Rural treatment of COVID-19 patients with pirfenidone, nitazoxanide and colchicine. Case series.

Combined treatments against SARS-CoV-2 are emerging and some have taken into account the post-COVID-19 fibrosis. The aim of this survey was to report the experience of treating COVID-19 patients with pirfenidone, nitazoxanide (NTZ) and colchicine. It was a case series report of COVID-19 patients treated from December 2020 to March 2021, in a rural health center located in the State of Mexico, Mexico. 23 patients were included (mean age 44.5 ± 17.1 years), 12 women (mean age 45.9 ± 17.9 years) and 11 men (mean age 43 ± 16.9 years) with four deaths (17.39%). The evolution time was of 17.3 ± 6.7 days being the main symptoms fever (82.6%), myalgia (69.6%) and cough (65.2%). The main comorbidities were overweight/obesity 18 (78.26%), type 2 diabetes mellitus (T2DM) 4 (17.39%), Chronic obstructive pulmonary disease (COPD) 5 (21.73%) and systemic hypertension 2 (8.69%). Two patients were intubated and both died; in these cases, they refused to take NTZ until after three days the medical doctor had prescribed it for the first time. It can be concluded that implementing a mixed treatment with pirfenidone, NTZ and colchicine could improve the survival rate in ambulatory patients of low socioeconomic status.

Differences in the Asymmetry of Beat-to-Beat Fetal Heart Rate Accelerations and Decelerations at Preterm and Term Active Labor.

The fetal autonomic nervous system responds to uterine contractions during active labor as identified by changes in the accelerations and decelerations of fetal heart rate (FHR). Thus, this exploratory study aimed to characterize the asymmetry differences of beat-to-beat FHR accelerations and decelerations in preterm and term fetuses during active labor. In an observational study, we analyzed 10 min of fetal R-R series collected from women during active preterm labor (32-36 weeks of pregnancy, n = 17) and active term labor (38-40 weeks of pregnancy, n = 27). These data were used to calculate the Deceleration Reserve (DR), which is a novel parameter that quantifies the asymmetry of the average acceleration and deceleration capacity of the heart. In addition, relevant multiscale asymmetric indices of FHR were also computed. Lower values of DR, calculated with the input parameters of T = 50 and s = 10, were associated with labor occurring at the preterm condition (p = 0.0131). Multiscale asymmetry indices also confirmed significant (p < 0.05) differences in the asymmetry of FHR. Fetuses during moderate premature labor may experience more decaying R-R trends and a lower magnitude of decelerations compared to term fetuses. These differences of FHR dynamics might be related to the immaturity of the fetal cardiac autonomic nervous system as identified by this system response to the intense uterine activity at active labor.

sRANKL and its correlation with metabolic syndrome parameters in children.

BACKGROUND: Activating receptor ligand for nuclear factor (RANKL) has been identified as a ligand attached to the cell membrane of osteoblasts and odontoclasts. AIM: To determine a possible association of sRANKL in saliva and serum with the parameters of metabolic syndrome (MS) in paediatric population aged 8-12 years. DESIGN: This was a clinical, analytical and comparative study. Students between 6 and 12 years with good oral hygiene were included. Anthropometry, clinical analysis, dentobacterial plaque registration were registered as well as sRANKL in total saliva and serum through the ELISA technique. RESULTS: A total of 43 children were enrolled, with a mean age of 9.7 (±0.8 years). Contrasting the groups by the presence or absence of the waist circumference above the normal limit, the difference in serum sRANKL concentration was statistically significant (P ≤ 0.05). A negative statistical significance was found in the correlation between serum sRANKL and HDLc (r2  = -0.310, P = 0.046). Saliva sRANKL did not show statistical difference between neither gender nor body mass index and was not correlated with any parameter of the MS. CONCLUSIONS: A good oral hygiene seems to avoid the effects of MS on the oral cavity.

[Expression of gamma interferon during HPV and Chlamydia trachomatis infection in cervical samples]. / Expresión de interferón gamma en la infección por el virus del papiloma humano y por Chlamydia trachomatis en muestras cervicales.

INTRODUCTION: The aim of this study was to mesure the expression of gamma interferon in HPV and Chlamydia trachomatis infection in squamous intraepithelial lesions. METHOD: Samples from 100 patients diagnosed by colposcopy with or without squamous intraepithelial lesions were used in the present study. Each patient was found to be infected by HPV and C.trachomatis. Relative gamma interferon mRNA expression was assessed using a real-time reverse transcriptase PCR assay (RT-PCR). RESULTS: The relative units of expression of gamma interferon mRNA were 13, 1.8 and 0.3, for HPV and C.trachomatis co-infection, or HPV or C.trachomatis infection, respectively. CONCLUSION: HPV and C.trachomatis could overstimulate the expression of gamma interferon.

Effectiveness of Toki's criteria and determination of variables for identification of HPV L1 protein in oral lesions.

OBJECTIVE: To evaluate the effectiveness of Toki's criteria in identifying the HPV L1 protein in oral lesions with the use of immunohistochemistry (IHC) and to determine which criteria optimize such identification. STUDY DESIGN: Retrospective study of 277 cases diagnosed as HPV lesions at 22 years. Tests of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), kappa coefficients, and chi2 values, as well as two logistic regression analyses (p≤0.05), were conducted. RESULTS: Of the lesions studied, 96.4% (267 of 277) were positive for HPV using Toki's criteria and 28.5% (79 of 277) were positive for L1 by IHC. Toki's criteria showed sensitivity=93.67%, specificity=2.53%, PPV=6.99%, and NPV=46.55%. Neither concordance nor statistically significant associations were observed between both tests. The logistic regression of Toki's criteria was useful in the diagnosis of L1, correctly classified 71.8% of the lesions positive for L1, and showed a Hosmer-Lemeshow adjustment of p=0.614 and a Nagelkerke's coefficient of determination of 6.8%. The explanatory variables statistically significant at p≤0.05 were dyskeratosis (p=0.01) and papillomatosis (p=0.04). Forty-nine independent variables (clinical and histopathologic) were involved in the second regression analysis. The model correctly classified 85.2% of the lesions and showed a Hosmer-Lemeshow adjustment of p=0.696 and a Nagelkerke's coefficient of determination of 60.2%. The explanatory variables statistically significant at p≤0.05 were: age younger than 35 years (p=0.001), multiple lesions (p=0.031), hyperorthokeratosis (p=0.019), focal intracellular edema (p=0.002), and the presence of 1 to more than 5 cells with degenerative changes in their nucleus (p=0.048). CONCLUSIONS: Toki's criteria are not adequate to make a diagnosis of lesions by HPV in the mouth, but the logistic regression analysis showed clinical and histopathologic variables which optimize the identification of lesions through the L1 protein. However, a PCR study is advisable when the presence of high-risk HPV is suspected.

Remission of central fever with morphine post traumatic brain injury.

After a brain injury, raised temperature may be due to a regulated readjustment in the hypothalamic 'set-point' in response to inflammation. The purpose of this report is to mention possible implications related to temperature and homeostasis of morphine treatment in a patient with brain injury. During the month previous to her hospitalization in our city she was treated for fever with paracetamol and metamizol without results. After 31 days with similar results, we changed to morphine IV considering the possibility of treating pain and fever. This option was successful and afterwards we changed to fentanyl patches, keeping fever absent. After 100 days of hospitalization, the patient was discharged to her home.

Analysis of fetal heart rate fluctuations in women diagnosed with preeclampsia during the latent phase of labor.

Introduction: Fetal heart rate variability (fHRV) is a tool used to investigate the functioning of the fetal autonomic nervous system. Despite the significance of preeclampsia, fHRV during the latent phase of labor has not been extensively studied. This study aimed to evaluate fetal cardiac autonomic activity by using linear and nonlinear indices of fHRV analysis in women diagnosed with preeclampsia without hypertensive treatment during gestation, compared to normotensive women during the latent phase of labor. Methods: A cross-sectional and exploratory study was conducted among pregnant women in the latent phase of labor, forming three study groups: normotensive or control (C, 38.8 ± 1.3 weeks of pregnancy, n = 22), preeclampsia with moderate features (P, 37.6 ± 1.4 weeks of pregnancy n = 10), and preeclampsia with severe features (SP, 36.9 ± 1.2 weeks of pregnancy, n = 12). None of the participants received anti-hypertensive treatment during their pregnancy. Linear and nonlinear features of beat-to-beat fHRV, including temporal, frequency, symbolic dynamics, and entropy measures, were analyzed to compare normotensive and preeclamptic groups. Results: Significantly lower values of multiscale entropy (MSE) and short-term complexity index (Ci) were observed in the preeclamptic groups compared to the C group (p < 0.05). Additionally, higher values of SDNN (standard deviation of R-R intervals) and higher values of low-frequency power (LF) were found in the P group compared to the C group. Conclusion: Our findings indicate that changes in the complexity of fetal heart rate fluctuations may indicate possible disruptions in the autonomic nervous system of fetuses in groups affected by undiagnosed preeclampsia during pregnancy. Reduced complexity and shifts in fetal autonomic cardiac activity could be associated with preeclampsia's pathophysiological mechanisms during the latent phase of labor.

The tetrad BMI, leptin, leptin/adiponectin (L/A) ratio and CA 15-3 are reliable biomarkers of breast cancer.

BACKGROUND: Several studies have reported that leptin levels, the leptin/adiponectin (L/A) ratio and carbohydrate antigen (CA) 15-3 are especially elevated in breast cancer patients with high body mass index (BMI). The purpose of this study was to evaluate BMI, leptin, L/A ratio and CA 15-3 all together as reliable biomarkers for breast cancer. METHODS: Serum levels of leptin, adiponectin and CA 15-3, as well as anthropometric and biochemical parameters were analysed in 88 female patients who participated in a mammography study. Predictive values of BMI, leptin, L/A ratio and CA 15-3 were determined with a 95% confidence interval. RESULTS: Women were diagnosed with either breast cancer (n = 40) or benign breast lesions (n = 48). Among anthropometric parameters, age (P ≤ 0.001), weight (P ≤ 0.05) and waist circumference (P ≤ 0.02) were higher in patients with breast cancer than in patients without this pathology. The 75th percentile values for BMI, leptin, L/A ratio and CA 15-3 were 29.24 kg/m(2), 26.65 ng/ml, 2.37 and 18.45 IU, respectively. The suggested odds ratio for breast cancer patients with the values that were above the 75th percentile of the tetrad was 6.7 (0.7505-60.0665 confidence interval). CONCLUSION: When the four variables were analysed together, a sensitivity of 83.3%, specificity of 80%, positive predictive value of 83.3% and negative predictive value of 80% were obtained. Results indicate that using the 75th percentile set points for BMI, leptin, L/A ratio and CA 15-3 together could offer a reliable approach to determine which women are at high risk for developing breast cancer.

[Incidence of congenital heart disease and factors associated with mortality in children born in two Hospitals in the State of Mexico]. / Incidencia de las cardiopatías congénitas y los factores asociados a la letalidad en niños nacidos en dos hospitales del Estado de México.

We studied the incidence, survival, and risk factors for mortality in a cohort of infants for a period of five years, born in two hospitals, one a second-level General Hospital, the second a tertiary perinatal hospital, both in the City of Toluca. The analysis of survival was performed with the Kaplan-Meier method, and Cox regression was used to estimate the risk of death according to different factors. We found an overall incidence of 7.4 per 1,000 live births; in preterm infants, the rate was 35.6 per 1,000, and in term newborns it was 3.68 per 1,000. The most common heart disease was the ductus arteriosus in the overall group and in preterm infants; in term newborns the most common was the atrial septal defect. The specific mortality was 18.64%, follow-up was 579 days, where we found, according to Kaplan-Meier, survival of an average of 437.92 days, with 95% confidence intervals of 393.25 to 482.6 days, with a standard error of 22.79 days; the cumulative probability of survival was 0.741, with a standard error of 0.44. In Cox regression, two variables had a high hazard ratio (HR): these were the presence or absence of cyanosis and the hospital where they were treated as newborns.

Multiscale asymmetry reveals changes in the maternal short-term heart rate dynamics of preeclamptic women during labor.

BACKGROUND: It is known that acceleration and deceleration patterns in heart rate variability (HRV) are asymmetrically distributed in healthy subjects. Accordingly, novel approaches for assessing the asymmetrical properties of HRV, such as the multiscale asymmetry (MSA), have been applied in the perinatal field. OBJECTIVE: To study the asymmetry of accelerations and decelerations of maternal short-term cardiac dynamics of thirty-six normotensive and preeclamptic women during labor/nonlabor by MSA analysis. METHODS: The RR interval time series obtained from these participants were classified into four groups: normotensive (control) without labor C-NL, n= 10; control with labor C-L, n= 10; and two preeclamptic groups with absence or presence of labor P-NL, n= 6; and P-L, n= 10, respectively. Multiscale indices of heart rate asymmetry (HRA) such as Porta (P%), Guzik (G%) and Ehlers (E) were used to explore the changes of HRA in the normotensive and preeclamptic groups in the presence or absence of labor. RESULTS: The main result of this study shows that preeclamptic women manifest decreased magnitude of decelerations of heart rate dynamics compared to normotensive women indicated by G% and E. We speculate that a lower cardiac parasympathetic response may be manifested in preeclamptic women during labor/nonlabor compared to normotensive women. CONCLUSIONS: These observations represented a new insight into the autonomic cardiovascular regulation in preeclampsia, which could contribute to the perinatal field in the future.

Changes in the autonomic cardiorespiratory activity in parturient women with severe and moderate features of preeclampsia.

Background: Cardiorespiratory coupling (CRC) is a physiological phenomenon that reflects the mutual interaction between the cardiac and respiratory control systems. It is mainly associated with efferent vagal activity from the central autonomic network. Few studies have explored the autonomic changes of CRC in preeclampsia, a critical obstetric complication related to possible autonomic dysfunctions and inflammatory disturbances. This study examined the autonomic mechanisms of CRC in women with severe and moderate preeclampsia and healthy controls by applying nonlinear methods based on information theory, such as mutual information (MI) and Renyi's mutual information (RMI) and the linear and nonlinear analysis of the Pulse-Respiration Quotient (PRQ). Methods: We studied three groups of parturient women in the third trimester of pregnancy with a clinical diagnosis of preeclampsia without severe symptoms (P, 38.5 ± 1.4 weeks of pregnancy, n=19), preeclampsia with severe symptoms (SP, 37.5 ± 0.9 weeks of pregnancy, n=22), and normotensive control women (C, 39.1 ± 1.3 weeks of pregnancy, n=20). 10-minutes of abdominal electrocardiograms (ECG) and respiratory signals (RESP) were recorded in all the participants. Subsequently, we obtained the maternal beat-to-beat (RR) and breath-to-breath (BB) time series from ECG and RESP, respectively. The CRC between RR and BB was quantified by nonlinear methods based on information theory, such as MI and RMI, along with the analysis of the novel index of PRQ. Subsequently, we computed the mean PRQ (mPRQ) and the normalized permutation entropy (nPermEn_PRQ) from the PRQ time series generated from BB and RR. In addition, we examined the vagal activity in the three groups by the logarithm of the median of the distribution of the absolute values of successive RR differences (logRSA). Results: The MI and RMI values were significantly lower (p<0.05) in the preeclamptic groups compared to the control group. However, no significant differences were found between the preeclamptic groups. The logRSA and nPermEn_PRQ indices were significantly lower (p<0.05) in SP compared to C and P. Conclusion: Our data suggest that parturient women with severe and mild preeclampsia may manifest an altered cardiorespiratory coupling compared with normotensive control women. Disrupted CRC in severe preeclampsia could be associated with vagal withdrawal and less complex cardiorespiratory dynamics. The difference in vagal activity between the preeclamptic groups may suggest a further reduction in vagal activity associated with the severity of the disease.

Development and validation of a multivariable genotype-informed gestational diabetes prediction algorithm for clinical use in the Mexican population: insights into susceptibility mechanisms.

INTRODUCTION: Gestational diabetes mellitus (GDM) is underdiagnosed in Mexico. Early GDM risk stratification through prediction modeling is expected to improve preventative care. We developed a GDM risk assessment model that integrates both genetic and clinical variables. RESEARCH DESIGN AND METHODS: Data from pregnant Mexican women enrolled in the 'Cuido mi Embarazo' (CME) cohort were used for development (107 cases, 469 controls) and data from the 'Mónica Pretelini Sáenz' Maternal Perinatal Hospital (HMPMPS) cohort were used for external validation (32 cases, 199 controls). A 2-hour oral glucose tolerance test (OGTT) with 75 g glucose performed at 24-28 gestational weeks was used to diagnose GDM. A total of 114 single-nucleotide polymorphisms (SNPs) with reported predictive power were selected for evaluation. Blood samples collected during the OGTT were used for SNP analysis. The CME cohort was randomly divided into training (70% of the cohort) and testing datasets (30% of the cohort). The training dataset was divided into 10 groups, 9 to build the predictive model and 1 for validation. The model was further validated using the testing dataset and the HMPMPS cohort. RESULTS: Nineteen attributes (14 SNPs and 5 clinical variables) were significantly associated with the outcome; 11 SNPs and 4 clinical variables were included in the GDM prediction regression model and applied to the training dataset. The algorithm was highly predictive, with an area under the curve (AUC) of 0.7507, 79% sensitivity, and 71% specificity and adequately powered to discriminate between cases and controls. On further validation, the training dataset and HMPMPS cohort had AUCs of 0.8256 and 0.8001, respectively. CONCLUSIONS: We developed a predictive model using both genetic and clinical factors to identify Mexican women at risk of developing GDM. These findings may contribute to a greater understanding of metabolic functions that underlie elevated GDM risk and support personalized patient recommendations.

Hyperleptinemia as a prognostic factor for preeclampsia: a cohort study.

INTRODUCTION: Leptin is an adipokine which has a direct relationship to obesity. Our aim was to measure this hormone in pregnant women at three months intervals throughout their pregnancies to determine the serum value of those who developed preeclampsia. MATERIAL AND METHODS: We followed 19 women (median age 24.8 +/- 5.7 years) with pre-gestational Body Mass Index (BMI) less than 25 kg/m2, 21 (median age 26.1 +/- 4.6 years) with BMI higher than 25 kg/m2 and 16 (median age 30.9 +/- 5.8 years) with Gestational Diabetes Mellitus (GDM) (median age 30.9 +/- 5.8 years), recruited in the 1st trimester of pregnancy. Serum levels of leptin were measured with radioimmunoassay (RIA) technique. RESULTS: In the first trimester of pregnancy leptin levels showed statistically significant differences between normal weight and overweight-obese women (p < 0.001), diabetic women (p < 0.05) and the subgroup of preeclamptic women (p < 0.001). For those women with PGBMI > or = 40 kg/m2 and leptin > or = 40 ng/ml in the second trimester, the Odds Ratio (OR) to develop preeclampsia was of 47.95% CI (4.1-527.2). Analyzing leptin values with ROC curves, the greatest area under the curve (AUC) was for leptin in the second trimester (0.773, CI: 0.634-0.911). CONCLUSION: Women with morbid obesity (BMI > or = 40 kg/m2) had significantly higher levels of serum leptin (p < 0.01) and a value of 40 ng/ml of this hormone seems to be predictive of developing preeclampsia in this group of patients.

Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with symptomatic versus asymptomatic irreversible pulpitis.

This study sought to determine the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine in patients with symptomatic and asymptomatic irreversible pulpitis in mandibular posterior teeth and if individual patient factors, pulpal disease characteristics, and previous medication are correlated to local anesthetic success. A second objective was to determine the specificity and sensibility of a cold test for prediction of anesthetic success prior to endodontic treatment. Seventy patients diagnosed with irreversible pulpitis in mandibular posterior teeth received 1.6 mL of 4% articaine with 1:100,000 epinephrine for an inferior alveolar nerve block (IANB) using a metal guide. The anesthetic solution was injected with a computer-preprogrammed delivery system for local anesthesia. Endodontic access was begun 15 minutes after solution deposition; later, patients rated their discomfort using the visual analog scale (VAS). The success rate for the IA NB using articaine was 64.2% in patients with symptomatic irreversible pulpitis and 86.9% in patients with asymptomatic irreversible pulpitis. Cold test prior to root canal treatment had a specificity and sensibility of 12.5% and 87.1%, respectively. The anesthetic efficacy of articaine in irreversible pulpitis is moderately acceptable, and anesthetic success increases when the patient has been premedicated with NSAIDs. The cold test appears to be a favorable indicator for predicting anesthetic success.

Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor.

Background: The autonomic nervous system of preterm fetuses has a different level of maturity than term fetuses. Thus, their autonomic response to transient hypoxemia caused by uterine contractions in labor may differ. This study aims to compare the behavior of the fetal autonomic response to uterine contractions between preterm and term active labor using a novel time-frequency analysis of fetal heart rate variability (FHRV). Methods: We performed a case-control study using fetal R-R and uterine activity time series obtained by abdominal electrical recordings from 18 women in active preterm labor (32-36 weeks of gestation) and 19 in active term labor (39-40 weeks of gestation). We analyzed 20 minutes of the fetal R-R time series by applying a Continuous Wavelet Transform (CWT) to obtain frequency (HF, 0.2-1 Hz; LF, 0.05-0.2 Hz) and time-frequency (Flux0, Flux90, and Flux45) domain features. Time domain FHRV features (SDNN, RMSSD, meanNN) were also calculated. In addition, ultra-short FHRV analysis was performed by segmenting the fetal R-R time series according to episodes of the uterine contraction and quiescent periods. Results: No significant differences between preterm and term labor were found for FHRV features when calculated over 20 minutes. However, we found significant differences when segmenting between uterine contraction and quiescent periods. In the preterm group, the LF, Flux0, and Flux45 were higher during the average contraction episode compared with the average quiescent period (p<0.01), while in term fetuses, vagally mediated FHRV features (HF and RMSSD) were higher during the average contraction episode (p<0.05). The meanNN was lower during the strongest contraction in preterm fetuses compared to their consecutive quiescent period (p=0.008). Conclusion: The average autonomic response to contractions in preterm fetuses shows sympathetic predominance, while term fetuses respond through parasympathetic activity. Comparison between groups during the strongest contraction showed a diminished fetal autonomic response in the preterm group. Thus, separating contraction and quiescent periods during labor allows for identifying differences in the autonomic nervous system cardiac regulation between preterm and term fetuses.

Perspectives for the use of silver nanoparticles in dental practice.

Nanotechnology has been used for medical applications in several forms, including dental practice with the development of silver nanoparticles (Ag NPs) as a useful tool. The aim of this review was to identify the properties and appliances of Ag NPs in dental practice. Silver compounds and NPs have already been used as dental restorative material, endodontic retrofill cements, dental implants and caries inhibitory solution. Despite the effectiveness that Ag NPs has shown in dental practice, Ag NPs remain a controversial area of research with respect to their toxicity in biological and ecological systems. Therefore any application of Ag NPs in dentistry requires more studies. In order to avoid the toxicity of these materials Ag NPs can be temporarily used in dentistry.

A Translational Perspective of Maternal Immune Activation by SARS-CoV-2 on the Potential Prenatal Origin of Neurodevelopmental Disorders: The Role of the Cholinergic Anti-inflammatory Pathway.

The emergent Coronavirus Disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) could produce a maternal immune activation (MIA) via the inflammatory response during gestation that may impair fetal neurodevelopment and lead to postnatal and adulthood mental illness and behavioral dysfunctions. However, so far, limited evidence exists regarding long-term physiological, immunological, and neurodevelopmental modifications produced by the SARS-CoV-2 in the human maternal-fetal binomial and, particularly, in the offspring. Relevant findings derived from epidemiological and preclinical models show that a MIA is indeed linked to an increased risk of neurodevelopmental disorders in the offspring. We hypothesize that a gestational infection triggered by SARS-CoV-2 increases the risks leading to neurodevelopmental disorders of the newborn, which can affect childhood and the long-term quality of life. In particular, disruption of either the maternal or the fetal cholinergic anti-inflammatory pathway (CAP) could cause or exacerbate the severity of COVID-19 in the maternal-fetal binomial. From a translational perspective, in this paper, we discuss the possible manifestation of a MIA by SARS-CoV-2 and the subsequent neurodevelopmental disorders considering the role of the fetal-maternal cytokine cross-talk and the CAP. Specifically, we highlight the urgent need of preclinical studies as well as multicenter and international databanks of maternal-fetal psychophysiological data obtained pre-, during, and post-infection by SARS-CoV-2 from pregnant women and their offspring.

Evolution of COVID-19 Pregnancies Treated With Nitazoxanide in a Third-Level Hospital.

Background Nitazoxanide shows adequate in vitro activity against coronavirus. The aim of this study was to describe the behavior of coronavirus disease 2019 (COVID-19) in pregnant women treated with nitazoxanide. Methodology This cross-sectional study included the files of COVID-19 positive pregnant women treated with nitazoxanide 500 mg every 6 hours, levofloxacin every 12 hours, and clarithromycin 500 mg every 12 hours. Results The data of 51 women (mean age: 27.4 ± 7.2 years) were analyzed. Eleven (21.56%) patients had to receive medical attention in the intensive care unit. There were 22 (43.13%) preterm deliveries, 21 by cesarean and one by vaginal delivery. The medical attention of this population was as follows: 31 cesareans, five vaginal deliveries, nine still pregnant, two requiring manual vacuum aspiration, two ectopic pregnancies, one requiring curettage, and one requiring hysterotomy. There were seven (13.72%) cases of preeclampsia, and there were two (3.92%) deaths. Conclusion Nitazoxanide prescription could be an option against COVID-19 in pregnancy due to its safety profile.

Prevalence of Obesity in Elementary School Children and its Association with Dental Caries.

PURPOSE: To determine any associations between obesity and caries activity in the mixed dentition stage among primary school children in a low-income Mexican primary school. MATERIALS AND METHODS: This cross-sectional study was performed in Mexican schoolchildren aged 8-12 years. The body mass index (BMI) was obtained, and children were classified as overweight/obese considering age and sex. The experience of caries in permanent and temporary dentition was established with the sum of decayed/missing/filled teeth (DMFT or deft index for permanent or temporal dentition); a caries index for all teeth was also considered (total decay [TD]). Mann-Whitney U-test was used to contrast the distribution between sexes of the quantitative variables and to contrast the distribution of each variable per category, the Kruskal-Wallis test was used. Spearman's Rho test was used to establish the correlation between the quantitative variables. Multiple linear regression models were performed to find the relationship between the O'Leary index and the BMI. A Multilayer Perceptron was constructed as follows: (a) dependent variables: deft, DMFT, TD and O'Leary index; (b) factor: BMI; (c) covariable: age. RESULTS: A total of 331 children were included in the study. Dental caries prevalence was 32.4% (95% CI 29.7-35.2), while the mean DMFT was 0.64 (± SD 1.00). Through the Spearmen test, a statistically significant negative correlation was found between BMI-for-age with the total experience of carious lesions (r = -0.127, p = 0.021) and with experience of carious lesions in the deciduous dentition (deft) (r = -0.195, p ≤0.001). But when using the linear and logistic regression models to analyse the relationship with the O'Leary index, BMI was not statistically significant. With the Multilayer Perceptron there appears to be less error in the prediction of deft than the other indexes. CONCLUSIONS: This study confirms the high prevalence of obesity in primary school children. It also shows the scarce association between carious lesions and obesity.

Association between a medical nutrition therapy program and eating behavior with gestational weight gain in women with diabetes.

Introduction: To assess the association of medical nutrition therapy (MNT) consultations and eating behavior with gestational weight gain (GWG) in Mexican women with type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM).Material and methods: Cross-sectional study conducted at (Blinded for Review) from 2013 to 2014. Fifty-seven patients with T2DM or GDM were invited to participate. The dependent variable was GWG and the main independent variables were MNT and eating behaviors. Data were obtained from medical records or interviews. Multiple linear regression models were used to assess associations.Results: Per each additional MNT consultation, GWG was reduced by 1.2 kg (ß = -1.2; 95% CI: -2, -0.3; p = .007). After adjusting for age, in women with normal pregestational weight, for each unit, increase in the EE behavior index, there was a GWG increase of 2.8 kg (ß = 2.8; 95% CI: 1.2, 4.4; p = .003).Conclusions: This study reinforces the need for additional research to determine how eating behaviors are related to GWG during pregnancy. ClinicalTrials.gov Identifier: NCT03767699.