The association between previous use of anti-obesity medication and semaglutide weight loss outcomes.

AIMS: To compare weight loss outcomes between patients starting semaglutide who had previously been on another anti-obesity medication (AOM) compared to those who were AOM-naïve. MATERIALS AND METHODS: We performed a retrospective study in patients with overweight or obesity taking semaglutide for weight loss for a duration of 3 to 12 months. Our primary endpoint was assessment of percentage of total body weight loss (TBWL) in patients who started semaglutide as their first AOM (AOM-naïve) compared to those who started semaglutide and had previously taken another AOM (non-AOM-naïve). The secondary outcome was a comparison of the proportions of patients achieving ≥5%, ≥10%, ≥15% and ≥20% TBWL between the groups. Our endpoints were analysed using independent t-tests and ANOVA/ANCOVA for continuous variables and Pearson's test for categorical variables. RESULTS: This study included 305 patients. Outcomes of semaglutide treatment were superior in AOM-naïve patients (n = 231) compared to non-AOM-naïve patients (n = 74) at 3 (6.3% vs. 3.8%), 6 (10.6% vs. 6.7%), 9 (14.0% vs. 9.1%) and 12 months (14.3% vs. 10.6%; p < 0.0001 at 3, 6 and 9 months, and p = 0.01 at 12 months). A greater proportion of patients in the AOM-naïve group achieved a TBWL ≥ 15% (48% vs 21%; p = 0.02) and ≥20% (27% vs 4% p < 0.01) at 12 months. CONCLUSION: The use of semaglutide in patients with previous intake of other AOMs was associated with inferior weight loss outcomes in comparison to patients who were AOM-naïve.

Cumulative effect of obesity phenotypes on body weight and body mass index.

BACKGROUND: Obesity originates from an imbalance between energy intake and expenditure. Changes in energy intake components (satiation, postprandial satiety, emotional eating) and energy expenditure have been linked to obesity and are referred to as obesity phenotypes. We aim to study if these obesity phenotypes have a cumulative effect on body weight and body mass index (BMI). SUBJECT/METHODS: This is a cross-sectional study of adult patients with obesity (BMI > 30 kg/m2) who completed the validated tests to measure the obesity phenotypes. A total of 464 were included in this study. INTERVENTIONS/METHODS: We defined higher calories to fullness during an ad libitum meal as abnormal satiation, accelerated time to half gastric emptying with scintigraphy as abnormal postprandial satiety, higher anxiety score on the Hospital Anxiety and Depression Scale as hedonic eating behavior, and decreased percentage of measured resting energy expenditure as abnormal energy expenditure. The primary analysis was done on the number of phenotypes ( ≤ 1 and ≥ 2) with body weight and BMI using an independent t-test. RESULTS: Our cohort included 464 patients (mean [SD] age 42.0 [10.9] years, 79% females, weight 111.2 [22.9] kg, BMI 38.9 [7.0] kg/m2). There were 294 patients who had ≤ 1 phenotype, and 170 patients with ≥ 2 phenotypes with no baseline demographical differences (i.e., age and sex). Having ≥ 2 phenotypes was associated with higher body weight (115 [25] kg vs. 109 [21] kg; p = 0.004), BMI (40 [8] kg/m2 vs. 38 [7] kg/m2; p = 0.02) and waist (118 [15] cm vs. 115 [13] cm; p = 0.04) and hip (129 [14] cm vs. 125 [13] cm; p = 0.01) circumferences compared to ≤ 1 phenotype. CONCLUSION: Obesity phenotypes are associated with an additive effect on the body weight and BMI. Patients who have multiple obesity phenotypes may require a more aggressive approach to enhance weight loss.

Worldwide Dissemination of blaKPC Gene by Novel Mobilization Platforms in Pseudomonas aeruginosa: A Systematic Review.

The dissemination of blaKPC-harboring Pseudomonas aeruginosa (KPC-Pa) is considered a serious public health problem. This study provides an overview of the epidemiology of these isolates to try to elucidate novel mobilization platforms that could contribute to their worldwide spread. A systematic review in PubMed and EMBASE was performed to find articles published up to June 2022. In addition, a search algorithm using NCBI databases was developed to identify sequences that contain possible mobilization platforms. After that, the sequences were filtered and pair-aligned to describe the blaKPC genetic environment. We found 691 KPC-Pa isolates belonging to 41 different sequence types and recovered from 14 countries. Although the blaKPC gene is still mobilized by the transposon Tn4401, the non-Tn4401 elements (NTEKPC) were the most frequent. Our analysis allowed us to identify 25 different NTEKPC, mainly belonging to the NTEKPC-I, and a new type (proposed as IVa) was also observed. This is the first systematic review that consolidates information about the behavior of the blaKPC acquisition in P. aeruginosa and the genetic platforms implied in its successful worldwide spread. Our results show high NTEKPC prevalence in P. aeruginosa and an accelerated dynamic of unrelated clones. All information collected in this review was used to build an interactive online map.

Aceptación y factores determinantes en vacunación contra COVID-19 en usuarios del Ambulatorio "El Ujano"

La vacunación contra la COVID-19 es una medida de prevención clave para reducir la tasa de contagios, contribuir con la inmunidad de rebaño y disminuir la severidad del cuadro clínico. Objetivos: Investigar la aceptación a la vacunación contra la COVID-19 y los factores determinantes en usuarios desde 18 años en el Ambulatorio Urbano tipo I "El Ujano" en Barquisimeto, Venezuela. Métodos: Se realizó un estudio descriptivo transversal, con una muestra no probabilística accidental de 276 usuarios en octubre-noviembre de 2021. La técnica de recolección utilizada fue la entrevista guiada y se formuló como instrumento de recolección de datos un cuestionario estructurado. El análisis fue de tipo descriptivo, usando medidas de frecuencia absolutas y relativas. Resultados: El 87,3 % aceptó la vacuna, prevaleciendo en ambos sexos y todos los grupos etarios. Independientemente del grado de instrucción de los encuestados, predominó el alto nivel de conocimiento sobre la COVID-19 y su prevención en un 60,2 %. La principal fuente de información fue la televisión (54,8 %). La presencia del antecedente patológico de infección por la COVID-19 personal, familiar o de conocidos se demostró en 81,2 % de los usuarios, de los cuales 53,3 % reportaron familiares o conocidos fallecidos debido a esta enfermedad. La principal causa de rechazo (12,7 %) a la vacunación fue "las personas enferman de COVID-19 cuando se vacunan" (31,4 %). Conclusiones: Este estudio aporta datos para la elaboración de planes que incentiven la aceptación de la vacunación como medida de prevención y de esta manera influir positivamente en el control de la pandemia.

Vaccination against COVID-19 is a key preventive measure to reduce the rate of infection, contribute to herd immunity and reduce the severity of the clinical presentation. Objectives: To investigate the acceptance of vaccination against COVID-19 and the determining factors in users from 18 years of age in the Urban Ambulatory type I "El Ujano" in Barquisimeto, Venezuela. Methods: A cross-sectional descriptive study was conduced with an accidental non-probabilistic sample made up of 276 users in October-November 2021. The collection technique used was the guided interview and a structured questionnaire was formulated as a data collection tool. The analysis was descriptive, using absolute and relative frequency measures. Results: 87,3 % accepted the vaccine, prevailing in both sexes and all age groups. Regardless of the level of education of the respondents, the high level of knowledge about COVID-19 and its prevention prevailed in 60,2 %. The main source of information was television (54,8 %). The presence of a pathological history of infection by personal, family or known COVID-19 was demonstrated in 81,2 % of users, of which 53,3 % reported relatives or acquaintances who died due to this disease. The main cause of rejection (12,7 %) to vaccination was "people get sick with COVID-19 when they are vaccinated" (31,4 %). Conclusions: this study provides data for the development of plans that encourage the acceptance of vaccination as a prevention measure and thus positively influence the control of the pandemic.

Tissue-specific Cd and Pb accumulation in Peruvian scallop (Argopecten purpuratus) transplanted to a suspended and bottom culture at Sechura Bay, Peru.

In order to understand the effect of different culture systems on Cd and Pb accumulation, suspended long-line and bottom cultures of Argopecten purpuratus were conducted during January until April 2010 (120 days). The Cd tissue levels were the highest at the middle of the experiment (30-d till 70-d) for suspended-cultured individuals, while bottom-cultured individuals showed an increasing trend. Gonad Pb levels were also higher during the same period for all cultures, while adductor muscle exhibited no considerable variations. Cd and Pb tissue concentrations were mainly greater in deeper cultures. There were no significant differences in Cd and Pb accumulation between individual sizes. The Cd and Pb levels in edible tissue (gonad+adductor muscle) did not exceed the EU and FDA maximum levels. Based on the target hazard quotient (THQ) and the provisional tolerance weekly intake (PTWI), no risk (THQ<1 and %PTWI<30) was found for human consumption.