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Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population.

Meningococcal B strains accounts for some 72% and 28% of meningococcal diseases in infants and toddlers in Europe and the USA, respectively. Nevertheless, meningococcal diseases are rare in Cuba owing to the wide spread program on antimeningococcal vaccination in the country. Finlay Institute is one of the pioneering organizations in Neisseria Vaccinology mainly by its contribution to N. meningitidis serogroup B outer membrane-based bivalent vaccine, VA-MENGOC-BC™. This vaccine was given intramuscularly in more than 60 million doses corresponding 10.7 millions of them to Cuban young adults, children, and infants. However, most dangerous or commensally Neisseria strains enter and establish in the mucosa, where the secretory (S) IgA is the main specific guardian and is mainly induced by mucosal routes. However, few mucosal vaccines exist principally due to the absent of mucosal adjuvants. We develop a Finlay Adjuvant (AF) platform based in outer membrane vesicles (Proteoliposome, PL) and its derivate Cochleate (Co). AFPL1 derived from serogroup B N. meningitidis is a potent Th1/CTL driving parenteral adjuvant. AFCo1 is a potent mucosal adjuvant. Therefore, we sought to go deeper in the possible mucosal cross recognition between N. meningitidis serogroups and Neisseria species and explore a concurrent mucosal and parenteral immunization strategy (SinTimVaS) in order to develop suitable mucosal vaccines. Experiments were conducted in Balb/c or C57Bl6 mice with mucosal and systemic immunization using AFCo1 and AFPL1. Human sera and saliva were also analyzed for cross cognition. Mucosal cross recognition at SIgA level in human saliva between N. meningitidis serogroups B, A, C, Y, and W135 were observed. This SIgA cross recognition response was also observed between pathogenic (N. meningitidis serogroup B, N. gonorrhoeae) and non-pathogenic strains (N. flava, N. lactamica). The possible influence of meningococcal vaccination against Gonorrhea was also explored. A proprietary Single Time Vaccination Strategy combining simultaneous mucosal and parenteral doses was developed. N. meningitidis and N. gonorrhoeae show significant cross immune response, and mucosal immunization with AFCo1 to obtain immunity against both strains may be a useful strategy to combat both infections in humans. Single Time Vaccination Strategy could be important to increased human vaccination coverage and herd immunity protecting both systemic and mucosal environments.

Muchos de los medicamentos que utilizamos en nuestras consultas, y a los que presuponemos inocuidad, pueden producir multitud de efectos secundarios que en ocasiones pueden llegar a ser letales. La agranulocitosis es una poco frecuente alteración sanguínea consistente en una neutropenia severa que asocia infecciones graves y una elevada mortalidad. Un gran número de medicamentos se han asociado con la producción de agranulocitosis antibióticos, antiinflamatorios , antidepresivos, etc... Dentro de estos medicamentos el metamizol ha sido uno de los fármacos que clásicamente se ha asociado a este trastorno sanguíneo. Ampliamente utilizado, el metamizol, goza de gran popularidad no sólo entre el ambiente médico sino entre los mismos pacientes que pueden conseguirlo sin receta médica en cualquier farmacia dentro de nuestro país. Aunque la asociación de agranulocitosis y metamizol es poco frecuente debemos tenerla presente por las graves consecuencias que puede traer. Tal fue el caso de la paciente que describimos, la cual tras haber recibido metamizol debió ser atendida urgentemente en su domicilio, siendo posteriormente remitida al hospital. La analítica en urgencias mostró una agranulocitosis. Posteriormente ingresaría en la unidad de cuidados intensivos donde, a pesar de las medidas de soporte y la antibioterapia, la paciente falleció a las pocas horas. Many of the medicines used daily and which are supposed harmless, may in fact produce numerous side-effects which can, on occasions, be life-threatening. Agranulocytosis is an uncommon alteration of the blood consisting of severe neutropenia with serious associated infections and a high mortality rate. A great number of medications have been associated with the production of agranulocytosis: antibiotics, anti-inflammatory, anti-depressants, etc. Of these medicines metamizol has been one of the most closely-associated with this blood disorder. Widely used, metamizol, is very popular not only in medical circles, but also amongst patients who are able to buy it without prescription from any pharmacy in our country. Although the association between agranulocytosis and metamizol is not common, we should be aware of the grave consequences which may arise. This was the case of the patient described who, having taken metamizol, required urgent treatment at home, before being admitted to hospital. Emergency room analysis revealed agranulocitosis. The patient was admitted to the Intensive Care Unit where, in spite of support and anti-biotherapy, she died within a few hours.