ABSTRACT
BACKGROUND: Acute otitis media (AOM) causes inflammation and hearing loss. Ventilation tubes are key in treatment. 3D printing improves prostheses in otorhinolaryngology, offering precision and greater adaptability. MATERIALS AND METHODS: An experimental study was conducted with Wistar rats from July to December 2020. 3D tympanostomy tube models were designed, with technical specifications and tests performed on inexpensive 3D printers. The tympanostomy tube was inserted endoscopically. RESULTS: Procedures were performed on five rats with implants in both ears. Pre-intervention pathologies, such as atical retraction and glue ear, were found. The PLA-printed tympanostomy tube showed improvement after adjustments. Histopathological results revealed significant middle and inner ear damage. CONCLUSION: In our study, the design and 3D printing of implants fulfilled the desired functions when modified, with a height of 5 mm. Complications included PLA degradation and ear damage. There were no adverse events during observation, highlighting the need for further research on 3D-printed implants.
ABSTRACT
INTRODUCTION: Soft tissue sarcomas (STSs) are rare and diverse primary malignant tumors that comprise approximately 1% of all malignancies. Misdiagnoses and unplanned excisions of STSs are common due to the tumor's rarity, leading to secondary tumor bed excisions (TBEs). Reconstructive outcomes for TBEs remain poorly understood, prompting this study to address the knowledge gap and inform preoperative discussions. METHODS: This was a retrospective cohort study of patients who underwent STS excisions at a quaternary cancer center. Patients were categorized into mass excision (ME) and TBE groups. Reconstructive approaches were divided into simple (primary closure, complex repair, skin grafts, local flaps) and advanced (pedicled or free flaps). The groups were compared for postoperative outcomes, including complications, recurrence, and death. RESULTS: When simple reconstructive techniques were used, TBEs exhibited higher rates of overall and major complications, whereas MEs had higher rates of overall and minor complications. Intergroup analysis revealed that with simple reconstruction, rates of overall and major complications were higher in TBEs than in MEs, and rates of minor complications were higher in MEs than in TBEs. Regression analyses revealed that simple reconstruction of TBEs had 90% and 180% higher odds of major complications and reoperation compared to simple reconstruction of MEs (P < 0.05). CONCLUSION: TBEs, despite their smaller size, exhibited a heightened susceptibility to overall and major complications, challenging the notion that simpler techniques suffice in these cases. Our findings encourage the consideration of advanced reconstructive techniques for TBEs that may seem amenable to simple reconstructive techniques.
ABSTRACT
BACKGROUND: The reconstructive ladder relies mostly on defect size and depth to determine reconstructive technique, however, in actuality, many more variables ultimately inform reconstructive decision making, especially regarding extremity soft tissue sarcoma (eSTS) defects. The purpose of this study was to describe eSTS patients who will most optimally benefit from an advanced method of reconstruction (defined as a pedicled regional flap or free flap) and to create a simple risk assessment scale that can be employed in clinical practice. STUDY DESIGN: A single-institution retrospective cohort study examined patients undergoing resection of soft tissue sarcoma affecting the upper or lower extremities between 2016 and 2021. We categorized patients who required a pedicled or free flap as having had advanced reconstruction, and all other techniques were considered simple reconstruction. A regression was used to create a risk scale to guide reconstructive decision-making. RESULTS: The following variables were identified as independent predictors of complications and used to create our risk scale: lower extremity tumor location, preoperative radiotherapy, tumor bed excision, male sex, hypertension, and tumor volume. Intermediate and high-risk patients reconstructed using simple techniques had significantly greater overall complication rates compared to those reconstructed with advanced techniques. Major complications were significantly greater in low-risk patients reconstructed with advanced techniques. CONCLUSIONS: To minimize postoperative wound complications, low-risk patients should receive simple methods of reconstruction, whereas high-risk patients should be reconstructed using advanced techniques.
Subject(s)
Plastic Surgery Procedures , Postoperative Complications , Sarcoma , Humans , Sarcoma/surgery , Sarcoma/pathology , Male , Retrospective Studies , Female , Middle Aged , Plastic Surgery Procedures/methods , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Aged , Adult , Extremities/surgery , Extremities/pathology , Risk Assessment , Soft Tissue Neoplasms/surgery , Soft Tissue Neoplasms/pathology , Decision Making , Surgical Flaps , Follow-Up Studies , Clinical Decision-MakingABSTRACT
BACKGROUND: Limb-sparing resections of thigh soft tissue sarcomas (STSs) can result in adverse outcomes. Identifying preoperative predictors for wound healing complications, tumor recurrence, and mortality is crucial for informed reconstructive decision-making. We hypothesized that preoperative measurements of thigh and tumor dimensions could serve as reliable indicators for postoperative complications, recurrence, and death. PATIENTS AND METHODS: In this retrospective cohort study conducted from March 2016 to December 2021, we analyzed patients undergoing thigh STS excisions followed by reconstruction. Preoperative magnetic resonance imaging or computed tomography scans provided necessary thigh and tumor dimensions. Univariate and multivariate regression assessed relationships between these dimensions and postoperative outcomes, including complications, recurrence, and death. RESULTS: Upon the analysis of 123 thighs, we found thigh width to be highly predictive of postoperative complications, even surpassing body mass index (BMI) and retaining significance in multivariate regression [odds ratio (OR) 1.19; 95% CI 1.03-1.39; p = 0.03]. Sarcoma-to-thigh width and thickness ratios predicted STS recurrence, with the thickness ratio retaining significance in multivariate regression (OR 1.03; 95% CI 1.001-1.05; p = 0.041). Notably, greater thigh thickness was independently protective against mortality in multivariate analysis (OR 0.80; 95% CI 0.65-0.98; p = 0.030). CONCLUSIONS: Thigh width outperformed BMI in association with postoperative complications. This may create an opportunity for intervention, where weight loss can play a role during the neoadjuvant therapy period to potentially reduce complications. Sarcoma-to-thigh width and thickness ratios, particularly the latter, hold substantial predictive value in terms of STS recurrence. Moreover, thigh thickness is an independent predictor of survival.
Subject(s)
Neoplasm Recurrence, Local , Postoperative Complications , Sarcoma , Thigh , Humans , Male , Female , Sarcoma/surgery , Sarcoma/pathology , Sarcoma/mortality , Retrospective Studies , Thigh/pathology , Thigh/surgery , Thigh/diagnostic imaging , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Recurrence, Local/mortality , Survival Rate , Aged , Prognosis , Follow-Up Studies , Adult , Magnetic Resonance Imaging , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/mortality , Soft Tissue Neoplasms/surgery , Soft Tissue Neoplasms/diagnostic imaging , Plastic Surgery ProceduresABSTRACT
Butyrate is a promising candidate for an antitumoral drug, as it promotes cancer cell apoptosis and reduces hormone receptor activity, while promoting differentiation and proliferation in normal cells. However, the effects of low-dose butyrate on breast cancer cell cultures are unclear. We explored the impact of sub-therapeutic doses of butyrate on estrogen receptor alpha (ERα) transcriptional activity in MCF-7 cells, using RT-qPCR, Western blot, wound-healing assays, and chromatin immunoprecipitation. Our results showed that sub-therapeutic doses of sodium butyrate (0.1 - 0.2 mM) increased the transcription of ESR1, TFF1, and CSTD genes, but did not affect ERα protein levels. Moreover, we observed an increase in cell migration in wound-healing assays. ChIP assays revealed that treatment with 0.1 mM of sodium butyrate resulted in estrogen-independent recruitment of ERα at the pS2 promoter and loss of NCoR. Appropriate therapeutic dosage of butyrate is essential to avoid potential adverse effects on patients' health, especially in the case of estrogen receptor-positive breast tumors. Sub-therapeutic doses of butyrate may induce undesirable cell processes, such as migration due to low-dose butyrate-mediated ERα activation. These findings shed light on the complex effects of butyrate in breast cancer and provide insights for research in the development of antitumoral drugs.
ABSTRACT
BACKGROUND: This study explores the surgical management and reconstruction options for augmented breasts in the context of breast conservation therapy (BCT) for breast cancer. We hypothesized that there would be no difference in the rates of complications, revisions, or patient satisfaction in patients who maintained their breast augmentation versus those that had their implants removed in the context of BCT. METHODS: We conducted a retrospective review of 142 patients who underwent BCT at a single center from March 2016 to March 2022. The study included patients who had a preexistent cosmetic augmentation at the time of breast cancer diagnosis and BCT. Patient demographics, clinical and treatment characteristics, breast implant details, reconstructive technique, complications, and revisions were recorded. Patient-reported outcomes were assessed using the BREAST-Q Breast-Conserving Therapy module. RESULTS: Ninety-three (65.5%) patients chose to maintain their implants, while 49 (34.5%) elected to have them removed during BCT. Patients with submuscular implants were more likely to maintain their implants. Oncoplastic mastopexy was associated with higher complication rates, particularly in patients opting for implant downsizing. However, multivariate logistic regression did not identify implant management strategy as an independent predictor for complications or revisions. Surgical site infection was the only predictor of implant explantation. Patient-reported outcomes did not differ significantly between the different implant management cohorts. CONCLUSIONS: This study demonstrates that maintaining breast implants during BCT does not increase the risk of complications or revisions. Overall, BCT in augmented women was found to be a safe approach, with high patient satisfaction.
ABSTRACT
We report the synthesis of a new set of amphiphilic saddle-shaped heptagon-containing polycyclic aromatic hydrocarbons (PAHs) functionalized with tetraethylene glycol chains and their self-assembly into large two-dimensional (2D) polymers. An in-depth analysis of the self-assembly mechanism at the air/water interface has been carried out, and the proposed arrangement models are in good agreement with the molecular dynamics simulations. Quite remarkably, the number and disposition of the tetraethylene glycol chains significantly influence the disposition of the PAHs at the interface and conditionate their packing under pressure. For the three compounds studied, we observed three different behaviors in which the aromatic core is parallel, perpendicular, and tilted with respect to the water surface. We also show that these curved PAHs are able to self-assemble in solution into remarkably large sheets of up to 150 µm2. These results show the relationship, within a family of curved nanographenes, between the monomer configuration and their self-assembly capacity in air/water interfaces and organic-water mixtures.
ABSTRACT
Genetically modified MON 89034 corn (Zea mays L.) expressing Bacillus thuringiensis (Bt) insecticidal proteins, viz. Cry1A.105 and Cry2Ab2, is a biotechnological option being considered for the management of the major corn pest in Indonesia, the Asian corn borer (Ostrinia furnacalis (Guenée) (Lepidoptera: Crambidae)). As a part of a proactive resistance-management program for MON 89034 corn in Indonesia, we assessed the baseline susceptibility of field-collected populations of O. furnacalis to Cry1A.105 and Cry2Ab2 proteins. Dose-response bioassays using the diet-dipping method indicated that the lethal concentration (LC50) values of Cry1A.105 and Cry2Ab2 in 24 different field populations of O. furnacalis ranged from 0.006 to 0.401 µg/mL and from 0.044 to 4.490 µg/mL, respectively, while the LC95 values ranged from 0.069 to 15.233 µg/mL for Cry1A.105 and from 3.320 to 277.584 µg/mL for Cry2Ab2. The relative resistance ratios comparing the most tolerant field populations and an unselected laboratory population were 6.0 for Cry1A.105 and 2.0 for Cry2Ab2 based on their LC50 values. Some field populations were more susceptible to both proteins than the unselected laboratory population. The LC99 and its 95% fiducial limits across the field populations were calculated and proposed as candidate diagnostic concentrations. These data provide a basis for resistance monitoring in Bt Corn and further support building resistance-management strategies in Indonesia.
Subject(s)
Bacillus thuringiensis , Moths , Animals , Bacillus thuringiensis/genetics , Bacillus thuringiensis/metabolism , Indonesia , Endotoxins/genetics , Endotoxins/metabolism , Bacterial Proteins/pharmacology , Bacterial Proteins/toxicity , Bacillus thuringiensis Toxins/metabolism , Plants, Genetically Modified/genetics , Plants, Genetically Modified/metabolism , Hemolysin Proteins/pharmacology , Hemolysin Proteins/toxicity , Moths/genetics , Moths/metabolism , Zea mays/genetics , Zea mays/metabolism , Insecticide Resistance/genetics , Larva/metabolismABSTRACT
In recent years, the determination of the antioxidant and antibacterial activity of essential oils in wild plants, such as Mexican oregano (Lippia graveolens Kunth), has become increasingly important. The objective was to compare the antioxidant and antibacterial activity of Mexican oregano essential oil obtained from plants occurring naturally in semiarid areas (Wild1 and Wild2), and those cultivated in the field (CField) and greenhouse (CGreenhouse) in northern Mexico. The Mexican oregano essential oil extraction was performed using the hydrodistillation method, the antioxidant activity was determined using the ABTS method, and the antibacterial activity was assessed through bioassays under the microwell method at nine different concentrations. The aim was to determine the diameter of the inhibition zone and, consequently, understand the sensitivity level for four bacterial species. The results revealed an antioxidant activity ranging from 90% to 94% at the sampling sites, with Wild1 standing out for having the highest average antioxidant activity values. Likewise, six out of the nine concentrations analyzed showed some degree of sensitivity for all the sampling sites. In this regard, the 25 µL mL-1 concentration showed the highest diameter of inhibition zone values, highlighting the Wild2 site, which showed an average diameter greater than 30 mm for the four bacteria tested. Only in the case of S. typhi did the CGreenhouse site surpass the Wild2, with an average diameter of the inhibition zone of 36.7 mm. These findings contribute to the search for new antioxidant and antibacterial options, addressing the challenges that humanity faces in the quest for opportunities to increase life expectancy.
Subject(s)
Abdominal Wall , Mammaplasty , Plastic Surgery Procedures , Humans , Abdominal Wall/surgery , Surgical Mesh , Retrospective StudiesABSTRACT
Inflammatory bowel diseases (IBDs) are chronic conditions of unknown cause or cure. Treatment seeks to reduce symptoms and induce and maintain remission. Many patients have turned to alternatives, such as cannabis, to alleviate living with IBD. This study reports the demographics, prevalence, and perception on cannabis use of patients attending an IBD clinic. Patients agreed to participate and completed an anonymous survey during their visit or online. Descriptive analysis, Fisher's exact test, and Wilcoxon-Mann-Whitney rank-sum test were used. One hundred and sixty-two adults (85 males, 77 with CD) completed the survey. Sixty (37%) reported use of cannabis, of which 38 (63%) used it to relieve their IBD. A value of 77% reported low to moderate knowledge about cannabis, and 15% reported little to no knowledge. Among cannabis users, 48% had discussed use with their physician, but 88% said they would feel comfortable discussing medical cannabis for IBD. Most saw improvement of their symptoms (85.7%). A considerable number of patients with IBD use medical cannabis for their disease, unknown to their physician. The study reinforces the importance that physicians understand the role of cannabis in the treatment of IBD in order to appropriately counsel patients.
Subject(s)
Cannabis , Hallucinogens , Inflammatory Bowel Diseases , Medical Marijuana , Male , Adult , Humans , Medical Marijuana/therapeutic use , Inflammatory Bowel Diseases/epidemiology , Surveys and QuestionnairesABSTRACT
Arsenic (As) is a common contaminant in drinking water in northeastern Mexico, which reduces the expression of cytochrome P450 (CYP 450). This enzyme group metabolizes numerous drugs, such as oral antidiabetic drugs such as pioglitazone (61% CYP 3A4, 49% CYP 2C8). When CYP 450's function is inadequate, it has decreased therapeutic activity in type 2 diabetes mellitus (T2DM). This study aimed to establish the effect of As on pioglitazone metabolism in patients with T2DM. METHODOLOGY: Urine, water, and plasma samples from a healthy population (n = 11) and a population with T2DM (n = 20) were obtained. Samples were analyzed by fluorescence spectroscopy/hydride generation (As) and HPLC (pioglitazone). Additionally, CYP 3A4 and CYP 2C8 were studied by density functional theory (DFT). RESULTS: The healthy and T2DM groups were exposed via drinking water to >0.010 ppm, Ka values with a factor of 4.7 higher, Cl 1.42 lower, and ABCt 1.26 times higher concerning the healthy group. In silico analysis (DFT) of CYP 3A4 and CYP 2C8 isoforms showed the substitution of the iron atom by As in the active sites of the enzymes. CONCLUSIONS: The results indicate that the substitution of Fe for As modifies the enzymatic function of CYP 3A4 and CYP 2C8 isoforms, altering the metabolic process of CYP 2D6 and CYP 3A4 in patients with T2DM. Consequently, the variation in metabolism alters the bioavailability of pioglitazone and the expected final effect.
Subject(s)
Arsenic , Diabetes Mellitus, Type 2 , Drinking Water , Humans , Pioglitazone/metabolism , Arsenic/metabolism , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/metabolism , Biological Availability , Cytochrome P-450 Enzyme System/metabolism , Microsomes, Liver/metabolismABSTRACT
Amidines are a structural surrogate for peptide bonds, yet have received considerably little attention in peptides due to limitations in existing methods to access them. The synthetic strategy developed in this study represents the first robust and general procedure for the introduction of amidines into the peptide backbone. We exploit and further develop the utility and efficiency of thioimidate protecting groups as a means to side-step reactivity that ultimately renders existing methods unsuitable for the installation of amidines along the main-chain of peptides. This work is significant because it describes a generally applicable path to access unexplored peptide designs and architectures for new therapeutics made possible by the unique properties of amidines.
Subject(s)
Amidines , Peptides , Amidines/chemistry , Peptides/chemistryABSTRACT
Se realizó una revisión breve con aproximación teórica a la actual organización hospitalaria y su modernización. Se muestra un enfoque de la actual organización hospitalaria. Además, se presenta el procedimiento y las particularidades de los rumbos del sector hospitalario; pudiendo posteriormente analizar los mecanismos de modernización a entes relacionados con el bienestar de la población y poder hacer uso de manera óptima de las metodologías de dirección. Los factores que motivan el cambio, por ser las organizaciones con mayor complicación en su área en específica; siendo así que sus actividades que varían en diversos sectores de acuerdo a lo especificado en sus lineamientos puedan ser entendidas de manera clara, aun cuando se consideren las peculiaridades de cada organización.
A brief review was carried out with a theoretical approach to the current hospital organization and its modernization. An approach of the current hospital organization is shown. In addition, the procedure and the particularities of the directions of the hospital sector are presented; Being able to later analyze the mechanisms of modernization to entities related to the well-being of the population and to be able to make optimal use of management methodologies. The factors that motivate the change, because they are the most complicated organizations in their specific area; being so that its activities that vary in different sectors according to what is specified in its guidelines can be clearly understood, even when considering the peculiarities of each organization.
ABSTRACT
Background: Laryngeal carcinoma is the 22nd most common cause of cancer in men worldwide and the second most common head and neck malignancy. The care of these patients is multidisciplinary. Factors such as tumor stage and initiation of treatment 60 days after diagnosis have been associated with worse survival. Objective: To know the overall time of care in laryngeal cancer and its impact on the outcome of patients in a tertiary health center. Material and methods: In July 2020, a retrospective study was carried out of 173 patients with laryngeal cancer diagnosed in the Department of Otorhinolaryngology from January 2014 to December 2018. Odds ratio and Fisher's exact test were calculated with a p value of 0.05. Results: 2 out of 77 patients started treatment at the recommended time. The total attention time (TAT) was 246 ± 159 days. 56% of the patients were still alive, 43% disease-free and 10% with progression. Control of the disease was achieved in 69% of early tumors and only 26% in advanced ones. Conclusions: The overall time of care impacts on the health status, affecting survival and control of disease. The stage of the tumor at the time of diagnosis is a decisive prognosis factor. Strategies towards multidisciplinary management and early detection in primary care should be created.
Introducción: el carcinoma de laringe es la vigésima segunda causa más común de cáncer en hombres a nivel mundial y la segunda malignidad más común en cabeza y cuello. La atención de estos pacientes es multidisciplinaria. Factores como el estadio del tumor y el inicio del tratamiento 60 días después del diagnóstico han sido asociados a una peor sobrevida. Objetivo: conocer el tiempo integrado de atención del cáncer de laringe y su impacto en el estado de salud de los pacientes en un centro terciario de atención. Material y métodos: en julio de 2020 se llevó a cabo un estudio retrospectivo de 173 pacientes con cáncer de laringe diagnosticados en el Servicio de Otorrinolaringología de enero de 2014 a diciembre de 2018. Se calculó la razón de momios y la prueba exacta de Fisher con valor de p = 0.05. Resultados: dos de 77 pacientes iniciaron tratamiento en tiempo recomendado. El tiempo total de atención fue de 246 +/- 159 días. El 56% de los pacientes continuaban con vida, 43% libres de enfermedad y 10% con progresión. El control de la enfermedad se logró en el 69% de los tumores tempranos y solo el 26% en los avanzados. Conclusiones: el tiempo integrado de atención impactó en el estado de salud, lo cual afectó en la sobrevida y el control de la enfermedad. El estadio de la enfermedad al momento del diagnóstico es un factor decisivo para el pronóstico. Deberán crearse estrategias para el manejo multidisciplinario y la detección temprana en la atención primaria.
Subject(s)
Laryngeal Neoplasms , Humans , Laryngeal Neoplasms/diagnosis , Laryngeal Neoplasms/therapy , Male , Neoplasm Staging , Prognosis , Retrospective StudiesABSTRACT
Background: The advance of the COVID-19 pandemic and spread of SARS-CoV-2 around the world has generated the emergence of new genomic variants. Those variants with possible clinical and therapeutic implications have been classified as variants of concern (VOCs) and variants of interest (VOIs). Objective: This study aims to describe the COVID-19 pandemic and build the evolutionary and demographic dynamics of SARS-CoV-2 populations in Mexico, with emphasis on VOCs. Methods: 30,645 complete genomes of SARS-CoV-2 from Mexico were obtained from GISAID databases up to January 25, 2022. A lineage assignment and phylogenetic analysis was completed, and demographic history for Alpha, Gamma, Delta and Omicron VOCs, and the Mexican variant (B.1.1.519) was performed. Results: 148 variants were detected among the 30,645 genomes analyzed with the Delta variant being the most prevalent in the country, representing 49.7% of all genomes. Conclusion: The COVID-19 pandemic in Mexico was caused by several introductions of SARS-CoV-2, mainly from the United States of America and Europe, followed by local transmission. Regional molecular epidemiological surveillance must implement to detect emergence, introductions and spread of new variants with biologically important mutations.
ABSTRACT
Sugar-based amphiphiles are a relevant natural alternative to synthetic ones due to their biodegradable properties. An understanding of their structure-assembly relationship is needed to allow the concrete synthesis of suitable derivatives. Here, four different mannose-derivative surfactants are characterized by pendant drop, dynamic light scattering, small-angle X-ray scattering, cryotransmission electron microscopy, and molecular dynamics techniques in aqueous media. Measurements denote how the polysaccharide average degree of polymerization (DP¯) and the addition of a hydroxyl group to the hydrophobic tail, and thus the presence of a second hydrophilic moiety, affect their self-assembly. A variation in the DP¯ of the amphiphile has no effect in the critical micelle concentration in contrast to a change in the hydrophobic molecular region. Moreover, high-DP¯ amphiphiles self-assemble into spherical micelles irrespective of the hydroxyl group presence. Low-DP¯ amphiphiles with only one hydrophilic moiety form cylindrical micelles, while the addition of a hydroxyl group to the tail leads to a spherical shape.
Subject(s)
Micelles , Sugars , Carbohydrates , Hydrophobic and Hydrophilic Interactions , Surface-Active Agents/chemistryABSTRACT
BACKGROUND: It has been reported that insulin resistance is related to cognitive decline. The triglycerides and glucose (TyG) index, is a reliable and inexpensive surrogate test for detecting insulin resistance. AIMS: The goal of this study was to evaluate the association between the TyG index and the mild cognitive impairment (MCI) in older adults. METHODS: A total of 135 individuals, men and women aged 60 to 90 years, were enrolled in a case and control study. Individuals with a diagnosis of MCI (n = 65) were allocated into the case group and compared with individuals without MCI (n = 70) in the control group. Alcohol intake, diabetes duration ≥5 years, diagnoses of cerebrovascular disease, brain injury, folic acid deficiency, dementia, moderate or severe CI, major depressive disorders, and thyroid disease were exclusion criteria. RESULTS: Individuals in the case group exhibited higher waist circumference (97.9 ± 13.9 versus 93.5 ± 13.0, p = .001) and TyG index (5.0 ± 0.3 versus 4.1 ± 0.2, p = .001) than individuals in the control group. The TyG index ≥4.68 (OR 6.91; 95% CI 2.05-11.68) and waist circumference (OR 1.03; 95% CI 1.01-1.06) were positively associated with MCI, while education level (OR 0.44; 95% CI 0.30-0.61), occupation (OR 0.75; 95% CI 0.59-0.61), and exercise (OR 0.34; 95% CI 0.22-0.52) were inversely associated with MCI. After controlling for sex, age, waist circumference, education level, occupation, and exercise, a TyG index ≥4.68 remained significantly associated with MCI (OR 2.97; 95% CI 1.12-14.71). CONCLUSION: The TyG index is independently associated with the presence of MCI in older people.
Subject(s)
Cognitive Dysfunction , Depressive Disorder, Major , Insulin Resistance , Aged , Biomarkers , Blood Glucose , Cognitive Dysfunction/diagnosis , Female , Glucose , Humans , Male , Risk Factors , TriglyceridesABSTRACT
BACKGROUND: Pseudomonas aeruginosa is an important opportunistic pathogen especially in nosocomial infections due to its easy adaptation to different environments; this characteristic is due to the great genetic diversity that presents its genome. In addition, it is considered a pathogen of critical priority due to the high antimicrobial resistance. OBJECTIVES: The aim of this study was to characterize the mobile genetic elements present in the chromosome of six Mexican P. aeruginosa strains isolated from adults with pneumonia and children with bacteremia. METHODS: The genomic DNA of six P. aeruginosa strains were isolated and sequenced using PacBio RS-II platform. They were annotated using Prokaryotic Genome Annotation Pipeline and manually curated and analyzed for the presence of mobile genetic elements, antibiotic resistances genes, efflux pumps and virulence factors using several bioinformatics programs and databases. RESULTS: The global analysis of the strains chromosomes showed a novel chromosomal rearrangement in two strains, possibly mediated by subsequent recombination and inversion events. They have a high content of mobile genetic elements: 21 genomic islands, four new islets, four different integrative conjugative elements, 28 different prophages, one CRISPR-Cas arrangements, and one class 1 integron. The acquisition of antimicrobials resistance genes into these elements are in concordance with their phenotype of multi-drug resistance. CONCLUSION: The accessory genome increased the ability of the strains to adapt or survive to the hospital environment, promote genomic plasticity and chromosomal rearrangements, which may affect the expression or functionality of the gene and might influence the clinical outcome, having an impact on the treatment.