Salivary Microbiota and Host-Inflammatory Responses in Periodontitis Affected Individuals With and Without Rheumatoid Arthritis.

Objectives: Periodontitis and rheumatoid arthritis (RA) are two widespread chronic inflammatory diseases with a previously suggested association. The objective of the current study was to compare the oral microbial composition and host´s inflammatory mediator profile of saliva samples obtained from subjects with periodontitis, with and without RA, as well as to predict biomarkers, of bacterial pathogens and/or inflammatory mediators, for classification of samples associated with periodontitis and RA. Methods: Salivary samples were obtained from 53 patients with periodontitis and RA and 48 non-RA with chronic periodontitis. The microbial composition was identified using 16S rRNA gene sequencing and compared across periodontitis patients with and without RA. Levels of inflammatory mediators were determined using a multiplex bead assay, compared between the groups and correlated to the microbial profile. The achieved data was analysed using PCoA, DESeq2 and two machine learning algorithms, OPLS-DA and sPLS-DA. Results: Differential abundance DESeq2 analyses showed that the four most highly enriched (log2 FC >20) amplicon sequence variants (ASVs) in the non-RA periodontitis group included Alloprevotella sp., Prevotella sp., Haemophilus sp., and Actinomyces sp. whereas Granulicatella sp., Veillonella sp., Megasphaera sp., and Fusobacterium nucleatum were the most highly enriched ASVs (log2 FC >20) in the RA group. OPLS-DA with log2 FC analyses demonstrated that the top ASVs with the highest importance included Vampirovibrio sp. having a positive correlation with non-RA group, and seven ASVs belonging to Sphingomonas insulae, Sphingobium sp., Novosphingobium aromaticivorans, Delftia acidovorans, Aquabacterium spp. and Sphingomonas echinoides with a positive correlation with RA group. Among the detected inflammatory mediators in saliva samples, TWEAK/TNFSF12, IL-35, IFN-α2, pentraxin-3, gp130/sIL6Rb, sIL-6Ra, IL-19 and sTNF-R1 were found to be significantly increased in patients with periodontitis and RA compared to non-RA group with periodontitis. Moreover, correlations between ASVs and inflammatory mediators using sPLS-DA analysis revealed that TWEAK/TNFSF12, pentraxin-3 and IL-19 were positively correlated with the ASVs Sphingobium sp., Acidovorax delafieldii, Novosphingobium sp., and Aquabacterium sp. Conclusion: Our results suggest that the combination of microbes and host inflammatory mediators could be more efficient to be used as a predictable biomarker associated with periodontitis and RA, as compared to microbes and inflammatory mediators alone.

Epidemiology of hospitalized patients with COVID-19 in a tertiary care hospital.

INTRODUCTION: COVID-19, caused by the betacoronavirus SARS-CoV-2, has overwhelmed the world's health systems. OBJECTIVE: To describe the epidemiological characteristics of patients treated in a tertiary care hospital. METHODS: A retrospective cohort study of patients diagnosed with or suspected of having COVID-19 from March 23 to July 31, 2020 was conducted. RESULTS: 4,401 patients were hospitalized at Central Military Hospital, out of which 35 % were beneficiaries, 26 % civilians, 28 % active military personnel, and only 11 %, retired military personnel. Male gender predominated, both in hospitalized patients and in those who died, as well as the O+ group and absence of comorbidities; among the observed comorbidities, the main ones were overweight and diabetes. Hospitalized patients' median age was 49 years, while median age of those who died was 62 years; women older than 51 years had a higher risk of dying. Adjusted case fatality rate was 18.5 %; 50 % died within the first six days. CONCLUSIONS: In this study, the epidemiological characteristics and main comorbidities in Mexican patients with SARS-CoV-2 infection were identified.

INTRODUCCIÓN: COVID-19, causada por el betacoronavirus SARS-CoV-2, ha saturado los sistemas de salud del mundo. OBJETIVO: Describir las características epidemiológicas de los pacientes atendidos en un hospital de tercer nivel. MÉTODOS: Se realizó una cohorte retrospectiva de pacientes con diagnóstico o sospecha de COVID-19, del 23 de marzo al 31 de julio de 2020. RESULTADOS: En el Hospital Central Militar se hospitalizaron 4401 pacientes, 35 % derechohabientes, 26 % civiles, 28 % militares en activo y solo 11 %, militares retirados. Predominó el sexo masculino, tanto en los pacientes hospitalizados como en los que fallecieron, el grupo O+ y la ausencia de comorbilidades; entre las comorbilidades que se observaron, las principales fueron el sobrepeso y la diabetes. La mediana de edad de los pacientes hospitalizados fue de 49 años, mientras que 62 años fue la edad de quienes fallecieron; las mujeres mayores de 51 años tuvieron mayor riesgo de fallecer. La tasa de letalidad ajustada fue de 18.5 %; 50 % falleció durante los primeros seis días. CONCLUSIONES: En este estudio se lograron identificar las características epidemiológicas y se destacaron las principales comorbilidades en pacientes mexicanos con infección por SARS-CoV-2.

Epidemiología de los pacientes hospitalizados con COVID-19 en un hospital de tercer nivel / Epidemiology of hospitalized patients with COVID-19 in a tertiary care hospital

Resumen Introducción: COVID-19, causada por el betacoronavirus SARS-CoV-2, ha saturado los sistemas de salud del mundo. Objetivo: Describir las características epidemiológicas de los pacientes atendidos en un hospital de tercer nivel. Métodos: Se realizó una cohorte retrospectiva de pacientes con diagnóstico o sospecha de COVID-19, del 23 de marzo al 31 de julio de 2020. Resultados: En el Hospital Central Militar se hospitalizaron 4401 pacientes, 35 % derechohabientes, 26 % civiles, 28 % militares en activo y solo 11 %, militares retirados. Predominó el sexo masculino, tanto en los pacientes hospitalizados como en los que fallecieron, el grupo O+ y la ausencia de comorbilidades; entre las comorbilidades que se observaron, las principales fueron el sobrepeso y la diabetes. La mediana de edad de los pacientes hospitalizados fue de 49 años, mientras que 62 años fue la edad de quienes fallecieron; las mujeres mayores de 51 años tuvieron mayor riesgo de fallecer. La tasa de letalidad ajustada fue de 18.5 %; 50 % falleció durante los primeros seis días. Conclusiones: En este estudio se lograron identificar las características epidemiológicas y se destacaron las principales comorbilidades en pacientes mexicanos con infección por SARS-CoV-2.

Abstract Introduction: COVID-19, caused by the betacoronavirus SARS-CoV-2, has overwhelmed the world's health systems. Objective: To describe the epidemiological characteristics of patients treated in a tertiary care hospital. Methods: A retrospective cohort study of patients diagnosed with or suspected of having COVID-19 from March 23 to July 31, 2020 was conducted. Results: 4,401 patients were hospitalized at the Central Military Hospital, out of which 35 % were beneficiaries, 26 % civilians, 28 % active military, and only 11%, retired military. Male gender predominated, both in hospitalized patients and in those who died, as well as the O+ group and absence of comorbidities; among the observed comorbidities, the main ones were overweight and diabetes. Hospitalized patients' median age was 49 years, while median age of those who died was 62 years; women older than 51 years had a higher risk of dying. Adjusted case fatality rate was 18.5 %; 50 % died within the first six days. Conclusions: In this study, the epidemiological characteristics and main comorbidities in Mexican patients with SARS-CoV-2 infection were identified.

Shotgun injuries. Need for a special point of view.

BACKGROUND: Shotgun injuries (SGI) are infrequent, but due its special ballistics, are related to adverse outcomes. OBJECTIVE: To analyze operative and administrative variables, critical for the institution. METHOD: Demographics and health-care related variables from SGI patients admitted to Military Central Hospital (Mexico City) between July 2006 and August 2019, were retrospectively studied. Statistics methods used were dispersion measures and relative occurrence frequency. RESULTS: Over a 15 months-span, 21 SGI patients were admitted. Mean age was 36.9 ± 13.6 years (range: 14-61) and male gender was dominant (n = 20; 95%). Type II SGI were the most common injuries (62%; 13/21). Mean hospital length of stay was 37.1 ± 28.7 days (range: 3-109) while stay at ICU was 20.3 ± 22.5 days (range: 3-99). Global rate of morbidity was 82% (17/21) and most frequent complications were infective. Global mortality rate was 24% (5/21). CONCLUSIONS: Once SGI cause prolonged length of stay, high rate of morbidity and of enormous consuming of material and human resources, primary prevention strategies are convenient for health-care systems compromised to the care of these cases.

ANTECEDENTES: Las lesiones por disparo de escopeta (LE) son infrecuentes, pero debido a su balística especial se relacionan con un pronóstico adverso. OBJETIVO: Analizar variables operativas y administrativas de los pacientes con LE, de interés para la institución. MÉTODO: Se estudiaron retrospectivamente variables demográficas y asistenciales de pacientes con LE admitidos al Hospital Central Militar (Ciudad de México) entre julio de 2006 y agosto de 2019. Los métodos estadísticos usados fueron medidas de dispersión y frecuencia relativa de ocurrencia. RESULTADOS: En 158 meses se admitieron 21 pacientes con LE. La edad media fue de 36.9 ± 13.6 años (rango: 14-61) y predominó el sexo masculino (n = 20; 95%). La LE tipo II fue la más frecuente (62%; 13/21). La estancia hospitalaria media fue de 37.1 ± 28.7 días (rango: 3-109) y en cuidados intensivos fue de 20.3 ± 22.5 días (rango: 3-99). La tasa global de morbilidad fue del 82% (17/21) y las complicaciones más frecuentes fueron infecciosas. La tasa gobal de mortalidad fue del 24% (5/21). CONCLUSIONES: Las LE son causa de estancia hospitalaria prolongada, alta tasa de morbilidad y un enorme consumo de recursos humanos y materiales, por lo que las estrategias de prevención primaria son convenientes para los sistemas de salud comprometidos con el cuidado de estos casos.

Experimental data on the degradation of caffeine by photo-electro-fenton using BDD electrodes at pilot plant.

Emerging contaminants (EC) are an imminent risk due to potential toxicity to aquatic ecosystems and human beings. This type of contaminants is found in low concentrations and usually present incomplete or inefficient removal by conventional treatments, which entail its permanence and constant increase. Advanced Oxidation Processes (AOP) are an alternative for the elimination of dangerous and resistant substances in wastewater. So, this research evaluates the caffeine degradation in aqueous solution by AOP, such as: Fenton, Electro-Oxidation (EO) with boron doped diamond (BDD) electrodes, Electro-Fenton (EF) and Photo-Electro-Fenton (PEF). The influences of pH, concentration of the supporting electrolyte and specific electric charge were investigated using a Taguchi׳s factorial design, which allowed to identify the contribution of each variable in the process. The data obtained in this work can be useful for scaling process and cost analysis because it provide the information at pilot plant scale.

QSAR-like models: a potential tool for the selection of PhACs and EDCs for monitoring purposes in drinking water treatment systems--a review.

Recent studies have demonstrated the presence of trace-level pharmaceutically active compounds (PhACs) and endocrine disrupting compounds (EDCs) in a number of finished drinking waters (DWs). Since there is sparse knowledge currently available on the potential effects on human health associated with the chronic exposure to trace levels of these Emerging Contaminants (ECs) through routes such as DW, it is suggested that the most appropriate criterion is a treatment criterion in order to prioritize ECs to be monitored during DW preparation. Hence, only the few ECs showing the lowest removals towards a given DW Treatment (DWT) process would serve as indicators of the overall efficiency of this process and would be relevant for DW quality monitoring. In addition, models should be developed for estimating the removal of ECs in DWT processes, thereby overcoming the practical difficulties of experimentally assessing each compound. Therefore, the present review has two objectives: (1) to provide an overview of the recent scientific surveys on the occurrence of PhACs and EDCs in finished DWs; and (2) to propose the potential of Quantitative-Structure-Activity-Relationship-(QSAR)-like models to rank ECs found in environmental waters, including parent compounds, metabolites and transformation products, in order to select the most relevant compounds to be considered as indicators for monitoring purposes in DWT systems.

The removal of endocrine disrupting compounds, pharmaceutically activated compounds and cyanobacterial toxins during drinking water preparation using activated carbon--a review.

This paper provides a review of recent scientific research on the removal by activated carbon (AC) in drinking water (DW) treatment of 1) two classes of currently unregulated trace level contaminants with potential chronic toxicity-pharmaceutically activate compounds (PhACs) and endocrine disrupting compounds (EDCs); 2) cyanobacterial toxins (CyBTs), which are a group of highly toxic and regulated compounds (as microcystin-LR); and 3) the above mentioned compounds by the hybrid system powdered AC/membrane filtration. The influence of solute and AC properties, as well as the competitive effect from background natural organic matter on the adsorption of such trace contaminants, are also considered. In addition, a number of adsorption isotherm parameters reported for PhACs, EDCs and CyBTs are presented herein. AC adsorption has proven to be an effective removal process for such trace contaminants without generating transformation products. This process appears to be a crucial step in order to minimize PhACs, EDCs and CyBTs in finished DW, hence calling for further studies on AC adsorption removal of these compounds. Finally, a priority chart of PhACs and EDCs warranting further study for the removal by AC adsorption is proposed based on the compounds' structural characteristics and their low removal by AC compared to the other compounds.

Cytotoxicity micropollutant removal in a crossflow membrane bioreactor.

The application of membrane bioreactor (MBR) technology was investigated with the aim of evaluating its potential for cytostatic drug and cytotoxicity bioremoval. The toxicity removal was assessed from biomarker test. CP removal of up to 80% was achieved under the operating conditions studied (HRT of 48 h and a SRT of 50 days). The increase of TMP was associated with an increase of supernatant toxicity as if fouling led to retention of the toxicity. Peaks of supernatant cytotoxicity were correlated with peaks in supernatant humic acid contents. It may suggest that molecules with a toxic effect may be adsorbed or entrapped in humic acids substances. Our study then points out that advances in wastewater treatment using an MBR can provide a suitable process for lowering CP concentrations before discharge into the aqueous environment. However, a tertiary treatment is necessary if complete elimination of toxicity is targeted.

Effect of cytostatic drugs on microbial behaviour in membrane bioreactor system.

The aim of this work is to evaluate the influence of cyclophosphamide and its principal metabolites (CPs) on microbial behaviour in a membrane bioreactor system. Two laboratory-scale membrane bioreactors (MBR) were run in parallel with a sludge retention time of 70 days (one with the cytostatic drugs, MBR-CPs, the second without, MBR-control). The microbial activity was measured by respirometric analysis. The endogenous and exogenous respirations of heterotrophic micro-organisms were evaluated. Micro-organisms exposed to CPs showed higher endogenous respiration rates and lower exogenous respiration rates than micro-organisms present in MBR-control. The effects were observed several days after adding the cocktail. Reduced sludge production was observed in MBR-CPs compared to MBR-control. This reduction of sludge production and the increase in the endogenous respiration rate in relation to MBR-control suggest that the chemical stress caused by CPs led to a diversion of carbon and/or energy from growth to adaptive responses and protection. In addition, the inhibitory effect on the assimilation of exogenous substrate (reduced exogenous respiration rate) suggests an inhibition of catabolism and anabolism despite the low CPs concentration studied (microg/L). However, this inhibitory effect can be offset by the biomass still active under low ratio (substrate/biomass) conditions in the bioreactor (due to complete retention of biomass and high sludge age), which helped to maintain high overall performance in the removal of conventional pollution.