Gaceta medica de Mexico最新文献

Prediabetes is a condition that precedes diabetes with similar damage mechanisms but different diagnostic criteria. In prediabetes, there are certain promoting factors that encourage its development and once established, they favor the progression of comorbidity, especially cardiovascular. Excessive body weight is a main risk factor, usually part of prediabetes so it is recommended to implement lifestyle changes to prevent the development of diabetes, or even get to revert to normoglycemia. This may be possible if there is an adequate identification of risk factors and screening to establish individualized modifications and avoid associated complications. Prediabetes should not be underestimated, since it is part of the diabetes spectrum, and in the long term it has repercussions on quality and life expectancy. This document proposes 10 basic guidelines to broaden the vision of this entity, identifying in which cases there is a probability of remission, related damage mechanisms, risk factors, macrovascular complications that it entails, start of screening, diagnostic criteria, recommendations for lifestyle changes, and pharmacological and non-pharmacological treatment options.

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.

Background: Antibiotic resistance in Klebsiella pneumoniae poses an increasing risk to human health worldwide.

Objectives: Whole-genome sequence data were used to characterize K. pneumoniae phage-plasmids isolated in different countries.

Materials and methods: Sequences of 15 genetically similar phage-plasmids were selected based on BLASTN analysis. Antibiotic resistance genes were screened using ResFinder, PhageAI, PlasmidFinder, PHASTEST, and PhageGE tools. Phage-plasmid sequences were then analyzed for a stable region in the genome using MAUVE analysis, and the protein of this stable region and its candidate inhibitor molecule were analyzed through molecular docking studies.

Results: Several resistance genes were detected in 7 of the 15 phage-plasmids screened. All plasmids had the Salmonella SSU5 prophage. MAUVE analysis indicated a common stable region encoding replication protein A. Molecular docking studies demonstrated that an interaction occurs between replication protein A and a fabimycin derivative.

Conclusion: Fabimycin could be used to control both phage plasmids and their host, which could affect the severity and incidence of K. pneumoniae infections.