Neck circumference as an indicator of Obesity for MetabolicSyndrome in Mexican Healthcare workers

Background: Neck circumference (NC) is a novel anthropometric indicator to assess adiposity in the cervical regionthat is rarely used in Mexico. The greatest advantage of this evaluation is the saving of time, minimal use of instruments, and no pre requisites for patients. Objective: This study aimed to determine the effective-ness of NC as an indicator of obesity for Metabolic Syndrome(MetS) in comparison with BMI and Waist Circumference(WC), and to define NC cutoff levels based on parameters established by the International Diabetes Federation in a groupof healthcare workers from a Public Health Hospital of the State of Morelos, Mexico. Methods: This was a no-randomized, cross-sectional-observational study. Instruments: Anthropometric evaluation and biochemical parameters: lipid profile, fasting glucose, and blood pressure. Statistical analysis: Descriptive, correlational, Poisson multiple regression adjusted by age/sex, and ROC curves using SPSS.23 program. Results: 200 healthcare workers were recruited (146 women and 54 men), age ẋ=42.87, σ=11.25 years. The prevalence of metS was 38% (37% in women and 40.7% in men). BMI, WC, and NC were significantly correlated: BMI and WC (r=.924),BMI and NC (r=.814), and NC and WC (r=.810) (p=.01).Like wise, they were related to hyperglycemia, hypertriglyceridemia, hypertension, and decreased in HDL-cholesterol levels. The NC best cut-off points coupled with two or more components of MetS in women was ≥35.12 cm [AUC=0.765 (95%CI, 0.688-0.843)] and in men ≥41.25 cm [AUC=0.787 (95%CI, 0.688-0.906)]. Conclusion: NC proved to be a reliable indicator that can be quickly and inexpensively evaluated for the determination of obesity for the preliminary diagnosis of MetS (AU)

Extended-spectrum ß-lactamase-producing enterobacteriaceae causing nosocomial infections in Mexico. A retrospective and multicenter study.

BACKGROUND AND AIMS: Extended-spectrum ß-lactamase (ESBLs) production is still the most frequent mechanism of resistance to cephalosporins in gram-negative bacteria. The aim of the study was to identify the types of ESBL-producing Enterobacteriaceae clinical isolates causing nosocomial infections in Mexico. METHODS: ESBL production was performed using a disk diffusion method. The MIC for several antibiotics was performed by agar dilution on Mueller-Hinton. PFGE typing was carried out on all enterobacteria assayed. The ß-lactamase pattern was obtained by IEF and bioassay. Genes of ß-lactamases were amplified by PCR with specific primers and products were sequenced and analyzed using informatics programs. Plasmid isolation and conjugation experiments were carried out using standard methodologies. RESULTS: There were 134 isolates of Enterobacteriaceae included from a retrospective and multicenter study that included eight Mexican hospitals from 1999 to 2005. The most prevalent species were K. pneumoniae (56%), Enterobacter cloacae (29%), and Escherichia coli (15%). Molecular analysis identified the underlying endemic and polyclonal spread of enterobacterials in each hospital. The most frequent ESBLs identified were SHV-type (84%), TLA-1 (11%), and CTX-M-15 (5%). Successful matings were detected in 68.4% (71/104) isolates. CONCLUSIONS: ESBL-producer K. pneumoniae remains the most frequent bacterial species obtained in nosocomial infections. The SHV-type and TLA-1 ESBLs were disseminated in most hospitals analyzed and CTX-M-15 was emerging in one of the studied hospitals. This work highlights the proper use of antibiotics to avoid the selection of these types of multiresistant bacteria.