RESUMO
The innate immune response in Salmo salar, mediated by pattern recognition receptors (PRRs), is crucial for defending against pathogens. This study examined DDX41 protein functions as a cytosolic/nuclear sensor for cyclic dinucleotides, RNA, and DNA from invasive intracellular bacteria. The investigation determined the existence, conservation, and functional expression of the ddx41 gene in S. salar. In silico predictions and experimental validations identified a single ddx41 gene on chromosome 5 in S. salar, showing 83.92% homology with its human counterpart. Transcriptomic analysis in salmon head kidney confirmed gene transcriptional integrity. Proteomic identification through mass spectrometry characterized three unique peptides with 99.99% statistical confidence. Phylogenetic analysis demonstrated significant evolutionary conservation across species. Functional gene expression analysis in SHK-1 cells infected by Piscirickettsia salmonis and Renibacterium salmoninarum indicated significant upregulation of DDX41, correlated with increased proinflammatory cytokine levels and activation of irf3 and interferon signaling pathways. In vivo studies corroborated DDX41 activation in immune responses, particularly when S. salar was challenged with P. salmonis, underscoring its potential in enhancing disease resistance. This is the first study to identify the DDX41 pathway as a key component in S. salar innate immune response to invading pathogens, establishing a basis for future research in salmonid disease resistance.
Assuntos
Doenças dos Peixes , Imunidade Inata , Filogenia , Piscirickettsia , Infecções por Piscirickettsiaceae , Renibacterium , Salmo salar , Animais , Piscirickettsia/genética , Imunidade Inata/genética , Salmo salar/microbiologia , Salmo salar/genética , Salmo salar/imunologia , Doenças dos Peixes/microbiologia , Doenças dos Peixes/imunologia , Doenças dos Peixes/genética , Infecções por Piscirickettsiaceae/microbiologia , Infecções por Piscirickettsiaceae/imunologia , Infecções por Piscirickettsiaceae/genética , Infecções por Piscirickettsiaceae/veterinária , Renibacterium/genética , Renibacterium/imunologia , Proteínas de Peixes/genética , Proteínas de Peixes/metabolismo , Proteínas de Peixes/imunologia , RNA Helicases DEAD-box/genética , RNA Helicases DEAD-box/metabolismo , Evolução MolecularRESUMO
Tattoos are less prevalent in Mexico and tattooed persons are frequently stigmatized. We examine the prevalence and correlates of interest in receiving tattoo removal services among 278 tattooed Mexican adults living in Tijuana, Mexico who responded to interviewer-administered surveys, including open-ended questions. Overall, 69% of participants were interested in receiving free tattoo removal services, 31% reported facing employment barriers due to their tattoos, and 43% of respondents regretted or disliked some of their tattoos. Having a voter identification card, reporting moderate/severe depression symptoms and believing that tattoo removal would remove employment barriers were independently associated with interest in tattoo removal. Our findings suggest that there is substantial interest in tattoo removal services. Publicly financed tattoo removal services may help disadvantaged persons gain access to Mexico's labor market and it may positively impact other life domains such as mental well-being and interactions with law enforcement.
Assuntos
Tatuagem , Adulto , Humanos , México , Prevalência , Inquéritos e Questionários , Populações VulneráveisRESUMO
In Mexico, tattooed migrants face discrimination and are at high-risk of incarceration, thus, we assessed whether receiving laser tattoo removal affected the likelihood of incarceration. In 2015-2016, 89 adults ages ≥ 18 years with visible tattoos were recruited at a free-clinic to receive laser tattoo removal or assigned to the wait-list; all completed baseline and 6-month questionnaires. Overall, 97.8% of participants ever migrated to the USA. In multivariate analyses restricted to migrants (n = 87), those receiving laser tattoo removal [Adjusted Odds Ratio (AOR) 0.27, 95% CI 0.07-0.89] and possessing a Mexican Voting card (AOR 0.14; 95% CI 0.03-0.58) were significantly less likely than wait-list participants to be incarcerated at 6-months. Previously incarcerated participants were significantly more likely to be incarcerated at follow-up. Tattoo removal may reduce incarceration among Mexican migrants. Future studies can assess other health and social benefits of tattoo removal for migrants/deportees returning to Mexico.
Assuntos
Terapia com Luz de Baixa Intensidade/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Tatuagem/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Fatores Etários , Feminino , Humanos , Relações Interpessoais , Lasers de Estado Sólido , Masculino , México/etnologia , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo , Estados Unidos/epidemiologia , Listas de EsperaRESUMO
La vertebroplastia percutánea es una técnica aplicable a pacientes con fractura vertebral con síndrome doloroso importante y que no mejora con un manejo ortopédico y clínico integral. Se incluye una apretada historia del procedimiento, y se revisan sus indicaciones y contraindicaciones, así como las publicaciones que analizan sus ventajas y riesgos (AU)
Percutaneous vertebroplasty is a technique for the treatment of patients with vertebral fracture who have persistent pain even after orthopedic and clinical therapeutic measures. A brief historical note of the procedure is presented, and its indications and contraindications are outlined, along with a literature overview of its advantages and risks (AU)
Assuntos
Feminino , Idoso , Fraturas da Coluna Vertebral/terapia , Vertebroplastia/história , Vertebroplastia/métodos , Osteogênese Imperfeita/complicações , Osteoporose/complicações , Vertebroplastia/efeitos adversosRESUMO
BACKGROUND: The prevalence of diabetes has increased substantially in Mexico over the last 40 years, leading to significant impacts on population health and the healthcare system. Technology-based solutions may improve diabetes outcomes in areas where lack of efficient transportation creates barriers to care. OBJECTIVES: To estimate the lifetime cost-effectiveness of a technology-based diabetes care management program from the perspective of the Mexican healthcare system. METHODS: Clinical outcomes and cost data from a 3-arm randomized clinical trial of Dulce Wireless Tijuana, a diabetes care management program incorporating short-term mobile technology, were used as inputs in a validated simulation model for type 2 diabetes. Study arms included a control group (CG), Project Dulce diabetes care management (PD), and Project Dulce with technology enhancement (PD-TE). RESULTS: Intervention costs were $1448 for PD and $1740 for PD-TE compared with $740 for CG. Both intervention arms increased quality-adjusted life-years and costs. The incremental cost-effectiveness ratio for PD was $1635 and for PD-TE was $2220, both compared with CG. The incremental cost-effectiveness ratio for PD-TE versus PD was $4299. The results were sensitive to the time horizon. The PE and PD-TE interventions were cost-effective under time horizons of 15 to 20 years, but were not cost-effective under time horizons of 5 to 10 years. CONCLUSIONS: Both the PD and PD-TE were highly cost-effective from a Mexican health system perspective. Considering the economic impact of the diabetes epidemic and the widespread use of cellular technology in Mexico, implementation of PD-TE is warranted.
Assuntos
Diabetes Mellitus Tipo 2/terapia , Telemedicina , Tecnologia Biomédica/economia , Tecnologia Biomédica/métodos , Análise Custo-Benefício , Diabetes Mellitus Tipo 2/economia , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Aplicativos Móveis/economia , Anos de Vida Ajustados por Qualidade de Vida , Telemedicina/economia , Telemedicina/métodos , Resultado do TratamentoRESUMO
CONTEXT: Physical, sexual, and emotional abuse in childhood-adverse childhood experiences (ACEs)-are associated with poor mental and physical health. OBJECTIVE: To determine the prevalence of ACEs and their relationship to depression among Latino migrants in Mexico, which has not been previously examined. METHODS: A total of 110 Latinos aged 18 years and older residing in Tijuana, Mexico, completed interviewer-administered questionnaires, including the ACE scale (range = 0 to 10 items), at baseline in 2015. We studied the prevalence of ACEs (score on the ACE scale) and the presence of depressive symptoms (Patient Health Questionnaire-9). Multivariate logistic regression models were used to estimate the association between the ACE score and depressive symptoms. RESULTS: Overall, 82% of participants were men, and 82% reported being deported from the US. At least 1 ACE was reported by 64% of participants, and 33% reported 3 or more ACEs. Those who reported ever being incarcerated were significantly more likely to have 3 or more ACEs compared with no ACEs (56% vs 28%; p = 0.039). Symptoms of mild, moderate, or severe depression were identified in 14% of participants. In multivariate analyses, for each additional ACE item reported, participants were significantly more likely to meet criteria for depressive symptoms (adjusted odds ratio = 1.42; 95% confidence interval = 1.13-1.78; p = 0.002). CONCLUSION: Among Latino migrants residing in the US-Mexico border region, ACEs were pervasive and associated with depression symptoms. Programs and policies targeting migrants in this region should consider addressing both ACEs and depression.
Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Depressão/epidemiologia , Migrantes/estatística & dados numéricos , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Fatores Etários , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , México/epidemiologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores Sexuais , Fatores SocioeconômicosRESUMO
We describe the creation of the Health Frontiers in Tijuana (HFiT) Undergraduate Internship Program (UIP), a novel global health experience for U.S. and Mexican undergraduate students based at the binational HFiT student-run free clinic. The UIP introduces students to a diverse underserved patient population, and U.S.-Mexico border public health.
Assuntos
Saúde Global , Promoção da Saúde , Internato e Residência , Humanos , México , EstudantesRESUMO
BACKGROUND: The global epidemic of diabetes calls for innovative interventions. This study evaluated the effectiveness of the Project Dulce model, with and without wireless technology, on glycemic control and other clinical and self-reported outcomes in patients with poorly controlled type 2 diabetes in Mexico. SUBJECTS AND METHODS: Adults with type 2 diabetes and a glycated hemoglobin A1c (HbA1c) level of ≥8% were recruited from Family Medical Unit #27 of the Instituto Mexicano del Seguro Social (IMSS) in Tijuana, México, and randomly assigned to one of three groups: Project Dulce-only (PD); Project Dulce technology-enhanced with mobile tools (PD-TE); or IMSS standard of care/control group (CG). Clinical and self-reported outcomes were assessed at baseline, Month 4, and Month 10. Time-by-group interactions and within-group changes were analyzed. RESULTS: HbA1c reductions from baseline to Month 10 were significantly greater in PD-TE (-3.0% [-33 mmol/mol]) and PD (-2.6% [-28.7 mmol/mol]) compared with CG (-1.3% [-14.2 mmol/mol]) (P = 0.009 and 0.001, respectively). PD-TE and PD also exhibited significant improvement in diabetes knowledge when compared with CG (P < 0.05 for both). No statistically significant differences were detected between PD and PD-TE on these indicators (P = 0.54 and 0.86, respectively). Several within-group improvements were observed on other clinical and self-report indicators but did not vary significantly across groups. CONCLUSIONS: Project Dulce with and without wireless technology substantially improved glycemic control and diabetes knowledge in high-risk patients with type 2 diabetes in a Mexican family medical unit, suggesting that integrating peer-led education, nurse coordination, and 3G wireless technology is an effective approach for improving diabetes outcomes in high-risk populations.
Assuntos
Diabetes Mellitus Tipo 2/terapia , Conhecimentos, Atitudes e Prática em Saúde , Hiperglicemia/prevenção & controle , Aplicativos Móveis , Cooperação do Paciente , Educação de Pacientes como Assunto/métodos , Influência dos Pares , Adulto , Estudos de Coortes , Terapia Combinada/enfermagem , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/enfermagem , Estudos de Viabilidade , Feminino , Seguimentos , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Risco , Autorrelato , Tecnologia sem FioRESUMO
BACKGROUND: In 2009, Mexico reformed its health law to partially decriminalize drug possession considered for personal use and to increase mandatory referrals to certified drug rehabilitation centers in lieu of incarceration. Concurrently, news media reported violent attacks perpetrated by drug cartels against Mexican drug rehabilitation centers and instances of human rights violations by staff against people who inject drugs (PWID) in treatment. In many cases, these violent situations took place at "Peer Support" (Ayuda Mutua) drug rehabilitation centers that house a large number of drug-dependent PWID. In an effort to understand barriers to treatment uptake, we examined prevalence and correlates of perceived risk of violence at drug rehabilitation centers among PWID in Tijuana, Mexico. METHODS: Secondary analysis of baseline data collected between March 2011 and May 2013 of PWID recruited into a prospective cohort study in Tijuana. Interviewer-administered surveys measured perceived risk of violence at drug rehabilitation centers by asking participants to indicate their level of agreement with the statement "going to rehabilitation puts me at risk of violence". Logistic regression was used to examine factors associated with perceived risk of violence. RESULTS: Of 733 PWID, 34.5 % perceived risk of violence at drug rehabilitation centers. In multivariate analysis, reporting ever having used crystal methamphetamine and cocaine (separately), having a great or urgent need to get help for drug use, and ever receiving professional help for drug/alcohol use were negatively associated with perceived risk of violence at drug rehabilitation centers, while having been told by law enforcement that drug rehabilitation attendance is mandatory was positively associated with perceived risk of violence. All associations were significant at a 0.05 alpha level. CONCLUSION: The perception of violence at drug rehabilitation centers among PWID does not represent the lived experience of those PWID who attended professionalized services, reported a great or urgent need to get help for their drug use and had a history of using crystal and cocaine. Professionalizing service delivery and engaging law enforcement in their new role of decriminalization and service referral for PWID could address the perceptions of violence at drug rehabilitation centers. Similarly, health authorities should expand periodic inspections at drug rehabilitation centers to guarantee quality service provision and minimize PWIDs' concerns about violence.