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Type 2 diabetes mellitus prevalence has increased worldwide, especially in low- and middle-income countries. This study aimed to evaluate in the Colombian context whether the geographic variations of mortality due to type 2 diabetes mellitus are random or statistically significant and to measure the effect of the socioeconomic conditions of municipalities on these variations. An ecological study of trends for regions and subregions was undertaken considering two periods (2003-2009 and 2010-2016). The study population consisted of adults of 20 to 79 years old residing in each of Colombia’s municipalities during the period 2003-2016. Smoothed and standardized mortality rates were obtained by fitting a hierarchical Bayesian model, which considers the spatial structure of the data. Four socioeconomic variables related to municipal deprivation and development were included into the model to obtain their relative risk (RR) and 95% credible intervals. Mortality due to type 2 diabetes mellitus decrease between 2003 and 2016 in Colombia, both nationally and regionally. In addition, there was a clear positive association between mortality due to diabetes mellitus and the level of municipal development; the wealthiest and most developed municipalities had higher mortality risks. La prevalencia de la diabetes mellitus tipo 2 ha aumentado a nivel global, principalmente en los países de renta media y baja. El estudio tuvo como objetivo evaluar si en Colombia las variaciones geográficas de la mortalidad por diabetes mellitus tipo 2 son aleatorias o estadísticamente significativas, además de medir el efecto de las condiciones socioeconómicas de los municipios sobre esas variaciones. Se realizó un estudio ecológico de las tendencias en las regiones y sub-regiones, considerando dos períodos (2003-2009 y 2010-2016). La población del estudio incluía adultos entre 20 y 79 años de edad, residentes en cada municipio de Colombia, durante el período de 2003-2016. Las tasas de mortalidad suavizadas y estandarizadas se obtuvieron mediante un ajuste de un modelo bayesiano jerárquico, teniendo en cuenta la estructura espacial de los datos. Cuatro variables socioeconómicas relacionadas con la privación y el desarrollo municipal se incluyeron en el modelo para obtener el riesgo relativo (RR) e intervalos de credibilidad de 95%. La mortalidad por diabetes mellitus tipo 2 disminuyó entre 2003 y 2016 en Colombia, en los niveles tanto nacional, como regional. Asimismo, hubo una asociación positiva entre mortalidad por diabetes mellitus y nivel de desarrollo municipal; los municipios más ricos y más desarrollados presentaron un mayor riesgo de mortalidad. A prevalência do diabetes mellitus tipo 2 tem aumentado em nível global, principalmente nos países de renda média e baixa. O estudo teve como objetivo avaliar se na Colômbia, as variações geográficas da mortalidade por diabetes mellitus tipo 2 são aleatórias ou estatisticamente significativas, além de medir o efeito das condições socioeconômicas dos municípios sobre essas variações. Foi realizado um estudo ecológico das tendências nas regiões e sub-regiões, considerando dois períodos (2003-2009 e 2010-2016). A população do estudo incluía adultos entre 20 e 79 anos de idade, residentes em cada município da Colômbia no período de 2003-2016. As taxas de mortalidade suavizadas e padronizadas foram obtidas pelo ajuste de um modelo bayesiano hierárquico, levando em conta a estrutura espacial dos dados. Quatro variáveis socioeconômicas relacionadas à privação e ao desenvolvimento municipal foram incluídas no modelo para obter o risco relativo (RR) e intervalos de credibilidade de 95%. A mortalidade por diabetes mellitus tipo 2 diminuiu entre 2003 e 2016 na Colômbia, nos níveis tanto nacional quanto regional. Além disso, houve uma associação positiva entre mortalidade por diabetes mellitus e nível de desenvolvimento municipal; os municípios mais ricos e mais desenvolvidos apresentaram o maior risco de mortalidade.

En los últimos años ha habido un cambio radical en las instituciones de educaciónsuperior. El número de estudiantes ha aumentado, la competencia en impartir programas de calidad es una exigencia que demanda el entorno del mercado. Con el pasar del tiempo, han aparecido nuevos grados académicos que van unidos de la mano de una sociedad cada vez más tecnológica. La globalización y el acceso democrático a la educación y las experiencias de académicas internacionales de muchos estudiantes, precisan la estandarización de sus títulos académicos. Las siguientes abreviaturas corresponden a los grados académicos que son usados y deben escribirse después del nombre y apellido de la persona. Los grados por debajo de una maestría y que no corresponden a un grado profesional no se escriben; a menos que sea el máximo título que tiene una persona. Los grados especializados, licencias, certificaciones y credenciales por debajo del nivel de maestría en los campos médicos y en general del área de la salud deben escribirse. Los grados inusuales deben ser verificados siempre con la persona. Hay diferentes categorías de grados académicos para los estudiantes de postsecundaria, principalmente: asociado o técnico, licenciatura o profesional, especialista, maestría o magister y doctorado. Obtener uno de estos grados puede tomar entre 1-8 años, dependiendo del nivel del grado y el campo de estudio. Los diplomados no conducen a la obtención de un título o grado académico; no se consideran estudios de posgrado, pero sirve en algunas ocasiones para certificar el conocimiento de un tema específico.

A balanced immune response to infection is essential to prevent the pathology and tissue damage that can occur from an unregulated or hyperactive host defense. Interferons (IFNs) are critical mediators of the innate defense to infection, and in this study we evaluated the contribution of a specific gene coding for IFIT2 induced by type I IFNs in a murine model of disseminated Candida albicans. Invasive candidiasis is a frequent challenge during immunosuppression or surgical medical interventions, and C. albicans is a common culprit that leads to high rates of mortality. When IFIT2 knockout mice were infected systemically with C. albicans, they were found to have improved survival and reduced fungal burden compared to wild-type mice. One of the mechanisms by which IFIT2 increases the pathological effects of invasive C. albicans appears to be suppression of NADPH oxidase activation. Loss of IFIT2 increases production of reactive oxygen species by leukocytes, and we demonstrate that IFIT2 is a binding partner of a critical regulatory subunit of NADPH oxidase, p67phox. Since the administration of IFN has been used therapeutically to combat viral infections, cancer, and multiple sclerosis, we evaluated administration of IFN-β to mice prior to C. albicans infection. IFN-β treatment promoted pathology and death from C. albicans infection. We provide evidence that IFIT2 increases the pathological effects of invasive C. albicans and that administration of IFN-β has deleterious effects during infection., IMPORTANCE The attributable mortality associated with systemic C. albicans infections in health care settings is significant, with estimates greater than 40%. This life-threatening disease is common in patients with weakened immune systems, either due to disease or as a result of therapies. Type I interferons (IFN) are cytokines of the innate defense response that are used as immune modulators in the treatment of specific cancers, viral infections, and multiple sclerosis. In this study, we show using a murine model that the loss of a specific IFN-stimulated gene coding for IFIT2 improves survival following systemic C. albicans infection. This result infers a harmful effect of IFN during C. albicans infection and is supported by our finding that administration of IFN-β prior to invasive infection promotes fatal pathology. The findings contribute to our understanding of the innate immune response to C. albicans, and they suggest that IFN therapies present a risk factor for disseminated candidiasis.