10 research outputs found

    Punto de corte de circunferencia braquial media: importancia obstétrica y neonatal

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    Introducción: La preeclampsia es un trastorno multisis- témico que se encuentra entre las principales causas de morbi-mortalidad materna durante la gestación, la obe- sidad es uno de los factores que interviene en la siopa- tología de esta alteración vascular. Por lo cual el objetivo de este estudio es evaluar el comportamiento del Índice de Masa Corporal (IMC) y la Circunferencia Braquial Me- dia (CBM) en pacientes preclámpticas ingresadas en la Maternidad Enrique C. Sotomayor de la ciudad de Guaya- quil, así como establecer un punto de corte del parámetro más relacionado con la preeclampsia. Materiales y Métodos: Se realizó un estudio caso-con- trol, aleatorio, en 30 mujeres sin preeclampsia y 30 con preeclampsia ingresadas en la Maternidad Enrique C. So- tomayor de la ciudad de Guayaquil, Ecuador, 2010. Se realizó una Curva COR para determinar el punto de corte de CBM para preeclampsia. Asimismo se realizó un mod- elo de regresión logística múltiple para factores asociados a complicación neonatal. Resultados: Las mujeres preeclámpticas presentaron va- lores más altos de CBM (30,3cm); p<0.0001. El punto de corte seleccionado para el diagnóstico de preeclampsia fue 27,5cm con un ABC=0,898 (sensibilidad: 90%; espe- ci cidad: 83,3%). La CBM alta fue el factor más asociado con la presencia de complicación neonatal (OR: 5,13; IC95%: 1,04-25,39; p=0,04). Conclusiones: Se sugiere medir la CBM en la paciente gestante para la valoración de obesidad, siendo 27,5cm el punto de corte a partir del cual hay una mayor relación con preeclampsia y complicaciones neonatales como bajo peso al nacer.&nbsp

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

    De Madrid a Santiago: retos y oportunidades : balances y perspectivas de las relaciones entre la Unión Europea y América Latina y el Caribe

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    En momentos de incertidumbre y de perplejidad como el que vivimos, conviene replegarse hasta el terreno de las certezas, por básicas que nos parezcan estas. En ese sentido y hablando de las relaciones entre Europa y América Latina, el punto de partida debe ser entonces que estas relaciones son antiguas, profundas, ricas, complejas y, en todos los sentidos, vivas y vibrantes. Lo son hoy y han sido así durante al menos los últimos cinco siglos, más allá de las coyunturas a uno y otro lado del Atlántico, más allá de las vicisitudes de la política local y de la geopolítica internacional

    Interethnic Variability in CYP2D6, CYP2C9, and CYP2C19 Genes and Predicted Drug Metabolism Phenotypes Among 6060 Ibero- and Native Americans: RIBEF-CEIBA Consortium Report on Population Pharmacogenomics

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    Pharmacogenetic variation in Latin Americans is understudied, which sets a barrier for the goal of global precision medicine. The RIBEF-CEIBA Network Consortium was established to characterize interindividual and between population variations in CYP2D6, CYP2C9, and CYP2C19 drug metabolizing enzyme genotypes, which were subsequently utilized to catalog their "predicted drug metabolism phenotypes" across Native American and Ibero American populations. Importantly, we report in this study, a total of 6060 healthy individuals from Ibero-America who were classified according to their self-reported ancestry: 1395 Native Americans, 2571 Admixed Latin Americans, 96 Afro-Latin Americans, 287 white Latin Americans (from Cuba), 1537 Iberians, and 174 Argentinean Ashkenazi Jews. Moreover, Native Americans were grouped into North-, Central-, and South Amerindians (from Mexico, Costa Rica, and Peru, respectively). All subjects were studied for the most common and functional CYP2D6, CYP2C9, and CYP2C19 allelic variants, and grouped as genotype-predicted poor or ultrarapid metabolizer phenotypes (gPMs and gUMs, respectively). Native Americans showed differences from each ethnic group in at least two alleles of CYP2D6, CYP2C9, and CYP2C19. Native Americans had higher frequencies of wild-type alleles for all genes, and lower frequency of CYP2D6*41, CYP2C9*2, and CYP2C19*17 (p < 0.05). Native Americans also showed less CYP2C19 gUMs than the rest of the population sample. In addition, differences within Native Americans (mostly North vs. South) were also found. The interethnic differences described supports the need for population-specific personalized and precision medicine programs for Native Americans. To the best of our knowledge, this is the largest study carried out in Native Americans and other Ibero-American populations analyzing CYP2D6, CYP2C9, and CYP2C19 genetic polymorphisms. Population pharmacogenomics is a nascent field of global health and warrants further research and education

    Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network.

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    AimThis report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico.Material and methodsA total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes.ResultsAmong blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each).ConclusionOur study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae

    Memorias del primer Simposio Nacional de Ciencias Agronómicas

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    Primer simposio nacional de Ciencias Agronómicas: El renacer del espacio de discusión científica para el Agro colombiano

    Memorias del primer Simposio Nacional de Ciencias Agronómicas

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    Primer simposio nacional de Ciencias Agronómicas: El renacer del espacio de discusión científica para el Agro colombiano

    Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain

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