Úlceras de pie diabético y plasma rico en plaquetas / Healing of diabetic foot ulcers with platelet-rich plasma

Introducción: El plasma rico en plaquetas (PRP) se encuentra en desarrollo desde los años 80, asociado con aplicaciones en medicina cardíaca, traumatológica y dermatológica. El PRP es una preparación autóloga, con una concentración de plaquetas por sobre el valor normal en sangre periférica, que se obtiene a partir de su centrifugación siguiendo diferentes protocolos que fueron valorados en distintas revisiones sistemáticas. El plasma luego se activa con trombina o cloruro cálcico, o por lisis física (ultrasonido o frizado). El PRP contiene factores de crecimiento, citoquinas y proteínas de adhesión que, al aplicarse en la lesión, favorecen la hemostasia, la síntesis de tejido conectivo y la revascularización. El producto se aplica en solución o gel. Se intentaron diferentes clasificaciones del PRP para estandarizarlo, sin éxito. Se conceptualizó la receta del PRP para aplicación clínica, que presentó las siguientes características: valores altos de plaquetas, disminución de la contaminación de glóbulos rojos, presencia de neutrófilos y leucocitos para el éxito terapéutico. Protocolo y casos: Se presenta el protocolo de preparación de PRP de centrifugación única de 7 minutos a 1400 rpm, con activación por medio de gluconato de calcio según la siguiente proporción: 3 ml plasma/0.4 ml gluconato cálcico. Además, se informan tres casos de úlceras de pie diabético de nuestra institución. Conclusión: El PRP no presenta complejidad en su preparación y aplicación, por lo que es factible de realizar en el primer nivel de atención que cuente con los recursos materiales y profesionales con conocimiento en el abordaje de heridas crónicas.

Introduction: Platelet-rich plasma (PRP) has been under development since the 1980s, associated with applications in cardiac, traumatological, and dermatological medicine. PRP is an autologous preparation with a platelet concentration above the normal value in peripheral blood that is obtained from its centrifugation following different protocols that were evaluated in different systematic reviews. The plasma is then activated with thrombin or calcium chloride, or by physical lysis (ultrasound or friz). PRP contains growth factors, cytokines, and adhesion proteins that, when applied to the lesion, favor hemostasis, connective tissue synthesis, and revascularization. The product is applied in solution or gel. Different classifications of the PRP were used with the intention of standardizing the procedure without success. The PRP recipe for clinical application was conceptualized. It presented the following characteristics: high platelet values, decreased red blood cell contamination, presence of neutrophils and leukocytes for therapeutic success. Protocol and cases: The PRP preparation protocol for single centrifugation for 7 minutes at 1400 rpm with activation through calcium gluconate is presented according to the following ratio: 3 ml plasma/0.4 ml of calcium gluconate. Three cases of diabetic foot ulcers from our institution are reported. Conclusion: The PRP does not present complexity in its preparation and application, so it is feasible to perform it in the first level of care that has the material and professional resources with knowledge in the approach to chronic wounds.

COVID-19 in a country with a very high prevalence of diabetes: The impact of admission hyperglycaemia on mortality.

Aims: To evaluate the frequency of diabetes and admission hyperglycaemia in Mexican COVID-19 patients, to describe the clinical and biochemical characteristics of patients with admission hyperglycaemia and to determinate the impact of diabetes and admission hyperglycaemia on COVID-19 severity and mortality. Methods: A multicentric study was performed in 480 hospitalized patients with COVID-19. Clinical and biochemical characteristics were evaluated in patients with admission hyperglycaemia and compared with non-hyperglycaemic patients. The effect of diabetes and admission hyperglycaemia on severity and risk of death were evaluated. Results: Age was 50.7 ± 13.6 years; 68.3% were male. Some 48.5% (n = 233) had admission hyperglycaemia; 29% (n = 139) of these patients had pre-existing diabetes. Patients with admission hyperglycaemia had more requirement of invasive mechanical ventilation (IMV), higher levels of urea, D-dimer and neutrophil-lymphocyte ratio (NLR), as well as lower lymphocyte count. An association between admission hyperglycaemia with IMV and D-dimer with glucose was found. Age ≥50 years (OR 2.09; 95%CI 1.37-3.17), pre-existing diabetes (OR 2.38; 95%CI 1.59-5.04) and admission hyperglycaemia (OR 8.24; 95%CI 4.74-14.32) were risk factors for mortality. Conclusions: Admission hyperglycaemia is presented in 48.5% of COVID-19 patients. Diabetes and admission hyperglycaemia are associated with the severity of disease and mortality. This study shows the devastating conjunction of hyperglycaemia and COVID-19. Clinical trial registration: Clinical characteristics of patients with COVID-19, DI/20/204/04/41 (Hospital General de Mexico) and NR-13-2020 (Hospital Regional de Alta Especialidad Ixtapaluca).

Efecto de la combinación de Metarhizium anisopliae y Gliocladium virens sobre la oviposición, eclosión y emergencia de Aedes aegypti / Effect of the combination of Metarhizium anisopliae and Gliocladium virens on the oviposition, hatching and emergency of Aedes aegypti

Resumen: Objetivo: Evaluar el efecto de la combinación de Metarhizium anisopliae y Gliocladium virens, ambos con Aqua Reslin Super, sobre oviposición, eclosión y emergencia de Aedes aegypti. Material y métodos: Se realizaron evaluaciones para determinar el efecto de los tratamientos impregnados en papel filtro y expuestos dentro de recipientes de plástico sobre la oviposición, eclosión y emergencia de Aedes aegypti. Resultados: Los resultados indicaron que las combinaciones hongo e insecticida no afectaron el comportamiento de oviposición, pero sí la eclosión de los huevos y la emergencia del adulto. Conclusión: Con los resultados se puede concluir que la combinación de hongos + insecticida puede ser una buena opción para aplicarse en sitios de oviposición con miras al desarrollo de una ovitrampa letal.

Abstract: Objective: To evaluate the effect of the combination of Metarhizium anisopliae and Gliocladium virens, both with Aqua Reslin Super, on the oviposition, hatching and emergence of Aedes aegypti. Materials and methods: Evaluations were carried out to determine the effect of treatments impregnated on filter paper and exposed within plastic containers on the oviposition, hatching and emergency of Aedes aegypti. Results: The results indicated that the fungus and insecticide combinations did not affect the oviposition behavior, but if the hatching of the eggs and the adult's emergency. Conclusion: With the results it can be concluded that the combination of fungi + insecticide can be a good option to be applied in oviposition sites with a view to the development of a lethal ovitrap.

[Effect of the combination of Metarhizium anisopliae and Gliocladium virens on the oviposition, hatching and emergency of Aedes aegypti]. / Efecto de la combinación de Metarhizium anisopliae y Gliocladium virens sobre la oviposición, eclosión y emergencia de Aedes aegypti.

OBJECTIVE: To evaluate the effect of the combination of Metarhizium anisopliae and Gliocladium virens, both with Aqua Reslin Super, on the oviposition, hatching and emergence of Aedes aegypti. MATERIALS AND METHODS: Evaluations were carried out to determine the effect of treatments impregnated on filter paper and exposed within plastic containers on the oviposition, hatching and emergency of Aedes aegypti. RESULTS: The results indicated that the fungus and insecticide combinations did not affect the oviposition behavior, but if the hatching of the eggs and the adult's emergency. CONCLUSIONS: With the results it can be concluded that the combination of fungi + insecticide can be a good option to be applied in oviposition sites with a view to the development of a lethal ovitrap.

OBJETIVO: Evaluar el efecto de la combinación de Metarhizium anisopliae y Gliocladium virens, ambos con Aqua Reslin Super, sobre oviposición, eclosión y emergencia de Aedes aegypti. MATERIAL Y MÉTODOS: Se realizaron evaluaciones para determinar el efecto de los tratamientos impregnados en papel filtro y expuestos dentro de recipientes de plástico sobre la oviposición, eclosión y emergencia de Aedes aegypti. RESULTADOS: Los resultados indicaron que las combinaciones hongo e insecticida no afectaron el comportamiento de oviposición, pero sí la eclosión de los huevos y la emergencia del adulto. CONCLUSIONES: Con los resultados se puede concluir que la combinación de hongos + insecticida puede ser una buena opción para aplicarse en sitios de oviposición con miras al desarrollo de una ovitrampa letal.