Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common complication of type 2 diabetes mellitus (T2DM); its diagnosis and treatment are based on symptomatic improvement. However, as pharmacological therapy causes multiple adverse effects, the implementation of acupunctural techniques, such as electroacupuncture (EA) has been suggested as an alternative treatment. Nonetheless, there is a lack of scientific evidence, and its mechanisms are still unclear. We present the design and methodology of a new clinical randomized trial, that investigates the effectiveness of EA for the treatment of DPN. METHODS: This study is a four-armed, randomized, controlled, multicenter clinical trial (20-week intervention period, plus 12 weeks of follow-up after concluding intervention). A total of 48 T2DM patients with clinical signs and symptoms of DPN; and electrophysiological signs in the Nerve Conduction Study (NCS); will be treated by acupuncture specialists in outpatient units in Mexico City. Patients will be randomized in a 1:1 ratio to one of the following four groups: (a) short fibre DPN with EA, (b) short fibre DPN with sham EA, (c) axonal DPN with EA and (d) axonal DPN with sham EA treatment. The intervention will consist of 32 sessions, 20 min each, per patient over two cycles of intervention of 8 weeks each and a mid-term rest period of 4 weeks. The primary outcome will be NCS parameters, and secondary outcomes will include DPN-related symptoms and pain by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS), Dolour Neuropatique Score (DN-4), Semmes-Westein monofilament, Numerical Rating Scale (NRS) for pain assessment, and the 36-item Short Form Health Survey (SF-36). To measure quality of life and improve oxidative stress, the inflammatory response; and genetic expression; will be analysed at the beginning and at the end of treatment. DISCUSSION: This study will be conducted to compare the efficacy of EA versus sham EA combined with conventional diabetic and neuropathic treatments if needed. EA may improve NCS, neuropathic pain and symptoms, oxidative stress, inflammatory response, and genetic expression, and it could be considered a potential coadjutant treatment for the management of DPN with a possible remyelinating effect. TRIAL REGISTRATION: ClinicalTrials.gov. NCT05521737 Registered on 30 August 2022. International Clinical Trials Registry Platform (ICTRP) ISRCTN97391213 Registered on 26 September 2022 [2b].

Study of Electrospun Membranes Composed of PCL and Tilapia-Skin Collagen with Tetracycline or Chloramphenicol in Contact with Human Skin Fibroblasts for Wound Dressing Treatment.

Diabetic foot ulcers are a common complication of diabetes mellitus and can lead to severe infections and delayed wound healing. The development of effective wound dressings is crucial to promoting faster healing and preventing infections. This investigation aims to fabricate and characterize electrospun meshes composed of poly(ε-caprolactone) and collagen, extracted from tilapia skin. Additionally, tetracycline and chloramphenicol were incorporated into the dressings to explore their potential to combat wound infections. A comprehensive characterization was carried out, covering the physical structure, chemical composition, and potential application-related properties of the materials by the combination of scanning electron microscopy, Fourier transform infrared (FTIR), mechanical analysis, cell viability, live/dead staining, and microbiological analysis. Changes in mechanical properties were observed, related to the morphology of the membranes; the presence of the active molecules is evidenced by FTIR analysis; cell viability above control was observed for all the prepared membranes, and they were active in antimicrobial tests, suggesting that the developed materials have the potential to be further explored as wound dressings or scaffolds for diabetic foot ulcers.

Preparation and Characterization of Poly(lactic acid) Membranes and Films Coated with Polyaniline for Potential Use in Environmental Remediation.

This research outlines the fabrication of polymeric membranes and films of poly(lactic acid) (PLA), prepared via electrospinning and extrusion, respectively. These materials were subsequently coated with polyaniline (PANi) by using the in situ chemical polymerization technique. Scanning electron microscopy micrographs revealed that the best coatings were achieved when 3 and 30 min of contact time with the monomeric solution were used for the membrane and film, respectively. Additionally, Fourier transform infrared spectra, thermogravimetric studies, and contact angle measurements demonstrated proper interaction between PLA and PANi. The findings of these studies suggest that PLA membranes and films can serve as suitable substrates for the deposition of PANi, and the composite materials hold potential for use in environmental remediation applications.

Gram-Negative ESKAPE Bacteria Surveillance in COVID-19 Pandemic Exposes High-Risk Sequence Types of Acinetobacter baumannii MDR in a Tertiary Care Hospital.

The interruption of bacteriological surveillance due to the COVID-19 pandemic brought serious consequences, such as the collapse of health systems and the possible increase in antimicrobial resistance. Therefore, it is necessary to know the rate of resistance and its associated mechanisms in bacteria causing hospital infections during the pandemic. The aim of this work was to show the phenotypic and molecular characteristics of antimicrobial resistance in ESKAPE bacteria in a Mexican tertiary care hospital in the second and third years of the pandemic. For this purpose, during 2021 and 2022, two hundred unduplicated strains of the ESKAPE group (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii) were collected from various clinical sources and categorized by resistance according to the CLSI. An analysis of variance (ANOVA) complemented by the Tukey test was performed to search for changes in antimicrobial susceptibility profiles during the study period. Finally, the mechanisms of resistance involved in carbapenem resistance were analyzed, and the search for efflux pumps and high-risk sequence types in A. baumannii was performed by multilocus analysis (MLST). The results showed no changes in K. pneumoniae resistance during the period analyzed. Decreases in quinolone resistance were identified in E. coli (p = 0.039) and P. aeruginosa (p = 0.03). Interestingly, A. baumannii showed increases in resistance to penicillins (p = 0.004), aminoglycosides (p < 0.001, p = 0.027), carbapenems (p = 0.027), and folate inhibitors (p = 0.001). Several genes involved in carbapenem resistance were identified (blaNDM, blaVIM, blaOXA, blaKPC, blaOXA-40, and blaOXA-48) with a predominance of blaOXA-40 and the adeABCRS efflux pump in A. baumannii. Finally, MLST analysis revealed the presence of globally distributed sequence types (ST369 and ST758) related to hospital outbreaks in other parts of the world. The results presented demonstrate that the ESKAPE group has played an important role during the COVID-19 pandemic as nosocomial antibiotic-resistant pathogens and in particular A. baumannii MDR as a potential reservoir of resistance genes. The implications of the increases in antimicrobial resistance in pathogens of the ESKAPE group and mainly in A. baumannii during the COVID-19 pandemic are analyzed and discussed.

Preparation and Characterization of Extruded PLA Films Coated with Polyaniline or Polypyrrole by In Situ Chemical Polymerization.

Conductive polymers, such as polypyrrole and polyaniline, have been extensively studied for their notable intrinsic electronic and ionic conductivities, rendering them suitable for a range of diverse applications. In this study, in situ chemical polymerization was employed to coat extruded PLA films with PPy and PANi. Morphological analysis reveals a uniform and compact deposition of both polyaniline and polypyrrole after polymerization periods of 3 and 1 h, respectively. Furthermore, the PLA-PANi-3h and PLA-PPy-1h composites exhibited the highest electrical conductivity, with values of 0.042 and 0.022 S cm-1, respectively. These findings were in agreement with the XPS results, as the polyaniline-coated film showed a higher proportion of charge carriers compared to the polypyrrole composite. The elastic modulus of the coated films showed an increase compared with that of pure PLA films. Additionally, the inflection temperatures for the PLA-PANi-3h and PLA-PPy-1h composites were 368.7 and 367.2 °C, respectively, while for pure PLA, it reached 341.47 °C. This improvement in mechanical and thermal properties revealed the effective interfacial adhesion between the PLA matrix and the conducting polymer. Therefore, this work demonstrates that coating biopolymeric matrices with PANi or PPy enables the production of functional and environmentally friendly conductive materials suitable for potential use in the removal of heavy metals in water treatment.

Molecular Characterization of Bacterial Agents Causing External Ocular Infections Isolates of Patients in a Third Level Hospital.

Empirical use of antibiotics in the treatment of eye infections leads to bacterial pathogens becoming resistant to antibiotics; consequently, treatment failure and eye health complications occur. The aim of this study was to describe the phenotype and genotype of the resistance and adherence of bacterial agents causing eye infections in patients at Hospital Juárez de México. An observational, prospective, cross-sectional, and descriptive study was carried out in patients with signs and symptoms of ocular infection. Bacterial agents were isolated and identified by classical microbiology and mass spectrometry. Antibiotic resistance and adherence profiles were determined. Finally, resistance (mecA/SCCmec) and virulence (icaA and icaD) genes were detected in the Gram-positive population. The results showed that blepharitis was the most prevalent condition in the study population. A MALDI-TOF analysis revealed that Staphylococcus and Pseudomonas genus were the most prevalent as causal agents of infection. Resistances to ß-lactams were detected of 44 to 100%, followed by clindamycins, aminoglycosides, folate inhibitors, and nitrofurans. A multiple correspondence analysis showed a relationship between mecA genotype and ß-lactams resistance. The identification of SCCmecIII and SCCmecIV elements suggested community and hospital sources of infection. Finally, the coexistence of icaA+/icaD+/mecA(SCCmecIII) and icaA+/icaD+/mecA(SCCmecIV) genotypes was detected in S. aureus. The identification of resistant and virulent isolates highlights the importance of developing protocols that address the timely diagnosis of ocular infections. Herein, implications for the failure of antimicrobial therapy in the treatment of ocular infections in susceptible patients are analysed and discussed.

Association of the rs5186 polymorphism of the AGTR1 gene with decreased eGFR in patients with type 2 diabetes from Mexico City.

BACKGROUND: Early biomarkers search for Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM), as genetic markers to identify vulnerable carriers of the disease even before Glomerular Filtration Rate (GFR) decline or microalbuminuria development, has been relevant during the last few years. The rs5186 (A116C) polymorphism of the Angiotensin II Receptor Type I gene (AGTR1), has been associated to multiple effects of renal injury risk, commonly detected in patients with Diabetes Mellitus (DM). It has been described that rs5186 could have an effect in stability proteins that assemble Angiotensin II Receptor Type I (AT1), modifying its action, which is why it should be considered as a risk factor for Chronic Kidney Disease (CKD), characterized by a GFR progressive reduction. Even though, the association between rs5186 AGTR1 gene polymorphism and DKD in patients with T2DM has been controversial, inconclusive, and even absent. This disputable issue might be as a result of association studies in which many and varied clinical phenotypes included are contemplated as CKD inductors and enhancers. Although, the sample sizes studied in patients with T2DM are undersized and did not have a strict inclusion criteria, lacking of biochemical markers or KDOQI classification, which have hindered its examination. OBJECTIVE: The aim of our study was to establish an association between rs5186 AGTR1 gene polymorphism and GFR depletion, assessed as a risk factor to DKD development in patients with T2DM. METHODS: We analyzed 297 not related patients with T2DM, divided into 221 controls (KDOQI 1) and 76 cases (KDOQI 2). Arterial pressure, anthropometric and biochemical parameters were measured. rs5186 of AGTR1 genotyping was performed by TaqMan assay real-time PCR method. Allele and genotype frequencies, and Hardy-Weinberg equilibrium were measured. Normality test for data distribution was analyzed by Shapiro-Wilk test, variable comparison by Student's t-test for continuous variables, and Chi-squared test for categorical variables; ANOVA test was used for mean comparison of more than two groups. Effect of rs5186 to DKD was estimated by multiple heritability adjustment models for risk variables of DKD. Statistical significance was indicated by p<0.05. Data was analyzed using Statistical Package STATA v11 software. RESULTS: Dominant and Over-dominant models showed a likelihood ratio to GFR depletion of 1.89 (1.05-3.39, p=0.031) and 2.01 (1.08-3.73, p=0.023) in patients with T2DM. Risk factor increased to 2.54 (1.10-5.89) in women in Over-dominant model. CONCLUSION: In clinical practice, most of nephropathies progress at a slow pace into a total breakdown of renal function, even asymptomatic. This is the first study, reporting that rs5186 polymorphism of AGTR1 gene contribution to GFR depletion, and this could be evaluated as a predisposing factor for DKD in patients with T2DM.

Typing of Candida spp. from Colonized COVID-19 Patients Reveal Virulent Genetic Backgrounds and Clonal Dispersion.

Advances in the knowledge of the pathogenesis of SARS-CoV-2 allowed the survival of COVID-19 patients in intensive care units. However, due to the clinical characteristics of severe patients, they resulted in the appearance of colonization events. Therefore, we speculate that strains of Candida spp. isolated from COVID-19 patients have virulent genetic and phenotypic backgrounds involved in clinical worsening of patients. The aim of this work was to virutype Candida spp. strains isolated from colonized COVID-19 patients, analyze their genomic diversity, and establish clonal dispersion in care areas. The virulent potential of Candida spp. strains isolated from colonized COVID-19 patients was determined through adhesion tests and the search for genes involved with adherence and invasion. Clonal association was done by analysis of intergenic spacer regions. Six species of Candida were involved as colonizing pathogens in COVID-19 patients. The genotype analysis revealed the presence of adherent and invasive backgrounds. The distribution of clones was identified in the COVID-19 care areas, where C. albicans was the predominant species. Evidence shows that Candida spp. have the necessary genetic tools to be able colonize the lungs, and could be a possible causal agent of coinfections in COVID-19 patients. The detection of dispersion of opportunistic pathogens can be unnoticed by classical epidemiology. Epidemiological surveillance against opportunistic fungal pathogens in COVID-19 patients is an immediate need, since the findings presented demonstrate the potential virulence of Candida spp.

Dermatoscopic Patterns in Childhood Vitiligo and Their Association With Reflectance Confocal Microscopy Findings.

INTRODUCTION: The diagnosis of vitiligo is mainly based on clinical findings. However, dermoscopy or reflectance confocal microscopy (RCM) could be useful for assessing its progression (stability, pigmen-tation, or depigmentation). OBJECTIVES: To evaluate the correlation of dermatological findings by dermoscopy and RCM in pediatric vitiligo. METHODS: We conducted a cross-sectional, descriptive, and analytical clinical study. Pediatric patients with vitiligo of both sexes, aged > 1 year and < 18 years, with all spectrums of the disease were includ-ed. Vitiligo lesions were evaluated clinically, by dermoscopy, and microscopy. RESULTS: A total of 40 patients with vitiligo were included. Eight dermoscopic patterns were found: reduced/absent pigment network, perifollicular pigmentation, trichromic, tapioca sago, perifollicular depigmentation, starburst, leukotrichia, and erythema. Skin with a normal pigment network showed complete dermal papillary rings and half-rings. Skin with reduced/absent pigment network also had an absence of papillary rings or only showed half-rings and was more common in unstable vitiligo. The trichrome pattern only showed half-rings. The Tapioca sago pattern showed complete papillary rings and appeared in younger patients. Perifollicular pigmentation showed half-rings and complete rings and did not show associations. The diffuse borders did not present complete papillary structures. It was found that vitiligo duration time of fewer than 24 months (Odds Ratio 4.56, CI 1.09-18.99) and absent papillary rings (OR 2.75, CI 1.01-7.51) are associated with unstable prognosis. CONCLUSIONS: Certain dermatoscopic and microscopic findings, such as the reduction/absence of the pigment network, tapioca sago pattern, and absence of papillary rings, can be used to assess the stabil-ity of the disease and provide insight into the clinical behaviour of vitiligo.

Epidemiological Overview of Urogenital Gonorrhea in Mexico (2003-2020).

In Mexico, urogenital gonorrhea (UG) is one of the main sexually transmitted diseases notifiable by health systems around the world. Epidemiological data on sexually transmitted infections (STIs) in Mexico indicated that UG was "under control" until 2017. However, international epidemiological reports indicate the increase in incidence due to several factors, including an increase during the first year of the COVID-19 pandemic. These factors suggest that this phenomenon may occur in developing countries, including Mexico. Therefore, the aim of this study was to analyze national surveillance data on UG from 2003-2019 and the first year of the COVID-19 pandemic. An epidemiological study of cases and incidence of UG (2003-2020) was performed in the annual reports issued by the General Directorate Epidemiology in Mexico. Cases and incidence were classified and analyzed by year, sex, age group, and seasons (by temperature). Distribution of UG was carried out using heat maps for the whole country. Ultimately, a seasonal and correlation analysis was performed for UG cases versus temperature. The results showed that the distribution of cases and incidence by sex showed that there was no variation over 14 years. From 2016 onward, a significant increase in UG was observed before the pandemic. During the first year of the pandemic, a significant increase was observed in females aged 24-44 years. A heterogeneous distribution of UG was identified; however, border states were ranked among the top states with elevated incidences and cases. Lastly, the occurrence of UG was associated with temperature, related to summer. The information presented is intended to be useful to promote prevention and to contribute to visualize the distribution of UG over the last 18 years for decision making, and to show one of the consequences of the collapse of epidemiological surveillance of UG during the first year of the COVID-19 pandemic.

Abundance and distribution of cigarette butts on the sand of five touristic beaches in Latin America during the COVID-19 pandemic.

Cigarette butts (CB) and cigarette butt fibers (CBF) are highly abundant and frequent residues on beach sand. Also, they are hazardous waste due to their significant toxicity and potential risk to the ecosystems' biota and the health of beach tourists. This study aimed to determine the abundance and density of CB and CBF found on the active, rest, and service zones of five pilot beaches in Argentina, Colombia, Brazil, Ecuador, and Mexico. The methodology involved collecting CB and CBF in 500 m2 transects of urban tourist beaches using a citizen science-adapted methodology between June 2021 and May 2022, during the COVID-19 pandemic. The abundance and density of CB and CBF, and the Cigarette Butt Pollution Index (CBPI) were calculated. The highest proportion of CB was found in service and rest areas. Bocagrande (CO) reported the highest generation of CB and CBF and a severe CBPI.

Mortality and Survival Factors in Patients with Moderate and Severe Pneumonia Due to COVID-19.

During the pandemic, some mortality-related factors were age, sex, comorbidities (obesity, diabetes mellitus, and hypertension), recovery time, hospitalizations, and biochemical markers. The present work aimed to identify the mortality and survival factors in adults with moderate and severe pneumonia due to COVID-19 during the first and second waves of the pandemic in Mexico at a third-level hospital (High-Specialty Regional Hospital of Ixtapaluca (HRAEI), Ixtapaluca, Estado de Mexico, Mexico). A database was generated using information from the electronic clinical records of patients hospitalized from December 2021 to August 2022. Survival analysis was performed associating age, sex, longer recovery times, and some drugs. The risk factors found were age in the patients between 40 and 60 years (OR = 1.70), male sex (OR = 1.53), the presence of comorbidities (OR = 1.66) and hypertension (OR = 2.19), work occupation (construction workers OR = 5.22, factory workers OR = 3.13, unemployed OR = 2.93), the prehospital use of metamizole sodium (OR = 2.17), cough (OR = 1.73), and in-hospital oxygen therapy (reservoir mask OR = 6.6). The survival factors found in this study were working in the healthcare field (OR = 0.26), the prehospital use of certain medications (paracetamol OR = 0.65, dexamethasone OR = 0.55, and azithromycin OR = 0.47), presenting ageusia (OR = 0.5) and hyporexia (OR = 0.34), and the time using in-hospital oxygen therapy (device 1 OR = 0.72). Prehospital treatment needs to be reevaluated as dexamethasone and azithromycin proved to be protective factors. Likewise, providing aggressive oxygen therapy during hospital admission decreased mortality risk.

Ultra-Processed Food Consumption during Pregnancy and Its Association with Maternal Oxidative Stress Markers.

Ultra-processed food (UPF) consumption during gestation may lead to increased oxidative stress (OS) and could affect pregnancy outcomes. This study aims to evaluate the association of UPF consumption during pregnancy with circulating levels of OS markers. Diet was assessed (average of three assessments) in 119 pregnant women enrolled in the OBESO perinatal cohort (Mexico), obtaining quantitative data and the percentage of energy that UPFs (NOVA) contributed to the total diet. Sociodemographic, clinical (pregestational body-mass index and gestational weight gain) and lifestyle data were collected. Maternal circulating levels of OS markers (malondialdehyde (MDA), protein carbonylation (PC), and total antioxidant capacity (TAC)) were determined at the third trimester of pregnancy. Adjusted linear regression models were performed to analyze the association between UPFs and OS markers. UPFs represented 27.99% of the total energy intake. Women with a lower UPF consumption (<75 percentile°) presented a higher intake of fiber, ω-3, ω-6, and a lower ω-6/3 ratio. Linear regression models showed that UPFs were inversely associated with TAC and MDA. Fiber intake was associated with PC. UPF intake during pregnancy may result in an increase in oxidative stress. When providing nutrition care, limiting or avoiding UPFs may be an intervention strategy that could promote a better antioxidant capacity in the body.

Utilization Efficiency of Human Milk Oligosaccharides by Human-Associated Akkermansia Is Strain Dependent.

Akkermansia muciniphila is a mucin-degrading bacterium found in the human gut and is often associated with positive human health. However, despite being detected by as early as 1 month of age, little is known about the role of Akkermansia in the infant gut. Human milk oligosaccharides (HMOs) are abundant components of human milk and are structurally similar to the oligosaccharides that comprise mucin, the preferred growth substrate of human-associated Akkermansia. A limited subset of intestinal bacteria has been shown to grow well on HMOs and mucin. We therefore examined the ability of genomically diverse strains of Akkermansia to grow on HMOs. First, we screened 85 genomes representing the four known Akkermansia phylogroups to examine their metabolic potential to degrade HMOs. Furthermore, we examined the ability of representative isolates to grow on individual HMOs in a mucin background and analyzed the resulting metabolites. All Akkermansia genomes were equipped with an array of glycoside hydrolases associated with HMO deconstruction. Representative strains were all able to grow on HMOs with various efficiencies and growth yields. Strain CSUN-19, belonging to the AmIV phylogroup, grew to the highest level in the presence of fucosylated and sialylated HMOs. This activity may be partially related to the increased copy numbers and/or the enzyme activities of the α-fucosidases, α-sialidases, and ß-galactosidases. This study examines the utilization of individual purified HMOs by Akkermansia strains representing all known phylogroups. Further studies are required to examine how HMO ingestion influences gut microbial ecology in infants harboring different Akkermansia phylogroups. IMPORTANCE Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk and provide several benefits to developing infants, including the recruitment of beneficial bacteria to the human gut. Akkermansia strains are largely considered beneficial bacteria and have been detected in colostrum, breast milk, and young infants. A. muciniphila MucT, belonging to the AmI phylogroup, contributes to the HMO deconstruction capacity of the infant. Here, using phylogenomics, we examined the genomic capacities of four Akkermansia phylogroups to deconstruct HMOs. Indeed, each phylogroup contained differences in their genomic capacities to deconstruct HMOs, and representative strains of each phylogroup were able to grow using HMOs. These Akkermansia-HMO interactions potentially influence gut microbial ecology in early life, a critical time for the development of the gut microbiome and infant health.

Massive sequencing of the V3-V4 hypervariable region of bronchoalveolar lavage from patients with COVID-19 and VAP reveals the collapse of the pulmonary microbiota.

Background. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a predisposing factor for the development of healthcare-associated infections, of which ventilator-associated pneumonia (VAP) is one.Hypothesis. VAP is caused by ESKAPE bacteria and other pathogens not detected by microbiological culture.Aim. To elucidate the bacterial pathogens of severe coronavirus disease 2019 (COVID-19) and VAP patients by massive sequencing and to predict their degree of relationship with the age and sex of the patients.Methods. Analysis of ribosomal libraries of the V3-V4 hypervariable region obtained by Illumina sequencing of bronchoalveolar lavages from COVID-19 and VAP (first wave) patients from Hospital Juárez de México.Results. Acinetobacter and Pseudomonas were the main bacterial genera in the bronchoalveolar lavages (BALs) analysed. Other members of the ESKAPE group, such as Enterococcus and Klebsiella, were also identified. Taxonomic composition per patient showed that non-ESKAPE genera were present with significant relative abundances, such as Prevotella, Stenotrophomas, Enterococcus, Mycoplasma, Serratia and Corynebacterium. Kruskal-Wallis analysis proved that VAP acquisition is an adverse event that is not influenced by the sex and age of COVID-19 patients.Discussion. Metagenomic findings in COVID-19/VAP patients highlight the importance of implementing comprehensive microbiological diagnostics by including alternative tools for the detection of the causal agents of healthcare-associated infections (HAIs).Conclusions. Timely identification of bacteria 'not sought' in diagnostic bacteriology laboratories will allow specific and targeted treatments. Implications for the restricted diagnosis of VAP causative agents in COVID-19 patients and the presence of pathogens not detected by classical microbiology are analysed and discussed.

Serum miRNA profile as a potential tool for non-invasive gastric cancer diagnosis in Mexican patients.

INTRODUCTION: Gastric cancer (GC) is the third leading cause of cancer death and a major public health-care problem worldwide. At present, methods for plasma detection of cancer are limited. MicroRNAs (miRNAs) have recently been proposed as genetic regulators, which are deregulated in different types of cancer. The miRNAs are stable in serum/plasma and can be detected. Circulating miRNAs in plasma have been proposed as potential diagnostic biomarkers in GC. MATERIALS AND METHODS: After reviewing the relevant literature, the expression levels of seven miRNAs (miR-16, miR-21, miR-25, miR-26a, miR-92, miR-218, miR-223, and miR-451) were assessed by quantitative reverse transcription polymerase chain reaction using TaqMan microRNA Assays (Applied Biosystems) in plasma samples from GC patients (n = 80) and healthy controls (n = 80). RESULTS: Our results demonstrated that the expression levels of miR-21 and miR-25 were significantly upregulated in GC patients compared to healthy controls with a Fold Change of 11.551 and 60.129, respectively, while miR-223 showed downregulation in GC patients compared to healthy controls with a Fold Change of -247.281. The absolute value of Fold Change > 2 was consider significant, p < 0.05. CONCLUSIONS: Our results indicated that miR-21, miR-25, and miR-223 in plasma samples can be served as a potential noninvasive tool in detection of GC.

INTRODUCCIÓN: El cáncer gástrico (CG) es la tercera causa de muerte por cáncer y un importante problema de salud pública. Actualmente, los métodos para la detección de CG en plasma son limitados. Recientemente se han propuesto los microARNs (miARN) como reguladores genéticos en diferentes tipos de cáncer. Los miARN son estables en plasma, lo que permite una fácil detección, pudiendo usarse como biomarcadores en CG. MATERIALES Y MÉTODOS: Los niveles de expresión de siete miARN seleccionados (miR-16, miR-21, miR-25, miR-26a, miR-92, miR218, miR-223, miR-451) fueron evaluados mediante qRT-PCR mediante análisis con microARN TaqMan (Applied Biosystems) en muestras de plasma de pacientes con CG (n = 80) y controles sanos (n = 80). RESULTADOS: Se observo que los niveles de expresión de miR-21 y miR-25 estaban significativamente regulados al alza en los pacientes con CG en comparación con los controles con un Fold Change de 11.551 y 60.129 respectivamente, mientras que miR-223 mostró una regulación negativa con un cambio de -247,281. El valor absoluto de Fold Change >2 se consideró estadísticamente significativo, P <0,05. CONCLUSIONES: Nuestros resultados indicaron que miR 21, miR 25 y miR-223 en plasma pueden servir como una potencial herramienta no invasiva en la detección de CG.

Genotype Distribution Change After Human Papillomavirus Vaccination in Two Autonomous Communities in Spain.

Context: It has been more than 10 years since the human papillomavirus (HPV) vaccination program was initiated in most advanced countries. Thus, it seems necessary to change the uterine cervical cancer screening strategy. Molecular-based tests are considered essential in this scenario. Objective: We aimed to review the distribution of the HPV genotypes after the introduction of the vaccination program with Cervarix® and Gardasil 4® in two autonomous communities in Spain, looking for possible changes in distribution and the occurrence of a herd effect. Design: A cross-sectional study was performed in 45,362 samples that were processed in the Cantabria and Aragon communities during the period from 2002 to 2016. We compared the genotype distribution before and after the vaccination program was initiated. Results: Genotypes HPV6 and HPV11 have decreased significantly after the introduction of the vaccine. HPV16 has had a decrease, but not a significant one in the statistical analysis. However, HPV31, HPV52, and HPV45 have increased in percentage. A replacement phenomenon with other genotypes not included in the vaccine has been observed in our population. Conclusions: Continued surveillance is needed to provide further indication of any changes over time in the genotypes in circulation. This will be facilitated by monitoring the genotyping results from the new model of cervical screening using primary HPV DNA testing.

Antisclerothic effect of tibolone by reducing proinflammatory cytokines expression, ROS production and LDL-ox uptake in THP-1 macrophages.

BACKGROUND: Cardiovascular disease is more frequent in menopausal women, which has been related to factor such as weight gain, altered fat distribution, and increased inflammation markers including adipokines (MCP-1, TNF-α, IL-6) and cytokines (IL-1, IL-6, TNF-α) produced by macrophages. In addition to their phagocytic activity, macrophages secrete cytokines and chemokines that induces cell recruitment, which is a process related to vascular damage that favors the formation of atheromatous plaques. Tibolone (Tb) therapy is used to reduce the symptoms of menopause as well as osteoporosis and it has been shown to decreases the risk of fractures. METHODS: To investigate the effect of tibolone in macrophage enzymatic activity, gene expression of cytokines, and its effect on foam cells formation. We use phorbol-12-myristate-13-acetate (PMA)-differentiated THP-1 cells. The cells were incubated 24 h and 48 h using pre and post-treatment schemes. We evaluated total ROS determination by NBT assay, expression of cytokines (IL-1ß, IL-6, TNF-α, NOS2, ARG1, TGFß) by RT-qPCR and foam cell formation in THP-1 differentiated macrophages stimulated with PMA. RESULTS: It was observed that the minor levels of total ROS determination were obtained with tibolone at 48 h in post-treatment scheme. Also, in a long term we found decrease the proinflammatory cytokines (IL-1ß, IL-6 and TNF-α). Finally, with treatment for 24 h with P4 y Tb we observed fewer LDL vesicles into macrophages cytoplasm. CONCLUSIONS: These results suggest that tibolone reduces the inflammatory process, also inhibits the foam cells formation; suggesting a possible role in reducing cardiovascular risk.

Demographic and clinical characterization of multiple sclerosis in Mexico: The REMEMBer study.

BACKGROUND: Multiple sclerosis (MS) is a chronic neurodegenerative disease of the central nervous system with high prevalence in young adults around the world. The vast majority of epidemiological studies and statistics are based on European and American data, so most clinical guidelines and medical consensus are based on this information. There is very limited evidence in Mexico regarding demographic and clinical aspects of MS. Therefore, this study comprehensively described the epidemiological and clinical features of MS in a large cohort of patients from eight tertiary-level centers in Mexico. METHODS: A cross-sectional multicenter study was conducted. A group of neurologists, the "Registro Mexicano de Esclerosis Multiple" (REMEMBer) group, compiled the information of MS patients (January to December 2019) from eight tertiary-level centers. Clinical and demographic data were extracted. RESULTS: A total of 1,185 patients were included. The mean age was 40.65 ± 11.43 years old. Women represented more than half of the whole cohort (64.9% vs. 35.1%). Of the whole cohort, forty-three percent of MS patients had a relative with at least one autoimmune disease (MS: 24%, other autoimmune disorders: 74.9%) or thyroid disease (28%). Furthermore, the mean age of clinical onset was 31.23 ± 9.71 (range: 16-68) years old, and the disease duration was 9.33 ± 7.25 (0.46-40.19) years. The most prevalent phenotype of MS was relapsing-remitting (87.76%). Primary (1.18%) and secondary (9.11%) progressive, as well as clinically isolated syndrome (CIS, 1.43%), were also found. Clinical phenotypes (facial, hearing, and speech disorders, and movement impairment and ataxia) and the frequency of thyroid disorders were different between genders. CONCLUSION: In Mexico, the frequency of MS seems to be higher in the female gender (2:1 women/men ratio) compared to other series. In addition, there was a predominance of facial, hearing and speech disorders, as well as movement impairment and ataxia. Thyroid diseases were more common in women with multiple sclerosis than men.