Comparison of abdominal adipose tissue versus body mass index (BMI) as a predictor of complications and survival in liver transplantation.

INTRODUCTION: Because of the obesity epidemic, more obese patients are on liver transplant (LT) waiting lists. The diseases associated with obesity may increase complications and limit survival after LT. However, there is no established measure or cut-off point to determine this impact and aid decision making. The aim of the present study is to evaluate obesity in patients undergoing LT via BMI and CT-based measurement of adipose tissue (AAT). These parameters will be used to predict the risk of postoperative complications and 5-year survival. METHODS: A retrospective, single-center study was carried out at a tertiary Spanish hospital, including all patients who received LT between January 2012 and July 2019 (n = 164). The patients were adults who underwent LT using the 'piggyback' technique, preserving the recipient vena cava. Visceral adipose tissue (VAT) and BMI were calculated to examine correlations with postoperative complications and 5-year survival. RESULTS: No significant association was found between postoperative complications by Comprehensive Complication Index, BMI, AAT/height, subcutaneous fat/height and VAT/height. Kaplan-Meier curves for 5-year survival compared LT recipients with BMI < 30.45 versus ≥30.45, with an estimated survival of 58.97 months versus 43.11 months, respectively (P < .001) (Fig. 3) and for LT recipients with an AAT/height <27.35 mm versus ≥27.35 mm, with an estimated survival of 57.69 months versus 46.34 months (P = .001). CONCLUSIONS: This study does not show a higher rate of postoperative complications in obese patients. There is a significantly lower long-term survival in patients with AAT/height ≥27.35 mm and BMI ≥ 30.45. BMI is a valid estimate of obesity and is predictive of survival.

Metatranscriptomics sheds light on the links between the functional traits of fungal guilds and ecological processes in forest soil ecosystems.

Soil fungi belonging to different functional guilds, such as saprotrophs, pathogens, and mycorrhizal symbionts, play key roles in forest ecosystems. To date, no study has compared the actual gene expression of these guilds in different forest soils. We used metatranscriptomics to study the competition for organic resources by these fungal groups in boreal, temperate, and Mediterranean forest soils. Using a dedicated mRNA annotation pipeline combined with the JGI MycoCosm database, we compared the transcripts of these three fungal guilds, targeting enzymes involved in C- and N mobilization from plant and microbial cell walls. Genes encoding enzymes involved in the degradation of plant cell walls were expressed at a higher level in saprotrophic fungi than in ectomycorrhizal and pathogenic fungi. However, ectomycorrhizal and saprotrophic fungi showed similarly high expression levels of genes encoding enzymes involved in fungal cell wall degradation. Transcripts for N-related transporters were more highly expressed in ectomycorrhizal fungi than in other groups. We showed that ectomycorrhizal and saprotrophic fungi compete for N in soil organic matter, suggesting that their interactions could decelerate C cycling. Metatranscriptomics provides a unique tool to test controversial ecological hypotheses and to better understand the underlying ecological processes involved in soil functioning and carbon stabilization.

Prevalence of SARS-CoV-2 infection and impact of the COVID-19 pandemic in avocado farmworkers from Mexico.

Introduction: The COVID-19 pandemic disproportionately affected farmworkers in the United States and Europe, leading to increased morbidity and mortality. However, little is known about the specific impact of the pandemic on agriculture and food production workers in low- and middle-income countries. This study aimed to investigate the prevalence of SARS-CoV-2 infection and assess the mental health and economic consequences of the COVID-19 pandemic among avocado farmworkers in Michoacan, Mexico. Methods: We conducted a cross-sectional study of adult farmworkers (n = 395) in May 2021. We collected survey data, nasal swabs and saliva samples for SARS-CoV-2 RNA detection, and blood samples for immunoglobulin G (IgG) reactivity measurements. Results: None of the farmworkers tested positive for SARS-CoV-2 RNA. However, among unvaccinated farmworkers (n = 336, 85%), approximately one-third (33%) showed evidence of past infection (positive for IgG against SARS-CoV-2). Unvaccinated farmworkers who lived with other farmworkers (aRR = 1.55; 95% CI: 1.05, 2.05), had ever lived with someone with COVID-19 (aRR = 1.82; 95% CI: 1.22, 2.43), and who had diabetes (aRR = 2.19; 95% CI: 1.53, 2.85) had a higher risk of testing IgG-positive for SARS-CoV-2 infection. In contrast, unvaccinated farmworkers living in more rural areas (outside of Tingambato or Uruapan) (aRR = 0.71; 95% CI: 0.46, 0.96) or cooking with wood-burning stove (aRR = 0.75; 95% CI: 0.55, 0.96) had a lower risk of IgG-positivity. Moreover, 66% of farmworkers reported a negative impact of the pandemic on their lives, 29% reported experiencing food insecurity and difficulty paying bills, and 10% reported depression or anxiety symptoms. Conclusion: The COVID-19 pandemic has significantly affected the mental health and financial well-being of avocado farmworkers. Consequently, the implementation of interventions and prevention efforts, such as providing mental health support and food assistance services, is imperative.

Hernioplastía video laparoscópica / Laparoscopic hernia repair

La cirugía videolaparoscópica en la actualidad ha introducido la técnica en las distintas áreas de la cirugía general, incluyendo el abordaje de las hernias inguinofemorales: El presente estudio reúne la experiencia de este procedimiento con un total de 10 pacientes con 11 hernias de la región inguinal. Se utilizó malla de polipropileno en posición preperitoneal con abordaje transabdominal en todos los casos, fijándola con grapas de titanio. No hubo complicaciones relacionadas con el procedimiento. El tiempo operatorio varió de 35 a 120 minutos; la estancia hospitalaria no excedió las 24 horas en ningún caso. Después de un año de seguimiento se tuvo una recidiva. Consideramos la presente como una alternativa en la reparación de hernias inguinofemorales

Seroepidemiología de la infección por el virus A de la hepatitis en comunidades de la frontera sur del estado de Chiapas / Seroepidemiology of hepatitis A in communities on the Southern border of the state of Chiapas

Se investigó la epidemiología de la hepatitis A en la población guatemalteca y mexicana asentada en la frontera sur de México. Se estudiaron 1,127 sueros por medio del análisis inmunoenzimático, buscando anticuerpos totales contra el virus A de la hepatitis y la inmunoglobulina M específica en los niños menores de cinco años. De 764 sueros de guatemaltecos, 756 (98,9%) fueron positivos para la hepatitis A y 362 (99%) de 363 sueros de mexicanos. Se encontró una positividad del 100% en casi todos los grupos de edad, con un pequeño descenso porcentual para el grupo de uno a dos años de edad, en los guatemaltecos (87.8%) y los mexicanos (93.8%). La mediana de porcentajes de neutralización varió de 90 a 100% en los individuos seropositivos de ambas poblaciones. En 47 (25%) de 186 niños guatemaltecos y mexicanos menores de cinco años, se encontraron IgM contra el virus A de la hepatitis. Los resultados obtenidos indican que la infección por el virus A de la hepatitis es hiperendémica en la zona estudiada, que los niños adquieren esta infección en los primeros tres años de la vida y que la epidemiología de la hepatitis A entre los mexicanos no se modificó con la llegada de los refugiados guatemaltecos