Derivation and validation of sex-specific continuous metabolic syndrome scores for the Mexican adult population.

Traditionally the diagnosis of Metabolic syndrome (MetS) is binary (present/absent). The goal of this work is to propose a sex-specific continuous score to measure the severity of MetS in Mexican adults using waist circumference and body mass index as adiposity measures. MetSx-WC and MetSx-BMI indexes by sex were derived by confirmatory factor analysis (CFA) using data for 6567 adult participants of the National Health and Nutrition Survey 2018. The overall fit of the two proposed CFA models was excellent. We then validated these scores using a community-based health study of 862 university participants and determined that the reliability and strength of agreement between the MetSx-WC and MetSx-BMI scores were excellent. The ROC analysis of the resulting indexes indicates that they have excellent ability to discriminate a MetS classification according to the different criteria. The correlations of MetSx scores and surrogate markers of insulin resistance and obesity ranged from weak to strong. Subsequently, a retrospective study of 310 hospitalized patients with COVID-19 was used to determined that MetSx-BMI score was associated with the mortality of patients with COVID-19. The proposed indices provide a continuous measure in the identification of MetS risk in Mexican adults.

Epidemiological and Clinical Characteristics of Hospitalized Pediatric Patients with SARS-CoV-2 Infection in Mexico City, Mexico.

Background: Evidence from across the world suggests that the pediatric population shows different clinical manifestations and has a lower risk of severe presentation of SARS-CoV-2 infection compared to adults. However, Mexico has one of the highest mortality rates in the pediatric population due to SARS-CoV-2 infection. Therefore, our objective was to explore the epidemiological and clinical characteristics associated with a positive confirmatory test in the Mexican pediatric population admitted to a tertiary care hospital in Mexico City. Methods: Clinical, imaging and laboratory data were retrospectively collected from 121 children hospitalized during the period from March 4th, 2020, to August 8th, 2021. The patients were identified as suspicious cases according to the guidelines of the General Directorate of Epidemiology of Mexico. Real-time polymerase chain reaction (RT-PCR) tests were used to confirm SARS-CoV-2 infection. Categorical variables were compared using the Chi-square test, and propensity score matching was performed to determine univariate and multivariate odds ratios of the population regarding a positive vs. negative SARS-CoV-2 result. Results: Of the 121 children, 36 had laboratory-confirmed SARS-CoV-2 infection. The main risk for SARS-CoV-2-associated pediatric hospitalization was contact with a family member with SARS-CoV-2. It was also found that fever and fatigue were statistically significantly associated with a positive SARS-CoV-2 test in multivariate models. Clinical and laboratory data in this Mexican hospitalized pediatric cohort differ from other reports worldwide; the mortality rate (1.6%) of the population studied was higher than that seen in reports from other countries. Conclusion: Our study found that fever and fatigue at hospital presentation as well as an antecedent exposure to a family member with SARS-CoV-2 infection were important risk factors for SARS-CoV-2 positivity in children at hospital admission.

Interaction of metabolic dysfunction-associated fatty liver disease and nonalcoholic fatty liver disease with advanced fibrosis in the death and intubation of patients hospitalized with coronavirus disease 2019.

Patients with pre-existing liver diseases are considered to have an increased risk of morbidity and mortality from any type of infection, including viruses. The aim of this work was to explore the implications of metabolic dysfunction-associated fatty liver disease (MAFLD) and nonalcoholic fatty liver disease (NAFLD) definitions in coronavirus disease 2019 (COVID-19) and to study the interaction between advanced fibrosis (AF) and each of these diseases in the death and intubation of patients hospitalized with COVID-19. We performed a retrospective study with 359 patients hospitalized with confirmed COVID-19 infection in a tertiary referral hospital who were admitted between April and June 2020. A multivariate Cox model was performed regarding the interaction of AF with MAFLD and NAFLD in the mortality and intubation of patients with COVID-19. The death rate was statistically significantly higher in the MAFLD group compared to the control group (55% vs. 38.3%, p = 0.02). No significant difference was seen in the death rate between the NAFLD and control group. The MAFLD (44.09% vs. 20%, p = 0.001) and NAFLD (40.51% vs. 20%, p = 0.01) groups had statistically significantly higher intubation rates than the control group. A statistically significant interaction between NAFLD and AF was associated with an increase in mortality (p = 0.01), while a statistically significant interaction between MAFLD and AF was associated with an increased risk of mortality (p = 0.006) and intubation (p = 0.049). In the case of patients hospitalized with COVID-19, our results indicate that the death rate was higher in the MAFLD group but not the NAFLD group compared to that in the control group. The intubation rates were higher in the NAFLD and MAFLD groups compared to rates in the control group, suggesting that both could be associated with COVID-19 severity. In addition, we found interactions between AF with MAFLD and NAFLD.

Association of ABO blood type with mortality in hospitalized patients with COVID-19 / Asociación de los grupos sanguíneos ABO con la mortalidad en pacientes hospitalizados por COVID-19

Abstract Objective: To explore the relation between ABO blood group system and in-hospital mortality in Mexican patients admitted with COVID-19. Materials and methods: We performed a retrospective study with 2,369 hospitalized patients with confirmed SARS-CoV-2 infection in a tertiary referral hospital, admitted between March 27 and December 10, 2020. Data were obtained from electronic health records. Adjusted and unadjusted Cox Proportional-Hazard models were performed to test the association of ABO blood groups with mortality of COVID-19 patients. The variables considered for adjustment of the models were age, sex, and main comorbidities. Results: Out of all studied patients, group O was the most frequent blood type with 1999 patients (84.3%), followed by group A (11.3%), B (3.5%) and AB (0.72%). Blood group A was associated with a lower hazard of death among COVID-19 patients compared with group O (adjusted HR = 0.72, 95% IC 0.55-0.95, P = 0.02. Groups B, AB and Positive Rh were not significantly associated with the outcome. Conclusions: We found evidence of a statistically significant association between ABO blood type and COVID-19 in-hospital death. Patients with blood group A may be less likely to die during hospitalization compared with group O.

Resumen Objetivo: Explorar la relación entre los grupos sanguíneos del sistema ABO y la mortalidad hospitalaria en pacientes mexicanos ingresados por COVID-19. Materiales y métodos: Se realizó un estudio retrospectivo con 2,369 pacientes hospitalizados con infección confirmada por SARS-CoV-2 en un hospital de tercer nivel, ingresados del 27 de marzo al 10 de diciembre del 2020, los datos fueron obtenidos del expediente clínico digital del hospital. Se realizaron modelos de Riesgos-Proporcionales de Cox ajustados y no ajustados para evaluar la asociación de los grupos sanguíneos ABO con la mortalidad hospitalaria de los pacientes COVID-19. Las variables consideradas en el modelo ajustado fueron edad, sexo y principales comorbilidades. Resultados: De todos los pacientes estudiados, el grupo O fue el más frecuente con 1999 pacientes (84.3%), seguido por el grupo A (11.3%), B (3.5%) y AB (0.72%). El grupo sanguíneo A se asoció a menor riesgo de muerte entre pacientes con COVID-19 comparado con el grupo O (HR ajustado = 0.72, IC 95% 0.55-0.95, valor de P = 0.02). Los grupos B, AB y Rh positivo no se asociaron significativamente con el desenlace. Conclusiones: Encontramos evidencia de una asociación estadísticamente significativa entre los grupos sanguíneos ABO y la muerte por COVID-19 en pacientes hospitalizados. El grupo A podría ser menos susceptible a morir durante la hospitalización respecto al grupo O.

Relación de la expresión génica de IP-10 con la actividad del lupus eritematoso sistémico / Relationship of IP-10 gene expression to systemic lupus erythematosus activity

Objetivo: Evaluar la expresión génica del gen IP-10 en pacientes con lupus eritematoso sistémico (LES) y su posible relación con la actividad de la enfermedad. Pacientes y métodos: El estudio incluyó 120 pacientes diagnosticados con LES y 30 controles sanos. Se investigó la expresión génica relativa de IP-10 con el método fold change, la cual fue correlacionada con el nivel de actividad lúpica evaluado con el instrumento SLEDAI 2-K. Resultados: Se encontraron diferentes niveles en la expresión génica de IP-10 relacionada con la actividad lúpica (p =<0,001). Estos fueron mayores en los pacientes con actividad grave respecto a aquellos sin actividad, baja y moderada. El incremento en la expresión génica del grupo con actividad grave fue significativo con un fold change de tres. Conclusión: El incremento significativo en la expresión génica relativa IP-10 puede ser un marcador de actividad lúpica grave.(AU)

Objectives: To evaluate IP-10 gene expression in patients with SLE, and its possible relationship with disease activity. Patients and methods: This study included 120 patients diagnosed with SLE and 30 healthy controls. The relative gene expression of IP-10 was investigated with the Fold Change method, which was correlated with the level of lupus activity evaluated with the SLEDAI 2-K instrument. Results: Different levels of gene expression were found according to the SLE activity (p =<0.001). IP-10 gene expression levels were higher in patients with severe activity than in those with no activity, low activity, and moderate activity. The increase in gene expression in the severe activity group was significant with a Fold Change of 3. Conclusion: The significant increase in relative gene expression IP-10 may be a marker of severe lupus activity.(AU)

Initial Histological Evaluation of a Novel Dura Mater Graft Based on Capsule Granulation Harvested From Subcutaneous Tissue: Experimental Model.

INTRODUCTION: Autografts are useful but unfortunately are limited in big dural defects, in such cases, synthetic implants have been recommended. Extensive evidence in the literature suggests that sometimes synthetic implants had high rates of complications like infections. This paper aims to present a novel dura matter graft based on capsule granulation tissue harvested from subcutaneous space as a dura substitute and its histological findings. MATERIALS AND METHODS: Wistar rats between 240 and 430 grams of both genders were included. First stage procedure introducing silicon spheres in the subcutaneous tissue. Second stage procedure 4 weeks later harvested de capsule granulation tissue that contain them. Then a craniectomy was performed to create a dura mater defect. This defect was reconstructed with the granulation tissue was placed onlay the defect. After another 4 weeks the subjects were euthanized and sent to an external pathology unit for analysis with validated integration scales. RESULTS: A total of 5 subjects were included (3 males and 2 females) with weight between 240 and 430 grams. Only 2 outcome out of 6 scales had significance difference between the samples: adhesions P = 0.011 and integration P = 0.006. CONCLUSIONS: The histological findings shown that capsule granulation graft is a compatible, autologous compatible substitute for dura mater. It has a great potential of full integration and an acceptable grade of adhesions.

Evaluation of Predictive Values of an Automatic Device Measuring Oximetry in Free Flaps.

Free-flap monitoring is challenging to perform in some centers. It requires the availability of trained health care personnel for 24 hours a day and seven days a week. Many methods had been proposed for flap monitoring, and none of them are superior to clinical evaluation. This study aimed to present a murine model to evaluate the accuracy (sensitivity, specificity, and the positive or negative predictive values) of a device. Wistar rats weighing 240-490 g were included for intervention and data collection. A murine model of left inferior epigastric vessel flaps was implemented. Intermittent pedicle clamping was performed to calculate the accuracy of the device that detects flow obstruction. The general variables studied were age, weight, and gender. The sensitivity, specificity, and negative or predictive values were calculated. The results showed a sensitivity of 97%, a specificity of 95% with a positive predictive value of 95%, and negative predictive value of 97%. The sensitivity and specificity showed excellent results within the range of clinical security. We require more data to analyze the multiparameter monitoring to see if it is feasible and cost-effective.

Lactate-dehydrogenase associated with mortality in hospitalized patients with COVID-19 in Mexico: a multi-centre retrospective cohort study.

INTRODUCTION AND OBJECTIVES: As of January 2021, over 88 million people have been infected with COVID-19. Almost two million people have died of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A high SOFA score and a D-Dimer >1 µg/mL identifies patients with high risk of mortality. High lactate dehydrogenase (LDH) levels on admission are associated with severity and mortality. Different degrees of alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) abnormalities have been reported in these patients, its association with a mortality risk remains controversial. The aim of this study was to explore the correlation between LDH and in-hospital mortality in Mexican patients admitted with COVID-19. MATERIALS & METHODS: We performed a retrospective multi-centre cohort study with 377 hospitalized patients with confirmed SARS-CoV-2 in three centres in Mexico City, Mexico, who were ≥18 years old and died or were discharged between April 1 and May 31, 2020. RESULTS: A total of 377 patients were evaluated, 298 (79.1%) patients were discharged, and 79 (20.9%) patients died during hospitalization. Non-survivors were older, with a median age of 46.7 ± 25.7 years old, most patients were male. An ALT > 61 U/l (OR 3.45, 95% CI 1.27-9.37; p = 0.015), C-reactive protein (CRP) > 231 mg/l (OR 4.71, 95% CI 2.35-9.46; p = 0.000), LDH > 561 U/l (OR 3.03, 95% CI 1.40-6.55; p = 0.005) were associated with higher odds for in-hospital death. CONCLUSIONS: Our results indicate that higher levels of LDH, CRP, and ALT are associated with higher in-hospital mortality risk in Mexican patients admitted with COVID-19.

Relationship of IP-10 gene expression to systemic lupus erythematosus activity. / Relación de la expresión génica de IP-10 con la actividad del lupus eritematoso sistémico.

OBJECTIVES: To evaluate IP-10 gene expression in patients with SLE, and its possible relationship with disease activity. PATIENTS AND METHODS: This study included 120 patients diagnosed with SLE and 30 healthy controls. The relative gene expression of IP-10 was investigated with the Fold Change method, which was correlated with the level of lupus activity evaluated with the SLEDAI 2-K instrument. RESULTS: Different levels of gene expression were found according to the SLE activity (p =<0.001). IP-10 gene expression levels were higher in patients with severe activity than in those with no activity, low activity, and moderate activity. The increase in gene expression in the severe activity group was significant with a Fold Change of 3. CONCLUSION: The significant increase in relative gene expression IP-10 may be a marker of severe lupus activity.