Gaceta medica de Mexico最新文献

Background: Multisystem inflammatory syndrome in children (MIS-C) has not been described in southeastern Mexico.

Objective: To report the clinical and epidemiological aspects of MIS-C in a private hospital in Mérida, Yucatán.

Material and methods: Retrospective, descriptive, consecutive case series study in children under 18 years of age, treated from January 2021 to March 2024. Patients diagnosed with MIS-C were selected. Patients underwent PCR testing, serological testing, or had known exposure to a family member with COVID-19. Descriptive statistics were analyzed with the X² test.

Results: Seventy patients were included: 59 (84%) were hospitalized and 11 (16%) were followed up in the outpatient clinic, all with a diagnosis of MIS-C, median age 48 months (4-192), 44 (74.58%) were < 5 years old (p < 0.001) and predominance of males with 36 (61%). Of the hospitalized cases, 40 (67.79%) had the MIS-C phenotype and 19 (32.2%) had Kawasaki disease and MIS-C. MIS-C predominated in those aged ≤ 60 months. Gastrointestinal symptoms predominated in 68.5% of cases, and cardiovascular symptoms in 68.5%. There were 6 cases with coronary aneurysms (8.5%).

Conclusions: Cases were most frequent in those aged < 5 years, with gastrointestinal and cardiovascular symptoms predominating. The presence of coronary aneurysms was low.

Background: Invasive candidiasis is a high-impact pathology in the neonatal intensive care unit (NICU).

Objective: To evaluate risk factors for invasive candidiasis in a referral center in Mexico City.

Material and methods: Observational case control study. Neonates diagnosed with invasive candidiasis were included, matched 1:3 with controls hospitalized in the NICU of the National Institute of Perinatology in Mexico City between 2011 and 2021. Risk factors for invasive candidiasis were explored using logistic regression.

Results: Among 2640 patients hospitalized in the NICU, we identified 51 cases of invasive candidiasis, with a prevalence of 1.95% (95% CI: 1.44-2.53). Invasive candidiasis cases were premature with low birth weight and higher exposure to antimicrobials compared to controls (n = 153). The most frequently isolated pathogens of invasive candidiasis were Candida albicans (62.7%), Candida parapsilosis (25.5%) and Nakaseomyces glabratus (5.9%). In multivariate analysis, gestational age at birth < 28 weeks (OR, 2.79; 95% CI: 1.05-7.43) and use of three or more antimicrobials prior to blood culture positivity (OR, 2.83; 95% CI: 1.22-6.59) were identified as risk factors for the development of invasive candidiasis compared to controls.

Conclusions: Prematurity and higher exposure to multiple antimicrobial regimens increased the risk of invasive candidiasis in the NICU.

The prevalence of metabolic diseases in Mexicans has grown in recent decades, which increases the burden on the health system. The study of the genetics of metabolic diseases is a complex process resulting from an interaction between environmental and genetic factors. Although most genome-wide association studies for these diseases have focused on populations other than the Mexican population, genetic variants almost exclusive to populations with high Native American ancestry have been discovered, or those initially identified in different populations without Amerindian ancestry have been replicated. Therefore, the objective of this review is to present an overview of the genetics of Mexicans and their relationship with some of the most frequent metabolic diseases in this population, such as type 2 diabetes, gestational diabetes, diabetic neuropathy, obesity, and dyslipidemias.

Background: The Prognostic Nutritional Index (PNI) as a prognostic tool for the postoperative outcomes in patients undergoing thoracic surgery due to an infectious etiology remains unexplored.

Objective: To evaluate the PNI as predictor of poor postoperative outcomes in patients undergoing surgery for a thoracic infection.

Material and methods: A retrospective analysis in patients undergoing VATS during January 2019 to December 2023, including 61 patients. We performed a ROC curve analysis to identify the optimal PNI cut-off value to classify the patients into groups: A high (HR) and low-risk (LR) group. Chi-square, Fisher exact, and Mann-Whitney tests were used to compare them. A multivariate analysis with Cox regression was also performed.

Results: The optimal PNI cut-off value was 28.69, with AUC 0.860 (p = 0.001), sensitivity 88.9%, specificity 78.8%. 42 patients were low-risk, while 19 high-risk. There was a significant difference in 30-day mortality between groups (HR 42% vs LR 2%, p < 0.001) as well as in 30-day major complications (HR 68% vs LR 16%, p < 0.001). A multivariate analysis revealed that PNI-based risk group was an independent predictor of mortality (p = 0.008) and major complications (p < 0.001).

Conclusions: The PNI is a valid predictor of poor postoperative outcomes in patients undergoing VATS for a thoracic infection.