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  1. Article ; Online: Diabetes and tuberculosis: a syndemic complicated by COVID-19.

    Antonio-Arques, Violeta / Franch-Nadal, Josep / Caylà, Joan A

    Medicina clinica

    2021  Volume 157, Issue 6, Page(s) 288–293

    Abstract: Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an ... ...

    Title translation Diabetes y tuberculosis: una sindemia complicada por la COVID-19.
    Abstract Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an important risk factor for developing TB, also presenting more complicated TB, more relapses and higher mortality. The DCs and the fourth world of the large cities are those with the highest incidence of TB and an increase in DM, which will make it difficult to control tuberculosis disease. At the same time, the COVID-19 pandemic is complicating the management of both diseases due to the difficulty of access to control and treatment and the worsening of socioeconomic inequalities. It is necessary to establish a bidirectional screening for TB and DM and promote recommendations for the joint management of both diseases.
    MeSH term(s) COVID-19 ; Diabetes Mellitus/epidemiology ; Humans ; Pandemics ; Risk Factors ; SARS-CoV-2 ; Syndemic ; Tuberculosis/complications ; Tuberculosis/diagnosis ; Tuberculosis/epidemiology
    Language Spanish
    Publishing date 2021-05-06
    Publishing country Spain
    Document type Journal Article ; Review
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2021.04.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Diabetes and tuberculosis: A syndemic complicated by COVID-19.

    Antonio-Arques, Violeta / Franch-Nadal, Josep / Caylà, Joan A

    Medicina clinica (English ed.)

    2021  Volume 157, Issue 6, Page(s) 288–293

    Abstract: Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an ... ...

    Abstract Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an important risk factor for developing TB, also presenting more complicated TB, more relapses and higher mortality. The DCs and the fourth world of the large cities are those with the highest incidence of TB and an increase in DM, which will make it difficult to control tuberculosis disease. At the same time, the COVID-19 pandemic is complicating the management of both diseases due to the difficulty of access to control and treatment and the worsening of socioeconomic inequalities. It is necessary to establish a bidirectional screening for TB and DM and promote recommendations for the joint management of both diseases.
    Language English
    Publishing date 2021-09-11
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 2387-0206
    ISSN (online) 2387-0206
    DOI 10.1016/j.medcle.2021.04.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Glycemic control and the risk of tuberculosis in patients with diabetes: A cohort study in a Mediterranean city.

    Antonio-Arques, Violeta / Caylà, Joan A / Real, Jordi / Moreno-Martinez, Antonio / Orcau, Àngels / Mauricio, Didac / Mata-Cases, Manel / Julve, Josep / Navas Mendez, Elena / Puig Treserra, Rai / Millet, Joan Pau / Del Val García, Jose Luis / Vlacho, Bogdan / Franch-Nadal, Josep

    Frontiers in public health

    2022  Volume 10, Page(s) 1017024

    Abstract: Background: Diabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active ... ...

    Abstract Background: Diabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active tuberculosis (TB). Subjects with DM are at a higher risk of infections, in addition to frequent micro and macrovascular complications, and therefore sought to determine whether poor glycemic control is linked to a higher risk of developing TB.
    Methods: We used a retrospective cohort of diabetic subjects to predict the incidence of TB. All DM patients were recruited from Ciutat Vella (the inner-city of Barcelona) from January 2007 until December 2016, with a follow-up period until December 2018 (≥2 years). Data were extracted from Barcelona's Primary Care medical record database - SIDIAP, and linked to the Barcelona TB Control Program. The incidence of TB and the impact of glycemic control were estimated using time-to-event curves analyzed by Cox proportional hazard regression. Hazard ratios (HRs) and 95% confidence intervals (CIs), unadjusted and adjusted by potential confounding variables, were also assessed, which included age, sex, diabetes duration, macrovascular and microvascular signs, BMI, smoking habit, alcohol consumption and geographical origin.
    Results: Of 8,004 DM patients considered for the study (equating to 68,605 person-years of follow-up), 84 developed TB [incidence rate = 70 (95% CI: 52-93) per 100,000 person-years]. DM subjects with TB were younger (mean: 52.2 vs. 57.7 years old), had higher values of glycosylated hemoglobin (HbA1c) (7.66 vs. 7.41%) and total triglycerides (122 vs. 105 mg/dl), and had twice the frequency of diabetic nephropathy (2.08 vs. 1.18%). The calculated incidence rate increased with increasing HbA1c: 120.5 (95% CI 77.2-179.3) for HbA1c ≥ 7.5%, 143 (95% CI 88.3-218.1) for HbA1c ≥ 8% and 183.8 (95% CI 105-298) for HbA1c ≥ 9%. An increase in the risk of TB was also observed according to a poorer optimization of glycemic control: adjusted HR 1.80 (95% CI 0.60-5.42), 2.06 (95% CI 0.67-6.32), and 2.82 (95% CI 0.88-9.06), respectively.
    Conclusion: Diabetic subjects with worse glycemic control show a trend toward a higher risk of developing TB.
    MeSH term(s) Humans ; Middle Aged ; Glycemic Control ; Cohort Studies ; Glycated Hemoglobin ; Retrospective Studies ; Quality of Life ; Diabetes Mellitus/epidemiology ; Tuberculosis/epidemiology
    Chemical Substances Glycated Hemoglobin A
    Language English
    Publishing date 2022-11-17
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2022.1017024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Subjects With Diabetes Mellitus Are at Increased Risk for Developing Tuberculosis: A Cohort Study in an Inner-City District of Barcelona (Spain).

    Antonio-Arques, Violeta / Franch-Nadal, Josep / Moreno-Martinez, Antonio / Real, Jordi / Orcau, Àngels / Mauricio, Didac / Mata-Cases, Manel / Julve, Josep / Navas Mendez, Elena / Puig Treserra, Rai / Barrot de la Puente, Joan / Millet, Joan Pau / Del Val García, Jose Luis / Vlacho, Bogdan / Caylà, Joan A

    Frontiers in public health

    2022  Volume 10, Page(s) 789952

    Abstract: Background: Tuberculosis is the leading cause of mortality from lung infectious disease worldwide in recent years, and its incidence has re-emerged in large cities in low-incidence countries due to migration and socioeconomic deprivation causes. ... ...

    Abstract Background: Tuberculosis is the leading cause of mortality from lung infectious disease worldwide in recent years, and its incidence has re-emerged in large cities in low-incidence countries due to migration and socioeconomic deprivation causes. Diabetes mellitus and tuberculosis are syndemic diseases, with diabetes being considered a risk factor for developing tuberculosis.
    Objective: To investigate whether diabetic patients were at increased risk of tuberculosis living in an inner-district of a large city of northeastern Spain.
    Methods: Observational matched retrospective cohort study based on clinical records from the population of the lowest socioeconomic status in Barcelona (Ciutat Vella district). A cohort including patients with type 1 and type 2 diabetes mellitus in 2007 and new cases until 2016 (8004 subjects), matched 1:1 by sex and age with a non-diabetic cohort. Follow-up period was until December 31st 2018. We evaluated the risk of developing tuberculosis in diabetic patients compared to non-diabetic patients during the follow up period. We used time-to-event analysis to estimate the incidence of tuberculosis, and competing risks regression by clusters and conditional Cox regression models to calculate the hazard ratio (HR) and its 95% confidence intervals (CI).
    Results: Among the 16,008 included subjects, the median follow-up was 8.7 years. The mean age was 57.7 years; 61.2% men and 38.8% women in both groups. The incidence of tuberculosis was 69.9 per 100,000 person-years in diabetic patients, and 40.9 per 100,000 person-years in non-diabetic patients (HR = 1.90; CI: 1.18-3.07). After adjustment for the country of origin, chronic kidney disease, number of medical appointments, BMI, alcoholism and smoking, the risk remained higher in diabetic patients (1.66: CI 0.99-2.77). Additionally, subjects from Hindustan or with a history of alcohol abuse also showed a higher risk of developing tuberculosis (HR = 3.51; CI:1.87-6.57, and HR = 2.73; CI:1.22-6.12 respectively).
    Conclusion: People with diabetes mellitus were at higher risk of developing tuberculosis in a large cohort recruited in an inner-city district with a high incidence for this outcome, and low socioeconomic conditions and high proportion of migrants. This risk was higher among Hindustan born and alcohol abusers.
    MeSH term(s) Cohort Studies ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spain/epidemiology ; Tuberculosis/epidemiology
    Language English
    Publishing date 2022-05-23
    Publishing country Switzerland
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2022.789952
    Database MEDical Literature Analysis and Retrieval System OnLINE

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