A nomogram combining prognostic nutritional index and platelet lymphocyte ratio predicts postoperative pulmonary infection following D2 radical gastrectomy for gastric cancer.

Introduction: Introduction: the prognostic nutritional index (PNI) and platelet-lymphocyte ratio (PLR) have been found to correlate with outcomes following radical gastrectomy for gastric cancer (GC). Objectives: to construct a nomogram combining PNI and PLR for individually forecasting the risk of postoperative pulmonary infection (POI) following D2 radical gastrectomy for GC. Methods: retrospectively, clinical data was gathered from 404 patients treated with D2 radical gastrectomy for GC. The study used multivariate logistic regression analysis to screen independent risk factors for POI after surgery. Subsequently, a nomogram was developed based on the above factors to forecast the POI probability accurately. Results: the multivariate logistic regression analysis identified age, PNI, PLR, CA199 level, ASA score, and ICU treatment as independent risk variables for POI following D2 radical gastrectomy (p < 0.001 or 0.05). The nomogram's area under the receiver operating characteristic curve (AUC) for predicting the risk of POI was 0.736 (95 % confidence interval (CI) = 0.678-0.794). The nomogram was internally validated using the bootstrap approach, involving repeated sampling 1000 times. The result yielded a concordance index (c-index) of 0.707 (95 % CI = 0.705-0.709). The calibration curves demonstrated an excellent concordance between the predicted values of the nomogram and the observed values. The nomogram's clinical value was shown to be high using decision analysis curves. Conclusions: a nomogram combining PNI and PLR is a dependable tool for forecasting the probability of POI following D2 radical gastrectomy for GC.

Introducción: Introducción: se ha observado que el índice nutricional pronóstico (INP) y el cociente plaquetas/linfocitos (PLR) se correlacionan con los resultados tras la gastrectomía radical por cáncer gástrico (CG). Objetivos: diseñar un nomograma que combine el INP y la RPL para predecir individualmente el riesgo de infección pulmonar postoperatoria (POI) tras una gastrectomía radical D2 por CG. Métodos: de forma retrospectiva, se recopilaron datos clínicos de 404 pacientes tratados con gastrectomía radical D2 por CG. El estudio utilizó un análisis de regresión logística multivariante para detectar factores de riesgo independientes de IOP tras la cirugía. Posteriormente, se desarrolló un nomograma basado en los factores mencionados para pronosticar con precisión la probabilidad de POI. Resultados: el análisis de regresión logística multivariante identificó la edad, el INP, el PLR, el nivel de CA199, la puntuación ASA y el tratamiento en la UCI como variables de riesgo independientes para el POI tras la gastrectomía radical D2 (p < 0,001 o 0,05). El área bajo la curva ROC (característica operativa del receptor) AUC del nomograma para predecir el riesgo de POI fue de 0,736 (intervalo de confianza [IC] del 95 % = 0,678-0,794). El nomograma se validó internamente mediante el método bootstrap, que consiste en repetir el muestreo 1000 veces. El resultado fue un índice de concordancia (índice c) de 0,707 (IC del 95 % = 0,705-0,709). Las curvas de calibración demostraron una excelente concordancia entre los valores predichos del nomograma y los valores observados. El valor clínico del nomograma se demostró elevado mediante curvas de análisis de decisión. Conclusiones: un nomograma que combina INP y PLR es una herramienta fiable para predecir la probabilidad de POI tras gastrectomía radical D2 por CG.

Identification of prognostic factors for survival in patients with metastatic gastric adenocarcinoma in a Mexican population.

INTRODUCTION AND AIMS: Gastric adenocarcinoma is among the high-ranking tumors, with respect to frequency and mortality, worldwide. The inflammatory process and immune system activity are associated with oncologic control. Our aim was to identify whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and other variables are prognostic factors for survival in patients with metastatic gastric cancer in a Mexican population. MATERIAL AND METHODS: Patients diagnosed with metastatic gastric adenocarcinoma, hospitalized within the time frame of December 2011 to 2021, were analyzed. The NLR, PLR, and albumin and hemoglobin levels obtained from blood samples were calculated. Functional status (ECOG and Karnofsky), sex, histology, and the presence of signet ring cells were also considered possible prognostic factors. Each factor's prognostic value for overall survival was determined through univariate and multivariate analyses. RESULTS: The study included 956 patients diagnosed with metastatic gastric cancer, of whom 494 (51.7%) were men and 462 (48.3%) were women. The main histologic finding was diffuse adenocarcinoma (n = 619, 64.7%), followed by intestinal adenocarcinoma (n = 293, 30.6%), and the presence of signet ring cells was found in 659 (68.9%) patients. Diagnostic laparoscopy was performed on 238 patients (24.9%) to confirm peritoneal carcinomatosis. The multivariate analysis showed that an NLR above 3.2 (HR 1.51, 95% CI 1.27-1.8; p < 0.001), albumin below 3.5 g/dl (HR 1.25, CI 1.06-1.47; p = 0.006), and an ECOG performance status of 2 or higher (HR 1.39, CI 1.10-1.76; p = 0.005) were independent factors that predicted a lower survival rate, whereas a Karnofsky score above 70% (HR 0.69, CI 0.53-0.91; p = 0.008) was associated with a better survival rate. Lastly, the PLR was not statistically significant in the multivariate analysis. CONCLUSIONS: The NLR, nutritional status assessed through albumin measurement, and functional status can act as independent prognostic survival factors in hospitalized Mexican patients diagnosed with metastatic gastric adenocarcinoma and be taken into account during therapeutic decision-making.

Avelumab to treat Merkel cell carcinoma: real-life experience in a dedicated oncology center. / Avelumab en el tratamiento del carcinoma de células de Merkel: experiencia en vida real en un centro monográfico oncológico.

The arrival of immunotherapy has revolutioned the management of patients with metastatic Merkel cell carcinoma (MCC). We conducted an observational, retrospective study of 14 cases treated with avelumab. The response rate was 57%: complete response was reached in 29% of patients, and partial responses in 29%. The drug proved effective in 83% (5/6) of the patients with a single metastatic site. However, the disease progressed in 75% (3/4) of the patients with bone metastases. PD1-L expression, MCC polyomavirus (MCPyV) positivity, and an impaired neutrophil-to-lypmhocyte ratio (NLR) could not be associated with responses to the therapy. Avelumab is an effective and safe drug for the management of advanced MCC, and its effectiveness appears to be impacted by the number and location of metastases.

Testes de Triagem Prevendo Metástase de Câncer na Etiologia do Derrame Pericárdico: HALP Score e PNI / Screening Tests Predicting Cancer Metastasis in the Etiology of Pericardial Effusion: HALP Score and PNI

Resumo Fundamento: A triagem do câncer é absolutamente necessária em pacientes com derrame pericárdico, pois o câncer é uma das doenças mais graves em sua etiologia. Estudos anteriores indicaram que o índice de inflamação imunológica sistêmica (IIS), o índice prognóstico nutricional (PNI) e o escore de hemoglobina, albumina, linfócitos e plaquetas (HALP) podem ser escores relacionados ao câncer. Objetivos: Este estudo foi iniciado considerando que esses sistemas de pontuação poderiam prever o câncer na etiologia de pacientes com derrame pericárdico. Métodos: Os pacientes submetidos à pericardiocentese entre 2006 e 2022 foram analisados retrospectivamente. A pericardiocentese foi realizada em um total de 283 pacientes com derrame pericárdico ou tamponamento cardíaco de moderado a grande no período especificado. Os índices de HALP, PNI e IIS foram calculados do sangue venoso periférico retirado antes do procedimento de pericardiocentese. O nível de significância estatística foi aceito em p<0,05. Resultados: O escore HALP foi de 0,173 (0,125-0,175) em pacientes com câncer. Detectou-se que em pacientes não oncológicos o escore foi de 0,32 (0,20-0,49; p<0,001). O escore de PNI foi de 33,1±5,6 em pacientes com câncer. Detectou-se que em pacientes não oncológicos o escore foi 39,8±4,8 (p<0,001). Conclusão: Os escores HALP e PNI são testes de triagem de câncer fáceis e rápidos que podem prever metástases de câncer na etiologia de pacientes com derrame pericárdico.

Abstract Background: Cancer screening is absolutely necessary in patients with pericardial effusion, given that cancer is one of the most serious diseases in the etiology of pericardial effusion. In previous studies, it was stated that the systemic immune-inflammation index (SII); the prognostic nutrition index (PNI); and the hemoglobin, albumin, lymphocyte, platelet (HALP) score can produce scores related to cancer. Objectives: This study began considering that these scoring systems could predict cancer in the etiology of patients with pericardial effusion. Methods: This study produced a retrospective analysis of patients who underwent pericardiocentesis between 2006 and 2022. Pericardiocentesis was performed in a total of 283 patients with moderate-to-large pericardial effusion or pericardial tamponade within the specified period. HALP, PNI, and SII scores were calculated according to the peripheral venous blood taken before the pericardiocentesis procedure. The statistical significance level was set at p<0.05. Results: The HALP score proved to be 0.173 (0.125-0.175) in cancer patients and 0.32 (0.20-0.49) in non-cancer patients (p<0.001). The PNI score proved to be 33.1±5.6 in cancer patients and 39.8±4.8 in non-cancer patients (p<0.001). Conclusion: The HALP score and PNI proved to be easy and fast cancer screening tests that can predict cancer metastasis in the etiology of patients with pericardial effusion.

Índice neutrófilo-linfocito e índice plaquetas-linfocito: herramientas pronósticas del cáncer de pulmón

El cáncer de pulmón es la neoplasia maligna que causa mayor mortalidad en el mundo. Dentro de los factores pronósticos de esta entidad, se encuentran el índice neutrófilo-linfocito y el índice plaquetas-linfocito, parámetros hematológicos que se utilizan para evaluar la inflamación y la respuesta inmunitaria en el cuerpo humano. Se realizó una revisión bibliográfica con el objetivo de exponer el valor que presentan el índice neutrófilo-linfocito y el índice plaquetas-linfocito como herramientas pronósticas del cáncer de pulmón, teniendo en cuenta la evidencia científica publicada hasta el momento. Se estudiaron 46 artículos, 28 de los cuales resultaron seleccionados para la elaboración de la investigación. Se emplearon como criterios de selección la calidad de los estudios, el nivel de actualización sobre el tema en cuestión, así como la fiabilidad de la fuente. Se usaron los recursos disponibles en la red Infomed para la selección de la información, entre ellos: PubMed, SciELO, EBSCO, Cumed, LILACS y Scopus, además de Medline, Academic Search Premier y MedicLatina. Se expuso el valor que presentan el índice neutrófilo-linfocito y el índice plaquetas-linfocito como herramientas pronósticas del cáncer de pulmón de células no pequeñas, en todos los estadios y con modalidades terapéuticas diferentes.

Lung cancer is the malignant neoplasm that causes higher mortality in the world. Among the prognostic factors of this entity are the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio, hematological parameters that are used to assess inflammation and the immune response in the human body. A bibliographic review was carried out with the objective of exposing the value of the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as a prognostic tool for lung cancer, taking into account the scientific evidence published to date. A total of 46 articles were studied, of which 28 were selected for the development of the research. The quality of the studies, the level of updating on the subject in question, as well as the reliability of the source was used as selection criteria. The resources available in the Infomed network were used to select the information, including PubMed, SciELO and EBSCO, Cumed, LILACS and Scopus, as well as Medline, Academic Search Premier and MedicLatina databases. The value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as a prognostic tool in non-small cell lung cancer at all stages and with different therapeutic modalities was exposed.

Índice neutrófilo linfocito como predictor de infección del sitio quirúrgico en cirugía abdominal urgente

Introducción: Las infecciones del sitio quirúrgico representan una carga significativa en relación con la morbilidad, la mortalidad y costos adicionales. Por lo tanto, la prevención es importante. Objetivo: Comparar el índice neutrófilos-linfocitos con la escala SENIC para predecir infección del sitio quirúrgico en pacientes que sufrieron una cirugía abdominal de urgencia. Materiales y Métodos: Estudio transversal analítico, realizado en el Hospital de Alta Especialidad de Veracruz en expedientes de pacientes post-operados de urgencia, valorándose la escala SENIC (que incluye tipo de cirugía, duración del procedimiento, grado de asepsia de la intervención y 3 o más diagnósticos posoperatorios) y el índice neutrófilos-linfocitos (definido como la razón neutrófilos sobre linfocitos). Resultados: La edad promedio de los pacientes fue de 47,7 ± 18,7 años, con un predominio del sexo masculino 83 (62%), la estancia hospitalaria media fue de 29,7 ± 14,7 días, los procedimientos fueron la laparotomía exploradora en 57 (42,2%) y la apendicectomía en 26 (19,2%). Se aisló Escherichia coli en 27 (30%). Se obtuvo una sensibilidad de 69% y especificidad de 58% para el índice neutrófilos-linfocitos y para SENIC una sensibilidad 45% y una especificidad de 73%. Las estadísticas C para el índice neutrófilos-linfocitos y SENIC fueron 0,603 (IC: 0,524 − 0,682) y 0,668 (IC 95%: 0,588 − 0,749), respectivamente. Discusión y Conclusión: Ambos métodos muestran una precisión predictiva similar para infección del sitio quirúrgico, si bien calcular el índice neutrófiloslinfocitos es mucho más rápido y sencillo.

Introduction: Surgical site infections represent a significant burden in relation to morbidity, mortality, and additional costs. Therefore, prevention is important. Objective: To compare the neutrophil-lymphocyte index with the SENIC scale to predict surgical site infection in patients who underwent emergency abdominal surgery. Materials and Methods: Analytical cross-sectional study, carried out at the Hospital de Alta Especialidad de Veracruz in records of emergency post-operative patients, evaluating the SENIC scale (which includes type of surgery, duration of the procedure, degree of asepsis of the intervention and 3 or more postoperative diagnoses) and the neutrophil-to-lymphocyte ratio (defined as the ratio of neutrophils to lymphocytes). Results: The average age of the patients was 47.7 ± 18.7 years, with a predominance of males 83 (62%); the mean hospital stay was 29.7 ± 14.7 days, the procedures were exploratory laparotomy in 57 (42.2%) and appendectomy in 26 (19.2%). Escherichia coli was isolated in 27 (30%). A sensitivity of 69% and specificity of 58% was obtained for the neutrophil-lymphocyte index and for SENIC a sensitivity of 45% and a specificity of 73%. The C statistics for the neutrophil-lymphocyte ratio and SENIC were 0.603 (CI: 0.524 − 0.682) and 0.668 (95% CI: 0.588 − 0.749), respectively. Discussion and Conclusion: Both methods show similar predictive accuracy for surgical site infection, although calculating the neutrophil-lymphocyte ratio is much faster and easier.

Relación entre ansiedad, depresión y linfocitos T CD4+ en pacientes con virus de inmunodeficiencia humana (VIH) en un hospital general de Lima* / Relationship between anxiety, depression and CD4+ T lymphocytes in patients with Human Immunodeficiency Virus (HIV) in a general hospital in Lima

RESUMEN Objetivo: Determinar la relación entre ansiedad, depresión y recuento de linfocitos T CD4+ en una muestra de personas portadoras del virus de inmunodeficiencia humana (VIH). Metodología: Estudio observacional y analítico. Se evaluó a 144 pacientes con VIH en un hospital general de Lima, Perú. Se utilizó la Escala de Ansiedad y Depresión Hospitalaria (HADS). Resultados: La edad media de los sujetos de estudio fue de 41 años. La mayoría estuvo constituida por varones (71,5 %), solteros (86,1 %) y con grado de instrucción secundaria (57,6 %). La duración promedio de la enfermedad fue 7,7 años; el 11,1 % presentó alguna comorbilidad; y el 95,1 % utilizó tenofovir como tratamiento. El 34 % y el 16,7 % presentaron algún nivel de ansiedad y depresión, respectivamente. Los pacientes que se encontraban en estadio de sida presentaron mayores niveles de ansiedad (p < 0,001) y depresión (p < 0,001). Los pacientes con VIH y comorbilidades médicas presentaron mayores niveles de depresión (p = 0,044). Los niveles de ansiedad (ρ = -0,516, p = 0,01) y depresión (ρ = -0,509; p = 0,01) estuvieron relacionados con el recuento de linfocitos T CD4+. Conclusión: Se encontraron mayores niveles de depresión en pacientes con comorbilidades y estadio de sida, así como mayores niveles de ansiedad en pacientes en estadio de sida. Se comprobó, además, una relación indirecta y significativa entre los niveles de ansiedad, depresión y el recuento de linfocitos T CD4+. Se recomienda capacitar a los profesionales de salud en el tamizaje de ansiedad y depresión, a fin de mejorar la salud mental de pacientes con VIH.

ABSTRACT Objective: To determine the relationship between anxiety, depression and CD4+ T lymphocyte count in a sample of people carrying the human immunodeficiency virus (HIV). Methodology: Observational and analytical study. A total of 144 HIV-positive patients were evaluated. The Hospital Anxiety and Depression Scale (HADS) was used. Results: The sample's mean age was 41 years. Most of the probands were male (71.5%), single (86.1%) and with secondary education (57.6%). The average length of the disease was 7.7 years, 11.1% presented some comorbidity, and 95.1% used tenofovir as treatment. Thirty-four and 16.7% presented some level of anxiety and depression, respectively. Patients at the AIDS stage presented higher levels of anxiety (p < 0.001) and depression (p < 0.001). Patients with HIV and medical comorbidities had higher levels of depression (p = 0.044). Anxiety (ρ = -0.516, p = 0.01) and depression (ρ = -0.509; p = 0.01) levels were related to CD4+ T lymphocyte count. Conclusion: Higher levels of depression were found in patients with comorbidities and AIDS stage, and higher levels of anxiety were found in patients at the AIDS stage. In addition, a significant indirect relationship was found between anxiety and depression levels and the CD4+ T cell count. Training healthcare professionals to screen for anxiety and depression in order to improve the mental health of HIV patients, is highly recommended.

Relación de los índices neutrófilo-linfocito y plaquetas-linfocito con desenlaces de severidad en isquemia aguda de miembros inferiores / Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio relation with outcomes in acute lower limb ischemia

Introducción: los índices neutrófi los/linfocitos (nLr) y plaquetas/linfocitos (pLr) son marcadores de infl amaciónsistémica y podrían correlacionarse con amputación y muerte en pacientes con isquemia aguda de miembrosinferiores. Métodos: estudio retrospectivo, analítico y multicéntrico en una cohorte de pacientes con isquemia aguda demiembros inferiores no traumática ni iatrogénica entre 2017 y 2018. Se analizaron los datos clínicos y paraclínicos,se calcularon los nLr y los pLr al ingreso y se buscó su relación con la amputación y la muerte. además, se realizóel seguimiento de dichos desenlaces hasta 24 meses después del evento. Resultados: se identifi caron 140 pacientes, 56 % de género masculino y con una edad media de 76 años. Un nLr> 5,2 es un factor de riesgo para amputación intrahospitalaria (Or: 3,16) y para una menor supervivencia libre deamputación (Hr: 3,75). Un nLr > 8,4 es factor de riesgo para mortalidad intrahospitalaria (Or: 6,38) y para unasupervivencia global menor (Hr: 2,58). por su parte, el pLr > 208 se relaciona con una menor supervivencia librede amputación (Hr: 1,93) y un pLr > 226 se correlaciona con una mortalidad intrahospitalaria mayor (Or 4,48) y esun factor de riesgo para una supervivencia global menor (Hr: 2,33). Se encontró, además, que una clasifi cación derutherford IIb o III al ingreso, edad > 60 años o antecedente de enfermedad renal crónica se asociaban con unamayor mortalidad intrahospitalaria. Conclusiones: valores elevados en nLr y pLr se relacionan con un mayor riesgo de amputación y de mortalidadintrahospitalaria y con una menor supervivencia libre de amputación y supervivencia global en pacientes conisquemia aguda de extremidades inferiores, por lo que pueden usarse como una herramienta más a la hora deestadificar a los pacientes de alto riesgo que ingresan con dicho diagnóstico.(AU)

Introduction: neutrophil/lymphocyte (nLr) and platelet/lymphocyte (pLr) ratio are markers of systemic inflammation and may correlate with major outcomes in patients with acute lower limb ischemia. Methods: a retrospective, analytic and multicenter study in a cohort of patients with acute lower limb ischemia,not traumatic or iatrogenic, between 2017 and 2018. Clinical and paraclinical data were analyzed, the nLr and pLrwere calculated on admission and their relationship with amputation and death was sought. In addition, theseoutcomes were monitored up to 24 months after the event. Results: 140 patients were identified, 56 % was male and they had a mean age of 76 years old. an nLr > 5,2is a risk factor for intra-hospital amputation (Or: 3,16) and for survival free of minor amputation (Hr: 3,75). annLr > 8,4 is a risk factor for in-hospital mortality (Or: 6,38) and for a lower overall survival (Hr: 2,58). Further-more, pLr > 208 is associated with a minor amputation-free survival (Hr: 1,93) and a pLr > 226 is correlatedwith greater hospital mortality (Or 4,48) and is a risk factor for a lower overall survival (Hr: 2,33). It was alsofound that a classification of rutherford IIb or III at admission, ages > 60 years and/or history of chronic kidneydisease were associated with higher intra-hospital mortality. Conclusions: high values in the nLr and pLr are associated with increased risk of amputation and hospital mor-tality and are risk factors for free survival of amputation and reduced overall survival in patients with acute lowerlimb ischemia. therefore, it can be used as one more tool when we’re staging high-risk patients who are admittedwith such a diagnosis.(AU)

Índice neutrófilo/linfocito en anestesia general con ventilación controlada por volumen versus ventilación controlada por presión: ensayo clínico aleatorizado / Neutrophil/lymphocyte ratio in general anesthesia with volume-controlled ventilation versus pressure-controlled ventilation: a randomized clinical trial

Resumen: Introducción: se ha demostrado que la ventilación mecánica induce la producción de citocinas proinflamatorias. El IN/L es un parámetro sencillo que se utiliza para evaluar el estado inflamatorio. Objetivo: comparar los promedios y porcentajes del índice neutrófilo/linfocito (IN/L) elevado, entre pacientes con anestesia general con ventilación mecánica controlada por volumen (VMCV) y ventilación mecánica controlada por presión (VMCP). Material y métodos: se seleccionaron adultos ≥ 18 años, ASA I-III con cirugía electiva y anestesia general. Ensayo clínico aleatorizado: 25 pacientes con VMCV y 25 con VMCP. A todos los pacientes se les determinó dos biometrías hemáticas: antes y 2 horas después de la cirugía. El IN/L fue medido en forma de razón y dicotómica (< 3 o ≥ 3). Análisis estadístico: se utilizaron las pruebas t de Student, χ2 y McNemar. Resultados: se estudiaron 50 pacientes (27 mujeres y 23 hombres) con un promedio de edad de 47 ± 16 años. El grupo de VMCV tuvo tendencia a presentar valores más bajos de promedios y porcentajes IN/L; sin embargo, no fue estadísticamente significativa (p = 0.06). En la comparación pareada ambos grupos presentaron incremento estadísticamente significativo de los promedios y porcentajes de IN/L. No obstante, el porcentaje de IN/L > 3 en el grupo de VMCP fue de 64%, mientras que en el grupo de VMCV fue de 40%. Conclusiones: la VMCV presenta promedios y porcentajes más bajos del IN/L comparados con VMCP; sin embargo, no fueron estadísticamente significativos.

Abstract: Introduction: it has been shown that mechanical ventilation induces production of proinflammatory cytokines. The Neutrophil-to-lymphocyte ratio (N/L r) is a simple parameter that is used to assess the inflammatory state. Objective: to compare the means and percentages of elevated neutrophil/lymphocyte ratio (N/L r) in patients under general anesthesia with volume-controlled mechanical ventilation (VCMV) and pressure-controlled mechanical ventilation (PCMV). Material and methods: adults ≥ 18 years old, ASA I-III, with elective surgery and general anesthesia. Randomized clinical trial: 25 patients with VCMV and 25 with PCMV. All patients had two blood counts determined: before and 2 hours after surgery. N/L r was measured as a ratio and dichotomous (< 3 or ≥ 3). Statistical analysis: the t-Student, χ2 and McNemar tests were used. Results: 50 patients (27 women and 23 men) with a mean age of 47 ± 16 years (range 18-84 years) were studied. The VCMV group tended to present lower values of means and percentages N/L r, however, it was not statistically significant (p = 0.06). In the paired comparison, both groups presented a statistically significant increase in the means and percentages of N/L r. However, the percentage of N/L r > 3 in the PCMV group was 64%, while in the VCMV group it was 40%. Conclusions: the VCMV presents lower means and percentages of N/L r compared to PCMV, however, they were not statistically significant.

Preoperative serum inflammation-based scores in medullary thyroid cancer.

INTRODUCTION: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are prognostic factors in several tumours, though little is known in medullary thyroid cancer (MTC). OBJECTIVE: To evaluate the association between preoperative NLR, PLR and SII with MTC clinicopathological and molecular features, and their predictive value for lymph node and distant metastasis. METHODS: We retrospectively analysed 75 patients with MTC who underwent surgery at our institution. The familial form of MTC was found in 12% of patients. RESULTS: In our cohort, 56% were females, the median age at diagnosis was 57 years (44-69), the median tumour diameter was 25mm (15-50); 21.3% were multifocal and 34.7% had extrathyroidal extension. Lymph node and distant metastasis were observed in 36 (48.0%) and 8 (10.7%) patients, respectively. Higher NLR was associated with preoperative calcitonin, angioinvasion, extrathyroidal extension, moderate/severe fibrosis; higher PLR was associated with extrathyroidal extension and advanced T stages; lower SII and NLR were associated with biochemical cure after surgery. Increased PLR, NLR and SII were associated with advanced MTC stages. In the univariate analysis, only NLR was associated with lymph node metastasis (odds ratio (OR)=2.69, 95% confidence interval (CI): 1.50-5.84; p=0.004); however, in the multivariate model, NLR was no longer a predictive factor for lymph node metastasis. None of these serum inflammatory markers predicted the occurrence of distant metastasis. CONCLUSION: In conclusion, NLR, PLR and SII are associated with aggressive MTC, but do not predict lymph node or distant metastasis.

Utilidad del índice neutrófilo-linfocito en la detección de apendicectomías negativas / The role of the neutrophil-to-lymphocyte ratio in avoiding negative appendectomies

Introducción: El índice neutrófilo-linfocito (INL) es un biomarcador inflamatorio fácilmente calculable a partir del recuento diferencial de leucocitos. El objetivo de este estudio es analizar el papel del INL en la detección de apendicetomías negativas, y comparar su utilidad con otros factores clínicos, ecográficos y de laboratorio previamente descritos. Métodos: Estudio retrospectivo en pacientes menores de 16 años con sospecha de apendicitis aguda intervenidos en nuestra institución entre 2017-2020, que fueron divididos en 2 grupos según hallazgos histológicos apendiculares: Grupo AN: apendicitis negativa; ausencia de inflamación y grupo AP: apendicitis positiva; presencia de inflamación en la pared apendicular. Se analizaron las características demográficas, clínicas, ecográficas y de laboratorio. Resultados: Se incluyeron 1.269 pacientes (1.244 en el grupo AP; 25 en el grupo AN), sin diferencias demográficas entre ellos. Los pacientes del grupo AN presentaron un porcentaje significativamente menor de náuseas y vómitos en comparación con el grupo AP (p<0,001) y menor diámetro ecográfico apendicular (8,1±2,1 vs. 9,7±2,8mm; p<0,001). Los recuentos de leucocitos, neutrófilos e INL fueron significativamente superiores en el grupo AP (p<0,001), así como la proteína C reactiva (18,6 vs. 2,6; p=0,005). El análisis mediante curva ROC mostró que el INL fue el parámetro con mayor AUC (0,879) para el diagnóstico de apendicitis negativa, con un punto de corte de 2,65 con una sensibilidad del 84,2% y una especificidad del 83,8% máximas. Conclusiones: El INL es el parámetro preoperatorio que mejor distingue a los pacientes sin apendicitis aguda. Los valores inferiores a 2,65 deben hacernos sospechar otra causa diferente a la apendicitis. (AU)

Introduction: The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that is easily calculated with data from the differential white blood cell count. The aim of our study was to analyse the role of the NLR in the detection of negative appendectomies and to compare its usefulness with other clinical, sonographic and laboratory factors previously described. Methods: We conducted a retrospective study in patients aged less than 16 years who underwent appendectomy in our hospital between 2017 and 2020. We divided patients into 2 groups based on appendiceal histological findings: NA group (negative appendicitis: absence of appendiceal inflammation) and PA group (positive appendicitis: presence of inflammation in any layer of the appendiceal wall). We analysed demographic, clinical, sonographic and laboratory characteristics. Results: We included a total of 1269 patients, 1244 in the PA group and 25 in the NA group, with no differences between groups in demographic characteristics. The proportion of patients that presented with nausea and vomiting was significantly smaller in the NA group compared to the PA group (P<.001), and there were no other differences in symptoms. The appendiceal diameter on ultrasound was significantly smaller in the NA group (8.1±2.1 vs. 9.7±2.8mm; P<.001). The white blood cell and neutrophil counts and the NLR were significantly higher in the PA group (P<.001), as was the level of C-reactive protein (18.6 vs. 2.6; P=.005). The ROC curve analysis revealed that the NLR was the parameter with the highest AUC (0.879) for the diagnosis of negative appendicitis, with a cut-off point of 2.65 for a maximum sensitivity of 84.2% and specificity of 83.8%. Conclusion: The NLR is the preoperative parameter that best discriminates patients without acute appendicitis. Values of less than 2.65 should make clinicians contemplate diagnoses other than appendicitis. (AU)

The role of the neutrophil-to-lymphocyte ratio in avoiding negative appendectomies.

INTRODUCTION: The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that is easily calculated with data from the differential white blood cell count. The aim of our study was to analyse the role of the NLR in the detection of negative appendectomies and to compare its usefulness with other clinical, sonographic and laboratory factors previously described. METHODS: We conducted a retrospective study in patients aged less than 16 years who underwent appendectomy in our hospital between 2017 and 2020. We divided patients into 2 groups based on appendiceal histological findings: NA group (negative appendicitis: absence of appendiceal inflammation) and PA group (positive appendicitis: presence of inflammation in any layer of the appendiceal wall). We analysed demographic, clinical, sonographic and laboratory characteristics. RESULTS: We included a total of 1269 patients, 1244 in the PA group and 25 in the NA group, with no differences between groups in demographic characteristics. The proportion of patients that presented with nausea and vomiting was significantly smaller in the NA group compared to the PA group (P < .001), and there were no other differences in symptoms. The appendiceal diameter on ultrasound was significantly smaller in the NA group (8.1 ±â€¯2.1 vs. 9.7 ±â€¯2.8 mm; P < .001). The white blood cell and neutrophil counts and the NLR were significantly higher in the PA group (P < .001), as was the level of C-reactive protein (18.6 vs. 2.6; P = .005). The ROC curve analysis revealed that the NLR was the parameter with the highest AUC (0.879) for the diagnosis of negative appendicitis, with a cut-off point of 2.65 for a maximum sensitivity of 84.2% and specificity of 83.8%. CONCLUSION: The NLR is the preoperative parameter that best discriminates patients without acute appendicitis. Values of less than 2.65 should make clinicians contemplate diagnoses other than appendicitis.

Asociación entre índice neutrófilo/linfocito como biomarcador de mortalidad en pacientes con quemaduras mayores durante el periodo del 01 de febrero de 2020 al 28 de enero de 2022 / Association between neutrophil/lymphocyte ratio as a biomarker of mortality in patientswith major burns during the period February 1, 2020 to January 28, 2022 / Associação entre a relação neutrófilo/linfócito como biomarcador de mortalidade empacientes com grandes queimaduras no período de 1º de fevereiro de 2020 a 28 de janeiro de 2022

resumen está disponible en el texto completo

Abstract: Introduction: burns are a serious public health problem, with several studies estimating that more than 11 million people were affected by burn injuries with approximately 300,000 deaths worldwide. Studies showed that the main causes of death were inhalation injuries, infection, and metabolic and hemodynamic complications ending in multi-organ failure. It has been shown that the increase in the systemic inflammatory response, whose parameters can be easily obtained, can be useful and directly related to poor prognosis. Several clinical studies indicate that the ratio of neutrophils to lymphocytes, an indicator of systemic inflammatory response, can signify the presence of inflammation in some diseases such as diabetes, coronary artery disease, cholangitis, rheumatoid arthritis, and recently COVID-19. Objective: to know the association between the neutrophil lymphocyte index as a biomarker of mortality in patients with major burns. Material and methods: an observational, retrospective, descriptive, longitudinal study will be carried out: with a user population of the National Center for Research and Attention to Burned Patients (CENIAQ) of the Luis Guillermo Ibarra Ibarra National Rehabilitation Institute. A review of the clinical records of the patients treated in the period will be carried out during the period from February 1, 2020 to February 28, 2022, the data of admission and discharge will be taken into account, as well as initial laboratory studies. The information will be recorded in an Excel spreadsheet to be later analyzed in the SPSS software, the results will be obtained and finally their analysis will be carried out. Results: in the analyzed population we found that the average age is 40 years, it was also found that the most affected gender in this population corresponds to the male gender with 81.2%. It was also found that, within the diagnoses of the population studied, fire burn was the one that most affected the population, this being 67.1% of all diagnoses. However, in this study no significant difference was found in the neutrophil lymphocyte index with respect to the type of burn. In our analysis, the neutrophil lymphocyte index was included as a biochemical predictor of mortality, since high levels of this index at admission are associated with increased mortality. In our population, a significant difference was found between the groups with a fatal clinical outcome and those who recovered, which is why it can be considered as a predictor of mortality in these patients since they presented a p value < 0.023, data that is consistent with what is reported in the international literature where the Neutrophil lymphocyte index value can be used as a predictor of mortality. Conclusions: an association was found between the elevation of the neutrophil/lynphocyte ratio and mortality in patients with severe burns.

Resumo: Introdução: as queimaduras são um grave problema de saúde pública, onde estima-se em diversos estudos que mais de 11 milhões de pessoas foram acometidas por queimaduras com aproximadamente 300.000 mortes em todo o mundo. Estudos mostraram que as principais causas de morte foram lesões inalatórias, infecções e complicações metabólicas e hemodinâmicas que culminaram em falência de múltiplos órgãos. Tem sido demonstrado que o aumento da resposta inflamatória sistêmica, cujos parâmetros podem ser facilmente obtidos, pode ser útil e estar diretamente relacionado ao mau prognóstico. Vários estudos clínicos indicam que a proporção de neutrófilos para linfócitos, um indicador de resposta inflamatória sistêmica, pode significar a presença de inflamação em algumas doenças como diabetes, doença arterial coronariana, colangite, artrite reumatóide e recentemente COVID-19. Objetivo: conhecer a associação entre o índice neutrófilo-linfócito como biomarcador de mortalidade em pacientes com grandes queimaduras. Material e métodos: será realizado um estudo observacional, descritivo, retrospectivo, longitudinal: com a população usuária do Centro Nacional de Pesquisa e Atenção ao Paciente Queimado (CENIAQ), do Instituto Nacional de Reabilitação Luis Guillermo Ibarra Ibarra. Realizaremos uma revisão dos prontuários clínicos dos pacientes atendidos no período de 1º de fevereiro de 2020 a 28 de fevereiro de 2022, serão levados em consideração os dados de admissão e alta, bem como os estudos laboratoriais iniciais. As informações serão registradas em planilha Excel para posteriormente serem analisadas no software SPSS, serão obtidos os resultados e por fim será realizada a análise. Resultados: na população analisada verificamos que a média de idade é de 40 anos, constatou-se também que o gênero mais acometido nesta população corresponde ao gênero masculino com 81.2%. Constatou-se também que, dentro dos diagnósticos da população estudada, a queimadura por fogo foi o que mais afetou a população, sendo este 67.1% do total de diagnósticos. No entanto, neste estudo não foi encontrada diferença significativa no índice neutrófilo-linfócito em relação ao tipo de queimadura. Em nossa análise, foram incluídos o índice neutrófilo-linfócito como preditor bioquímico de mortalidade, uma vez que altos níveis desse índice na admissão estão associados a aumento da mortalidade. Em nossa população, foi encontrada diferença significativa entre os grupos com desfecho clínico fatal e os recuperados, motivo pelo qual pode ser considerado como preditor de mortalidade nesses pacientes, pois apresentaram valor de p < 0.023, dado compatível com o relatado em a literatura internacional onde o valor do índice neutrófilo-linfócito pode ser utilizado como preditor de mortalidade. Conclusões: encontrou-se associação entre a elevação do índice neutrófilo/linfócito e mortalidade em pacientes com queimaduras graves.

The Value of Lymphocyte-CRP Ratio Predicting the Prognosis in COVID-19 Patients / El valor de la relación linfocito-PCR para predecir el pronóstico en pacientes con COVID-19

Introduction: Although prevention of the disease and its spread is the primary goal in the fight against the pandemic, studies on the correct management of those who have the disease and the predictability of the prognosis are also important. This study aimed to determine whether lymphocyte-C-reactive protein ratio, together with other inflammation markers, would be useful in predicting intensive care unit admission and mortality in Coronavirus disease 2019 cases.Material and methods: 883 patients were followed in 758 wards and 125 intensive care units. Data of the patients included in the study were compared with those admitted to the service and intensive care unit, and with those who survived and developed mortality.Results: According to the receiver operating characteristic analysis to distinguish the patients followed in the intensive care unit from the patients hospitalized in the ward that was determined that lymphocyte-C-reactive protein ratio, C-reactive protein ratio, CRP-albumin ratio, and neutrophil-lymphocyte ratio were moderate (70%–80%). D-dimer was good (80%–90%) predicting follow-up in intensive care unit. Increase in age, increase in lactate dehydrogenase and interleukin-6 levels, and uptake in tomography were determined as independent risk factors that increase intensive care unit admission. 243 (27.5%) of the patients were mortal. The mean age of the patients with a mortal course was 70±14 years, and mortality increased with increasing age. In the receiver operating characteristic analysis of patients with a mortal course that was determined that lymphocyte-C-reactive protein ratio, neutrophil-lymphocyte ratio, and D-dimer had a good (80–90%) ability to distinguish patients with a mortal course. Age, fever, and increases in lactate dehydrogenase and interleukin-6 levels were determined to be independent risk factors increasing mortality. Conclusions: ... (AU)

Introducción: Si bien la prevención de la enfermedad y su propagación es el objetivo principal en la lucha contra la pandemia, también son importantes los estudios sobre el correcto manejo de los pacientes con la enfermedad y la previsibilidad del pronóstico. El objetivo de este estudio fue determinar si la proporción de linfocitos y proteína C reactiva, junto con otros marcadores inflamatorios, sería útil para predecir el ingreso a la unidad de cuidados intensivos y la mortalidad en casos de enfermedad por coronavirus en 2019.Material y métodos: Se siguieron 883 pacientes en 758 salas y 125 unidades de cuidados intensivos. Los datos de los pacientes incluidos en el estudio se compararon con los ingresados en el servicio y unidad de cuidados intensivos, y con los que sobrevivieron y desarrollaron mortalidad.Resultados: Según el análisis de las características operativas del receptor para distinguir los pacientes seguidos en la unidad de cuidados intensivos de los pacientes hospitalizados en el servicio, se encontró que la relación linfocitos a proteína C reactiva, proteína C reactiva a albúmina y neutrófilos a la proporción de linfocitos fue moderada y el dímero D fue bueno para predecir el seguimiento en la unidad de cuidados intensivos. Se encontró que el aumento de la edad, el aumento de los niveles de lactato deshidrogenasa e interleucina-6 y la captación en la tomografía eran factores de riesgo independientes para el ingreso a la unidad de cuidados intensivos. 243 (27,5%) de los pacientes fallecieron. En el análisis de las características operativas del receptor de pacientes con un desenlace fatal, se encontró que la proporción de linfocitos a proteína C reactiva, la proporción de neutrófilos a linfocitos y el dímero D tenían una buena capacidad para discriminar a los pacientes con un desenlace fatal. ... (AU)

Recuento de linfocitos CD4, carga viral y colonización oral por Candida en personas viviendo con VIH/SIDA

Objetivos: determinar la correlación entre el recuento de CD4, carga viral y la colonización oral por Candida en personas viviendo con VIH/SIDA (PVVS) que reciben terapia antirretroviral (TAR). Métodos: se realizó un estudio transversal correlacional con 35 participantes que recibían tratamiento antirretroviral. Mediante citometría de flujo se determinó el recuento de CD4; la carga viral se determinó mediante RT-PCRq y la confirmación de colonización oral se realizó mediante aislamiento de Candida spp. Resultados: el recuento de CD4 se correlacionó significativamente de manera inversa con la carga viral (rho de Spearman = -0,457, p=0,006; Kendall Tau-b= -0,306, p=0,012) y con la colonización oral por Candida (rho de Spearman = -0,442, p=0,008; Kendall Tau-b= -0,366, p=0,010), no se encontró significancia estadística entre la carga viral y colonización (p>0,05). Conclusiones: En las PVVS que reciben TAR, los recuentos bajos de CD4 se relacionan con mayor colonización oral por Candida, no se encontró asociación de dicha colonización con la carga viral.

Objectives: to determine the correlation between CD4 count, viral load, and oral Candida colonization in people living with HIV/AIDS (PLWHA) receiving antiretroviral therapy (ART). Methods: a correlational cross-sectional study was conducted with 35 participants receiving antiretroviral treatment. Using flow cytometry, the CD4 count was determined; the viral load was determined by RT-PCRq and confirmation of oral colonization was made by isolating Candida spp. Results: CD4 count was significantly inversely correlated with viral load (Spearman's rho = -0.457, p=0.006; Kendall Tau-b= -0.306, p=0.012) and with oral Candida colonization (Spearman's rho = -0.442, p=0.008; Kendall Tau-b= -0.366, p=0,010), no statistical significance was found between viral load and colonization (p>0.05). Conclusions: in PLWHA receiving ART, low CD4 counts are associated with greater oral colonization by Candida; no association of said colonization with viral load was found.

First evidence of systemic infection and specific cytotoxic T lymphocyte immune response evoked by oral infection with recombinant Salmonella entérica serovar Albany-Ovalbumin in C57BL/6 mice / Primera evidencia de infección sistémica y respuesta inmune celular citotóxicaespecífica evocada por la infección oral en ratones C57BL/6 con Salmonella entericaserovar Albany-Ovoalbúmina recombinante

Abstract Our group isolated Salmonella enterica serovar Albany from food and feces of wildcaptive carnivores in a zoo from northwestern Mexico. This serovar was also associated with thedeath of an ocelot (Leopardus pardalis) in the same zoo. Another group associated S. Albanywith the death of a human patient. It is due to this zoonotic potential that the in vivo study of thehost-S. Albany relationship is critical. The recombinant S. Albany-Ovalbumin (rSAO) strain wasused to analyze a murine oral infection and its specific cytotoxic T lymphocyte (CTL) response.Our results have shown for the first time that rSAO establishes a systemic infection and evokesepitope-specific lysis with a Th1-like cytokine profile in vivo.

Resumen Salmonella entérica serovar Albany fue aislada por nuestro grupo de investigación de alimentos contaminados y de heces de animales carnívoros en cautiverio en un zoológico del noroeste de México; posteriormente, se logró asociar a este serovar con la muerte de un ocelote (Leopardus pardalis), dentro de este mismo zoológico. Otro grupo de investigación asoció a este serovar con la muerte de un paciente. Es debido a este potencial zoonótico que el estudio in vivo de la relación hospedero-S. Albany es crítico. La cepa recombinante S. Albany-Ovoalbúmina (rSAO) fue utilizada para analizar la infección múrida, al igual que la respuesta inmune celular citotóxica específica. Nuestros resultados demuestran, por primera vez, que rSAO establece una infección sistémica y evoca lisis epítopo-específica con un perfil de citocinas tipo Th1 in vivo.

Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis / Papel prognóstico da relação neutrófilo-linfócito no carcinoma espinocelular da laringe: uma metanálise

Abstract Introduction New evidence suggests that the ratio of neutrophils to lymphocytes is associated with the prognosis of other carcinoma, but the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma remains controversial. Objective The objective of this meta-analysis was to clarify the prognostic effectiveness of the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma. Methods According to the meta-analysis of the free guide, we searched EMBASE, Pubmed, the Cochrane Library databases. The ratio of neutrophils to lymphocytes of laryngeal squamous cell carcinoma patients was evaluated using mean standard vehicle and confidence interval. The overall survival, disease-free survival and progression free survival of patients with laryngeal squamous cell carcinoma were expressed by standard mean carrier method and confidence interval. The risk ratio of 95% confidence interval was used as an evaluation index for patients with laryngeal squamous cell carcinoma. Results Eight studies, including 1780 patients, used a variety of different end values to classify the ratio of neutrophils to lymphocytes (range 1.78-4.0). Among the eight studies that reported risk ratio of the overall survival, the higher median value was 2.72, and 2 of 4 studies reported disease-free survival results. The critical value of ratio of neutrophils to lymphocytes and overall survival deterioration (risk ratio = 1.68, 95% confidence interval 1.43-1.99, p< 0.001), disease-free survival (risk ratio = 2.09, 95% confidence interval 1.62-2.6, p< 0.001) and progression free survival (risk ratio = 1.92, 95% confidence interval 1.75-2.10, p< 0.001) was associated with with laryngeal aquamous cell carcinoma. The ratio of neutrophils to lymphocytes had prognostic value for laryngeal squamous cell carcinoma. Conclusion The results of this meta-analysis showed that the increase of neutrophils to lymphocytes ratio was related to poor prognosis of laryngeal squamous cell carcinoma. The neutrophils to lymphocytes ratio may serve as a cost-effective prognostic biomarker of poor prognosis of laryngeal squamous cell carcinoma. More high-quality prospective trials are needed to assess the practicability of evaluating the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma.

Resumo Introdução Novas evidências sugerem que a relação neutrófilo-linfócito está associada ao prognóstico de vários carcinomas, mas a relação neutrófilo-linfócito no carcinoma espinocelular da laringe ainda permanece controversa. Objetivo Esclarecer a eficácia prognóstica da relação neutrófilo-linfócito no carcinoma espinocelular de laringe. Método De acordo com as diretrizes de metanálise, conduzimos uma busca nas bases de dados Embase, PubMed, e Cochrane Library. A relação neutrófilo-linfócito de pacientes com carcinoma espinocelular de laringe foi avaliado com a diferença de médias padronizadas e intervalo de confiança. A sobrevida global, sobrevida livre de doença e sobrevida livre de progressão de pacientes com carcinomaespinocelular de laringe foram expressas pelo método da diferença de médias padronizadas e intervalo de confiança. A razão de risco do intervalo de confiança 95% foi usada como um índice de avaliação para pacientes com carcinoma espinocelular de laringe. Resultados Oito estudos, que incluíram 1.780 pacientes, usaram uma variedade de valores finais diferentes para classificar a relação neutrófilo-linfócito (intervalo de 1,78-4,0). Entre os oito estudos que relataram a razão de risco de sobrevida global, o maior valor médio foi de 2,72 e 2 de 4 estudos relataram resultados com sobrevida livre de doença. O valor crítico de relação neutrófilo-linfócito e deterioração da sobrevida global (razão de risco = 1,68, intervalo de confiança 95% 1,43-1,99, p ˂ 0,001), sobrevida livre de doença (razão de risco = 2,09, intervalo de confiança 95% 1,62-2,6, p ˂ 0,001) e sobrevida livre de progressão (razão de risco = 1,92, intervalo de confiança 95% 1,75-2,10, p ˂ 0,001) foi associado com carcinoma espinocelular de laringe. A relação neutrófilo-linfócito tem valor prognóstico para carcinoma espinocelular de laringe. Conclusão Os resultados da metanálise mostraram que o aumento da relação neutrófilo-linfócito estava relacionado ao mau prognóstico do carcinoma espinocelular de laringe. A relação neutrófilo-linfócito pode servir como um biomarcador custo-efetivo de prognóstico do carcinoma espinocelular de laringe. Entretanto, mais estudos prospectivos de alta qualidade são necessários para avaliar a sua praticabilidade.

Índice linfocito proteína c reactiva en COVID-19: una herramienta poco explorada / Lymphocyte-to-C-reactive protein ratio in COVID-19: an unexplored tool

Resumen Introducción: El COVID-19 genera respuestas inflamatorias graves que pueden terminar en la muerte. En pandemia resulta fundamental tener instrumentos de fácil acceso que estimen su evolu ción. El índice linfocito proteína C reactiva (LPCR) es un marcador pronóstico estudiado en patología oncológica que podría mostrar ventajas en la etapa precoz de la enfermedad por COVID-19. Objetivo: estimar los niveles de LPCR < 100 y su riesgo de mortalidad en pacientes internados con COVID-19. Métodos: Se incluyeron pacientes con COVID 19 que ingresaron a la sala de internación general desde marzo hasta octubre de 2020. Se realizó un modelo de regresión de Cox para estimar la relación entre el LPCR < 100 y mortalidad. Resulta dos: Se incluyeron 730 pacientes. La edad media de presentación fue 49.9 años (DE 16.8) y 401 (55%) fueron hombres. La mediana de días de internación fue 8 (RIC 6). El modelo de regresión de Cox evidenció asociación entre LPCR <100 y mortalidad (HR 6.2; IC95% 1.6 a 23.5; p 0.008) ajustado por edad, neumonía grave, pases a terapia intensiva, hipertensión arterial, y comorbilidades. Discusión: El LPCR <100 en la evaluación inicial de los pacientes que se internan con COVID-19 podría sugerir mayor riesgo de mortalidad.

Abstract Background: COVID-19 develops severe inflammatory responses that can lead to death. It is es sential in a pandemic to have accessible instruments to estimate the prognosis of the disease. The lymphocyte-to- C-reactive protein ratio (LCR) is a predictive biomarker studied in oncology, which could have some advantages in COVID-19 patients in the early stages of the disease. Our objective was to estimate the risk of LCR < 100 and mortality in hospitalized patients with COVID-19. Methods: hospitalized patients with COVID-19 seen between March to October 2020 were included. The patients were grouped according to LCR < 100 and LCR > 100. A Cox regression model was performed to estimate the association between LCR < 100 and mortality. Results: we included 730 patients with COVID-19. The mean age at diagnosis was 49.9 years (SD 16.8) and 401 (55%) were men. Cox regression model showed an association between LCR <100 and mortality (HR 6.2; 95% CI 1.6 to 23.5; p 0.008), adjusting by age. severe pneumonia, intensive care requirements, and comorbidities. Conclusion: LPCR <100 in the initial assessment of hospitalized patients with COVID-19 suggests a higher risk of mortality.

Inflammation and hemodialysis adequacy: are C-reactive protein levels influenced by the dose of dialysis?

INTRODUCTION: Chronic inflammation and the underlying cardiovascular comorbidity are still current problems in chronic hemodialysis patients. There are few studies comparing the "dialysis dose" with the degree of inflammation in the patient. Our main objective was to determine whether there is a relationship between serum C-reactive protein (CRP) levels and the "dialysis dose" (Kt / V) using ionic dialysance. METHODS: Multicenter cross-sectional study. 536 prevalent chronic hemodialysis patients were included. CRP levels, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were collected. Kt was obtained by ionic dialysance and urea distribution volume was calculated from the Watson's formula. The sample was divided into two groups, taking the median CRP as the cut-off point. Dialysis adequacy obtained in each group was compared. Finally, a logistic regression model was carried out to determine the variables with the greatest influence. RESULTS: Median CRP was 4.10 mg/L (q25-q75: 1.67-10) and mean Kt/V was 1.48 ± 0.308. Kt/V was lower in the patients included in the high inflammation group (p = 0.01). In the multivariate logistic regression, the "high" levels of CRP were directly correlated with the Log INL (p < 0.001) and inversely proportional with serum albumin values (p = 0.014), Kt/V (p = 0.037) and serum iron (p < 0.001). CONCLUSION: The poorer adequacy in terms of dialysis doses, lower Kt / V values, may contribute to a higher degree of inflammation in chronic hemodialysis patients.

First evidence of systemic infection and specific cytotoxic T lymphocyte immune response evoked by oral infection with recombinant Salmonella enterica serovar Albany-Ovalbumin in C57BL/6 mice.

Our group isolated Salmonella enterica serovar Albany from food and feces of wild captive carnivores in a zoo from northwestern Mexico. This serovar was also associated with the death of an ocelot (Leopardus pardalis) in the same zoo. Another group associated S. Albany with the death of a human patient. It is due to this zoonotic potential that the in vivo study of the host-S. Albany relationship is critical. The recombinant S. Albany-Ovalbumin (rSAO) strain was used to analyze a murine oral infection and its specific cytotoxic T lymphocyte (CTL) response. Our results have shown for the first time that rSAO establishes a systemic infection and evokes epitope-specific lysis with a Th1-like cytokine profile in vivo.