C.; OPS; 2024-10-01. (OPS/NMH/NV/24-0006).
Monografía en Español | PAHO-IRIS | ID: phr-61776

RESUMEN

La actividad física regular es un factor de protección fundamental para prevenir y controlar enfermedades no transmisibles como la diabetes. También favorece la salud mental, ya que previene el deterioro cognitivo, la depresión y la ansiedad, y contribuye al bienestar general. Por último, como aumenta la sensibilidad a la insulina, ayuda a reducir el nivel de glucosa en la sangre y a disminuir las condiciones que agravan la diabetes y sus complicaciones. Gracias a que también fortalece el corazón, mejora la circulación de las piernas, hace descender la presión arterial y los niveles de colesterol, la actividad física también es imprescindible para prevenir las principales complicaciones de la diabetes, que son la retinopatía, la enfermedad renal crónica y las lesiones en los pies (pie diabético). Otro de los beneficios es la posibilidad de mantener un peso saludable. Por esa razón, si una persona tiene sobrepeso u obesidad, la actividad física, junto con una alimentación saludable, puede contribuir a reducir el peso y la grasa del abdomen (circunferencia abdominal). Este módulo describe un elemento clave en el cuidado de la diabetes, que es la actividad física. Está dirigido a las personas que conviven con la enfermedad, a sus familias y a sus cuidadores. Su propósito es contribuir al autocuidado mediante la entrega de algunas recomendaciones básicas para incorporar la actividad física como parte de la vida cotidiana de las personas con diabetes. Estas recomendaciones no reemplazan las indicaciones del médico o del equipo de salud, pero pueden servir de ayuda para mejorar el automanejo de la diabetes y también para prevenir sus complicaciones.


Asunto(s)
Diabetes Mellitus , Salud Pública , Enfermedades no Transmisibles , Complicaciones de la Diabetes , Ejercicio Físico
4.
Washington D. C; Organización Panamericana de la Salud; 1 ed; Oct. 2024. 13 p. ilus.
Monografía en Español | MINSAPERÚ, LIPECS | ID: biblio-1577324

RESUMEN

EL presente módulo describe un elemento clave en el cuidado de la diabetes, que es la actividad física. Está dirigido a las personas que conviven con la enfermedad, a sus familias y a sus cuidadores. Su propósito es contribuir al autocuidado mediante la entrega de algunas recomendaciones básicas para incorporar la actividad física como parte de la vida cotidiana de las personas con diabetes. Estas recomendaciones no reemplazan las indicaciones del médico o del equipo de salud, pero pueden servir de ayuda para mejorar el automanejo de la diabetes y también para prevenir sus complicaciones


Asunto(s)
Humanos , Autocuidado , Ejercicio Físico , Complicaciones de la Diabetes , Diabetes Mellitus , Monitores de Ejercicio , Enfermedades no Transmisibles
5.
Oxid Med Cell Longev ; 2024: 2812290, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39411276

RESUMEN

Diabetes mellitus is associated with chronic wound-healing problems that significantly impact patients' quality of life and substantially increase expenditure on healthcare. Therefore, the identification of compounds that can aid healing is justified. Anredera cordifolia (Ten.) has been used in folk medicine for curative purposes; however, the causal mechanisms underlying its healing effects remain to be elucidated. In this study, the effect of the ethanolic extract of A. cordifolia was evaluated in an in vitro healing model using fibroblasts cultivated under normoglycemic and hyperglycemic environments. The extract was predominantly composed of phytol and exhibited genoprotective activity. Fibroblast migration attenuated the adverse effects of hyperglycemia, favoring cell proliferation. Collagen levels were significantly increased in ruptured fibroblasts under both standard and hyperglycemic environments. The phytogenomic effect of the extract on three genes related to extracellular matrix formation, maintenance, and degradation showed that A. cordifolia increased the expression of genes related to matrix synthesis and maintenance in both normoglycemic and hyperglycemic individuals. Furthermore, it reduced the expression of genes related to matrix degradation. Overall, this is the first study to demonstrate the effectiveness of A. cordifolia in wound healing, elucidating possible causal mechanisms that appear to be based on the genoprotective effect of this plant on the migratory and proliferative phases of the wound healing process; these effects are probably related to phytol, its main constituent.


Asunto(s)
Movimiento Celular , Proliferación Celular , Fibroblastos , Hiperglucemia , Extractos Vegetales , Cicatrización de Heridas , Proliferación Celular/efectos de los fármacos , Movimiento Celular/efectos de los fármacos , Extractos Vegetales/farmacología , Fibroblastos/efectos de los fármacos , Fibroblastos/metabolismo , Cicatrización de Heridas/efectos de los fármacos , Humanos , Hiperglucemia/tratamiento farmacológico , Etanol/química , Diabetes Mellitus/tratamiento farmacológico
7.
Public Health Nutr ; 27(1): e165, 2024 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-39291654

RESUMEN

OBJECTIVE: To investigate the causal link between the North American Free Trade Agreement (NAFTA) unrestricted sugar trade agreement signed in 2008 between the USA and Mexico and the diabetes prevalence across all fifty US states. DESIGN: A quasi-experimental research design to investigate the causal effect of the NAFTA unrestricted sugar trade agreement on diabetes prevalence. Our study utilises a comprehensive panel dataset spanning from 2000 to 2016, comprising 1054 observations. To conduct our analysis, we applied both the difference-in-differences and event-study methodologies. SETTING: All the states in the USA. PARTICIPANTS: The fifty states in the USA. RESULTS: After the enactment of the NAFTA sugar trade agreement between the USA and Mexico in 2008, most states witnessed an increase in diabetes prevalence. The annual impacts displayed significant variation among states, with percentage increases spanning from 0·50 to 2·28 %. CONCLUSIONS: States with a higher percentage of their population living below the poverty line, a larger Black resident population and a lower proportion of high school graduates had more significant increases in diabetes prevalence attributed to the NAFTA sugar trade agreement.


Asunto(s)
Comercio , Salud Pública , Humanos , Comercio/estadística & datos numéricos , Estados Unidos/epidemiología , México/epidemiología , Prevalencia , Diabetes Mellitus/epidemiología , Cooperación Internacional
8.
Int J Mol Sci ; 25(17)2024 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-39273161

RESUMEN

The Target-Based Virtual Screening approach is widely employed in drug development, with docking or molecular dynamics techniques commonly utilized for this purpose. This systematic review (SR) aimed to identify in silico therapeutic targets for treating Diabetes mellitus (DM) and answer the question: What therapeutic targets have been used in in silico analyses for the treatment of DM? The SR was developed following the guidelines of the Preferred Reporting Items Checklist for Systematic Review and Meta-Analysis, in accordance with the protocol registered in PROSPERO (CRD42022353808). Studies that met the PECo strategy (Problem, Exposure, Context) were included using the following databases: Medline (PubMed), Web of Science, Scopus, Embase, ScienceDirect, and Virtual Health Library. A total of 20 articles were included, which not only identified therapeutic targets in silico but also conducted in vivo analyses to validate the obtained results. The therapeutic targets most frequently indicated in in silico studies were GLUT4, DPP-IV, and PPARγ. In conclusion, a diversity of targets for the treatment of DM was verified through both in silico and in vivo reassessment. This contributes to the discovery of potential new allies for the treatment of DM.


Asunto(s)
Simulación por Computador , Diabetes Mellitus , Suplementos Dietéticos , Hipoglucemiantes , Humanos , Diabetes Mellitus/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Hipoglucemiantes/farmacología , Transportador de Glucosa de Tipo 4/metabolismo , Animales , Desarrollo de Medicamentos/métodos , PPAR gamma/metabolismo , Simulación del Acoplamiento Molecular , Terapia Molecular Dirigida/métodos
9.
J Diabetes Res ; 2024: 3451158, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39228387

RESUMEN

Aim: This study is aimed at assessing the prevalence of poor glycemic control using different metrics and its association with in-hospital adverse outcomes. Methods: This cross-sectional study was conducted in diabetic patients admitted to a third-level hospital in Colombia between January and July 2022. Poor glycemic control was determined using capillary glucose metrics, including mean glucose values outside the target range, derived time in range (dTIR) (100-180 mg/dL) < 70%, coefficient of variation (CV > 36%), and hypoglycemia (<70 mg/dL). Multiple regression models were adjusted for hospital outcomes based on glycemic control, as well as other sociodemographic and clinical covariates. Results: A total of 330 Hispanic patients were included. A total of 27.6% had mean glucose measurements outside the target range, 33% had a high CV, 64.8% had low dTIR, and 28.8% experienced hypoglycemia. The in-hospital mortality rate was 8.8%. An admission HbA1c level greater than 7% was linked to an increased mortality risk (p = 0.016), as well as a higher average of glucometer readings (186 mg/dL vs. 143 mg/dL; p < 0.001). A lower average of dTIR (41.0% vs. 60.0%; p < 0.001) was also associated with a higher mortality risk. Glycemic variability was correlated with an increased risk of mortality, hypoglycemia, delirium, and length of hospital stay (LOS). Conclusion: A significant number of hospitalized diabetic patients exhibit poor glycemic control, which has been found to be associated with adverse outcomes, including increased mortality. Metrics like dTIR and glycemic variability should be considered as targets for glycemic control, highlighting the need for enhanced management strategies.


Asunto(s)
Glucemia , Diabetes Mellitus , Hemoglobina Glucada , Control Glucémico , Mortalidad Hospitalaria , Hipoglucemia , Centros de Atención Terciaria , Humanos , Estudios Transversales , Masculino , Femenino , Colombia/epidemiología , Persona de Mediana Edad , Glucemia/metabolismo , Glucemia/análisis , Anciano , Diabetes Mellitus/sangre , Diabetes Mellitus/epidemiología , Hipoglucemia/epidemiología , Hipoglucemia/sangre , Hemoglobina Glucada/metabolismo , Hemoglobina Glucada/análisis , Adulto , Hospitalización/estadística & datos numéricos , Factores de Tiempo
10.
Int J Mol Sci ; 25(17)2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39273600

RESUMEN

Diabetes mellitus, a chronic and non-transmissible disease, triggers a wide range of micro- and macrovascular complications. The differentiation of pancreatic ß-like cells (PßLCs) from induced pluripotent stem cells (iPSCs) offers a promising avenue for regenerative medicine aimed at treating diabetes. Current differentiation protocols strive to emulate pancreatic embryonic development by utilizing cytokines and small molecules at specific doses to activate and inhibit distinct molecular signaling pathways, directing the differentiation of iPSCs into pancreatic ß cells. Despite significant progress and improved protocols, the full spectrum of molecular signaling pathways governing pancreatic development and the physiological characteristics of the differentiated cells are not yet fully understood. Here, we report a specific combination of cofactors and small molecules that successfully differentiate iPSCs into PßLCs. Our protocol has shown to be effective, with the resulting cells exhibiting key functional properties of pancreatic ß cells, including the expression of crucial molecular markers (pdx1, nkx6.1, ngn3) and the capability to secrete insulin in response to glucose. Furthermore, the addition of vitamin C and retinoic acid in the final stages of differentiation led to the overexpression of specific ß cell genes.


Asunto(s)
Ácido Ascórbico , Diferenciación Celular , Diabetes Mellitus , Células Madre Pluripotentes Inducidas , Células Secretoras de Insulina , Tretinoina , Células Secretoras de Insulina/metabolismo , Células Secretoras de Insulina/efectos de los fármacos , Células Secretoras de Insulina/citología , Ácido Ascórbico/farmacología , Células Madre Pluripotentes Inducidas/metabolismo , Células Madre Pluripotentes Inducidas/citología , Células Madre Pluripotentes Inducidas/efectos de los fármacos , Tretinoina/farmacología , Diferenciación Celular/efectos de los fármacos , Humanos , Diabetes Mellitus/metabolismo , Proteínas de Homeodominio/metabolismo , Proteínas de Homeodominio/genética , Transducción de Señal/efectos de los fármacos , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/metabolismo , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/genética , Transactivadores/metabolismo , Transactivadores/genética , Insulina/metabolismo , Proteínas del Tejido Nervioso
11.
Sensors (Basel) ; 24(17)2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-39275490

RESUMEN

An increase in plantar pressure and skin temperature is commonly associated with an increased risk of diabetic foot ulcers. However, the effect of insoles in reducing plantar temperature has not been commonly studied. The aim was to assess the effect of walking in insoles with different features on plantar temperature. Twenty-six (F/M:18/8) participants-13 with diabetes and 13 healthy, aged 55.67 ± 9.58 years-participated in this study. Skin temperature at seven plantar regions was measured using a thermal camera and reported as the difference between the temperature after walking with an insole for 20 m versus the baseline temperature. The mixed analyses of variance indicated substantial main effects for the Insole Condition, for both the right [Wilks' Lambda = 0.790, F(14, 492) = 4.393, p < 0.01, partial eta squared = 0.111] and left feet [Wilks' Lambda = 0.890, F(14, 492) = 2.103, p < 0.011, partial eta squared = 0.056]. The 2.5 mm-tall dimple insole was shown to be significantly more effective at reducing the temperature in the hallux and third met head regions compared to the 4 mm-tall dimple insole. The insoles showed to be significantly more effective in the diabetes group versus the healthy group, with large effect size for the right [Wilks' Lambda = 0.662, F(14, 492) = 8.037, p < 0.000, Partial eta-squared = 0.186] and left feet [Wilks' Lambda = 0.739, F(14, 492) = 5.727, p < 0.000, Partial eta-squared = 0.140]. This can have important practical implications for designing insoles with a view to decrease foot complications in people with diabetes.


Asunto(s)
Pie Diabético , Ortesis del Pié , Pie , Presión , Temperatura Cutánea , Humanos , Persona de Mediana Edad , Masculino , Femenino , Temperatura Cutánea/fisiología , Pie/fisiopatología , Pie/fisiología , Pie Diabético/fisiopatología , Zapatos , Caminata/fisiología , Anciano , Diabetes Mellitus/fisiopatología , Adulto , Temperatura
12.
BMC Public Health ; 24(1): 2383, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39223469

RESUMEN

OBJECTIVE: Evidence from low- and middle-income countries regarding the effect of smoking in people with diabetes is lacking. Here, we report the association of smoking with mortality in a large cohort of Mexican adults with diabetes. METHODS: Participants with diabetes mellitus (self-reported diagnosis, use of antidiabetic medications or HbA1c ≥ 6.5%) aged 35-74 years when recruited into the Mexico City Prospective Study were included. Cox regression confounder-adjusted mortality rate ratios (RRs) associated with baseline smoking status were estimated. RESULTS: Among 15,975 women and 8225 men aged 35-74 years with diabetes but no other comorbidities at recruitment, 2498 (16%) women and 2875 (35%) men reported former smoking and 2753 (17%) women, and 3796 (46%) men reported current smoking. During a median of 17 years of follow-up there were 5087 deaths at ages 35-74 years. Compared with never smoking, all-cause mortality RR was 1.08 (95%CI 1.01-1.17) for former smoking, 1.11 (95%CI 1.03-1.20) for current smoking, 1.09 (95%CI 0.99-1.20) for non-daily smoking, 1.06 (95%CI 0.96-1.16) for smoking < 10 cigarettes/day (median during follow-up 4 cigarettes/day), and 1.28 (95% CI 1.14-1.43) for smoking ≥ 10 cigarettes/day (median during follow-up 15 cigarettes/day). Mortality risk among daily smokers was greatest for COPD, lung cancer, cardiovascular diseases, and acute diabetic complications. CONCLUSION: In this cohort of Mexican adults with diabetes, low-intensity daily smoking was associated with increased mortality, despite observing smoking patterns which are different from other populations, and over 5% of total deaths were associated with smoking.


Asunto(s)
Causas de Muerte , Diabetes Mellitus , Fumar , Humanos , Persona de Mediana Edad , Masculino , Femenino , México/epidemiología , Adulto , Estudios Prospectivos , Anciano , Fumar/epidemiología , Diabetes Mellitus/mortalidad , Diabetes Mellitus/epidemiología , Factores de Riesgo
13.
PLos ONE ; 19(9)set.2024.
Artículo en Inglés | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1570486

RESUMEN

INTRODUCTION: Southern Hemisphere countries have been underrepresented in epidemiological studies on acute kidney injury (AKI). The objectives of this study were to determine the frequency, risk factors, and outcomes of AKI in adult hospitalized patients from the emergency department of a public high-complexity teaching hospital in the city of São Paulo, Brazil. METHODS: Observational and prospective study. AKI was defined by the KDIGO guidelines (Kidney Disease: Improving Global Outcomes) using only serum creatinine. RESULTS: Among the 731 patients studied (age: median 61 years, IQR 47-72 years; 55% male), 48% had hypertension and 28% had diabetes as comorbidities. The frequency of AKI was 52.1% (25.9% community-based AKI [C-AKI] and 26.3% hospital-acquired AKI [H-AKI]). Dehydration, hypotension, and edema were found in 29%, 15%, and 15% of participants, respectively, at hospital admission. The in-hospital and 12-month mortality rates of patients with vs. without AKI were 25.2% vs. 11.1% (p<0.001) and 36.7% vs. 12.9% (p<0.001), respectively. The independent risk factors for C-AKI were chronic kidney disease (CKD), chronic liver disease, age, and hospitalization for cardiovascular disease. Those for H-AKI were CKD, heart failure as comorbidities, hypotension, and edema at hospital admission. H-AKI was an independent risk factor for death in the hospital, but not at 12 months. C-AKI was not a risk factor for death. CONCLUSIONS: AKI occurred in more than half of the admissions to the clinical emergency department of the hospital and was equally distributed between C-AKI and H-AKI. Many patients had correctable risk factors for AKI, such as dehydration and arterial hypotension (44%) at admission. The only independent risk factor for both C-AKI and H-AKI was CKD as comorbidity.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Enfermedades Cardiovasculares , Estudios Epidemiológicos , Insuficiencia Renal Crónica , Comorbilidad , Estudios de Cohortes , Diabetes Mellitus , Servicio de Urgencia en Hospital , Hospitales de Enseñanza , Hipertensión
14.
mSystems ; 9(9): e0043424, 2024 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-39166873

RESUMEN

Mexican Americans are disproportionally affected by metabolic dysfunction-associated steatotic liver disease (MASLD), which often co-occurs with diabetes. Despite extensive evidence on the causative role of the gut microbiome in MASLD, studies determining the involvement of the gut phageome are scarce. In this cross-sectional study, we characterized the gut phageome in Mexican Americans of South Texas by stool shotgun metagenomic sequencing of 340 subjects, concurrently screened for liver steatosis by transient elastography. Inter-individual variations in the phageome were associated with gender, country of birth, diabetes, and liver steatosis. The phage signatures for diabetes and liver steatosis were subsequently determined. Enrichment of Inoviridae was associated with both diabetes and liver steatosis. Diabetes was further associated with the enrichment of predominantly temperate Escherichia phages, some of which possessed virulence factors. Liver steatosis was associated with the depletion of Lactococcus phages r1t and BK5-T, and enrichment of the globally prevalent Crassvirales phages, including members of genus cluster IX (Burzaovirus coli, Burzaovirus faecalis) and VI (Kahnovirus oralis). The Lactococcus phages showed strong correlations and co-occurrence with Lactococcus lactis, while the Crassvirales phages, B. coli, B. faecalis, and UAG-readthrough crAss clade correlated and co-occurred with Prevotella copri. In conclusion, we identified the gut phageome signatures for two closely linked metabolic diseases with significant global burden. These phage signatures may have utility in risk modeling and disease prevention in this high-risk population, and identification of potential bacterial targets for phage therapy.IMPORTANCEPhages influence human health and disease by shaping the gut bacterial community. Using stool samples from a high-risk Mexican American population, we provide insights into the gut phageome changes associated with diabetes and liver steatosis, two closely linked metabolic diseases with significant global burden. Common to both diseases was an enrichment of Inoviridae, a group of phages that infect bacterial hosts chronically without lysis, allowing them to significantly influence bacterial growth, virulence, motility, biofilm formation, and horizontal gene transfer. Diabetes was additionally associated with the enrichment of Escherichia coli-infecting phages, some of which contained virulence factors. Liver steatosis was additionally associated with the depletion of Lactococcus lactis-infecting phages, and enrichment of Crassvirales phages, a group of virulent phages with high global prevalence and persistence across generations. These phageome signatures may have utility in risk modeling, as well as identify potential bacterial targets for phage therapy.


Asunto(s)
Bacteriófagos , Hígado Graso , Microbioma Gastrointestinal , Americanos Mexicanos , Viroma , Humanos , Masculino , Femenino , Microbioma Gastrointestinal/genética , Bacteriófagos/genética , Persona de Mediana Edad , Viroma/genética , Hígado Graso/genética , Estudios Transversales , Adulto , Diabetes Mellitus , Heces/microbiología , Heces/virología , Anciano
15.
Food Res Int ; 192: 114730, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39147547

RESUMEN

Coffee husks are the main by-product of the coffee industry and have been traditionally discarded in the environment or used as fertilizers. However, recent studies have shown that coffee husks have bioactive compounds, such as phenolics and fiber-bound macro antioxidants, offering a range of potential health benefits. This study evaluated the antioxidant capacity, cytoprotective/cytotoxic properties, and stimulatory effects on the relative abundance of selected intestinal bacterial populations of individuals with diabetes of organic coffee husks. Organic coffee husk had good antioxidant capacity, maintained under simulated gastric conditions, with more than 50% of antioxidant capacity remaining. Organic coffee husk exerted cytoprotective properties in Caco-2 cells, indicating that cellular functions were not disturbed, besides not inducing oxidation. Overall, organic coffee husk promoted positive effects on the abundance of distinct intestinal bacterial groups of individuals with diabetes during in vitro colonic fermentation, with a higher relative abundance of Bifidobacterium spp., indicating the availability of components able to reach the colon to be fermented by intestinal microbiota. Organic coffee husk could be a circular material to develop new safe and pesticide-free functional ingredients with antioxidant and potential beneficial effects on human intestinal microbiota.


Asunto(s)
Antioxidantes , Café , Microbioma Gastrointestinal , Humanos , Antioxidantes/farmacología , Células CACO-2 , Café/química , Microbioma Gastrointestinal/efectos de los fármacos , Fermentación , Diabetes Mellitus , Coffea/química , Bacterias/efectos de los fármacos
16.
BMC Health Serv Res ; 24(1): 1009, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39217352

RESUMEN

BACKGROUND: Technological advances based on mobile health (mHealth), the field of digital health (eHealth) aimed at managing health services and care and their concomitant transformations, have become increasingly important in the 21st century. In this context, care for individuals diagnosed with Chronic Non-Communicable Diseases (CNCDs) deserves to be highlighted. The aim of this study is to present the creation, development and implementation of the Telehealth Center of the Federal University of Viçosa (NUTELES - UFV), for the monitoring and management of health care for individuals with Arterial Hypertension (AH) and/or Diabetes Mellitus (DM). METHODS: This study, carried out in 2022 and 2023, involved 374 patients diagnosed with AH and/or DM in the health micro-region of Viçosa/MG, Brazil, comprising nine municipalities. The research aims to describe the creation, development and implementation of a software (NutelesApp) for the collection, storage, management and analysis of epidemiological research in public health, focusing specifically, on the monitoring and management of health care for individuals with AH and/or DM monitored by Primary Health Care (PHC). The parameters collected and analyzed were obtained through a questionnaire applied to patients, consisting of 70 questions, subdivided into 12 classes of questions. The epidemiological survey data was collected using mobile devices and analyzed using computer techniques based on statistical analysis. Once the field teams had completed their work, the files were transferred to servers for general analysis processing, using estimates of means, prevalence and respective standard errors, calculated using the Statistical Package for Social Science (SPSS) program, which takes into account the planning variables and includes the basic weights resulting from the sampling process. This study was approved by the Human Research Ethics Committee and registered, prior to recruitment, by the Brazilian Registry of Clinical Trials (ReBEC), ID: RBR-45hqzmf (Last approval date: 11/30/2022). RESULTS: The information obtained through data collection with subsequent exploratory analysis of epidemiological data using the NutelesApp software suggests that mobile applications intended for the purpose of monitoring and managing healthcare for people with AH and/or DM should address the variables necessary to support a process of understanding the health conditions and/or disease of the individual as a whole and provide short- and long-term learning. Regarding the results of the survey using the software, the variables of 374 people were analyzed. Majority are female (73.2%) and white (43.5%). Most patients are elderly (average 64 years), with blood pressure levels within the normal range for this population, BMI indicates overweight, AC increased risk for cardiovascular events and CC within the recommendation value. All biochemical parameters analyzed were above normal limits. CONCLUSIONS: The description of the creation and development of the software includes practical examples of its implementation, the results collected and its applicability in real scenarios, presenting determining criteria that can provide assertive and timely interventions for monitoring and managing the health and/or disease parameters of patients with HA and/or DM. In addition, the beneficial consequences of using this application will extend to health units and their respective management, improving the services provided by PHC and enhancing strategies and actions for health promotion and disease prevention.


Asunto(s)
Diabetes Mellitus , Aplicaciones Móviles , Telemedicina , Humanos , Enfermedad Crónica/terapia , Brasil , Diabetes Mellitus/terapia , Diabetes Mellitus/epidemiología , Masculino , Femenino , Hipertensión/terapia , Hipertensión/epidemiología , Hipertensión/diagnóstico , Persona de Mediana Edad , Adulto , Encuestas y Cuestionarios , Anciano
17.
Int J Mol Sci ; 25(16)2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39201678

RESUMEN

Skin wounds, primarily in association with type I diabetes mellitus, are a public health problem generating significant health impacts. Therefore, identifying the main pathways/mechanisms involved in differentiating fibroblasts into myofibroblasts is fundamental to guide research into effective treatments. Adopting the PRISMA guidelines, this study aimed to verify the main pathways/mechanisms using diabetic murine models and analyze the advances and limitations of this area. The Medline (PubMed), Scopus, and Web of Science platforms were used for the search. The studies included were limited to those that used diabetic murine models with excisional wounds. Bias analysis and methodological quality assessments were undertaken using the SYRCLE bias risk tool. Eighteen studies were selected. The systematic review results confirm that diabetes impairs the transformation of fibroblasts into myofibroblasts by affecting the expression of several growth factors, most notably transforming growth factor beta (TGF-beta) and NLRP3. Diabetes also compromises pathways such as the SMAD, c-Jun N-terminal kinase, protein kinase C, and nuclear factor kappa beta activating caspase pathways, leading to cell death. Furthermore, diabetes renders the wound environment highly pro-oxidant and inflammatory, which is known as OxInflammation. As a consequence of this OxInflammation, delays in the collagenization process occur. The protocol details for this systematic review were registered with PROSPERO: CRD42021267776.


Asunto(s)
Transdiferenciación Celular , Inflamación , Miofibroblastos , Cicatrización de Heridas , Miofibroblastos/metabolismo , Miofibroblastos/patología , Animales , Inflamación/patología , Inflamación/metabolismo , Humanos , Ratones , Factor de Crecimiento Transformador beta/metabolismo , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patología
18.
PLoS One ; 19(8): e0299674, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39110713

RESUMEN

AIMS: To evaluate the external validity of Finnish diabetes risk score (FINDRISC) and Latin American FINDRISC (LAFINDRISC) for undiagnosed dysglycemia in hospital health care workers. METHODS: We carried out a cross-sectional study on health workers without a prior history of diabetes mellitus (DM). Undiagnosed dysglycemia (prediabetes or diabetes mellitus) was defined using fasting glucose and two-hour oral glucose tolerance test. LAFINDRISC is an adapted version of FINDRISC with different waist circumference cut-off points. We calculated the area under the receptor operational characteristic curve (AUROC) and explored the best cut-off point. RESULTS: We included 549 participants in the analysis. The frequency of undiagnosed dysglycemia was 17.8%. The AUROC of LAFINDRISC and FINDRISC were 71.5% and 69.2%; p = 0.007, respectively. The optimal cut-off for undiagnosed dysglycemiaaccording to Index Youden was ≥ 11 in LAFINDRISC (Sensitivity: 78.6%; Specificity: 51.7%) and ≥12 in FINDRISC (Sensitivity: 70.4%; Specificity: 53.9%). CONCLUSION: The discriminative capacity of both questionnaires is good for the diagnosis of dysglycemia in the healthcare personnel of the María Auxiliadora hospital. The LAFINDRISC presented a small statistical difference, nontheless clinically similar, since there was no difference by age or sex. Further studies in the general population are required to validate these results.


Asunto(s)
Diabetes Mellitus , Tamizaje Masivo , Humanos , Femenino , Masculino , Adulto , Perú/epidemiología , Persona de Mediana Edad , Estudios Transversales , Tamizaje Masivo/métodos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Diabetes Mellitus/sangre , Personal de Salud , Prueba de Tolerancia a la Glucosa , Glucemia/análisis , Factores de Riesgo , Estado Prediabético/diagnóstico , Estado Prediabético/sangre , Estado Prediabético/epidemiología
19.
J Diabetes Res ; 2024: 2527791, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39161705

RESUMEN

Aim: To estimate the prevalence and factors associated with diabetes among older adults and compare the prevalence rate of a three-round national survey of the Mexican Health and Aging Study (MHAS). Methods: A cross-sectional study was conducted with data obtained from MHAS 2015 (n = 8167), 2018 (n = 7854), and 2021 (n = 8060), which comprised a nationally representative sample of older adults in Mexico. The measures included sociodemographic characteristics and health. A binary logistic regression model was used to identify the association between independent variables and self-reported diabetes. Results: The prevalence of diabetes was 26.3%, 27.7%, and 28.1% in 2015, 2018, and 2021, respectively. This prevalence decreased with age and was higher for female, urban older adults, those with multimorbidity, a lower level of education, and without social security coverage for the three years. Age was associated with a lower possibility of presenting diabetes ([OR = 0.79[0.71-0.89]] and [OR = 0.41[0.33-0.52]] in groups aged 75-84 years and ≥85 years, respectively). Females continue to be more likely to present diabetes than males (OR = 1.39 [95% CI 1.25-1.55]). Older adults living in rural areas are 20% less likely to present diabetes than those living in urban areas (OR = 0.80 [95% CI 0.69-0.93]). Uninsured older adults (OR = 1.35 [95% CI 1.20-1.53]), those who wear glasses (OR = 1.23 [95% CI 1.16-1.30]), those with multimorbidity (OR = 1.13 [95% CI 1.01-1.27]), and those who currently drink alcohol (OR = 1.12 [95% CI 1.00-1.25]) were significantly more likely to have diabetes. Conclusion: An elevated prevalence of diabetes was found in older adults in Mexico, while not having access to social security was associated with a higher possibility of presenting diabetes and living in a rural area was associated with a lower possibility of presenting diabetes. Detection, prevention, and control programs should be implemented to reduce the incidence and severity of the disease in older adults and, thus, prevent its associated complications.


Asunto(s)
Diabetes Mellitus , Autoinforme , Humanos , Anciano , Femenino , Masculino , México/epidemiología , Estudios Transversales , Prevalencia , Anciano de 80 o más Años , Diabetes Mellitus/epidemiología , Factores de Riesgo , Encuestas Epidemiológicas , Factores de Edad , Envejecimiento , Persona de Mediana Edad , Factores Sexuales
20.
Braz Oral Res ; 38: e075, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39109771

RESUMEN

This study assessed the features of the 100 most-cited papers on diabetes mellitus (DM) in dentistry using bibliometric measures. A search of the most cited papers on DM using journals included in the category "Dentistry, Oral Surgery and Medicine" in the Web of Science database up to January 2023 was performed. The complete bibliographic records of the selected papers were exported in plain text or Research Information Systems (RIS) file format. The following bibliometric indicators were collected: title, year, authors, number of citations, mean number of citations, institution, country, continent, study design, journal, impact factor, and keywords. Graphical bibliometric networks were created using the VOSviewer software. The number of citations for the 100 most-cited papers in DM research ranged from 111 to 566. Six papers each had more than 400 citations. Most were observational studies (n = 50) from the United States (USA) (n = 23) and were published in the Journal of Periodontology (30%; n=30). Robert Genco was the most cited author and contributed the most to the top 100 articles (3,653 citations; n = 13). The VOSviewer map of co-authorship showed the existence of clusters in research collaboration. The most prolific institutions were the Universities of Buffalo and Michigan (n = 6 each). "Diabetes mellitus" was the most frequent keyword, with 31 occurrences. In conclusion, the most cited studies that investigated the relationship between dentistry and DM were in periodontology. Observational studies, primarily from the USA, have been the most cited thus far.


Asunto(s)
Bibliometría , Diabetes Mellitus , Factor de Impacto de la Revista , Humanos , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Investigación Dental/estadística & datos numéricos , Odontología/estadística & datos numéricos , Autoria
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