A Novel Approach to Obtain Vaccine Effectiveness Continuous Profiles. Example Case: COVID-19 in Elderly Mexicans.

Population-wide vaccination is the most promising long-term COVID-19 disease management strategy. However, the protection offered by the currently available COVID-19 vaccines wanes over time, requiring boosters to be periodically given, which represents an unattainable challenge, especially if it is necessary to apply several doses per year. Therefore, it is essential to design strategies that contribute to maximizing the control of the pandemic with the available vaccines. Achieving this objective requires knowing, as precisely and accurately as possible, the changes in vaccine effectiveness over time in each population group, considering the eventual dependence on age, sex, etc. Thus, the present work proposes a novel approach to calculating realistic effectiveness profiles against symptomatic disease. In addition, this strategy can be adapted to estimate realistic effectiveness profiles against hospitalizations or deaths. All such time-dependent profiles allow the design of improved vaccination schedules, where each dose can be administrated to the population groups so that the fulfillment of the containment objectives is maximized. As a practical example for this analysis, vaccination against COVID-19 in Mexico was considered. However, this methodology can be applied to other countries' data or to characterize future vaccines with time-dependent effectiveness values. Since this strategy uses aggregated observational data collected from massive databases, assumptions about the data validity and the course of the studied epidemic could eventually be necessary.

Efficacy and Safety of Tranexamic Acid for the Control of Surgical Bleeding in Patients Under Liposuction.

Liposuction remains one of the most frequently performed cosmetic surgical procedures and its popularity is increasing every year. However, since its inception, justified concerns regarding patient safety have placed limits on the volume of fat that can be aspirated, influenced by hemodynamic fluctuations and blood loss during liposuction. Tranexamic acid (TXA) is an antifibrinolytic agent that competitively inhibits the conversion of plasminogen to plasmin, thus preventing the binding and degradation of fibrin. Despite the existence of evidence of the effectiveness of TXA in orthopedic and cardiac surgeries, there is little evidence of its use in liposuction. The objective of this study was to evaluate the efficacy and safety of tranexamic acid in the control of surgical bleeding in patients undergoing liposuction, through a prospective, open, randomized and controlled clinical trial. Two groups of 25 participants each were formed to whom the application of TXA in a tumescent solution prior to liposuction or liposuction with the traditional technique was randomly assigned. The results showed a decrease in blood loss reflected by the differences in the final hematocrit values, as well as decrease in the same per aspirated volume (p = 0.003). No adverse events were found related with the TXA application and no blood transfusions were required in this group, in contrast to the control group where the need for blood transfusion was present in 20% of the intervened participants. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

A Quantitative Spectroscopic Study of the Bleaching Phenomena in Plasticized Formulations Containing PVC Exposed to Outdoor Conditions.

In this work, a quantitative spectroscopic study of the bleaching phenomena occurring in plasticized formulations containing poly(vinyl chloride) was performed, proposing a general methodology to comparatively analyze the effect of degrading conditions on the polyene accumulation behaviors (PABs) exhibited by a set of tested formulations. In the study, a set of environmental indexes (temperature (T*), UV energy (UV*), and days with rain) were proposed, which allowed for the suitable globalization of the changing environmental conditions occurring throughout the different degrading periods. A procedure to numerically describe the PAB, followed by each formulation undergoing each degrading condition was also proposed, which required only two primary fitting parameters and four secondary fitting parameters. Then, the combined effects of certain environmental conditions on the PABs were studied, quantifying the stabilizing effects of the rain and the combined decrement on the T* and UV* indexes. Finally, on the basis of the proposed fitting equation and the values of its fitting parameters, the relative importance of the dehydrochlorination reactions as compared with the photo-oxidative reactions simultaneously occurring in the studied systems was estimated.

Calculating the metabolizable energy of macronutrients: a critical review of Atwater's results.

The current values for metabolizable energy of macronutrients were proposed in 1910. Since then, however, efforts to revise these values have been practically absent, creating a crucial need to carry out a critical analysis of the experimental methodology and results that form the basis of these values. Presented here is an exhaustive analysis of Atwater's work on this topic, showing evidence of considerable weaknesses that compromise the validity of his results. These weaknesses include the following: (1) the doubtful representativeness of Atwater's subjects, their activity patterns, and their diets; (2) the extremely short duration of the experiments; (3) the uncertainty about which fecal and urinary excretions contain the residues of each ingested food; (4) the uncertainty about whether or not the required nitrogen balance in individuals was reached during experiments; (5) the numerous experiments carried out without valid preliminary experiments; (6) the imprecision affecting Atwater's experimental measurements; and (7) the numerous assumptions and approximations, along with the lack of information, characterizing Atwater's studies. This review presents specific guidelines for establishing new experimental procedures to estimate more precise and/or more accurate values for the metabolizable energy of macronutrients. The importance of estimating these values in light of their possible dependence on certain nutritional parameters and/or physical activity patterns of individuals is emphasized. The use of more precise values would allow better management of the current overweight and obesity epidemic.

Folate levels and N(5),N(10)-methylenetetrahydrofolate reductase genotype (MTHFR) in mothers of offspring with neural tube defects: a case-control study.

BACKGROUND: Neural tube defects (NTDs) have been associated with biochemical factors involved in the conversion of homocysteine to methionine as folate deficiency and the mutation 677T in the N(5),N(10)-methylenetetrahydrofolate reductase gene (MTHFR). METHODS: A case-control study was performed to detect this mutation in 38 unrelated women with NTD deceased products and 31 mothers without antecedents of NTD offspring. All products were born in Nuevo León (northeastern Mexico) during 1997. Erythrocyte and plasmatic folate levels and the genotype of the 677 polymorphism at the MTHFR locus were analyzed in both groups. RESULTS: Although no significant differences were found in mean blood folate levels, the percentage of women in the case group with erythrocyte folate levels <160 ng/mL was significantly higher than in the control group (75 vs. 51.2%, p <0.05). The proportion of women with plasma folate levels <3.5 ng/mL was higher in the case group (16.2 vs. 0%, p <0.01). Genotype analysis demonstrated a significantly higher proportion of 677T homozygous mothers with NTD products (39.6 vs. 9.1%, p <0.05). Allele frequencies for the 677T mutation were 0.55 and 0.36 for cases and controls, respectively. The odds ratio (OR) for having a NTD product was 6.1 (95%, CI 1.56-23.6) for homozygous 677T mothers vs. homozygous 677C and heterozygous mothers. Significantly low levels of erythrocyte folate were found in the 677C homozygous case group and in plasma folate in the 677C/677T heterozygous case mothers. CONCLUSIONS: Our study suggests that folate deficiency and MTHFR unfavorable genotype in mothers are important risk factors for severe NTD phenotype in our population.

[Impact of weekly administration of folic acid on folic acid blood levels]. / Efecto de la administración semanal de ácido fólico sobre los valores sanguíneos.

OBJECTIVE: To evaluate the effect of weekly administration of 5 mg. folic acid (FA) intake on folic acid blood levels. MATERIAL AND METHODS: This concurrent comparative study was conducted in 1998, in urban and rural areas of Nuevo Leon State, Mexico. The study population consisted of 74 women who delivered a child during 1997, 39 of whom had a child with a neural tube defect. Women were given 5 mg. of folic acid, weekly for 3 months. Blood levels of folic acid were determined by radioimmunoassay (RIA) at baseline, and a week after taking the last folic acid dose. Data are presented as means and standard deviations. RESULTS: Ninety per cent of the women had significantly increased folic acid intraerythrocytary blood levels. Red cell folate increased from 150.49 +/- 31.17 ng/ml to 184.21 +/- 35.53 ng/ml (p < 0.005). Plasma folate increased from 5.93 +/- 1.98 ng/ml a 7.03 +/- 2.5 ng/ml (p < 0.05). Eighty-two per cent of women reached intracellular levels above 160 ng/ml. CONCLUSIONS: The weekly administration of folic acid is a simple and efficient method that could be used to supplement this vitamin to low-income populations. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Studies of polymerized sodium N-undecylenyl-L-valinate in chiral micellar electrokinetic capillary chromatography of neutral, acidic, and basic compounds.

The polymerized surfactant poly(sodium N-undecylenyl amino L-valinate) [poly(L-SUV)] has been used in micellar electrokinetic capillary chromatography for the chiral separation of various acidic and basic drugs, as well as neutral compounds. Under the conditions studied, poly(L-SUV) was shown to be a very versatile anionic chiral selector in the pH range of 5.6-11. The micelle was used for the enantioseparation of coumarinic anticoagulant drugs with various buffers under moderately acidic conditions. Neutral and alkaline buffer conditions were used to successfully separate the neutral atropisomers (+/-)-1,1'-bi-2-naphthol, (+/-)-1,1'-binaphthyl-2,2'-diamine, and Tröger's base. Chiral separation of the cationic paveroline drugs, laudanosine, norlaudanosoline, and laudanosoline, was influenced by pH and the use of coated capillaries. The acquired data focused on optimizing the migration times, capacity and separation factors, and electrophoretic mobilities of the various racemic mixtures.

Analysis of sulfamethazine in the presence of sulfamerazine or sulfadiazine by first-derivative photochemically induced fluorescence.

A first-derivative photochemically-induced fluorescence method is proposed for the determination of sulfamethazine (SMTZ) in the presence of sulfamerazine (SMRZ) or sulfadiazine (SDZ). Linear calibration plots were obtained for SMTZ in SMTZ-SMRZ or SMTZ-SDZ binary mixtures with correlation coefficients larger than 0.999. For SMTZ the lower limits of detection were 7-13 ppb. Recoveries of 91-114% were obtained in the analysis of SMTZ in pharmaceutical formulations.

Host-guest stabilized room temperature phosphorescence in beta-cyclodextrin/ bromoalcohol solutions from 2-naphthyl-oxy-acetic acid and 1-naphthyl-acetic acid.

Room temperature phosphorescence (RTP) from 2-naphthyl-oxy-acetic acid (NOA) and 1-naphthyl-acetic acid (NAA), with stabilization by use of beta-cyclodextrin (beta-CD) as a host system, has been examined. 2-Bromoethanol and 2,3-dibromopropanol have been evaluated as external heavy atom perturbers to enhance the rate of intersystem crossing and, consequently, populating the triplet state for phosphorescence emission. The deoxygenation of the solutions was achieved chemically by use of sodium sulphite. The spectral characteristics of the phosphorescence emission from these relatively polar compounds and the optimization of the chemical variables involved are reported. The role of the bulkiness of the bromoalcohol employed, in comparison with the unoccupied space of the interior of the cyclodextrin cavity by the guest, is an important factor in the attainment of an effective RTP emission, and should be taken into account in the selection of the appropriate external heavy atom for the observation of RTP from other organic molecules of interest by this approach. 2,3-Dibromopropanol seems a more adequate bromoalcohol than 2-bromoethanol for the observation of RTP emission in the systems investigated.

Spectrofluorimetric determination of sulphonamides in pharmaceutical compounds and foods.

Spectrofluorimetry and room temperature photochemically-induced fluorescence (RTPF) have been applied to the determination of sulphacetamide (SAC), sulphaguanidine (SG) and sulphamethazine (SMT) in milk and pharmaceutical formulations. The methods are suitable for determining 0.02-0.10 micrograms ml of SAC, 0.10-0.50 micrograms ml of SG, and 0.40-1.00 micrograms of SMT.