ABSTRACT
The difficulty in predicting fatal outcomes in patients with coronavirus disease 2019 (COVID-19) impacts the general morbidity and mortality due to severe acute respiratory syndrome-coronavirus 2 infection, as it wears out the hospital services that care for these patients. Unfortunately, in several of the candidates for prognostic biomarkers proposed, the predictive power is compromised when patients have pre-existing comorbidities. A cohort of 147 patients hospitalized for severe COVID-19 was included in a descriptive, observational, single-center, and prospective study. Patients were recruited during the first COVID-19 pandemic wave (April-November 2020). Data were collected from the clinical history whereas immunophenotyping by multiparameter flow cytometry analysis allowed us to assess the expression of surface markers on peripheral leucocyte. Patients were grouped according to the outcome in survivors or non-survivors. The prognostic value of leucocyte, cytokines or HLA-DR, CD39, and CD73 was calculated. Hypertension and chronic renal failure but not obesity and diabetes were conditions more frequent among the deceased patient group. Mixed hypercytokinemia, including inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines, was more evident in deceased patients. In the deceased patient group, lymphopenia with a higher neutrophil-lymphocyte ratio (NLR) value was present. HLA-DR expression and the percentage of CD39+ cells were higher than non-COVID-19 patients but remained similar despite the outcome. Receiver operating characteristic analysis and cutoff value of NLR (69.6%, 9.4), percentage NLR (pNLR; 71.1%, 13.6), and IL-6 (79.7%, 135.2 pg/mL). The expression of HLA-DR, CD39, and CD73, as many serum cytokines (other than IL-6) and chemokines levels do not show prognostic potential, were compared to NLR and pNLR values.
Subject(s)
COVID-19 , Humans , COVID-19/complications , Prospective Studies , Interleukin-6 , Pandemics , Prognosis , Biomarkers , Neutrophils , HLA-DR Antigens , Retrospective StudiesABSTRACT
BACKGROUND: SARS-CoV-2, the etiological agent causing COVID-19, has infected more than 27 million people with over 894000 deaths worldwide since its emergence in December 2019. Factors for severe diseases, such as diabetes, hypertension, and obesity have been identified however, the precise pathogenesis is poorly understood. To understand its pathophysiology and to develop effective therapeutic strategies, it is essential to define the prevailing immune cellular subsets. METHODS: We performed whole circulating immune cells scRNAseq from five critically ill COVID-19 patients, trajectory and gene ontology analysis. RESULTS: Immature myeloid populations, such as promyelocytes-myelocytes, metamyelocytes, band neutrophils, monocytoid precursors, and activated monocytes predominated. The trajectory with pseudotime analysis supported the finding of immature cell states. While the gene ontology showed myeloid cell activation in immune response, DNA and RNA processing, defense response to the virus, and response to type 1 interferon. Lymphoid lineage was scarce. Expression of genes such as C/EBPß, IRF1and FOSL2 potentially suggests the induction of trained immunity. CONCLUSIONS: Our results uncover transcriptomic profiles related to immature myeloid lineages and suggest the potential induction of trained immunity.
Subject(s)
COVID-19/blood , Myeloid Cells/pathology , COVID-19/pathology , COVID-19/virology , Critical Illness , Humans , SARS-CoV-2/isolation & purificationABSTRACT
BACKGROUND: The COVID-19 (from Coronavirus Disease 2019) is a disease that has generated a pandemic that has affected the world, Mexico included. The spectrum of the disease ranges from asymptomatic infection to severe acute respiratory distress syndrome (ARDS). The objective of the case is to demonstrate the usefulness of the prone position in non-intubated patients. CLINICAL CASE: We present the case of a woman without comorbidities with COVID-19 and moderate ARDS, in whom intubation was avoided after improvement with the prone position, as determined by arterial oxygen saturation by pulse oximetry and by the relationship of arterial oxygen pressure and the fraction of inspired oxygen (PaO2/FiO2). CONCLUSION: There is scarce evidence of this therapeutic maneuver in awake patients. However, it can help to improve oxygenation and to avoid intubation in these patients.
INTRODUCCIÓN: la COVID-19 (del inglés Coronavirus Disease 2019) es una enfermedad que ha generado una pandemia, la cual ha afectado a todo el mundo, incluido México. Esta enfermedad puede presentarse desde una infección asintomática hasta síndrome de distrés respiratorio agudo (SDRA) grave. El objetivo del reporte de caso es mostrar la utilidad de la posición prono en pacientes no intubados. CASO CLÍNICO: presentamos el caso de una mujer sin comorbilidades con COVID-19 y SDRA moderado, en quien se evitó la intubación tras la mejoría con la posición prono, evaluada por la saturación arterial de oxígeno por pulsioximetría y por la relación de la presión arterial de oxígeno y la fracción inspirada de oxígeno (PaO2/FiO2). CONCLUSIÓN: existe poca evidencia sobre esta maniobra terapéutica en pacientes despiertos. Sin embargo, puede ser de ayuda para mejorar la oxigenación y evitar la intubación en estos pacientes.
ABSTRACT
This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico.
Subject(s)
Cities/legislation & jurisprudence , Climate Change , Conservation of Natural Resources/legislation & jurisprudence , Interprofessional Relations , Policy Making , Politics , Science , Decision Making , Humans , Local Government , MexicoABSTRACT
We present a male newborn child with a sacrococcygeal mass who was sent to clinic 46 of the Mexican Social Security Institute located in Gomez Palacio, Durango, Mexico for pediatric/neonatal surgical resolution. The mass was detected on gestation week 24 in the sacrococcygeal area and was initially interpreted as a myelomeningocele. On gestation week 32, the mass had grown, so the diagnosis of cystic hygroma was posed. The child was born at 38 weeks of gestational age with a large tumor in the sacrococcygeal area. Images were obtained, and tumor resection was performed without complications. Pathologic examination confirmed the diagnosis of sacrococcygeal teratoma. The postoperative course was uneventful and there were no further complications.
Se presenta el caso de un recién nacido del género masculino que es enviado a la clínica 46 del Instituto Mexicano del Seguro Social de Gómez Palacio, Durango, México para manejo por cirugía pediátrica y neonatología, por la presencia de una masa en región sacrococígea que fue detectada en la semana 24 de gestación como probable mielomeningocele. A las 32 semanas de gestación se observó un mayor crecimiento y se sospechó de un higroma quístico. Se programa cesárea a las 38 semanas de gestación y, después de exámenes imagenológicos, se realiza resección del tumor sin complicaciones. El estudio anatomopatológico confirmó el diagnóstico de teratoma sacrococcígeo. La evolución posoperatoria inmediata y su condición en la actualidad, son satisfactorias.
Subject(s)
Fetal Diseases/diagnosis , Prenatal Diagnosis , Teratoma/diagnosis , Female , Fetal Diseases/pathology , Fetal Diseases/surgery , Humans , Infant, Newborn , Male , Mexico , Pregnancy , Sacrococcygeal Region , Teratoma/congenital , Teratoma/surgeryABSTRACT
This paper describes analytical and experimental work developed to evaluate the effects of the electromagnetic fields produced by high-voltage lines (400 kV) on wireless data transmission at the 900MHz band. In this work the source of the data transmission is located inside the electromagnetic field and the reception station is located at different distances from the power lines. Different atmospheric conditions are considered.
ABSTRACT
Num recorte de cena composta de NDVI (Normal Difference Vegetation Index) foram localizados casos de leishmaniose tegumentar americana (LTA) em Hipólito Yrigoyen (HY), na Província de Salta, Argentina. Foram discriminados os casos ocorridos em regiões rurais (por atividades laborais ou de caça e pesca) dos casos urbanos. O objetivo foi identificar os possíveis locais de transmissão. Uma vez identificados os casos urbanos, construiu-se uma matriz simples de casos por zonas para cada ano, na localidade de HY, obtendo-se linhas de contorno para descrever a distribuição espacial dos casos de LTA. Os resultados permitem observar que no ano de 2005 houve um foco importante na zona Sudeste e outro menos importante na Noroeste, os quais se deslocaram para Sudoeste e centro de HY no ano de 2006. A distribuição espacial dos casos urbanos no período mostra que existe risco de aquisição da doença na localidade estudada.
