Soluble MIC-A, IPI, and response to treatment strongly predict survival in patients with germinal center diffuse large B cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is the most frequent lymphoma. MIC-A and MIC-B are the natural ligands for NKG2D, a receptor expressed in NK cells. MIC-A soluble isoforms (sMICA) have been described in different malignancies. OBJECTIVES: To analyze lymphocyte subsets and sMIC-A in germinal center DLBCL. MATERIALS AND METHODS: sMICA, sMICB, and peripheral blood lymphocyte subsets (CD4+, CD8+, NK, NKT, γδ T cells, and dendritic cells) were analyzed in 59 patients and 60 healthy donors. RESULTS: Patients had decreased numbers of type 1 and type 2 dendritic cells, NK, iNKT, CD4 T, and CD8 T cells, and higher levels of sMIC-A. The 2-year PFS for high IPI scores and high sMIC-A was 24% and 28%, respectively. The 2-year OS for high IPI scores and high sMIC-A was 42% and 33%. The 2-year PFS and OS for patients not achieving response to treatment were 0% and 10%, respectively. The MICPI score (one point each for high IPI score and high sMIC-A) showed that those patients summing two points had worse PSF and OS. CONCLUSIONS: Patients with DLBCL have decreased numbers of peripheral lymphocyte subsets and high levels of sMIC-A. The addition of sMIC-A to IPI could improve its prognostic relevance.

Lymphocyte subsets and soluble forms of MIC-A and MIC-B are prognostic factors in non-Hodgkin lymphoma patients.

MIC-A and MIC-B are the natural ligands for NKG2D, an activator receptor expressed in NK cells. Soluble isoforms of MIC-A and MIC-B (sMICA, sMICB) have been identified in different malignancies, affecting NK cells' cytotoxicity. The study was performed to determine the levels of sMICA, sMICB, the expression of MIC-A, and MIC-B on tumor tissues, and lymphocyte subpopulations (CD4 + , CD8 + , NK, NKT, Tγδ cells, B cells, monocytes) in 94 patients with non-Hodgkin's lymphoma (NHL) and 72 healthy donors.The most frequent lymphoma was diffuse large B cell lymphoma (48%). Patients with NHL had decreased numbers of CD4 T cells, CD8 T cells, B cells, monocytes, NK cells, type 1 dendritic cells, γδ T cells, and increased iNKT cells. Patients showed higher levels of sMIC-A and similar serum levels of sMIC-B.Survival was poorer in patients having higher LDH values and lower numbers of CD4 T cells, type 1 dendritic cells, gamma-delta T cells, and high levels of sMIC-A.In conclusion, high levels of sMIC and decreased numbers in circulating lymphocyte subsets are related to poor outcomes in NHL.

Significant increase in MIC-A and MIC-B and soluble MIC-A and MIC-B in canine lymphomas.

Non-Hodkin's lymphoma (NHL) is the most frequent hematologic malignancy in humans and dogs. NKG2D is one of the most critical receptors on NK cells, recognizing their natural ligands on malignant cells such as A and B major histocompatibility complex-related proteins (MIC-A and MIC-B). Soluble molecules (sMIC-A and sMIC-B) can interfere with immune synapsis between NK cells and tumor cells, impeding NK cytotoxicity. The main objectives of this study were to analyze, in dogs with diffuse large B cell lymphoma, NK cell lymphoma, and reactive lymphadenopathies, the role of NK cells, their activating receptors NKG2D and NKp46, and their ligands MIC-A and MIC-B, as well as soluble molecules sMIC-A and sMIC-B. Thirty-six dogs with a possible diagnosis of NHL and eight healthy dogs were studied. NHL was diagnosed in 28 (78 %) dogs; in the other 8 (22 %), reactive lymphadenopathies were present. Most of the lymphomas corresponded to B cell NHL (82 %). The most predominant subtype was diffuse large B cell lymphoma (21, 71.5 %), followed by five cases (18 %) that were Non-B Non-T lymphomas (presumably NK cell lymphomas) and other B cell lymphomas (3, 10.5%). There were no cases of T cell NHL. MIC-A was positive in 7 of 27 (26 %) cases of NHL, and MIC-B in 20 of 27 (74 %) NHL. In non-malignant lymphadenopathies, three (37.5 %) dogs were positive for MIC-A, and five (62.5 %) expressed MIC-B. Dogs with lymphoma had higher numbers of NK cells than eight healthy dogs. In 15 dogs (12 cases with NHL and three cases with reactive adenopathies) and eight controls, there were no differences in the number of NK cells expressing NKP46 and NKG2D. NHL dogs had higher values of sMIC-A and sMIC-B. B-cell and NK cell lymphomas correspond to 86 % and 14 % of all canine lymphomas. MIC-A, MIC-B, and sMIC-A and sMIC-B were increased in canine lymphomas.

[Impact of hyperglycemia on the prognosis of patients hospitalized for severe pneumonia in COVID-19]. / Impacto de hiperglucemia en el pronóstico de hospitalizados por neumonía grave en COVID-19.

Background: Adequate glycemic control improves the prognosis of patients hospitalized for pneumonia associated with severe COVID-19. Objective: To evaluate the impact of hyperglycemia (HG) on the prognosis of patients hospitalized for severe pneumonia associated with COVID-19 in unvaccinated patients. Material and methods: Prospective cohort study. We included patients hospitalized from August 2020 to February 2021, with severe COVID-19 pneumonia, not vaccinated against SARS-CoV-2. Data was collected from admission to discharge. We used descriptive and analytical statistics according to the data distribution. ROC curves were used to determine the cut-off points with the highest predictive performance for HG and mortality, with the IBM SPSS program, version 25. Results: We included 103 patients, 32% women, 68% men, age 57 ± 13 years; 58% were admitted with HG (191, IQR 152-300 mg/dL) and 42% with normoglycemia (NG < 126 mg/dL). Mortality was higher in HG at admission 34 (56.7%) than in NG 13 (30.2%) (p = 0.008). HG was associated with diabetes mellitus 2 and neutrophilia (p < 0.05). The risk of death increases 1.558 times (95% CI 1.118-2.172) if HG is at admission and 1.43 times (95% CI 1.14-1.79) during hospitalization. Maintaining NG throughout the hospitalization contributed independently to survival (RR = 0.083 [95% CI 0.012-0.571], p = 0.011). Conclusion: HG significantly impacts prognosis by increasing mortality more than 50% during hospitalization for COVID-19.

Introducción: el adecuado control glucémico mejora el pronóstico de pacientes hospitalizados por neumonía asociada a COVID-19 grave. Objetivo: evaluar el impacto de la hiperglucemia (HG) sobre el pronóstico de pacientes hospitalizados por neumonía grave asociada a COVID-19 en no vacunados. Material y métodos: estudio de cohorte prospectivo. Se incluyeron pacientes hospitalizados de agosto de 2020 a febrero de 2021, con neumonía grave por COVID-19, no vacunados contra SARS-CoV-2. Los datos fueron recolectados desde el ingreso hasta el egreso. Se empleó estadística descriptiva y analítica de acuerdo con la distribución de datos. Se construyeron curvas ROC para determinar los puntos de corte de mayor rendimiento predictivo para HG y mortalidad, con el programa IBM SPSS, versión 25. Resultados: se incluyeron 103 pacientes, 32% mujeres, 68% hombres, edad 57 ± 13 años; 58% ingresaron con HG (191, IQR 152-300 mg/dL) y 42% en normoglucemia (NG < 126 mg/dL). La mortalidad fue mayor en HG al ingreso 34 (56.7%) que en NG 13 (30.2%) (p = 0.008). La HG se asoció con diabetes mellitus 2 y neutrofilia (p < 0.05). El riesgo de muerte se incrementó 1.558 veces (IC 95% 1.118-2.172) si la HG fue al ingreso y 1.43 veces (IC 95% 1.14-1.79) durante la hospitalización. Mantener NG durante todo el internamiento contribuyó de manera independiente a la sobrevida (RR 0.083 [IC 95% 0.012-0.571], p = 0.011). Conclusión: la HG impacta significativamente el pronóstico al incrementar en más de 50% la mortalidad durante la hospitalización por COVID-19.

Consenso mexicano para el diagnóstico y tratamiento de la trombastenia de Glanzmann / Mexican consensus on the diagnosis and treatment of Glanzmann thrombasthenia

Resumen Las plaquetas tienen un papel central en diferentes escenarios fisiológicos, incluyendo la hemostasia; se unen unas con otras en la agregación plaquetaria, lo cual permite formar un coágulo plaquetario. Para que la agregación sea apropiada se requiere del complejo glicoproteico IIb/IIIa (GPIIb/IIIa) en la superficie plaquetaria. Toda alteración funcional plaquetaria, hereditaria o adquirida, impide la formación adecuada del coágulo y se manifiesta como hemorragia. Las enfermedades plaquetarias hereditarias son raras y, hasta recientemente, fueron ignoradas. Una de las más reconocidas y estudiadas es la trombastenia de Glanzmann (TG), entidad en la cual el número de plaquetas puede ser normal pero la función está alterada. Es un padecimiento autosómico y recesivo que causa hemorragia de diferente intensidad toda la vida y en la cual el problema radica en precisamente en la GPIIb/IIIa. Las hemorragias son típicamente mucocutáneas: equimosis, púrpura, epistaxis, gingivorragia; menos frecuentes son la hemorragia gastrointestinal, hemartrosis o en sistema nervioso central. La hiperpolimenorrea es común en las mujeres y llega a ser tan importante que amerita transfusiones en la menarca. La TG afecta a todos los grupos étnicos y su prevalencia varía entre 1/40,000 y 1/400,000. A pesar de esta información acerca de la TG en el mundo, hay pocas guías o recomendaciones basadas en la opinión de expertos y experiencias unicéntricas. En México la TG es rara y no se cuenta con una recomendación general para su diagnóstico y tratamiento. El objetivo de este documento fue establecer un consenso y hacer sugerencias generales para su diagnóstico y tratamiento.

Abstract Platelets have a central role in several physiological scenarios including hemostasis. Platelets bind each other during platelet aggregation allowing the proper formation of the clot; to be appropriate, platelet aggregation requires the glycoproteic complex IIb/IIIa (GPIIb/IIIa). Every platelet function abnormality both, congenital or acquired, impedes clot formation and favors bleeding episodes. Hereditary platelet abnormalities are rare and, until recently, they were almost ignored. Among these disorders, Glanzmann Thrombasthenia (GT) is a widely recognized abnormality in which platelet counts may be normal, but their function is affected. GT is an autosomal, recessive disease that causes life-long bleeding of different intensity. Main biochemical abnormality resides in GPIIb/IIIa. Bleeding is typically mucocutaneous: easy bruising, purpura, and nose and gum bleeds; less frequently are gastrointestinal bleeds, hemarthrosis, or intracranial. Menorrhagia and hyperpolymenorrhea are common findings in in women and may be the cause of anemia requiring blood transfusions at fertile age. GT affects all ethnic groups and its prevalence ranges between 1/40,000 to 1/400,000. Despite this worldwide information regarding GT, only a few guidelines and recommendations have been published, most of them based on expert opinions. In Mexico, GT is rare and there is not a general recommendation regarding its diagnosis and treatment. The aim of this document was to establish a consensus to suggest a general guideline for the diagnosis and treatment of GT in Mexico.

Development and Evaluation of a Set of Spike and Receptor Binding Domain-Based Enzyme-Linked Immunosorbent Assays for SARS-CoV-2 Serological Testing.

The implementation and validation of anti-SARS-CoV-2 IgG serological assays are reported in this paper. S1 and RBD proteins were used to coat ELISA plates, and several secondary antibodies served as reporters. The assays were initially validated with 50 RT-PCR positive COVID-19 sera, which showed high IgG titers of mainly IgG1 isotype, followed by IgG3. Low or no IgG2 and IgG4 titers were detected. Then, the RBD/IgG assay was further validated with 887 serum samples from RT-PCR positive COVID-19 individuals collected at different times, including 7, 14, 21, and 40 days after the onset of symptoms. Most of the sera were IgG positive at day 40, with seroconversion happening after 14-21 days. A third party conducted an additional performance test of the RBD/IgG assay with 406 sera, including 149 RT-PCR positive COVID-19 samples, 229 RT-PCR negative COVID-19 individuals, and 28 sera from individuals with other viral infections not related to SARS-CoV-2. The sensitivity of the assay was 99.33%, with a specificity of 97.82%. All the sera collected from individuals with infectious diseases other than COVID-19 were negative. Given the robustness of this RBD/IgG assay, it received approval from the sanitary authority in Mexico (COFEPRIS) for production and commercialization under the name UDISTEST-V2G®.

Poor Survival in COVID-19 Associated with Lymphopenia and Higher Neutrophile-Lymphocyte Ratio.

BACKGROUND: Immune cell counts in blood in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may be useful prognostic biomarkers of disease severity, mortality, and response to treatment. OBJECTIVES: To analyze sub-populations of lymphocytes at hospital admission in survivors and deceased from severe pneumonia due to coronavirus disease-2019 (COVID-19). METHODS: We conducted a cross-sectional study of healthcare workers confirmed with SARS-CoV-2 in convalescents (control group) and healthy controls (HC) diagnosed with severe COVID-19. Serum samples were taken at hospital admission and after recovery. Serum samples ≥ 25 days after onset of symptoms were analyzed for lymphocyte subpopulations through flow cytometry. Descriptive statistics, Kruskall-Wallis test, receiver operating characteristic curve, calculation of sensitivity, specificity, predictive values, and Kaplan-Meier analysis were performed. RESULTS: We included 337 patients: 120 HC, 127 convalescents, and 90 severe COVID-19 disease patients (50 survivors, 40 deceased). For T cells, total lymphocytes ≥ 800/µL, CD3+ ≥ 400/µL, CD4+ ≥ 180/µL, CD8+ ≥ 150/µL, B cells CD19+ ≥ 80/µL, and NK ≥ 34/µL subsets were associated with survival in severe COVID-19 disease patients. All subtypes of lymphocytes had higher concentrations in survivors than deceased, but similar between HC and convalescents. Leukocytes ≥ 10.150/µL or neutrophils ≥ 10,000/µL were associated with increased mortality. The neutrophil-to-lymphocyte ratio (NLR) ≥ 8.5 increased the probability of death in severe COVID-19 (odds ratio 11.68). CONCLUSIONS: Total lymphocytes; NLR; and levels of CD3+, CD4+, CD8+, and NK cells are useful as biomarkers of survival or mortality in severe COVID-19 disease and commonly reach normal levels in convalescents.

Assessment and potential-site determination of a wheat straw power plant by Aspen Plus and multi-criteria GIS model.

Wheat is one of the most important crops worldwide. Mexicali, Baja California, is an important wheat producer in Mexico with an average production of 507,543 t. Wheat straw is generated as a residue which could be used for different purposes such as bioenergy, heat and power generation. In this work, an assessment and potential site determination of a biomass power plant operating with wheat straw as fuel was performed. Aspen Plus was used to evaluate a plant capacity of at least 10 MW considering the physicochemical properties and an higher heating value of 14.86 MJ kg-1 of the wheat straw from the region. The combustion produced 39.76 MW, and the overall plant efficiency was 25.52%. The development of the multi-criteria geographic information system model allowed us to assess and analyse four factors and three restrictions to determine the potential site for the biomass power plant. The factors were raw material, wheat crops, electric transmission lines, paths and roads, water canals and aqueducts, while the restrictions were localities, Ramsar sites and faults. The biomass power plant is technically and geographically feasible. The geographical coordinates of the potential site of the biomass power plant that fulfils all the criteria are 32°29'29.72″N and 115°15'39.45″W.

Clinical relevance of NKT cells and soluble MIC-A in Hodgkin lymphoma.

Previous studies demonstrated that the majority of Hodgkin lymphoma (HL) patients achieve response after treatment, while 5% become refractory. Studies analyzing the role of lymphocyte subsets in peripheral blood are limited. This investigation sought to evaluate peripheral blood lymphocyte subsets and soluble MHC class I chain-related proteins A and B (sMIC-A/B) and their correlation with survival in patients with newly diagnosed HL. The study recruited 36 patients and 72 healthy donors. HL patients showed a decrease in CD4, B, monocytes, NK, and NKT cells; and an increase in γ-δ T cells and soluble MIC-A serum levels. Higher values of s-MIC-A  >100 ng/mL and NKT cells >40 µL correlated with poor overall survival (OS). In conclusion, in HL peripheral blood CD4 T and B cells, monocytes, NK, and NKT cells were decreased, while s-MIC-A and γ-δ T cells increased. Higher values of s-MIC-A and NKT cells correlated with poor survival.

Important decrease in invariant natural killer T, CD4+ regulatory T cells, CD8+ regulatory T cells, gamma-delta T cells, and CD4+ T lymphocytes in HIV-negative patients with hemophilia.

Hereditary hemophilias are X-linked inherited bleeding disorders defined as deficiencies of the coagulation factors VIII or IX. They are characterized by easy to provoke or spontaneous bleeding. HIV infection in hemophilic patients is a risk factor for the reduction of CD4+ T cells. There is no information regarding the cellular immune function in HIV-negative patients with hemophilia. To evaluate the number of lymphocyte subsets in adult patients with hemophilia A or B as compared with healthy donors. 39 Adult hemophilics and 27 healthy donors were included. Lymphocyte subsets [CD4 and CD8 T cells, natural killer cells, natural killer T (NKT) cells, invariant NKT (iNKT) cells, gamma-delta T (γδT) cells, type 1 and 2 dendritic cells, CD14 monocytes, CD4 and CD8 regulatory T cells (Tregs), and B cells], were analyzed by flow cytometry. A significant decrease of CD4+ T lymphocytes, γδT cells, iNKT cells, CD4+ and CD8+ Tregs was observed in patients with hemophilia. Those patients having factor VIII inhibitor had the lowest CD4+ Treg and CD8+ Treg counts. CD14 monocytes were increased, as well as iNKT and type 2 dendritic cells in obese-overweight hemophilics. CD4+ lymphocytes, iNKT, γδT cells, and Tregs (CD4+ and CD8+), are significantly decreased in patients with hemophilia. Depletion of Tregs is more important in patients with factor VIII inhibitor. Physicians caring for hemophilia patients should realize that, even when they are not suffering infections frequently, may have early evidence of cellular immunodeficiency.

FLT3-ITD and CD135 Over-Expression are Frequent Findings of Poor Survival in Adult Patients with Acute Leukemias.

BACKGROUND: Fms-like tyrosine kinase 3 (FLT3) expression and mutation have been considered a poor prognostic factor in acute myeloid leukemia (AML). FLT3-ITD mutation is present in 30% of adult patients with AML and 2-5% in childhood acute lymphoblastic leukemia (ALL). The impact of these mutations on the prognosis of ALL patients, has not yet been established. Moreover, a limited number of publications regarding the level of expression of the FLT3 receptor (CD135) in both leukemias exist. This study aimed to analyze the clinical outcomes associated to the presence of FLT3-ITD mutation and the expression of CD135. METHODS: 82 adult patients with newly diagnosed acute leukemia (39 with AML and 43 with ALL) were included. Flow cytometry and RT-PCR were done to analyze the expression of CD135 and the presence of FLT3 ITD mutation, respectively. RESULTS: FLT3-ITD was present in 14 (36%) of AML and 15 (35%) of ALL patients. Disease free survival (DFS) and overall survival (OS) were lower in ALL patients having a CD135 expression >3000 cells/µL. There was a trend for poor OS in AML patients expressing FLT3 ITD. OS was worse in AML patients with high expression of CD135. CONCLUSION: A higher (35%) frequency of FLT3-ITD was found in adult ALL patients. The presence of FLT3-ITD was associated with a trend of poor OS in AML cases, and overexpression of CD135 was correlated with poor DFS in ALL cases and poor OS in both acute leukemias.

Pathophysiology of Alloimmunization.

INTRODUCTION: Alloimmunization is caused by exposure to erythrocytes from a donor that expresses blood group antigens other than those of the recipient and is related to processes that alter the balance of the immune system. Knowing the pathophysiology of alloimmunization process is essential to understand clinical complications associated with this process. PATIENTS AND METHODS: From October 2016 to April 2017, irregular antibody screening was performed in 1,434 polytransfused (compatible with the ABO and D system) patients by means of agglutination techniques using erythrocytes of a known phenotype of 44 patients with a positive alloantibody screening. Non-alloimmunized (control) subjects were matched for age, gender, pathology, and treatment group with alloimmunized patients. The subsets of B, T, and Treg lymphocytes were determined by flow cytometry. RESULTS: The results of screening for alloantibodies in patients by specificity of antibodies were as follows: nonspecific (30%), followed by anti-Dia (13%), anti-e (9%), anti-S (9%), anti-I (7%), anti-K (7%), and anti-P (7%). A lower percentage of CD4+ T lymphocytes and an increase of CD8+ T lymphocytes were observed in alloimmunized patients, as well as a low CD4/CD8 ratio (0.7 vs. 1.6, p = 0.003), a higher percentage of B lymphocytes versus the control group (30 vs. 20%, p = 0.003), and a decrease of Treg CD4+ lymphocytes versus the control group (3 vs. 12 cells/µL, p = 0.043). These observations suggest that alloimmunized patients have important alterations in the number of some lymphocyte subsets that can be translated into clinical immune dysregulation. CONCLUSION: A decreased CD4/CD8 ratio, increased B lymphocytes, and Treg lymphocyte deficiency are the most significant changes observed in alloimmunized patients.

γδ T Cells Number, CD200, and Flt3 Expression Is Associated with Higher Progression Free Survival in Patients with Chronic Myeloid Leukemia.

BACKGROUND: Tumor immunoedition involves alterations in cells of immune system, which may play an important role in the immunosurveillance of patients with cancer diseases. AIM OF THE STUDY: To determine the association between the number of immune cells and the expression of surface markers in leukemic cells of patients with de novo CML who achieved molecular response. METHODS: A longitudinal study was conducted in 31 patients with de novo CML. Peripheral blood samples were obtained at diagnosis for quantification of immune cells and tumor cells expressing CD200, CD135, GpP, and Bcl-2. Results were compared with a group of 60 healthy donors. Lymphocyte subsets were analyzed during a 48 month follow-up period and molecular response to treatment was assessed simultaneously by QT-PCR. The group of patients with deep molecular response was compared with de novo CML patients; the cut-off value of cell count was determined by ROC analysis. Kaplan-Meier and Cox proportional hazard model were used to determine the significant association between the number of cells and progression-free survival. RESULTS: Differences in number of CD4, CD4Tregs, NK, γδT, monocytes, and pDC's, tumor-cells expressing CD200+, CD135+, GpP+, and Bcl-2+ were observed between patients and healthy donors. The number of γδT lymphocytes, CD200+, and CD135+ cells were associated with longer progression-free survival (p = 0.0112, p = 0.0012 and p = 0.0201 respectively). CONCLUSION: A γδT lymphocyte count <63 cel/uL, CD200+ <997 cel/uL, and CD135+ <23 317 cel/uL at diagnosis is associated with the maintenance of deep molecular response at 48 months in patients with de novo CML.

Social correlates of sedentary behavior in young people: The UP&DOWN study.

Purpose: The aim of the present study was to analyze the associations of youths' sedentary behavior (SB) with parents' and siblings' SB and physical activity (PA), as well as the associations of youths' coparticipation with parents, siblings, and friends in PA and SB with youths' SB. Methods: The sample consisted of 1543 youths (12.02 ± 2.51 years; 788 boys) enrolled in the baseline cohort of the UP&DOWN study. SB was assessed by accelerometry and questionnaire. Participants reported the time spent by their parents and siblings watching television, playing videogames, surfing the Internet, sitting/resting, and doing PA. Further, participants reported coparticipation with parents, siblings, and friends in these activities. Linear mixed models, including school and city as random effects, were performed. Results: Parents' television time was positively associated with youths' screen-based SB. Coparticipation with friends in playing videogames (in boys) and in surfing the Internet (in girls) showed a positive association with screen-based SB and a negative association with educational-based SB. Moreover, coparticipation with siblings and friends in PA was inversely associated with accelerometer-based SB in boys and girls. Conclusion: Our results emphasize the important role of social modeling in the development of sedentary lifestyles in youths. Interventions aimed at reducing health risk behaviors in youths could be more effective if they are oriented from a social perspective that involves their families and networks of their closest friends.

Phenotypes and concentration of PON1 in cardiovascular disease: The role of nutrient intake.

BACKGROUND AND AIMS: Paraoxonase 1 (PON1) is considered to play a crucial role as an anti-atherosclerotic factor. The PON1 activity is affected by genetic polymorphisms, environmental factors, age, sex, lifestyle, pharmaceutical drugs, and dietary factors. The aim of this study was to evaluate the association between macro- and micronutrients as well as PON1 concentration and activities in patients with cardiovascular diseases (CVD), cardiovascular risk factors but no CVD (CRF), and in healthy controls (control group). METHODS AND RESULTS: A case-control study was carried out with 356 volunteers from the Mexican Institute of Social Security, Mexico. Clinical parameters, lipid profile, PON1 activities (AREase, LACase, CMPAase and PONase), and PON1 concentration were evaluated. There was a differential intake of macro- and micronutrients among the study groups. The intake of proteins and carbohydrates was higher in the CVD group than in the CFR and control groups (p < 0.05). AREase, LACase, and CMPAase activities and PON1 concentration were lowest in the CVD group. CONCLUSION: LACase and CMPAase activities, as well as PON1 concentration, could be included in the battery of CVD predictive biomarkers in the Mexican population.

Plasmid pSfr64a and the symbiotic plasmid pSfr64b of Sinorhizobium fredii GR64 control each other's conjugative transfer through quorum-sensing elements.

Rhizobia are nitrogen-fixing symbionts of plants. Their genomes frequently contain large plasmids, some of which are able to perform conjugative transfer. Plasmid pSfr64a from Sinorhizobium fredii GR64 is a conjugative plasmid, whose transfer is regulated by quorum sensing genes encoded by itself (traR64a, traI64a), in the symbiotic plasmid pSfr64b (traR64b, traI64b), and in the chromosome (ngrI). Also, transfer of pSfr64b requires quorum sensing elements encoded in this plasmid (traR64b, traI64b), in pSfr64a (traR64a), and in the chromosome (ngrI). These results demonstrate that pSfr64a and the symbiotic plasmid depend on each other for conjugative transfer. Plasmid pSfr64a from S. fredii GR64 is unable to transfer from the genomic background of Rhizobium etli CFN42. Our results show that the relaxase of pRet42a is able to process the oriT of pSfr64a, and viceversa, underlining their functional similarity and suggesting that in addition to the external signals, the "cytoplasmic environment" may pose a barrier to plasmid dissemination, even if the plasmids are functional in other aspects.

Infección nosocomial por Acinetobacter y su efecto en un hospital de segundo nivel / Nosocomial infection due to Acinetobacter and its effect on a second level hospital

Resumen OBJETIVOS: Determinar la frecuencia de infecciones nosocomiales por Acinetobacter baumannii e identificar las características que inciden en la probabilidad de ocurrencia de estas infecciones. MATERIAL Y MÉTODO: Estudio transversal analítico que incluyó todos los pacientes con reporte de cultivo positivo para Acinetobacter en el Hospital General Ticomán de enero de 2016 a diciembre de 2017. Se utilizó el programa SPSS y Graphpad Prism 0.7 para análisis estadístico con homogeneidad de x 2, análisis de supervivencia con estimado de Kaplan-Meier, OR y prueba de U de Mann-Whitney. RESULTADOS: Se analizaron 80 pacientes, se formaron dos grupos: muertos (n = 40) y vivos (n = 40) con infección por Acinetobacter. La media de edad fue de 52 ± 16 años; 61.3% era de sexo masculino; la media de estancia hospitalaria fue de 28 ± 19 días; el foco infeccioso más frecuente fue el pulmonar (72%); 76% requirió apoyo mecánico ventilatorio, se realizó punto de corte con base en los días de ventilación < 7 días y > 7 días con lo que se obtuvo valor p = 0.0013. El análisis de supervivencia con Kaplan-Meier concluyó que la estancia en Medicina Interna aumenta la mortalidad (p = 0.012). CONCLUSIÓN: La supervivencia disminuye en pacientes con apoyo ventilatorio durante más de siete días y foco infeccioso pulmonar.

Abstract OBJECTIVES: To determine the frequency of nosocomial infections due to Acinetobacter baumannii and to identify the characteristics influencing the probability of these infections. MATERIAL AND METHOD: An analytical cross-sectional design was carried out, including all patients with a positive culture report for Acinetobacter in the General Hospital of Ticoman, Mexico City, from January 2016 to December 2017. SPSS and Graphpad Prism 0.7 software were used for statistical analysis with x 2 homogeneity, survival analysis with Kaplan-Meier estimate, OR and Mann Whitney U test. RESULTS: An analysis of 80 patients was performed, 2 groups were formed: dead (n = 40) and alive (n = 40) with Acinetobacter infection. Mean age was 52 ± 16 years, 61.3% were male; mean hospital stay was of 28 ± 19 days, the most frequent infectious focus was pulmonary (72%); 76% required mechanical ventilatory support, a cut-off was performed based on ventilation days < 7 days and > 7 days, obtaining p value = 0.0013. The survival analysis with Kaplan-Meier concluded that the stay in Internal Medicine increased mortality (p = 0.012). CONCLUSION: Survival decreases in patients with ventilatory support for > 7 days and pulmonary infectious focus.

Post-treatment improvement of NK cell numbers predicts better survival in myeloma patients treated with thalidomide-based regimens.

Multiple myeloma (MM) is a disease characterized by antitumoral immune dysfunction. The objective of the present study was to determine lymphocyte subsets (B, T, NK, NKT, iNKT, dendritic cells, and regulatory T cells) in 68 newly diagnosed patients and 113 healthy donors. Lymphocyte subsets were studied in the same patients 6 months after treatment. Pre-treatment values of CD4+ T cells, NK cells, type 2 dendritic cells, and B cells in MM patients were lower than in healthy donors. Forty patients (59%) received MPT treatment and 28 (41%) thal-dex. Patients with no response to treatment, exhibited a decrease in CD4+ T cells and NK cells, as well as an increase in Treg cell numbers. Median DFS and OS was lower in patients not achieving response, in patients having low numbers of NK cells, and higher values of LDH. The number of CD4 T cells, NK, DC2, and B cells at diagnosis is lower in patients with MM. Non-responder patients had lower CD4 and NK, but higher Treg cell values. Patients in which response is not achieved, and those holding lower values of NK cells and higher levels of LDH, have poor DFS and OS.

El índice neutrófilo/linfocito como predictor de morbilidad y mortalidad en neumonía por influenza / The neutrophil/lymphocyte index as a predictor of morbidity and mortality in pneumonia due to influenza

Resumen: OBJETIVO: Demostrar si el índice neutrófilo/linfocito predice la mortalidad en pacientes con neumonía tipo influenza. MATERIAL Y MÉTODO: Estudio de casos y controles, observacional, analítico, transversal, retrospectivo y retrolectivo que incluyó pacientes con neumonía por influenza que padecieron neumonía aguda grave de 2009 a 2017. Se calculó APACHE II, SMART COP y el índice neutrófilo/linfocito (INL). Se determinó supervivencia mediante Kaplan y Meier, para la asociación entre INL y mortalidad, APACHE II, SMART COP y comorbilidades se usó χ2 y razón de momios (RM), así como correlación entre APACHE II, SMART COP e INL. RESULTADOS: Se incluyeron 69 pacientes. La RM entre el INL y la mortalidad fue de 0.174 (p = 0.533; IC95% 0.274 a 2.08). Hubo asociación significativa entre el INL y componentes del síndrome metabólico en pacientes vivos. No hubo diferencia en la supervivencia entre INL mayor o menor de 7. Correlación positiva entre APACHE II e INL de 0.4295 (p = 0.0002; IC95% 0.00 a 0.063). CONCLUSIONES: Existe asociación entre el INL y el síndrome metabólico en pacientes vivos, así como correlación positiva con APACHE II. No hay asociación entre el INL y mortalidad. El punto de corte del INL se desplazó cuatro puntos comparado con otras poblaciones.

Abstract: OBJECTIVE: To demonstrate if neutrophil/lymphocyte index predicts mortality in patients with influenza-like pneumonia. MATERIAL AND METHOD: A case-control, observational, analytical, cross-sectional, retrospective and retrolective study with patients with influenza like pneumonia who developed severe acute pneumonia from 2009 to 2017. APACHE II, SMART COP and neutrophil lymphocyte index (INL) were calculated. Survival was determined by Kaplan and Meier, for the association between INL and mortality, APACHE II, SMART COP and comorbidities was used χ2 and odds ratio (OR), as well as correlation between APACHE II, SMART COP and INL. RESULTS: There were included 69 patients. OR between the INL and mortality was of 0.174 (p = 0.533, IC95% 0.274-2.08). There was significant association between INL and components of the metabolic syndrome in living patients. There was no difference in survival between INL greater or less than 7. Positive correlation between APACHE II and INL of 0.4295 (p = 0.0002, IC95% 0.00 to 0.063). CONCLUSIONS: There is an association between INL and metabolic syndrome in liv- ing patients, as well as a positive correlation with APACHE II. There is no association between INL and mortality. The cutoff point of the INL shifted 4 points compared to other populations.

The Role of School in Helping Children and Adolescents Reach the Physical Activity Recommendations: The UP&DOWN Study.

BACKGROUND: The aims were to: (1) examine the levels of physical activity (PA) during different time periods (ie, daily PA, school hour PA, recess PA, physical education classes [PEC] PA) in children and adolescents; and (2) identify the rate of compliance with the specific PA recommendations for these time periods. METHODS: The participants were 1925 (940 girls) children and adolescents from 40 Spanish schools. Hip-worn accelerometers were used to assess PA during different time periods. RESULTS: Boys and children were more physically active and had a greater percentage meeting the daily PA recommendation and the school-based PA recommendation than girls and adolescents, respectively. Compliance with daily PA recommendation was markedly higher than that with the school-based PA recommendation, regardless of sex and age groups (ie, 80.4% vs 24.1% for daily and school-based PA recommendations, respectively, in child boys). A very low percentage (ie, 9.7% and 1.2% of child boys with almost 50% of moderate-to-vigorous PA during recess and PEC, respectively) of students reached the recommended PA levels for recess and PEC. CONCLUSIONS: Physical activity levels during school hours, recess, and PEC in children and adolescents are very low. Promoting PA in school settings is essential, especially in girls and adolescents.