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BACKGROUND: The relationship of microbiota composition dynamics and the progression of subclinical atherosclerosis in people with HIV (PWH) remains unknown. METHODS: 96-week, prospective, longitudinal study in virologically-suppressed PWH. Carotid intima-media thickness (cIMT) measurements and stool samples were obtained at baseline, 48-week and 96-week visits. cIMT progression was defined as an increase >10% and/or detection of new carotid plaque. To profile the gut microbiome, amplification and sequencing of 16S ribosomal-RNA (V3-V4 variable regions) were carried out following the Illumina protocol. Sequencing was performed with MiSeq platform. RESULTS: 191, 190 and 167 patients had available fecal samples for microbiome analysis at the baseline, 48- and 96-week visits, respectively. 87 (43%) participants showed atherosclerosis progression, and 54 (26.7%) presented new carotid plaque. No significant differences were observed in adjusted α-diversity indices between groups defined by cIMT progression. Beta-diversity determined through principal coordinate analysis distances showed that the groups exhibited distinct microbial profiles (PERMANOVA p-value = 0.03). Longitudinal analysis with ANCOM-BC2 adjusted for traditional cardiovascular risk factors, MSM and nadir CD4 count revealed that cIMT progression was consistently associated with Agathobacter and Ruminococcus_2, while non-progression was consistently associated with Prevotella_7. CONCLUSION: Progression of atherosclerosis in PWH might be associated with distinctive signatures in the gut microbiota.
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BACKGROUND: Non-AIDS defining malignancies present a growing challenge for persons with HIV (PWH), yet tailored interventions for timely cancer diagnosis are lacking. The Spanish IMPAC-Neo protocol was designed to compare two comprehensive cancer screening strategies integrated into routine HIV care. This study reports baseline data on the prevalence and types of precancerous lesions and early-stage cancer among participants at enrolment. Acceptability of the procedure was additionally assessed. METHODS: Cross-sectional analysis of a comprehensive screening protocol to detect precancer and cancer. The readiness of healthcare providers to implement the protocol was evaluated using a validated 4-item survey. RESULTS: Among the 1430 enrolled PWH, 1172 underwent 3181 screening tests, with positive findings in 29.4% of cases, leading to further investigation in 20.7%. Adherence to the protocol was 84%, with HIV providers expressing high acceptability (97.1%), appropriateness (91.4%), and feasibility (77.1%). A total of 145 lesions were identified in 109 participants, including 60 precancerous lesions in 35 patients (3.0%), 9 early-stage cancers in 9 patients (0.8%), and 76 low-risk lesions in 65 subjects (5.5%). Adverse events related to screening occurred in 0.8% of participants, all mild. The overall prevalence of cancer precursors or early-stage cancer was 3.8% (95% CI, 2.74%-5.01%), with highest rates observed in individuals screened for anal and colorectal cancers. CONCLUSIONS: The baseline comprehensive cancer screening protocol of the IMPAC-Neo study successfully identified a significant proportion of PWH with precancerous lesions and early-stage cancer. High adherence rates and positive feedback from providers suggest effective implementation potential in real-world healthcare settings.
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BACKGROUND: Fear of childbirth affects women worldwide and can have adverse consequences. Midwives have implemented a number of interventions, autonomously or as part of a professional team. However, midwives have been unable to identify the most appropriate intervention for ensuring the reduction or alleviation of this fear to provide the best perinatal outcomes. OBJECTIVE: This study aimed to evaluate the effectiveness of a prenatal educational intervention followed by specific support during childbirth, designed and delivered exclusively by midwives for women with a high fear of childbirth. METHOD: This randomized controlled trial was performed with two arms in two phases: an online prenatal education phase followed by a support phase during childbirth. Participating women with a high fear of childbirth, which was determined using the Wijma Delivery Expectancy Questionnaire-A-Spanish version, were assigned to the experimental group or the usual care control group at a 1:1 ratio. RESULTS: Women showed a reduction in fear of childbirth in both phases of the study. According to the intention to treat analysis, a significant mean difference was observed in the prenatal stage in favor of the intervention group, as well as a nonsignificant difference in favor of this same group after delivery. DISCUSSION: The effectiveness of continuous specific prenatal education with preferential support during childbirth by midwives was indicated by improvements in the level of fear of childbirth.
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BACKGROUND: We measured T-cell and antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vaccinated patients hospitalized for coronavirus disease 2019 (COVID-19) and explored their potential value to predict outcomes. METHODS: This was a prospective, longitudinal study including vaccinated patients hospitalized with Delta and Omicron SARS-CoV-2 variants. TrimericS-IgG antibodies and SARS-CoV-2 T-cell response were measured using a specific quantitative interferon-γ release assay (IGRA). Primary outcome was all-cause 28-day mortality or need for intensive care unit (ICU) admission. Cox models were used to assess associations with outcomes. RESULTS: Of 181 individuals, 158 (87.3%) had detectable SARS-CoV-2 antibodies, 92 (50.8%) showed SARS-CoV-2-specific T-cell responses, and 87 (48.1%) had both responses. Patients who died within 28 days or were admitted to ICU were less likely to have both unspecific and specific T-cell responses in IGRA. In adjusted analyses (adjusted hazard ratio [95% confidence interval]), for the entire cohort, having both T-cell and antibody responses at admission (0.16 [.05-.58]) and Omicron variant (0.38 [.17-.87]) reduced the hazard of 28-day mortality or ICU admission, whereas higher Charlson comorbidity index score (1.27 [1.07-1.51]) and lower oxygen saturation to fraction of inspired oxygen ratio (2.36 [1.51-3.67]) increased the risk. CONCLUSIONS: Preexisting immunity against SARS-CoV-2 is strongly associated with patient outcomes in vaccinated individuals requiring hospital admission for COVID-19. Persons showing both T-cell and antibody responses have the lowest risk of severe outcomes.
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COVID-19 , SARS-CoV-2 , Humanos , COVID-19/diagnóstico , Testes de Liberação de Interferon-gama , Estudos Longitudinais , Estudos Prospectivos , Linfócitos TRESUMO
Human immunodeficiency virus type 1 RNA levels were longitudinally evaluated in 211 rectal and 152 seminal samples from 12 virologically suppressed participants switching to monthly long-acting cabotegravir plus rilpivirine or continuing with daily dolutegravir-abacavir-lamivudine. Maintenance of viral suppression in rectal and seminal compartments was comparable, and blips occurred with similar frequency with both treatment regimens. CLINICAL TRIALS REGISTRATION: NCT02938520.
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Fármacos Anti-HIV , Infecções por HIV , HIV-1 , Humanos , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1/genética , Estudos Longitudinais , Rilpivirina/uso terapêutico , RNA/uso terapêuticoRESUMO
BACKGROUND: We evaluated a standardized interferon-γ (IFN-γ) release assay (IGRA) for detection of T-cell immune response after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination. METHODS: This prospective study included patients with coronavirus disease 2019 (COVID-19) with different severity of illness and follow-up (FU), vaccinated subjects, and healthy unvaccinated persons. SARS-CoV-2 T-cell response was measured using a specific quantitative IGRA in whole blood (Euroimmun, Germany) and TrimericS-IgG and neutralizing antibodies with validated serological platforms. Positivity of reverse transcription-polymerase chain reaction or vaccination was considered as the reference standard. RESULTS: A total of 239 individuals were included (152 convalescent, 54 vaccinated, and 33 uninfected unvaccinated). Overall sensitivity, specificity, and positive- and negative-predictive values (95% confidence interval) of the IGRA were 81.1% (74.9-86%), 90.9% (74.5-97.6%), 98.2% (94.5-99.5%), and 43.5% (31.8-55.9%), respectively. All vaccinated SARS-CoV-2-naive subjects had positive IGRA at 3 months. In convalescent subjects the magnitude of IFN-γ responses and IGRA accuracy varied according to disease severity and duration of FU, with the best performance in patients with severe COVID-19 at 3 months and the worst in those with mild disease at 12 months. The greatest contribution of IGRA to serological tests was observed in patients with mild disease and long-term FU (incremental difference, 30.4%). CONCLUSIONS: The IGRA was a reliable method of quantifying T-cell response after SARS-COV-2 infection or vaccination. In convalescent patients, the sensitivity is largely dependent on disease severity and time since primary infection. The assay is more likely to add clinical value to serology in patients with mild infections.
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COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , COVID-19/diagnóstico , Humanos , Testes de Liberação de Interferon-gama , Estudos Prospectivos , Linfócitos T , VacinaçãoRESUMO
OBJECTIVES: To assess the benefits of remdesivir in hospitalized COVID-19 patients receiving combined immunomodulatory therapy (CIT) with dexamethasone and tocilizumab. METHODS: This was a cohort study of microbiologically confirmed COVID-19 hospitalized patients. The primary outcome was all-cause 28â day mortality. Secondary outcomes were need for invasive mechanical ventilation (IMV) and IMV/death. Subgroup analyses according to SARS-CoV-2 cycle threshold (Ct) values and inflammation biomarkers were performed. Multivariable marginal structural Cox proportional hazards regression models were used to analyse the association between remdesivir therapy and the risk of outcomes of interest. RESULTS: Of 1368 hospitalized patients treated with corticosteroids, 1014 (74%) also received tocilizumab, 866 (63%) remdesivir and 767 (56%) tocilizumabâ+âremdesivir. The 28â day mortality was 9% in the overall cohort, with an adjusted HR (aHR) of 0.32 (95% CIâ=â0.17-0.59) for patients receiving CIT. In the latter group, the 28â day mortality was 6.5%, with an aHR of 1.11 (95% CIâ=â0.57-2.16) for remdesivir use and there were no differences in secondary outcomes. The risk of primary and secondary outcomes with remdesivir differed by Ct and C-reactive protein (CRP) levels in patients receiving CIT: for 28â day mortality, the aHR was 0.48 (95% CIâ=â0.21-1.11) for Ct <25, 0.12 (95% CIâ=â0.02-0.66) for Ct <25 and <5â day symptom duration and 0.13 (95% CIâ=â0.03-0.50) for CRP <38â mg/L; for IMV and IMV/death, the aHR was 0.32 (95% CIâ=â0.13-0.77) and 0.33 (95% CIâ=â0.17-0.63), respectively, in patients with Ct <25. CONCLUSIONS: The benefits of remdesivir administered with dexamethasone and tocilizumab in hospitalized COVID-19 patients differ depending on Ct and CRP. Remdesivir decreases the risk of mortality and need for IMV in patients with high viral loads and low-grade systemic inflammation.
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Tratamento Farmacológico da COVID-19 , SARS-CoV-2 , Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Alanina/uso terapêutico , Antivirais/uso terapêutico , Estudos de Coortes , Dexametasona , Humanos , Inflamação/tratamento farmacológico , Carga ViralRESUMO
BACKGROUND: Mycobacterium africanum is a member of the Mycobacterium tuberculosis complex (MTBC) and is endemic in West Africa, where it causes up to half of all cases of pulmonary tuberculosis. Here, we report the first isolation of Mycobacterium africanum from the pericardial effusion culture of a patient with tuberculous pericarditis. CASE PRESENTATION: A 31-year-old man, native from Senegal, came to the emergency room with massive pericardial effusion and cardiac tamponade requiring pericardiocentesis. M. africanum subtype II was identified in the pericardial fluid. The patient completed 10 months of standard treatment, with a favorable outcome. CONCLUSIONS: We report the first case of tuberculous pericarditis caused by Mycobacterium africanum, which provide evidence that this microorganism can cause pericardial disease and must be considered in patients from endemic areas presenting with pericardial effusion.
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Tamponamento Cardíaco , Mycobacterium , Derrame Pericárdico , Pericardite Tuberculosa , Adulto , Humanos , Masculino , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/etiologia , Pericardiocentese/efeitos adversos , Pericardite Tuberculosa/complicações , Pericardite Tuberculosa/diagnóstico , Pericardite Tuberculosa/tratamento farmacológicoRESUMO
BACKGROUND: The relationship of host immune response and viral replication with health outcomes in patients with COVID-19 remains to be defined. We aimed to characterize the medium and long-term clinical, virological, and serological outcomes after hospitalization for COVID-19, and to identify predictors of long-COVID. METHODS: Prospective, longitudinal study conducted in COVID-19 patients confirmed by RT-PCR. Serial blood and nasopharyngeal samples (NPS) were obtained for measuring SARS-CoV-2 RNA and S-IgG/N-IgG antibodies during hospital stay, and at 1, 2, and 6 months post-discharge. Genome sequencing was performed where appropriate. Patients filled out a COVID-19 symptom questionnaire (CSQ) at 2-month and 6-month visits, and those with highest scores were characterized. RESULTS: Of 146 patients (60% male, median age 64 years) followed-up, 20.6% required hospital readmission and 5.5% died. At 2 months and 6 months, 9.6% and 7.8% patients, respectively, reported moderate/severe persistent symptoms. SARS-CoV-2 RT-PCR was positive in NPS in 11.8% (median Ct = 38) and 3% (median Ct = 36) patients at 2 months and 6 months, respectively, but no reinfections were demonstrated. Antibody titers gradually waned, with seroreversion occurring at 6 months in 27 (27.6%) patients for N-IgG and in 6 (6%) for S-IgG. Adjusted 2-month predictors of the highest CSQ scores (OR [95%CI]) were lower peak S-IgG (0.80 [0.66-0.94]) and higher WHO severity score (2.57 [1.20-5.86]); 6-month predictors were lower peak S-IgG (0.89 [0.79-0.99]) and female sex (2.41 [1.20-4.82]); no association was found with prolonged viral RNA shedding. CONCLUSIONS: Long-COVID is associated with weak anti-SARS-CoV-2 antibody response, severity of illness, and female gender. Late clinical events and persistent symptoms in the medium and long term occur in a significant proportion of patients hospitalized for COVID-19.
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COVID-19/complicações , COVID-19/imunologia , SARS-CoV-2/fisiologia , Adulto , Idoso , Anticorpos Antivirais/sangue , Formação de Anticorpos , COVID-19/diagnóstico , COVID-19/mortalidade , Feminino , Hospitalização , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores Sexuais , Análise de Sobrevida , Síndrome de COVID-19 Pós-AgudaRESUMO
OBJECTIVES: Durability of the humoral immune response to SARS-CoV-2 has yet to be defined. We longitudinally evaluated during a 12-month period the antibody responses to SARS-CoV-2, and analysed predictors of antibody titres decline and seroreversion. METHODS: Prospective study conducted in a cohort of patients hospitalized for microbiologically-confirmed COVID-19. Blood and nasopharyngeal samples were sequentially obtained during hospital stay and at 1, 2, 6 and 12 months after patients' discharge for measuring anti-spike (S) and anti-nucleocapsid (N) IgG antibody levels and SARS-CoV-2 RNA, respectively. RESULTS: 80 non-vaccinated patients were analysed. At month 12 after discharge, 73 (91.2%) patients exhibited detectable S-IgG and 35 (43.8%) N-IgG antibody titres. A gradual wane was observed in S-IgG and N-IgG antibody titres. Linear regression showed that S-IgG decline was positively associated with peak antibody titres (coefficient [95% CI] 0.059 [0.05-0.067], p < 0.001), inversely with WHO severity score (coefficient [95% CI] -0.042 [-0.079/-0.004], p = 0.033), and there was a trivial positive association with age (coefficient [95% CI] 0.002 [0-0.005], p = 0.10); N-IgG decline was positively associated with peak antibody titres (coefficient [95% CI] 0.091 [0.078-0.105], p < 0.001). Logistic regression showed that seroreversion for S-IgG was inversely associated with peak S-IgG (OR 0.19; 95% CI, 0.04-0.45; p = 0.004); seroreversion for N-IgG was inversely associated with peak N-IgG (OR 0.71; 95% 0.53-0.90; p = 0.009) and positively with cycle threshold of RT-PCR (OR 1.14; 95% CI, 1.00-1.33; p = 0.062). CONCLUSION: Anti-spike IgG antibodies remain detectable one year after hospitalization for COVID-19. Higher peak antibody titres and disease severity were associated with increased durability of detectable antibodies.
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Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , COVID-19/imunologia , Imunoglobulina G/imunologia , SARS-CoV-2/imunologia , Viremia/imunologia , Adulto , Idoso , Antígenos Virais/imunologia , Convalescença , Proteínas do Nucleocapsídeo de Coronavírus/imunologia , Feminino , Seguimentos , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Fosfoproteínas/imunologia , Estudos Prospectivos , RNA Viral/sangue , Glicoproteína da Espícula de Coronavírus/imunologia , Fatores de Tempo , Viremia/sangueRESUMO
BACKGROUND: We aimed to assess the relationship between sexually transmitted infections (STIs)-including a large panel of human papillomavirus (HPV) genotypes-and high-grade anal intraepithelial neoplasia (HGAIN) in men who have sex with men (MSM) who were living with human immunodeficiency virus (HIV). METHODS: In a prospective study in an HIV cohort, participants underwent high-resolution anoscopy (HRA) for anorectal swabs collection to investigate STIs and for anal biopsy. Multiplex real-time polymerase chain reactions were performed, detecting several STIs and 28 HPV genotypes. Univariate and multivariate generalized linear models were used to analyze the relationships of variables of interest with HGAIN. RESULTS: There were 145 participants included; in 49, 2 HRAs were performed. Ureaplasma urealyticum (UU) was detected in 25 (17.2%) participants, Chlamydia trachomatis (CT) in 13 (9.0%), Mycoplasma genitalium (MG) in 4 (2.8%), HPV16 in 38 (26.2%), HPV52 in 29 (20%), and HPV53 and HPV42 in 28 (19.3%) participants each. There were 35 (24.1%) subjects diagnosed with HGAIN. In the univariate analysis, HGAIN was associated with CT, UU, MG, HPV16, HPV53, HPV68, and HPV70, and significant interactions were found between CT and HPV16 (odds ratio [OR] 31.0 95% confidence interval [CI] 4.3-221.7) and between UU and HPV16 (OR 8.8, 95% CI 2.1-37.5). In the adjusted model, CT, HPV16, HPV53, HPV70, the CD4+/CD8+ ratio, and the interaction between CT and HPV16 remained independent predictors of HGAIN. HPV16, HPV53, and HPV70 persisted in the second HRA in all the participants with recurrent HGAIN. CONCLUSIONS: Coinfection with CT may potentiate the oncogenic capability of HPV16 and increase the risk of HGAIN in people with HIV. HPV53 and HPV70 should be considered among the genotypes associated with HGAIN.
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Neoplasias do Ânus , Infecções por HIV , Infecções por Papillomavirus , Minorias Sexuais e de Gênero , Neoplasias do Ânus/epidemiologia , Chlamydia trachomatis , HIV , Infecções por HIV/complicações , Homossexualidade Masculina , Humanos , Masculino , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Estudos ProspectivosRESUMO
BACKGROUND: The time at which the protective effect of starting ART is achieved in male rectal and genital reservoirs is not clearly established. OBJECTIVES: To quantify HIV-1 RNA decay towards virological suppression in rectal mucosa and semen in MSM starting dolutegravir/abacavir/lamivudine (DTG/ABC/3TC). METHODS: A longitudinal cohort study of ART-naive HIV-positive MSM was performed. HIV-1 RNA was quantified in rectal mucosa and seminal plasma samples at day 1 of ART initiation (baseline) and every 4 weeks until week 20 (w20; all participants) and week 64 (w64; 6 of 12 participants). RESULTS: Twelve MSM, with median (IQR) age 36 (33-40) years and baseline CD4+ count 449 (411-503) cells/mm3, were included. At baseline, HIV-1 RNA was detectable in all plasma and seminal samples and 10/12 rectal samples. All participants achieved plasma virological suppression by w20, whereas HIV-1 RNA was detectable in 42% and 50% of seminal and rectal samples, respectively. At w64, HIV-1 RNA was detectable in 1/6 seminal and 1/6 rectal samples. A relationship of baseline seminal and rectal HIV-1 RNA levels with viral shedding in reservoirs (HIV-1 RNA >200 copies/mL or copies/swab) was found. In addition, a significant association of baseline plasma viral load with time to rectal HIV-1 RNA <200 copies/swab was found (P=0.025). CONCLUSIONS: Viral decay after initiating DTG/ABC/3TC is slower in rectal mucosa and semen than in plasma. Approximately half of patients achieved undetectable HIV-1 RNA levels in rectal and genital secretions at w20 and in some patients viral shedding persisted for up to 1 year. Initial plasma viral load influences time to rectal suppression.
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Fármacos Anti-HIV , Infecções por HIV , HIV-1 , Minorias Sexuais e de Gênero , Adulto , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Didesoxinucleosídeos/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1/genética , Compostos Heterocíclicos com 3 Anéis , Homossexualidade Masculina , Humanos , Lamivudina/uso terapêutico , Estudos Longitudinais , Masculino , Oxazinas , Piperazinas , Piridonas , Estabilidade de RNA , RNA Viral , Carga ViralRESUMO
BACKGROUND: We aim to assess COVID-19 outbreak-related emotional symptoms, identify gender differences, and study the relationship between the emotional state and environmental features in the elderly. METHODS: We conducted a cross-sectional study starting on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory) and acute stress (Acute Stress Disorder Inventory) were compared between people over and under 60 years old. Gender differences and the relationship of loneliness, regular exercise, economic losses and use of anxiolytics on the mental state were evaluated. RESULTS: One thousand six hundred thirty-nine (150 [9.2%] aged ≥60) participants completed the survey. The greater than or equal to 60 group showed lower mean (SD) BDI levels than the less than 60 group (3.02 [3.28] versus 4.30 [4.93]); and lower mean (SD) acute stress disorder inventory scores than the less than 60 group (3.68 [3.20] versus 4.45 [3.06]). There were no gender differences in any of the clinical measures. The presence of economic losses as well as the increase in the use of anxiolytics was significantly associated with higher emotional distress in the elderly compared to the younger group. CONCLUSIONS: Older people have shown less emotional distress, with no differences between men and women. Economic loss and substance use should be monitored to guarantee the emotional well-being of the elderly.
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Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Pneumonia Viral/epidemiologia , Transtornos de Estresse Traumático Agudo/epidemiologia , Fatores Etários , Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Ansiedade/psicologia , Betacoronavirus , COVID-19 , Depressão/psicologia , Surtos de Doenças , Status Econômico , Exercício Físico/psicologia , Feminino , Humanos , Renda , Solidão/psicologia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Angústia Psicológica , SARS-CoV-2 , Espanha/epidemiologia , Transtornos de Estresse Traumático Agudo/tratamento farmacológico , Transtornos de Estresse Traumático Agudo/psicologiaRESUMO
Background and Objectives: Coronary artery disease (CAD) is a major health problem in México. The identification of modifiable risk factors and genetic biomarkers is crucial for an integrative and personalized CAD risk evaluation. In this work, we aimed to validate in a Mexican population a set of eight selected polymorphisms previously associated with CAD, myocardial infarction (MI), or dyslipidemia. Materials and Methods: A sample of 907 subjects (394 CAD cases and 513 controls) 40-80 years old was genotyped for eight loci: PSRC1 (rs599839), MRAS (rs9818870), BTN2A1 (rs6929846), MTHFD1L (rs6922269), CDKN2B (rs1333049), KIAA1462 (rs3739998), CXCL12 (rs501120), and HNF1A (rs2259816). The association between single nucleotide polymorphisms (SNPs) and CAD was evaluated by logistic regression models. Results: Multiple logistic regression analysis with adjustment by age, gender, and body mass index showed that rs599839 was significantly associated with CAD (ORADD = 0.72, p = 0.009; ORDOM = 0.66, p = 0.007). Conclusions: The PSRC1 rs599839 polymorphism shows a significant protective association with CAD in this sample of the Mexican population.
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Doença da Artéria Coronariana/genética , Etnicidade/genética , Fosfoproteínas/genética , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , Dislipidemias/genética , Feminino , Marcadores Genéticos , Estudo de Associação Genômica Ampla , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , México , Pessoa de Meia-Idade , Infarto do Miocárdio/genéticaRESUMO
BACKGROUND: Preeclampsia occurs in 8% of pregnancies and generates 25% of perinatal deaths. Although its etiology is multifactorial, some metabolic alterations are associated with the endothelial dysfunction present in the disease, and its study could identify early markers of damage. OBJECTIVE: To determine the relationship between plasma concentration of triglycerides in pregnant patients with hypertensive disease induced by pregnancy. METHODS: Prospective study that included 147 healthy pregnant women and 120 women with hypertensive disease induced by pregnancy. Total cholesterol, low-density lipoprotein, high-density lipoprotein, Hemoglobin A1c, triglycerides, BH, QS, serum electrolytes, serum nitrites and liver function tests were determined. RESULTS: A significant difference was found in the concentration of triglycerides between normotensive and patients with preeclampsia (261.22 ± 80.27 vs. 361.46 ± 135.17 mg/dl, p < 0.0008). In addition, a lower serum concentration of nitrites was observed in patients with preeclampsia, which helps explain vasoconstriction. CONCLUSIONS: We found an association between hypertriglyceridemia and the presence of diabetes mellitus II with the development of hypertensive disease induced by pregnancy.
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Hipertrigliceridemia/complicações , Pré-Eclâmpsia/sangue , Triglicerídeos/sangue , Adulto , Estudos de Casos e Controles , Colesterol/sangue , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hipertensão Induzida pela Gravidez/sangue , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Óxido Nítrico/sangue , Gravidez , Estudos ProspectivosRESUMO
BACKGROUND: Preeclampsia occurs in 8% of pregnancies and generates 25% of perinatal deaths. Although its etiology is multifactorial, some metabolic alterations are associated with the endothelial dysfunction present in the disease, and its study could identify early markers of damage. OBJECTIVE: To determine the relationship between plasma concentration of triglycerides in pregnant patients with hypertensive disease induced by pregnancy. METHODS: Prospective study that included 147 healthy pregnant women and 120 women with hypertensive disease induced by pregnancy. Total cholesterol, low-density lipoprotein, high-density lipoprotein, Hemoglobin A1c, triglycerides, BH, QS, serum electrolytes, serum nitrites and liver function tests were determined. RESULTS: A significant difference was found in the concentration of triglycerides between normotensive and patients with preeclampsia (261.22 ± 80.27 vs. 361.46 ± 135.17 mg/dl, p < 0.0008). In addition, a lower serum concentration of nitrites was observed in patients with preeclampsia, which helps explain vasoconstriction. CONCLUSIONS: We found an association between hypertriglyceridemia and the presence of diabetes mellitus II with the development of hypertensive disease induced by pregnancy.
ANTECEDENTES: La preeclampsia se presenta en el 8% de los embarazos y genera el 25% de las muertes perinatales. Aunque su etiología es multifactorial, algunas alteraciones metabólicas se asocian a la disfunción endotelial presente en la enfermedad, y su estudio podría identificar marcadores tempranos de daño. OBJETIVO: Determinar la relación existente entre concentración plasmática de triglicéridos en las pacientes embarazadas con enfermedad hipertensiva inducida por el embarazo. MÉTODO: Estudio prospectivo que incluyó 147 pacientes gestantes sanas y 120 mujeres con enfermedad hipertensiva inducida por el embarazo y se determinaron colesterol total, lipoproteínas de baja densidad (LDL), lipoproteínas de alta densidad (HDL), hemoglobina glucosilada (HbA1c), biometría hemática (BH), química sanguínea (QS), electrolitos séricos, nitritos séricos y pruebas de función hepática. RESULTADOS: Se encontró una diferencia significativa en la concentración de triglicéridos entre las pacientes normotensas y con preeclampsia (261.22 ± 80.27 vs. 361.46 ± 135.17 mg/dl; p < 0.0008). Además, se observó una menor concentración sérica de nitritos en las pacientes con preeclampsia, que contribuye a explicar la vasoconstricción. CONCLUSIONES: Se encontró una asociación entre la hipertrigliceridemia y la presencia de DM II con el desarrollo de la enfermedad hipertensiva inducida por el embarazo.
Assuntos
Hipertensão Induzida pela Gravidez/etiologia , Hipertrigliceridemia/complicações , Adulto , Feminino , Humanos , Hipertensão Induzida pela Gravidez/sangue , Pré-Eclâmpsia/etiologia , Gravidez , Estudos ProspectivosRESUMO
INTRODUCTION: Anaplastic large cell lymphoma associated with breast implants is receiving increased attention. Most cases have been reported in Europe, North America (USA and Canada), Australia and New Zealand. Fewer cases have been reported in Latin America (including Mexico), Africa and Asia. METHODS: This report was delivered during our national plastic surgery meeting in Cancun in May 2017. Before the meeting, two participants reviewed the literature. The review was performed using the following information sources: PubMed, Embase, Cochrane, Fisterra, Google Scholar and LILACS, with entries from 1980 to August 2015 in several languages (English, Spanish, French and Portuguese). The results were revealed during the meeting to the other participants. The consensus was divided into two parts. The first part included an open-ended question regarding the incidence and prevalence of the problem. The second part included clinical scenarios with different items that were rated by the participants. After this activity, accordance among the responses was evaluated. RESULTS: Seven cases were reported during the meeting (3 from Mexico, 3 from Chile and 1 from Argentina). Fifty percent of the participants reported consulting with guidelines and clinical centers to help with potential cases. Most agreed that further studies must be done in cases of chronic seroma where the capsule plays an important role. DISCUSSION: A current debate exists about the incidence of this problem in Latin America because we did not report the same number of cases as Europe, Australia or North America. More studies are required to determine the differences among reports in Latin America. CONCLUSION: Most representatives agreed that further studies must be done. Concern is increasing, and the problem is known. Other factors involved may be considered, and the problem must not be ignored. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Linfoma Anaplásico de Células Grandes/etiologia , Guias de Prática Clínica como Assunto , Adulto , Implante Mamário/métodos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Consenso , Feminino , Humanos , Incidência , América Latina/epidemiologia , Linfoma Anaplásico de Células Grandes/epidemiologia , Linfoma Anaplásico de Células Grandes/patologia , Pessoa de Meia-Idade , Medição de RiscoRESUMO
Analysis of external injuries in captive and free-ranging Morelet's crocodiles Crocodylus moreletii was performed in the northern wetlands of Campeche, Mexico. From March to September of 2007, a total of 52 free-ranging and 51 captive Morelet's crocodiles were studied. Captive crocodiles presented significantly more injuries. Sixteen free-ranging crocodiles presented some type of lesion, mostly superficial abrasions. Nineteen captive crocodiles presented lesions, mostly incisions from agonistic interactions. Overall, the injuries with highest prevalence were the incisions. The tail was the most frequently injured body region. Injuries were more common in adults than in other size classes. Conversely, the presence of lesions caused by the parasite Paratrichosoma spp. was greater in crocodiles captured in the coastal channels (mangrove habitat). The information presented here is important to understand some of the effects of individual interactions and to foresee and manage the consequences of conservation and management activities of crocodile populations.
Assuntos
Jacarés e Crocodilos , Ferimentos e Lesões/veterinária , Animais , Feminino , Masculino , México/epidemiologia , Nematoides/classificação , Infecções por Nematoides/epidemiologia , Infecções por Nematoides/parasitologia , Infecções por Nematoides/veterinária , Dermatopatias Parasitárias/epidemiologia , Dermatopatias Parasitárias/parasitologia , Dermatopatias Parasitárias/veterinária , Ferimentos e Lesões/etiologiaRESUMO
In this study, we assessed the effects of inorganic and organic pollutants [As, Cu, Fe, Mn, Pb, Zn, PAHs (11 compounds) and total phenols] from a panel of biomarkers [O2, H2O2, thiobarbituric acid reactive substances (TBARS), carbonyl proteins (RCO), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and total cytochrome P450 activities] evaluated in the Snout Scraping (SS), Serum (S) and Peripheral Blood Cells (PBC) of the Morelet's crocodile (Crocodylus moreletii) inhabiting the reference locality (Lake Mocu) and polluted locality (Champoton River) using Principal Component Analysis (PCA). In male crocodiles from the reference site, only H2O2 in PBC was related to levels of fluoranthene on the Keel of Caudal Scales (KCS), but, in females, no association was detected. In contrast, a sex-linked response was detected in specimens from the polluted locality. Levels of benzo[a]pyrene, benzo[a]anthracene, chrysene, pyrene, phenanthrene, acenaphthene, Zn, Cu, and Pb in KCS of the female crocodil were related to the oxidative stress biomarkers on PBC, incluing the total CYP450 activity and levels of O2, H2O2 in serum. However, in male crocodiles, the oxidative stress in SS and in the serum (TBARS, RCO, CAT, GPx), and SOD in PBC was related to As, Pb, Cu, Fe, and benzo[a]pyrene water concentrations and to the burdens of As, Fe, Mn, indeno[1,2,3cd]pyrene in KCS. These results confirm the usefulness of minimal or non-invasive methods of evaluating the oxidative stress response for the environmental monitoring program on the wild Morelet's crocodile that is subject to special protection in Mexican guidelines.