[Efficacy and safety of convalescent plasma administration in patients with COVID-19 infection]. / Eficacia y seguridad de la administración de plasma de convaleciente en pacientes con COVID-19.

INTRODUCTION: During the COVID-19 pandemic, several strategies were suggested for the management of the disease, including pharmacological and non-pharmacological treatments such as convalescent plasma (CP). The use of CP was suggested due to the beneficial results shown in treating other viral diseases. OBJECTIVE: To determine the efficacy and safety of CP obtained from whole blood in patients with COVID-19. METHODS: Pilot clinical trial in patients with COVID-19 from a general hospital. The subjects were separated into three groups that received the transfusion of 400ml of CP (n=23) or 400ml of standard plasma (SP) (n=19) and a non-transfused group (NT) (n=37). Patients also received the standard available medical treatment for COVID-19. Subjects were followed up daily from admission to day 21. RESULTS: The CP did not improve the survival curve in moderate and severe variants of COVID-19, nor did it reduce the degree of severity of the disease evaluated with the COVID-19 WHO and SOFA clinical progression scale. No patient had a severe post-transfusion reaction to CP. CONCLUSIONS: Treatment with CP does not reduce the mortality of patients even when its administration has a high degree of safety.

Mental Health Disorders and Coping Strategies in Healthcare Workers during the COVID-19 Pandemic: An Analytical Cross-Sectional Study in Southeastern Mexico.

Mental health disorders are relatively common in the general population and were already an important issue for the healthcare sector before COVID-19. COVID-19, being a worldwide crucial event and evidently a great stressor has increased both the prevalence and incidence of these. Therefore, it is evident that COVID-19 and mental health disorders are closely related. Moreover, several coping strategies exist to endure said disorders such as depression and anxiety, which are used by the population to confront stressors, and healthcare workers are not the exception. This was an analytical cross-sectional study, conducted from August to November 2022, via an online survey. Prevalence and severity of depression, anxiety, and stress were assessed via the DASS-21 test, and coping strategies were assessed via the CSSHW test. The sample consisted of 256 healthcare workers and of those, 133 (52%) were males with a mean age of 40.4 ± 10.35, and 123 (48%) were females with a mean age of 37.28 ± 9.33. Depression was prevalent in 43%, anxiety in 48%, and stress in 29.7%. Comorbidities were a significant risk factor for both depression and anxiety with an OR of 10.9 and 4.18, respectively. The psychiatric background was a risk factor for depression with an OR of 2.17, anxiety with an OR of 2.43, and stress with an OR of 3.58. The age difference was an important factor in the development of depression and anxiety. The maladaptive coping mechanism was prevalent in 90 subjects and was a risk factor for depression (OR of 2.94), anxiety (OR of 4.46) and stress (OR of 3.68). The resolution coping mechanism was a protective factor for depression (OR of 0.35), anxiety (OR of 0.22), and stress (OR of 0.52). This study shows that mental health disorders are highly prevalent among healthcare workers in Mexico and that coping strategies are associated with their prevalence. It also implies that not only occupations, age, and comorbidities might affect mental health, but also the way patients confront reality and the behavior and decisions they take towards stressors.

Identification and phenotypic characterization of patients with LADA in a population of southeast Mexico.

Latent autoimmune diabetes in adults (LADA) has clinical and metabolic features of type 1 and type 2 diabetes. LADA does not have specific features for its diagnosis apart from autoantibody detection; however, these tests are not affordable in clinical settings. In this cross-sectional study, we analyzed clinical criteria, metabolic control, pharmacological treatment, and diabetic complications in two groups of patients with diabetes -LADA and T2D- in order to identify specific characteristic of these clinical entities. Finally, we evaluated if the estimated glucose disposal rate (eGDR) and age at diagnosis of diabetes could be used as a diagnostic criterion for LADA. Demographic, biochemical, clinical and treatment were measured in 377 individuals with diabetes. The diagnostics of LADA were determined using Glutamic acid decarboxylase autoantibodies levels. Chi-square test or t-Student test were used to establish differences between groups. To identify factors associated with LADA, a logistic regression analysis was used. Finally, a ROC curve was plotted to assess the possible variables as diagnostic criteria for LADA. The 377 patients with diabetes were separated into 59 patients with LADA and 318 patients with T2D. Patients with LADA showed lower fasting glucose values, fewer diabetic complications, younger age at diagnosis of diabetes, higher insulin use, and higher eGDR in comparison to patients with T2D. Both groups had a mean BMI classified as overweight. The ROC evaluated the sensitivity and specificity, this analysis indicated that an age younger than 40.5 years and an eGDR value higher than 9.75 mg/kg/min correlated better with LADA. These parameters could be useful to identify patients suspected to have LADA at the first level of medical care in the population of southeastern Mexico and refer them to a second level of care.

Prevalence and Risk Factors of Adverse Effects and Allergic Reactions after COVID-19 Vaccines in a Mexican Population: An Analytical Cross-Sectional Study.

Vaccinations have helped to control the COVID-19 pandemic; however, few studies focus on the adverse effects and allergic reactions of these vaccines and fewer have a scope in the Latin American population. The objective of this study was to assess the associations between vaccinations, sex, age, allergic reactions, and adverse effects. This was an analytical cross-sectional study conducted between 1 July and 1 October 2022. The sample consisted of 443 surveyed participants, with a total of 1272 COVID-19 vaccine doses. Seven vaccines (Pfizer BioNTech, Oxford-AstraZeneca, CanSino, Moderna, Johnson and Johnson, Sinovac, and Sputnik V) were evaluated. A total of 12.6% of those surveyed had at least one allergic reaction posterior to vaccination, and females had a greater chance of developing one (p < 0.001, OR 3.1). The most common allergic reaction was chest pain, and Pfizer-BioNTech and Oxford-AstraZeneca were associated with the onset of allergic reactions (p < 0.005). A total of 54.6% of those surveyed developed adverse effects, the most common of which were myalgia, fever, cephalea, asthenia or adynamia, and arthralgia; moreover, older age was associated with the onset of adverse effects (p < 0.5). This study concludes that the BNT162b2 (Pfizer BioNTech) and ChAdOX1 nCOV-19 (Oxford-AstraZeneca) vaccines are strongly associated with the onset of allergic reactions, with ORs of 1.6 (CI 95%, 1.18 to 2.3) and 1.87 (CI 95%, 1.35 to 2.6), respectively. In addition, females have a greater chance of developing allergic reactions associated with COVID-19 vaccinations, and there was a relation found between older age and a greater prevalence of comorbidities, adverse effects after vaccination, and COVID-19 infection after vaccination.

Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes: A Randomized Crossover Study.

We previously observed beneficial effects of native banana starch (NBS) with a high resistant starch (RS) content on glycemic response in lean and obese participants. Here, we aimed to determine the effects of NBS and high-amylose maize starch (HMS) on glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes (T2D) when treatments were matched for digestible starch content. In a randomized, crossover study, continuous glucose monitoring (CGM) was performed in 17 participants (aged 28-65 years, BMI ≥ 25 kg/m2, both genders) consuming HMS, NBS, or digestible maize starch (DMS) for 4 days. HMS and NBS induced an increase in 24 h mean blood glucose during days 2 to 4 (p < 0.05). CONGA, GRADE, and J-index values were higher in HMS compared with DMS only at day 4 (p < 0.05). Yet, NBS intake provoked a reduction in fasting glycemia changes from baseline compared with DMS (p = 0.0074). In conclusion, under the experimental conditions, RS from two sources did not improve GC or GV. Future longer studies are needed to determine whether these findings were affected by a different baseline microbiota or other environmental factors.

Effects of Non-Nutritive Sweeteners on Energy Intake, Body Weight and Postprandial Glycemia in Healthy and with Altered Glycemic Response Rats.

The aim of this study was to evaluate the effects of non-nutritive sweeteners (NNS) consumption on energy intake, body weight and postprandial glycemia in healthy and with altered glycemic response rats. Animals on normal diet (ND) or high-fat diet (HFD) were divided to receive NNS (sucralose, aspartame, stevia, rebaudioside A) or nutritive sweeteners (glucose, sucrose) for 8 weeks. The NNS were administered at doses equivalent to the human acceptable daily intake (ADI). A test using rapidly digestible starch was performed before and after treatments to estimate glycemic response. No effects of NNS consumption were observed on energy intake or body weight. Sucrose provoked an increased fluid consumption, however, energy intake, and weight gain were not altered. In ND, no effects of NNS on glycemic response were observed. In HFD, the glycemic response was increased after sucralose and stevia when only the final tolerance test was considered, however, after including the baseline test, these results were no longer significant compared to glucose. These findings provide further evidence suggesting that at the recommended doses, NNS do not alter feeding behavior, body weight or glycemic tolerance in healthy and with altered glycemic rats.

Quality of life of Latin-American individuals with type 2 diabetes mellitus: A systematic review.

OBJECTIVE: Diabetes mellitus is a serious public health problem that causes a decrease in the patients' quality of life. The present study was aimed to analyze the quality of life of patients with diabetes mellitus in Latin-American population through a systematic review, using the two instruments of greater validity and reliability at international level, SF-36 and WHOQOL. METHODS: We performed extensive searches in Redalyc, SciELO, PubMed, Scopus and Web of Science databases. To delimit our search, we only included countries that are members of the Latin American Association of Diabetes. We identified 2168 articles, where 35 were considered relevant for this systematic review. RESULTS: Our results showed that patients that regularly receive guidance and treatment to control the diabetes, showed better quality of life; in contrast, patients with foot ulcers or comorbidities showed the worse quality of life. CONCLUSION: The current literature analysis suggests that this disease greatly influences in the quality of life of the patients.

[Anticancer effect of modified banana (Musa cavendish AAA) starch in rats with 1.2-dimethylhydrazine]. / Efecto anticancerígeno del almidón modificado de banano (Musa cavendish AAA) en ratas con 1,2-dimetilhidrazina.

INTRODUCTION: Introduction: resistant starch (RS) is not completely digested in the human intestine but is fermented in the colon; intestinal pH decreases as short-chain fatty acids are produced. This is beneficial for health, and for preventing and treating rectal colon cancer. Pyrodextrinization and enzymatic hydrolysis are modifications to native starch (NS) that may increase the amount of RS. Objective: the objective of this project was to evaluate the effects of M. cavendish AAA native and both chemically and enzymatically modified starches on tumor markers in rats. Methods: modifications (chemical and enzymatic) were made to M. cavendish AAA NS, and were evaluated in rats with 1,2-DMH. Male Sprague Dawley rats (25) were used, divided into five experimental groups: PC, NC, NS, PI, and ERM. During 4 weeks they received the experimental diet assigned to each group. The PC, NS, PI and ERM groups received 2 weekly s.c. (subcutaneous) injections of 1,2-DMH (40 mg/kg) (third and fourth week). In feces, pH, ß-glucuronidase enzyme, and short-chain fatty acids were evaluated, and a histopathological study was performed of the intestine to detect microscopic lesions. Results: the activity of ß-glucuronidase decreased (p < 0.05) for NS, PI and ERM vs. PC. The highest proportion of butyric acid was observed in the NS (p < 0.05) vs. NC group. Sixty percent of enteritides were severe in grade in the PC group, and 40 % in the experimental groups. Conclusions: native starch granules resisted pyrodextrinization, but treatment with α-amylase broke the structure of the pyrodextrin granule. According to the treatments given to the rats, as the amount of RS present in the diet increases (NS), the neoplastic cells do not advance beyond the basement membrane, suggesting a possible cell-protective or anticancer effect.

INTRODUCCIÓN: Introducción: el almidón resistente (AR) no se digiere completamente en el intestino humano sino que se fermenta en colon; disminuye el pH intestinal, ya que se producen ácidos grasos de cadena corta, interviniendo de manera benéfica en el tratamiento preventivo y curativo del cáncer de colon rectal. La pirodextrinización y la hidrólisis enzimática son modificaciones al almidón nativo (AN) que pueden incrementar la cantidad de AR. Objetivo: el objetivo de este proyecto fue evaluar los efectos del almidón nativo de M. cavendish AAA y de los almidones modificados química y enzimáticamente sobre diversos marcadores tumorales en ratas. Métodos: se realizaron modificaciones (química y enzimática) del AN del banano M. cavendish AAA y se evaluaron en ratas tratadas con 1,2-DMH. Se utilizaron 25 ratas Sprague Dawley machos divididas en cinco grupos experimentales: CP, CN, AN, PI y MER. Durante 4 semanas recibieron la dieta experimental asignada a cada grupo. Los grupos CP, AN, PI y MER recibieron 2 inyecciones s.c. (subcutáneas) semanales de 1,2-DMH (40 mg/kg) (semanas 3 y 4). En las heces se evaluaron el pH, la enzima ß-glucuronidasa y los ácidos grasos de cadena corta, y se realizó un estudio histopatológico del ciego y el colon para detectar lesiones microscópicas. Resultados: la actividad de ß-glucuronidasa disminuyó (p < 0,05) para los grupos AN, PI y MER en comparación con el CP. La mayor proporción de ácido butírico se observó en el AN (p < 0,05) frente al CN. El 60 % de las enteritis fueron de grado severo en el CP, mientras que en los grupos experimentales fueron de 40 %. Conclusiones: los gránulos de almidón nativo resistieron la pirodextrinización pero el tratamiento con α-amilasa rompió la estructura del gránulo de pirodextrina. De acuerdo a los tratamientos suministrados a las ratas, conforme mayor es la cantidad de AR presente en la dieta (AN), las células neoplásicas no avanzan más allá de la membrana basal, sugiriendo un posible efecto protector o anticancerígeno celular.

[Is vitamin-E supplementation beneficial or harmful?]. / Suplementación con vitamina E, benéfica o dañina?

Even though the beneficial effects of vitamin E have been experimentally observed, some clinical trials failed to verify a consistent benefit. One reason for this situation has been the difficulty to make comparisons among different studies. There are differences due to subjects, chemical forms of vitamin E, stages of the disease and others. The intake of high doses of vitamin E as a supplement has increased in many countries. Novel studies, have informed that vitamin E not only has antioxidant properties but can acts through precise molecular actions interacting with proteins and enzymes and modulating cellular signaling, transcriptional regulation and apoptosis induction. However, some recent clinical and meta analysis studies have found that daily supplementation with vitamin E 400 IU or higher is associated to increased mortality. In conclusion, a complete understanding of vitamin E actions at the cell does not exist yet and the controversy about its clinical effects is still present. This paper offers current knowledge on the characteristics, metabolism, properties, beneficial effect as well as the potential toxicity of vitamin E.

Effects of modified banana (Musa cavendish)starch on glycemic control and blood pressure in rats with high sucrose diet.

INTRODUCTION: insulin resistance (IR) is the preliminary stage of diseases such as diabetes and hypertension. These diseases can be controlled through medication, yet the consumption of functional foods (FF) may be one complementary treatment option. Ingredients for these FF could be the pyrodextrin and enzymatically resistant maltodextrin (ERM) obtained from the native starch (NS) of M. cavendishin this study. OBJECTIVE: to evaluate the effects of modified banana starch on glycemic control and blood pressure in rats with high sucrose diet (HSD). METHODS: we utilized 25 male Wistar rats 20 of which received a HSD and five were fed a normal diet and purified water (PW) for 12 weeks. At the end of week 8, the rats fed a HSD were divided into four groups: positive control (PC), native starch (NS), pyrodextrin (PI), and enzymatically resistant maltodextrin (ERM). The negative control (NC) comprised the five rats fed PW. We evaluated the glucose tolerance test, blood pressure (BP), insulin levels, total cholesterol (TC), high-density lipoproteins (HDL), and triglycerides. RESULTS: differential scanning calorimetry and scanning electron microscopy of the modified starches demonstrated that the pyroconversion treatment did not visibly affect the NS granules, while ERM was modified by the action of α-amylase. Starch treatments reduced glucose, insulin, HOMA-IR, and BP in comparison with PC (p < 0.05). Glucose AUC (0-120 min) was also decreased after starch treatments with respect to PC (p < 0.05). CONCLUSION: NS and its modified products exerted beneficial effects on glycemic control, lipid metabolism, and BP in obese rats fed a HSD. Although the modified starches presented lower resistance to digestion than NS, their expected properties were maintained.

Lack of Association of Coffee Consumption with the Prevalence of Self-Reported Type 2 Diabetes Mellitus in a Mexican Population: A Cross-Sectional Study.

It is estimated that almost 366 million people are currently suffering from diabetes mellitus worldwide. However, it has been suggested that coffee consumption has a protective effect against the development of type 2 diabetes mellitus. This association has been observed in many regions around the world. Today, there are no reports in Mexico regarding this association. Therefore, the aim of this study was to assess the association between coffee intake and self-reported type 2 diabetes mellitus in the southeastern part of Mexico. This study included 1277 residents of Comalcalco, a municipality of Tabasco State, Mexico. We calculated the prevalence for diabetes and performed multivariate analysis using multiple logistic regressions to evaluate the combined association with type 2 diabetes mellitus. The prevalence of the diabetes was 12.52% (95% CI: 10.67⁻14.38). The majority of people surveyed (77.29%; 95% CI: 74.95⁻79.60) indicated they were coffee drinkers. The results of multivariate analysis showed a non-significant relationship between the number of cups of coffee drank and type 2 diabetes mellitus. The adjusted odds ratio gave the following values: 1.20, (95% CI: 0.59⁻2.41) for non-daily consumption; 1.66 (0.82⁻3.34), for 1 cup of coffee peer day, and 1.49 (0.78⁻2.86) for 2⁻3 cups. Subsequently, an adjustment was made for age, gender, marital status, education, alcohol consumption, and cigarette smoking. In our population, we did not observe an association between coffee intake and its protective relationship with self-reported type 2 diabetes mellitus.

Efecto anticancerígeno del almidón modificado de banano (Musa cavendish AAA) en ratas con 1.2-dimetilhidrazina / Anticancer effect of modified banana (Musa cavendish AAA) starch in rats with 1.2-dimethylhydrazine

Introducción: el almidón resistente (AR) no se digiere completamente en el intestino humano sino que se fermenta en colon; disminuye el pH intestinal, ya que se producen ácidos grasos de cadena corta, interviniendo de manera benéfica en el tratamiento preventivo y curativo del cáncer de colon rectal. La pirodextrinización y la hidrólisis enzimática son modificaciones al almidón nativo (AN) que pueden incrementar la cantidad de AR. Objetivo: el objetivo de este proyecto fue evaluar los efectos del almidón nativo de M. cavendish AAA y de los almidones modificados química y enzimáticamente sobre diversos marcadores tumorales en ratas. Métodos: se realizaron modificaciones (química y enzimática) del AN del banano M. cavendish AAA y se evaluaron en ratas tratadas con 1,2-DMH. Se utilizaron 25 ratas Sprague Dawley machos divididas en cinco grupos experimentales: CP, CN, AN, PI y MER. Durante 4 semanas recibieron la dieta experimental asignada a cada grupo. Los grupos CP, AN, PI y MER recibieron 2 inyecciones s.c. (subcutáneas) semanales de 1,2-DMH (40 mg/kg) (semanas 3 y 4). En las heces se evaluaron el pH, la enzima ß-glucuronidasa y los ácidos grasos de cadena corta, y se realizó un estudio histopatológico del ciego y el colon para detectar lesiones microscópicas. Resultados: la actividad de ß-glucuronidasa disminuyó (p < 0,05) para los grupos AN, PI y MER en comparación con el CP. La mayor proporción de ácido butírico se observó en el AN (p < 0,05) frente al CN. El 60 % de las enteritis fueron de grado severo en el CP, mientras que en los grupos experimentales fueron de 40 %. Conclusiones: los gránulos de almidón nativo resistieron la pirodextrinización pero el tratamiento con a-amilasa rompió la estructura del gránulo de pirodextrina. De acuerdo a los tratamientos suministrados a las ratas, conforme mayor es la cantidad de AR presente en la dieta (AN), las células neoplásicas no avanzan más allá de la membrana basal, sugiriendo un posible efecto protector o anticancerígeno celular

Introduction: resistant starch (RS) is not completely digested in the human intestine but is fermented in the colon; intestinal pH decreases as short-chain fatty acids are produced. This is beneficial for health, and for preventing and treating rectal colon cancer. Pyrodextrinization and enzymatic hydrolysis are modifications to native starch (NS) that may increase the amount of RS. Objective: the objective of this project was to evaluate the effects of M. cavendish AAA native and both chemically and enzymatically modified starches on tumor markers in rats. Methods: modifications (chemical and enzymatic) were made to M. cavendish AAA NS, and were evaluated in rats with 1,2-DMH. Male Sprague Dawley rats (25) were used, divided into five experimental groups: PC, NC, NS, PI, and ERM. During 4 weeks they received the experimental diet assigned to each group. The PC, NS, PI and ERM groups received 2 weekly s.c. (subcutaneous) injections of 1,2-DMH (40 mg/kg) (third and fourth week). In feces, pH, ß-glucuronidase enzyme, and short-chain fatty acids were evaluated, and a histopathological study was performed of the intestine to detect microscopic lesions. Results: the activity of ß-glucuronidase decreased (p < 0.05) for NS, PI and ERM vs. PC. The highest proportion of butyric acid was observed in the NS (p < 0.05) vs. NC group. Sixty percent of enteritides were severe in grade in the PC group, and 40 % in the experimental groups. Conclusions: native starch granules resisted pyrodextrinization, but treatment with a-amylase broke the structure of the pyrodextrin granule. According to the treatments given to the rats, as the amount of RS present in the diet increases (NS), the neoplastic cells do not advance beyond the basement membrane, suggesting a possible cell-protective or anticancer effect

Effects of modified banana (musa cavendish)starch on glycemic control and blood pressure in rats with high sucrose diet / Efectos del almidón modificado de banano (Musa cavendish AAA) sobre el control glucémico y la presión arterial en ratas con dieta alta en sacarosa

Objective: to evaluate the adequacy of dietary intake and the anthropometric nutritional status of pregnant adolescents in the city of Niterói, Rio de Janeiro, Brazil. Materials and methods: forty-two adolescents (13-19 years of age), with single-fetus gestation, assisted in the public prenatal health care units between 2008-2014, participated in the study. Body mass index (BMI) was used to assess the nutritional status. Dietary intake was assessed by 24h dietary recalls on two days during a week and one during weekend. Basal metabolic rate was measured by indirect calorimetry and used to determine the energy requirements. Mixed effects models were used to assess dietary intake over the gestational weeks (random effect) and BMI. Results: mean age (SD) of the pregnant women was 16.5 (1.5) years and the majority received allowance from a cash transfer federal program. Overall, 30.3% were overweight/obese pre-pregnancy and 16.7%, during pregnancy. Energy and protein intake adequacies decreased with increasing BMI and gestational week. There was adequate dietary intake of energy, protein, vitamin A and zinc and insufficient intakes of iron and calcium. There was excessive intake of sodium. Conclusions: pregnant adolescents living in underprivileged socio-economic environments assisted for prenatal care in primary health care units have adequate intakes of energy, protein, vitamin A and zinc. Pre-pregnancy overweight and high sodium intake are causes of concern due to the future implications for their health. The official Brazilian recommended criterion for anthropometric assessment in pregnancy of adolescents proved to be inadequate

Objetivo: evaluar la adecuación de la ingesta dietética y el estado nutricional antropométrico de adolescentes embarazadas en Niterói, Río de Janeiro, Brasil. Materiales y métodos: participaron en el estudio 42 adolescentes de 13-19 años, con gestación de feto único, asistidas en las unidades públicas de atención prenatal entre 2008 y 2014. El índice de masa corporal (IMC) se utilizó para evaluar el estado nutricional. La ingesta dietética fue evaluada por recuerdos diarios de 24h dos días durante una semana y uno durante el fin de semana. La tasa metabólica basal se midió mediante calorimetría indirecta y se utilizó para determinar los requerimientos energéticos. Se emplearon modelos de efectos mixtos para evaluar la ingesta alimentaria durante las semanas de gestación (SG, efecto aleatorio) y el IMC. Resultados: la mayoría de las mujeres embarazadas recibían subsidios de un programa federal de Transferencia de efectivo. En general, el 30,3% tenía sobrepeso/obesidad antes del embarazo y el 16,7%, durante el embarazo. La cantidad de energía y la ingesta de proteínas disminuyeron con el aumento del IMC y la SG. Había una ingesta dietética adecuada de energía, proteínas, vitamina A y una ingesta insuficiente de hierro y calcio. Conclusiones: las adolescentes embarazadas tienen un consumo adecuado de energía, proteínas y vitamina A. El sobrepeso previo y el alto consumo de sodio son causas de preocupación debido a las implicaciones futuras para su salud. El criterio oficial brasileño recomendado para la evaluación antropométrica en el embarazo de los adolescentes demostró ser inadecuado

Eficacia y seguridad de la administración de plasma de convaleciente en pacientes con COVID-19 / Efficacy and safety of convalescent plasma administration in patients with COVID-19 infection

Introducción Durante la pandemia de COVID-19 surgieron diversas estrategias para el manejo de la enfermedad, incluidos los tratamientos farmacológicos y no farmacológicos como el plasma convaleciente (PC). El uso de PC se sugirió debido a los resultados benéficos mostrados al tratar otras enfermedades virales. Objetivo Determinar la eficacia y la seguridad de la administración de PC obtenido de sangre total en pacientes con COVID-19. Métodos Ensayo clínico piloto en pacientes con COVID-19 de un hospital general. Los sujetos se separaron en 3 grupos que recibieron la transfusión de 400ml de PC (n=23) o 400ml de plasma estándar (PE) (n=19) y un grupo no transfundido (NT) (n=37). Los pacientes recibieron además, el tratamiento médico estándar disponible para COVID-19. El seguimiento de los sujetos se llevó a cabo diariamente desde el ingreso hasta el día 21. Resultados El PC no mejoró la curva de supervivencia en las variantes moderadas y graves de COVID-19, ni disminuyó el grado de severidad de la enfermedad evaluado con la escala de progresión clínica COVID-19, OMS y SOFA. Ningún paciente presentó una reacción postransfusional severa al PC. Conclusiones El tratamiento con PC no disminuye la mortalidad de los pacientes, aun cuando su administración tiene un alto grado de seguridad (AU)

Introduction During the COVID-19 pandemic, several strategies were suggested for the management of the disease, including pharmacological and non-pharmacological treatments such as convalescent plasma (CP). The use of CP was suggested due to the beneficial results shown in treating other viral diseases. Objective To determine the efficacy and safety of CP obtained from whole blood in patients with COVID-19. Methods Pilot clinical trial in patients with COVID-19 from a general hospital. The subjects were separated into three groups that received the transfusion of 400ml of CP (n=23) or 400ml of standard plasma (SP) (n=19) and a non-transfused group (NT) (n=37). Patients also received the standard available medical treatment for COVID-19. Subjects were followed up daily from admission to day 21. Results The CP did not improve the survival curve in moderate and severe variants of COVID-19, nor did it reduce the degree of severity of the disease evaluated with the COVID-19 WHO and SOFA clinical progression scale. No patient had a severe post-transfusion reaction to CP. Conclusions Treatment with CP does not reduce the mortality of patients even when its administration has a high degree of safety (AU)

Suplementación con vitamina E, benéfica o dañina? / Is vitamin-E supplementation beneficial or harmful?

Aunque en estudios de laboratorio se han observado efectos potencialmente benéficos de la vitamina E, los resultados de la evaluación clínica son inconsistentes. Una situación que ha limitado el conocimiento en esta área, es la dificultad para establecer comparaciones entre los diferentes estudios. Existen diferencias entre sujetos, tipos de formulaciones, etapas de la enfermedad, y otros aspectos. El consumo de megadosis de esta vitamina se ha incrementado en muchos países. En estudios recientes se ha informado que además de su capacidad antioxidante, esta vitamina tiene acciones moleculares precisas que influyen sobre la actividad de varias enzimas modulando la expresión de genes y la inducción de apoptosis. Sin embargo, algunos estudios clínicos y metaanálisis han informado que dosis de 400 UI/día o mayores de α-tocoferol, se asocian con aumento del índice de mortalidad. Resulta claro que hasta la fecha no se tiene un conocimiento completo de los efectos de estas sustancias a nivel celular y que existe controversia en los resultados de ensayos clínicos. En el presente trabajo se revisa el conocimiento actual sobre las características de esta vitamina, sus principales efectos benéficos, su toxicidad potencial y se discuten los resultados de algunos metaanálisis recientes en relación al aumento del riesgo de mortalidad.

Even though the beneficial effects of vitamin E have been experimentally observed, some clinical trials failed to verify a consistent benefit. One reason for this situation has been the difficulty to make comparisons among different studies. There are differences due to subjects, chemical forms of vitamin E, stages of the disease and others. The intake of high doses of vitamin E as a supplement has increased in many countries. Novel studies, have informed that vitamin E not only has antioxidant properties but can acts through precise molecular actions interacting with proteins and enzymes and modulating cellular signaling, transcriptional regulation and apoptosis induction. However, some recent clinical and meta analysis studies have found that daily supplementation with vitamin E 400 IU or higher is associated to increased mortality. In conclusion, a complete understanding of vitamin E actions at the cell does not exist yet and the controversy about its clinical effects is still present. This paper offers current knowledge on the characteristics, metabolism, properties, beneficial effect as well as the potential toxicity of vitamin E.

Gnathostomiasis ocular. Registro del primer caso para el estado de Tabasco, México / Human ocular Gnathostomiasis. First case report in Tabasco, México

La gnathostomiasis es una enfermedad parasitaria poco conocida en México, la cual es causada por un nemátodo espiruroideo del género Gnathostoma, la cual se adquiere al ingerir peces de agua dulce y salobre crudos o insuficientemente cocidos. En este reporte se describe el caso de una persona del sexo femenino de 15 años de edad, procedente del puerto de Frontera, municipio de Centla, Tabasco, a la cual se le localizó una larva del parásito Gnathostoma en la cámara anterior del ojo izquierdo, la cual fue extraída por una incisión en limbo esclerocorneal.