Marcadores de funcionamiento renal en pacientes infectados por SARS-CoV-2. Revisión rápida de la literatura.

 Objetivo. Resumir la evidencia científica sobre las altera-ciones renales asociadas con la infección por SARS-CoV-2. Material y métodos. Se realizó una revisión rápida con la metodología Cochrane. Resultados. La enfermedad renal crónica (ERC) preexistente en pacientes con SARS-CoV-2 varió de 1 a 38% y la lesión renal aguda (LRA), de 2.9 a 86.4%. El pronóstico de la infección fue peor en pacientes con ERC y en aquellos con reserva renal remanente (RRR) intacta que desarrollaron LRA. El riesgo de muerte fue mayor (riesgo relativo combinado = 1.49; IC95%: 1.09-2.04) en pacientes infectados por SARS-CoV-2 con ERC preexistente. Los mar-cadores de RRR mostraron alteraciones en pacientes con SARS-CoV-2 graves y fatales; el marcador más utilizado fue la creatinina sérica. Conclusiones. La evidencia científica muestra la relevancia de la evaluación y monitoreo perma-nente de la RRR en pacientes hospitalizados por SARS-CoV-2 para mejorar el pronóstico de aquellos con ERC preexistente, así como de aquellos sin ERC que desarrollan LRA.

Exposure to the pesticide DDT and risk of diabetes and hypertension: Systematic review and meta-analysis of prospective studies.

BACKGROUND: Experimental evidence suggests that p,p'-DDE might be involved in the development of diabetes and hypertension (HTN); however, the evidence in humans is inconclusive. OBJECTIVE: To summarize the epidemiological evidence for the association of p,p'-DDT exposure and its breakdown products with the risk of diabetes and HTN from prospective studies. METHODS: We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Eligible studies (prospective) were search in PubMed, Web of Science, EBSCO, and SciELO databases (July 11, 2020). Different search algorithms were used for diabetes and HTN. Pooled odds ratios (ORs) were estimated from meta-analysis with random effects for each exposure and outcome. RESULTS: A total of 23 prospective studies were included in this review, 16 assessed diabetes and seven HTN; very few measured p,p'-DDT. Exposure to p,p'-DDE was associated with a slightly increased risk of type 2 diabetes (T2D) (pooled OR = 1.44; 95%CI: 1.00, 2.07; p = 0.049) and HTN (pooled OR = 1.21; 95%CI: 1.07, 1.38). Dose-response meta-analysis suggested a non-linear relation between p,p'-DDE and T2D. Exposure to p,p'-DDE was not associated with gestational diabetes (pooled OR = 1.01; 95%CI: 0.94, 1.09); similarly, p,p'-DDT was not associated with T2D (pooled OR = 1.03; 95%CI: 0.79, 1.35). CONCLUSIONS: Evidence from prospective studies suggests that exposure to p,p'-DDE, the main breakdown product of p,p'-DDT, might increase the risk of developing T2D; such increase may be apparent only at low levels. Exposure to p,p'-DDE may also increase the risk of having HTN; however, further evidence is required.

[Blood lead levels and poor school performance among children in Mexico City]. / Concentraciones de plomo en sangre y reprobación de escolares en la ciudad de México.

OBJECTIVE: To describe the relationship between blood lead levels (BLL) and poor school performance. MATERIAL AND METHODS: A cross-sectional study was carried out in 1996 among 792 schoolchildren aged 7-14 years, who attended the outpatient units of five pediatric hospitals of Mexico City. BLL was measured together with lead exposure and academic performance. RESULTS: Reported BLL and geometric means (GM) were 8.6 microg/dL and 7.7 microg/dL, respectively. The main source of exposure was the use of glazed pottery (difference of use =-1.182; p = 0.000). Among schoolchildren who failed any school year, GM of the BLL was 8.1 microg/dL, compared with children who did not fail (GM = 7.6 microg/dL; p = 0.240). The risk of failing a school year between the 1st and 3rd grade with a BLL greater than 10 microg/dL was 1.73 (p = 0.012, IC 95% 1.13-2.66) and from 1st to 4th grade was 1.62 (p = 0.021, IC 95% 1.07-2.46). CONCLUSIONS: Blood lead levels, among other conditions, may contribute to the failure in school performance observed in the children participating in this study.

Marcadores de funcionamiento renal en pacientes infectados por SARS-CoV-2. Revisión rápida de la literatura / Markers of kidney function among SARS-CoV-2 infected patients. A rapid review of the literature

Resumen Objetivo: Resumir la evidencia científica sobre las alteraciones renales asociadas con la infección por SARS-CoV-2. Material y métodos: Se realizó una revisión rápida con la metodología Cochrane. Resultados: La enfermedad renal crónica (ERC) preexistente en pacientes con SARS-CoV-2 varió de 1 a 38% y la lesión renal aguda (LRA), de 2.9 a 86.4%. El pronóstico de la infección fue peor en pacientes con ERC y en aquellos con reserva renal remanente (RRR) intacta que desarrollaron LRA. El riesgo de muerte fue mayor (riesgo relativo combinado = 1.49; IC95%: 1.09-2.04) en pacientes infectados por SARS-CoV-2 con ERC preexistente. Los marcadores de RRR mostraron alteraciones en pacientes con SARS-CoV-2 graves y fatales; el marcador más utilizado fue la creatinina sérica. Conclusiones: La evidencia científica muestra la relevancia de la evaluación y monitoreo permanente de la RRR en pacientes hospitalizados por SARS-CoV-2 para mejorar el pronóstico de aquellos con ERC preexistente, así como de aquellos sin ERC que desarrollan LRA.

Abstract: Objective: To summarize the scientific literature on kidney abnormalities associated with SARS-CoV-2 infection. Materials and methods: It was conducted a rapid review using the Cochrane methodology. Results: Pre-existing chronic kidney disease (CKD) in SARS-CoV-2 infected patients ranged from 1-38% and acute kidney injury (AKI) ranged from 2.9-86.4%. The prognosis of patients with SARS-CoV-2 infection was worse among those with CKD and those with normal remnant kidney function (RKF) that developed AKI. The risk of death was higher (pooled risk ratio =1.49; 95%CI: 1.09-2.04) among SARS-CoV-2 infected patients with pre-existing CKD. The RKF markers showed alterations among severe and non-surviving SARS-CoV-2 patients; the most common marker was serum creatinine. Conclusions: The scientific evidence shows the relevance of the evaluation and permanent monitoring of the RKF in SARS-CoV-2 hospitalized patients to improve the prognosis of those with pre-existing CKD as well as the prognosis of those without CKD who develop AKI.

[Prevalence of sexually transmitted infections and associated risk factors among female commercial sex workers in Cuautla, Morelos]. / Prevalencia de infecciones de transmisión sexual y factores de riesgo concomitantes en sexo servidoras de Cuautla, Morelos.

OBJECTIVE: To determine the prevalence of sexually transmitted infections (STI) among female commercial sex workers in Cuautla, Morelos, Mexico. MATERIAL AND METHODS: A cross-sectional survey was conducted in 1998, in the red-light district of Cuautla, Morelos, Mexico. It included 100 female commercial sex workers who labored permanently in bars and night clubs. Data were collected using two questionnaires, one on socio-demographic characteristics, and the other on commercial sex, risk perception, and knowledge on preventive measures and contagion of sexually transmitted diseases/AIDS. Blood and cervicovaginal specimens were also collected to assess the prevalence of sexually transmitted and reproductive system infections (RSI). Outcome variables were STI (syphilis and chlamydiasis) and RSI (vaginosis and candidiasis). RESULTS: Sexually transmitted prevalence was of 11%, reproductive system infections prevalence was of 39%. When candidiasis was included in the sexually transmitted infections group, prevalence was of 31%. The main factors associated with sexually transmitted infections were: who instructed on condom use, time having intercourse with partner, and years of commercial sex work. Factors related to reproductive system infections were: illiteracy, use of condom with partner, who instructed on condom use, and years of commercial sex work. Multivariate analysis showed an increased likelihood of acquiring a sexually transmitted infection and/or reproductive system infection with illiteracy, instruction on condom use by a person other than a healthcare worker, and lack of condom use. CONCLUSIONS: Regular use of condoms during intercourse is the most important preventive measure to avoid and control STI and RSI. Study findings pinpoint spatial and temporal factors that contribute to infection. Intervention measures directed at these factors should strengthen preventive and educational programs to improve medical care for these infections.

Concentraciones de plomo en sangre y reprobación de escolares en la ciudad de México / Blood lead levels and poor school performance among children in Mexico City

Objetivo: Describir la relación de los niveles de plomo en sangre y reprobación escolar. Material y métodos: Estudio transversal en 792 escolares de 7 a 14 años de edad asistentes a la consulta externa de cinco hospitales pediátricos de la ciudad de México en 1996. Se midió el nivel de plomo en sangre, se exploró la exposición al metal, así como el desempeño académico. Resultados: Se reportó una media de plomo en sangre de 8.6 μg/dL y una media geométrica de 7.7 μg/dL. La principal fuente de exposición fue el uso de loza de barro vidriado (diferencia de uso = –1.182, p = 0.000). En los escolares que reprobaron algún año, la media geométrica de plomo en sangre fue de 8.1 μg/dL, en comparación con los niños que no reprobaron (media geométrica = 7.6 μg/dL, p = 0.240). El riesgo de reprobar entre el primer y el tercer año de primaria con plomo en sangre mayor a 10 μg/dL fue de 1.73 (p=0.012, IC 95% 1.13-2.66), y del primero al cuarto año de primaria fue de 1.62 (p=0.021, IC 95% 1.07-2.46). Conclusiones: Es probable que el plomo sanguíneo, entre otros condicionantes, contribuya a la reprobación repetida en los escolares de este estudio.

OBJECTIVE: To describe the relationship between blood lead levels (BLL) and poor school performance. MATERIAL AND METHODS: A cross-sectional study was carried out in 1996 among 792 schoolchildren aged 7-14 years, who attended the outpatient units of five pediatric hospitals of Mexico City. BLL was measured together with lead exposure and academic performance. RESULTS: Reported BLL and geometric means (GM) were 8.6 microg/dL and 7.7 microg/dL, respectively. The main source of exposure was the use of glazed pottery (difference of use =-1.182; p = 0.000). Among schoolchildren who failed any school year, GM of the BLL was 8.1 microg/dL, compared with children who did not fail (GM = 7.6 microg/dL; p = 0.240). The risk of failing a school year between the 1st and 3rd grade with a BLL greater than 10 microg/dL was 1.73 (p = 0.012, IC 95% 1.13-2.66) and from 1st to 4th grade was 1.62 (p = 0.021, IC 95% 1.07-2.46). CONCLUSIONS: Blood lead levels, among other conditions, may contribute to the failure in school performance observed in the children participating in this study.