COVID-19 infection and mortality among non-pregnant indigenous adults in Mexico 2020-2022: Impact of marginalisation.

Background: Indigenous individuals have higher rates of mortality and poverty in Mexico and more than half are marginalised, and COVID-19 pandemic aggravated the existing burden of health disparities. We aimed to analyse the effects of being indigenous and marginalised on coronavirus (COVID-19) infection fatality in Mexico. Methods: We identified 3 424 690 non-pregnant, COVID-19 positive adults ≥19 years in the Mexico national COVID-19 database with known date of symptom. We used demographic information, indigenous status, marginalisation status, and co-morbidities in binary logistic regression to predict mortality, adjusting for covariates, including hospitalisation, admission to the intensive care unit (ICU), and mechanical ventilation use. We also assessed the interaction between indigenous status and marginalisation. Results: Marginalisation was much higher among indigenous (53.7%) compared to non-indigenous individuals (4.8%). COVID-19 fatalities were approximately 20 years older (64.4 and 63.0 years) than survivors (44.7 and 41.2 years) among indigenous vs non-indigenous individuals, respectively. The unadjusted risk of COVID-19 fatality among indigenous individuals was nearly two-fold (odds ratio (OR) = 1.92)) compared to non-indigenous individuals (OR = 1.05). COVID-19 fatality was higher among highly marginalised individuals (upper quartile) (OR = 1.51; 95% confidence interval (CI) = 1.49-1.54). Marginalised indigenous individuals had a significantly lower likelihood of ICU admission compared to non-indigenous non-marginalised individuals. The likelihood of mechanical ventilation for indigenous individuals was 4% higher compared to non-indigenous individuals. Indigenous marginalised individuals had a significantly lower probability of mechanical ventilation compared to non-indigenous non-marginalised individuals. COVID-19 comorbidity risks of fatality significantly differed between the two groups in the Cox survival analysis. In the fully adjusted model, indigenous individuals were 4% more likely to die from COVID-19 compared to non-indigenous. Conclusions: Indigenous, marginalised individuals with COVID-19 had higher risk of hospitalisation and ICU admission than non-indigenous patients. Marginalised, indigenous individuals were less likely to receive mechanical ventilation compared to non-indigenous, but had a higher risk of COVID-19. Indigenous individuals had a 4% higher COVID-19 mortality risk COVID-19 compared to non-indigenous individuals. Improved community medical care and augmented health services in rural hospitals could mitigate barriers to health care access in indigenous, marginalised populations.

π-Donor/π-Acceptor Interactions for the Encapsulation of Neurotransmitters on Functionalized Polysilicon-Based Microparticles.

Bipyridinium salts, commonly known as viologens, are π-acceptor molecules that strongly interact with π-donor compounds, such as porphyrins or amino acids, leading their self-assembling. These properties have promoted us to functionalize polysilicon microparticles with bipyridinium salts for the encapsulation and release of π-donor compounds such as catecholamines and indolamines. In this work, the synthesis and characterization of four gemini-type amphiphilic bipyridinium salts (1·4PF6-4·4PF6), and their immobilization either non-covalently or covalently on polysilicon surfaces and microparticles have been achieved. More importantly, they act as hosts for the subsequent incorporation of π-donor neurotransmitters such as dopamine, serotonin, adrenaline or noradrenaline. Ultraviolet-visible absorption and fluorescence spectroscopies and high-performance liquid chromatography were used to detect the formation of the complex in solution. The immobilization of bipyridinium salts and neurotransmitter incorporation on polysilicon surfaces was corroborated by contact angle measurements. The reduction in the bipyridinium moiety and the subsequent release of the neurotransmitter was achieved using ascorbic acid, or Vitamin C, as a triggering agent. Quantification of neurotransmitter encapsulated and released from the microparticles was performed using high-performance liquid chromatography. The cytotoxicity and genotoxicity studies of the bipyridinium salt 1·4PF6, which was selected for the non-covalent functionalization of the microparticles, demonstrated its low toxicity in the mouse fibroblast cell line (3T3/NIH), the human liver carcinoma cell line (HepG2) and the human epithelial colorectal adenocarcinoma cell line (Caco-2).

Role of CC Chemokines Subfamily in the Platinum Drugs Resistance Promotion in Cancer.

Cancer is a significant medical issue, being one of the main causes of mortality around the world. The therapies for this pathology depend on the stage in which the cancer is found, but it is usually diagnosed at an advanced stage in which the treatment is chemotherapy. Platinum drugs are among the most commonly used in therapy, unfortunately, one of the main obstacles to this treatment is the development of chemoresistance, which is the ability of cancer cells to evade the effects of drugs. Although some molecular mechanisms involved in resistance to platinum drugs are described, elucidation is still required of others. Secretion of inflammatory mediators such as cytokines and chemokines, by tumor microenvironment components or tumor cells, show direct influence on proliferation, metastasis and progression of cancer and are related to chemoresistance and poor prognosis. In this review, the general mechanisms associated with resistance to platinum drugs, inflammation on cancer development and chemoresistance in various types of cancer will be approached with special emphasis on the current history of CC chemokines subfamily-mediated chemoresistance.

Synthesis and in vitro phototoxicity of multifunctional Zn(II)meso-tetrakis(4-carboxyphenyl)porphyrin-coated gold nanoparticles assembled via axial coordination with imidazole ligands.

HYPOTHESIS: Metalloporphyrins are extensively investigated for their ability to form reactive oxygen species and as potent photosensitisers for use in photodynamic therapy. However, their hydrophobicity generally causes solubility issues concerning in vivo delivery due to lack of distribution and low clearance from the body. Immobilising porphyrins on carriers, such as gold nanoparticles (GNP), can overcome some of these drawbacks. The mode of assembling the porphyrins to the carrier influences the properties of the resulting drug delivery systems. EXPERIMENTS: We describe the synthesis and characterisation of new porphyrin decorated water soluble GNP and we explore Zn-imidazole axial coordination as the mode of linking the porphyrin to the metallic core of the nanoparticles. Quantification of singlet oxygen production, toxicity in dark, cellular uptake by SK-BR-3 cells and phototoxicity have been assessed. FINDINGS: Axial coordination limits the number of porphyrins on the gold surface, reduces the formation of aggregates, and diminishes metal exchange in the porphyrin, all of which contribute to enhance the efficiency of singlet oxygen generation from the immobilised porphyrin. In vitro experiments on SK-BR-3 cells reveal a fast uptake followed by more than 80% cell death after irradiation with low doses of light.

Amphiphilic gemini pyridinium-mediated incorporation of Zn(II)meso-tetrakis(4-carboxyphenyl)porphyrin into water-soluble gold nanoparticles for photodynamic therapy.

Zn-containing porphyrins are intensely investigated for their ability to form reactive oxygen species and thereby being potent photosensitizers for use in photodynamic therapy (PDT). Some of the drawbacks of the PDT approach, such as unspecific distribution, could be addressed by means of photosensitizer drug delivery systems. In this work, we synthesize and characterize new water-soluble gold nanoparticles (GNP) stabilized by a mixture of a polyethyleneglycol-containing thiol (to improve water solubility) and a new amphiphilic gemini-type pyridinium salt, which also acts as promotor of the incorporation of the anionic photosensitizer Na-ZnTCPP into the GNP. The obtained GNP have sizes between 7 and 10nm, as observed by Transmission Electron Microscopy. The incorporation of the photosensitizer caused an increase in the hydrodynamic size, detected by Dynamic Light Scattering, as well as a shift in the Surface Plasmon Resonance peak on the GNP UV-vis absorption spectra. The presence of the photosensitizer in the GNP was corroborated using Fluorescence Spectroscopy. The amount of Na-ZnTCPP was found to be 327 molecules per GNP. The porphyrin-containing Na-ZnTCPP-1·GNP showed good enhanced ability to produce singlet oxygen, compared to free Na-ZnTCPP. Their cytotoxicity and phototoxicity were investigated in vitro using two different human breast cell lines, one of tumoral origin (SKBR-3) and another of normal epithelium origin (MCF-10A). SKBR-3 cells showed higher sensitivity to Na-ZnTCCP and Na-ZnTCPP-1·GNP in dark conditions. After irradiation, no significant differences were observed between both cell lines except for 1µM Na-ZnTCCP-1·GNP where SKBR-3 cells were also more sensitive.

Gemini pyridinium amphiphiles for the synthesis and stabilization of gold nanoparticles for drug delivery.

HYPOTHESIS: Gemini pyridinium-based amphiphiles can play a triple role as: gold nanoparticles (AuNPs) synthesis facilitator, particle stabilizer and anion recognition centre. The so formed nanoparticles should be able to bind and release anionic drugs. EXPERIMENTS: We describe (a) Synthesis, by a phase transfer method, of both new organic media and water soluble AuNPs using gemini-type surfactants based on bis-pyridinium salts as ligands, acting as transfer agents into organic media and also as nanoparticle stabilizers, (b) Examination of their stability in solution, (c) Chemical and physical characterization of the nanoparticles, (d) Toxicity data concerning both the bis-pyridinium ligands and the bis-pyridinium coated nanoparticles, and (e) Study of their ability for delivering anionic pharmaceuticals such as ibuprofen and piroxicam. FINDINGS: Pyridinium gemini-type surfactants show the ability to play multiple roles such as transfer agent and stabilizer, as well as ionophores: They are responsible for the preparation, stability, and delivery properties of these AuNPs, which gold core is stabilized by the anions present in the bis-pyridinium salts. The tetrahydropyridine resulting from the reduction of the bis-pyridinium salt is capable of reduce gold, due to its spontaneous oxidation to the corresponding pyridinium salt, leading to the formation of stable AuNPs.

Trypanosoma cruzi in persons without serologic evidence of disease, Argentina.

Current diagnosis of chronic Chagas disease relies on serologic detection of specific immunoglobulin G against Trypanosoma cruzi. However, the presence of parasites detected by polymerase chain reaction (PCR) in patients without positive conventional serologic testing has been observed. We determined the prevalence and clinical characteristics of persons with seronegative results and T. cruzi DNA detected by PCR in a population at high risk for chronic American trypanosomiasis. We studied a total of 194 persons from two different populations: 110 patients were recruited from an urban cardiology clinic, and 84 persons were citizens from a highly disease-endemic area. Eighty (41%) of persons had negative serologic findings; 12 (15%) had a positive PCR. Three patients with negative serologic findings and positive PCR results had clinical signs and symptoms that suggested Chagas cardiomyopathy. This finding challenges the current recommendations for Chagas disease diagnosis, therapy, and blood transfusion policies.

Nutricion parenteral en el neonato / Parenteral nutrition in neonate

El grupo de soporte nutricional neonatal del Instituto Materno Infantil ha elaborado las guías sobre valoración nutricional, nutrición enteral y nutrición parenteral mediante un proceso teórico-práctico que incluyó: o La capacitación científica en nutrición y metabolismo neonatal, mediante la revisión y discusión de la bibliografía actual especializada en el tema. o La recolección de la información acerca de la experiencia institucional de nutricionistas, neonatólogos, pediatras, cirujanos pediatras y enfermeras que han trabajado en los últimos 15 años en el manejo de la nutrición parenteral en neonatos. o El diseño e implementación de un programa de computador para el cálculo de mezclas de nutrición parenteral exclusivo para neonatos. o El montaje de la Unidad de Preparación de Mezclas de Nutrición Parenteral con un sistema computarizado bajo estrictas medidas de asepsia y antisepsia, para garantizar mezclas de excelente calidad, estabilidad, compatibilidad, esterilidad y con protocolos establecidos a cargo de profesionales Idóneos en esta área. El establecimiento de protocolos de cateterización venosa y la colaboración en el entrenamiento técnico por parte de profesionales de diferentes disciplinas del área de Neonatología para facilitar y prevenir complicaciones en la administración de la nutrición parenteral. La divulgación permanente en los diferentes servicios a través de la revista Médica de los aspectos relacionados con la valoración nutricional y el soporte nutricional con el objeto de orientar la formulación individualizada que permita optimizar este recurso. El decisivo apoyo de la Dirección Científica, la Dirección Administrativa y los Departamentos de Nutrición, Enfermería, Farmacia, Pediatría, Neonatología y Cirugía Pediátrica