Prevalencia de secuelas en pacientes con diabetes mellitus tipo 2 sobrevivientes al COVID-19

Objective: To assess whether there is an association between the prevalence of sequelae due to COVID-19 and type 2 diabetes mellitus. Material and methods: Cross-sectional analytical design. A structured questionnaire, validated by experts, was applied by telephone to patients who had been discharged for at least three months, and clinical data was obtained from their medical records. An informed consent was applied. Results: 52% were male (p=0,5); the median age was 57 years (IQR: 21), and the time between discharge and interview was 9 months. The severity of COVID-19 was: moderate 51%, severe 38%, critical 9%; diabetics 23,75% (p<0,05). An association was found between general sequelae and diabetes (OR=3,04, CI95%: 1,51-6,13, p: 0,001, RPa: 2,4), followed by cardiovascular sequelae (OR=2,91, CI95%: 1,57-5,38, p: 0,000, RPa: 2,1). Of the 57 diabetics, 85,9% had sequelae due to COVID-19; and of the 183 non-diabetics, 68,3% (p: 0,009, OR: 2,84, 95% CI: 1,26-6,38, PRc: 2,32). Conclusions: The prevalence of sequelae due to COVID-19 was higher in diabetic patients than in non-diabetic patients; the most frequent type of sequelae was fatigue.Objetivo: Evaluar si existe asociación entre la prevalencia de secuelas por COVID-19 y diabetes mellitus tipo 2. Material y métodos: Diseño analítico trasversal. Se aplicó por teléfono un cuestionario estructurado, validado por expertos, a pacientes con al menos tres meses de alta y se obtuvieron datos clínicos de sus historias clínicas. Se aplicó un consentimiento informado. Resultados: El 52% fueron varones (p=0,5); la mediana de edad 57 años(RIC:21), y el tiempo entre alta y entrevista fue 9 meses. La severidad de COVID-19 fue: moderado 51%, grave 38%, critico 9%; diabéticos 23,75% (p<0,05). Se halló asociación entre secuelas generales y diabetes (OR=3,04, IC95%: 1,51-6,13, p:0,001, RPa:2,4), seguida por secuelas cardiovasculares (OR=2,91, IC95%: 1,57-5,38, p:0,000, RPa:2,1). De los 57 diabéticos, 85,9% hicieron secuelas por COVID-19; y de los 183 no diabéticos, el 68,3% (p: 0,009, OR:2,84, IC95%:1,26-6,38, RPc:2,32). Conclusiones: La prevalencia de secuelas por COVID-19 fue mayor en pacientes diabéticos que en los no diabéticos; el tipo de secuelas más frecuente fue fatiga

Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort

Background: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. Methods: We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. Results: Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). Conclusions: In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes

Antibodies against endogenous retroviruses promote lung cancer immunotherapy

B cells are frequently found in the margins of solid tumours as organized follicles in ectopic lymphoid organs called tertiary lymphoid structures (TLS). Although TLS have been found to correlate with improved patient survival and response to immune checkpoint blockade (ICB), the underlying mechanisms of this association remain elusive. Here we investigate lung-resident B cell responses in patients from the TRACERx 421 (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy) and other lung cancer cohorts, and in a recently established immunogenic mouse model for lung adenocarcinoma. We find that both human and mouse lung adenocarcinomas elicit local germinal centre responses and tumour-binding antibodies, and further identify endogenous retrovirus (ERV) envelope glycoproteins as a dominant anti-tumour antibody target. ERV-targeting B cell responses are amplified by ICB in both humans and mice, and by targeted inhibition of KRAS(G12C) in the mouse model. ERV-reactive antibodies exert anti-tumour activity that extends survival in the mouse model, and ERV expression predicts the outcome of ICB in human lung adenocarcinoma. Finally, we find that effective immunotherapy in the mouse model requires CXCL13-dependent TLS formation. Conversely, therapeutic CXCL13 treatment potentiates anti-tumour immunity and synergizes with ICB. Our findings provide a possible mechanistic basis for the association of TLS with immunotherapy response

Ejercicio, Obesidad y Sindrome Metabólico

Los bajos niveles de actividad física y/o ejercicio, junto a los malos hábitos alimentarios presentes a nivel nacional e internacional, han traído consigo una serie de complicaciones y/o morbilidades que han provocado un importante aumento de las tasas de mortalidad por enfermedades adquiridas, muchas de ellas ligadas a esta malnutrición por exceso y sedentarismo, descritos en encuestas nacionales e internacionales. La falta de movimiento es extrema en la población chilena y mundial, cada día la industria desarrolla elementos que buscan disminuir la ejecución de ejercicio físico, lo que se refleja de cierta manera en las encuestas ejecutadas, donde las tasas de inactividad física son elevadísimas, tanto en adultos como en niños, ya sean estos hombres o mujeres. Esto, sumado a los elevados niveles de obesidad, hace que enfoquemos nuestra atención al desarrollo de un tratamiento que combata estos dos factores de riesgo de manera paralela, pues en la ecuación de Balance Energético un 50% de ella corresponde a la ingesta y un 50% al gasto de energía. Los elevados niveles de sobrepeso y obesidad de nuestra realidad chilena (60% de la población), son la evidencia de un balance energético positivo provocado por una mayor ingesta de alimentos y un menor gasto en actividad física lo que ha llevado a que aumente progresivamente el Síndrome Metabólico y las ECNT en nuestra población

Hydration with different beverages and their impact on performance in a raid of two hours of spinning

El Spinning es una actividad que se realiza sobre una bicicleta estática al ritmo de la música. Si bien, este tipo de actividades no está relacionada con el rendimiento deportivo, y debido a la naturaleza de las bicicletas empleadas, se desconoce aspectos como la potencia, velocidad o distancia recorrida en una clase o raids de mayor duración. Por otra parte, la hidratación durante la actividad física es un elemento importante sobre todo cuando se desarrollan actividades de más de una hora de duración. Fue el propósito de esta investigación el cuantificar el rendimiento a través de la distancia recorrida en un raid de spinning de dos horas de duración y determinar el efecto de la hidratación con diferentes bebidas sobre el rendimiento. 10 sujetos (5 hombres y 5 mujeres) fueron sometidos a 4 raid de dos horas de spinning espaciados por 7 días cada uno. Bebieron ad libitum; agua, bebida con carbohidratos (6%), agua con saborizante y nuevamente agua. La distancia recorrida promedio de los 4 raids fue de 42,05±1,68 km. La distancia recorrida para el primer raid fue de 40,62±4,37 km, para el segundo raid fue de 44,31±4,02 km, para el tercer raid fue de 42,34±4,66 km, para el cuarto raid fue de 40,93±3,97 km. Hubo diferencia significativa entre el 1er y 2° raid (p<0,05) y entre el 2° y 4° raid (p<0,05). No hubo diferencia significativa en la frecuencia cardiaca promedio de los 4 raids. En conclusión, en un raid de spinning de dos horas, consumir una bebida con hidratos de carbono mejora el desempeño, valorado a través de la distancia recorrida, en comparación a la ingesta de agua.The Spinning is an activity that is performed on a bicycle to the beat. While this type of activity is not related to sporting performance, and because of the nature of bicycles used are not known areas such as power, speed or distance in a class or longer raids. Furthermore, the hydration during physical activity is an important component especially in activities over an hour. It was the purpose of this research to quantify the performance across the distance in a two-hour spinning raid and determine the effect of different beverages on hydration and performance. 10 subjects (5 males and 5 females) were subjected to 4 two hours spinning raid spaced 7 days each. Drinking ad libitum; water, drink with carbohydrates (6%), flavored water (without calories) and water again. The average distance from 4 raids was 42.05 ± 1.68 km. The distance for the first raid was 40.62 ± 4.37 km, for the second raid was 44.31 ± 4.02 km, for the third raid was 42.34 ± 4.66 km, and for the fourth raid was 40.93 ± 3.97 km. There was significant difference between the 1st and 2 ° raid (p <0.05) and between 2 ° and 4 ° raid (p <0.05). There was no significant difference in heart rate average of 4 raids. In conclusion, in a spinning two hours raid, consume a drink with carbohydrate improves performance, as assessed by the distance travelled, compared to the intake of water alone.Sin financiaciónNo data 200

Estimation of the Aerobic-anaerobic Transition by Heart Rate Variability in Athletes and Non-athletes Subjects

Background: The estimate of aerobic-anaerobic threshold is commonly used for exercise prescription in athletes and non-athletes subjects; however, the methods currently used are expensive, and some of them use invasive techniques. The analysis of changes in heart rate variability during exercise may contribute to the introduction of a novel methodology to estimate the aerobic-anaerobic metabolic transition. Objective: The purpose of this study was to estimate the heart rate variability threshold (HRVT) through the Discrete Wavelet Transform (DWT) and compare the exercise intensities at which this happens to the moment when the aerobic-anaerobic metabolic transition occurs, estimated by the ventilatory threshold 2 (VT2) in athletes and non-athletes. Methods: 24 male subjects were enrolled (12 athletes; 12 non-athletes). Ventilatory parameters and R-R intervals were recorded breath by breath in a maximal incremental intensity exercise. HRVT was estimated through DWT and the VT2 was determined by 5 indicators: respiratory quotient ≥1.0, non-linear increase of the VE and VCO2, decrease of the PETCO2 and increase of the PETO2. Reserve heart rate frequency percentages (%RHRF) are determined, compared and correlated to VT2 (%RHRF-VT2) and HRVT (%RHRF-HRVT). We used a significance level of p<0.05 for all our analysis. Results: The results showed that there is no significant difference between the %RHRF-VT and %RHRF-HRVT in the assessed subject groups (total, athletes, non-athletes). There is a correlation between %RHRF-VT and %RHRF-HRVT in the whole group (r=0.91; p<0.001), athletes (r=0.84; p<0,001) and non-athletes (r=0.88; p<0,001). Conclusion: We conclude that the aerobic-anaerobic metabolic transition (i.e. VT2) during an incremental maximal exercise can be estimated through the HRVT measured by the DWT in athletes and non-athletes. Keywords: non-linear analysis, anaerobic threshold, exercise tes

Estimation of the Aerobic-anaerobic Transition by Heart Rate Variability in Athletes and Non-athletes Subjects

Background: The estimate of aerobic-anaerobic threshold is commonly used for exercise prescription in athletes and non-athletes subjects; however, the methods currently used are expensive, and some of them use invasive techniques. The analysis of changes in heart rate variability during exercise may contribute to the introduction of a novel methodology to estimate the aerobic-anaerobic metabolic transition. Objective: The purpose of this study was to estimate the heart rate variability threshold (HRVT) through the Discrete Wavelet Transform (DWT) and compare the exercise intensities at which this happens to the moment when the aerobic-anaerobic metabolic transition occurs, estimated by the ventilatory threshold 2 (VT2) in athletes and non-athletes. Methods: 24 male subjects were enrolled (12 athletes; 12 non-athletes). Ventilatory parameters and R-R intervals were recorded breath by breath in a maximal incremental intensity exercise. HRVT was estimated through DWT and the VT2 was determined by 5 indicators: respiratory quotient ≥1.0, non-linear increase of the VE and VCO2, decrease of the PETCO2 and increase of the PETO2. Reserve heart rate frequency percentages (%RHRF) are determined, compared and correlated to VT2 (%RHRF-VT2) and HRVT (%RHRF-HRVT). We used a significance level of p0.05 for all our analysis. Results: The results showed that there is no significant difference between the %RHRF-VT and %RHRF-HRVT in the assessed subject groups (total, athletes, non-athletes). There is a correlation between %RHRF-VT and %RHRF-HRVT in the whole group (r=0.91; p0.001), athletes (r=0.84; p0,001) and non-athletes (r=0.88; p0,001). Conclusion: We conclude that the aerobic-anaerobic metabolic transition (i.e. VT2) during an incremental maximal exercise can be estimated through the HRVT measured by the DWT in athletes and non-athletes.Keywords: non-linear analysis, anaerobic threshold, exercise tes