Accuracy of acute hyperglycemia as a biomarker of severe brain damage in children with traumatic brain injury.

PURPOSE: Biomarkers are substances measured at the systemic level to evaluate organic responses in certain situations, establishing diagnoses, disease staging, and prognosis. Blood glucose is a biomarker recognized as a predictor of prognosis in children victims of traumatic brain injury (TBI). The scope of this study was to identify the accuracy of blood glucose as a biomarker of severe brain injury. METHODS: A retrospective analytical study was conducted through the consecutive review of medical records of children and teenage victims of TBI who underwent neurological surgery between 2016 and 2023 in a level 1 trauma center. Two groups were compared: children with Glasgow Coma Scale (GCS) score ≤ 8 and children with GCS > 8. We calculated the predictive values to define the accuracy of blood glucose as a biomarker of brain injury. RESULTS: Ninety-two medical records were included for analysis. Hyperglycemia predominated in cases with GCS ≤ 8 (48% vs 3%; p < 0.0001; OR, 30; 95% CI, 5.9902-150.2448). The glycemic measurement considering the cutoff point of 200 mg/dL or 11.1 mmol/L showed a specificity of 97%, a positive predictive value of 86%, an accuracy of 84%, and a likelihood ratio for a positive test of 16. CONCLUSION: Victims with GCS ≤ 8 are 16 times more likely to develop acute hyperglycemia after TBI when compared to those with GCS > 8. Blood glucose is a biomarker with an accuracy of 84% to predict severe brain injury, considering the cutoff point of 200 mg/dL or 11.1 mmol/L.

Genetic variations in the human immune system influence susceptibility to tegumentary leishmaniasis: a systematic review and meta-analysis.

OBJECTIVES: The outcomes of tegumentary leishmaniasis (TL) rely on a complex interaction between the host immune system and the parasite. This study assessed the influence of polymorphisms in immune-related genes on TL. METHODS: Web of Science, Scopus, PubMed, and Embase databases were searched systemically. The meta-analysis used a retrospective model in examining alleles, heterozygotes, and homozygotes. A quality assessment and an analysis of cumulative evidence were performed. RESULTS: A total of 29 genes (encoding for cytokines, chemokines, and other immune receptors) and 84 polymorphisms were analyzed. The IL-1ß_rs16944 (OR = 1.341, p = 0.003), TNF-α_rs1800629 (OR = 3.804, p = 0.004), MIF_rs755622 (OR = 3.357, p = 0.001), and INF- γ_rs243056 (OR = 1.670, p = 0.028) polymorphisms were speculated as risk factor for TL. They decrease the expression of the corresponding genes crucial for TL control. The quality assessment score was approximately 50%, suggesting the need for a clear method and polymorphism characterization for further comparison. The relevant risk of bias and other considerations resulted in low and moderate cumulative evidence confidence. CONCLUSIONS: IL-1ß_rs16944, TNF-α_rs1800629, MIF_rs755622, and INF-γ_rs2430561 polymorphisms were speculated as risk factor for TL, corroborating that IL-1ß, TNF-α, INF-γ, and MIF are involved in the TL pathogenesis.

Turning cacay butter and wheat bran into substrate for lipase production by Aspergillus terreus NRRL-255.

Cacay oil and butter were evaluated as enzymatic inducers for lipase production from Aspergillus terreus NRRL-255 by solid-state fermentation (SSF). Initially, physicochemical characteristics of agro-industrial wastes were evaluated in order to identify a potential solid substrate for lipase production. Higher water absorption index (3.65 g H2O/g substrate), adequate mineral content, great carbon source, and nitrogen concentration were factors that influenced the choice of wheat bran as a solid substrate. Cacay butter presented the highest lipolytic activity (308.14 U g-1) in the screening of lipid inducer. Then, the effects of lipid inducer concentration (cacay butter), temperature, pH, moisture, and fermentation time were evaluated on process performance using multivariate statistical methodology. Under optimal conditions, the highest lipase activity observed was 2,867.18 U g-1. Regarding the lipase characterization, maximum relative activity was obtained at pH 7.0 and at 35 °C. An inhibitory effect was observed for Ca2+, Mn2+, Zn2+, Fe2+, and Cu2+ ions. Lipase activity was increased with the reduction of sodium dodecyl sulfate (SDS) concentration and the increase of Triton X-100. Therefore, the use of wheat bran as a solid substrate combined with cacay butter demonstrated a substantial lipase production, indicating its biotechnological industrial potential.