Gaceta medica de Mexico最新文献

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.

Background: Non-alcoholic fatty liver disease (NAFLD) affects 9-18% of the general pediatric population, and 41-53% of obese children, with a higher risk in the Hispanic population.

Objective: To determine the prevalence of suspected NAFLD in pediatric patients.

Material and methods: A retrospective study of pediatric medical records, including anthropometric and biochemical data. Suspicion of NAFLD was assessed using body mass index (BMI) for age, the triglyceride-glucose (TyG) index, and the hepatic steatosis index (HSI).

Results: 240 medical records were analyzed. The prevalence of suspected NAFLD based on BMI was 68.3%, using TyG was 62.5%, and using HSI, evaluated in 32 patients with complete laboratory data, was 31%. The age was of 14 years-old (11-16), with 59.6% female patients, weight 61 ± 17.4 kg, height 156.0 ± 11.7 cm, BMI 24.7 ± 5.4 kg/m², and BMI-for-age 92.6% (69.5-97.1%). 2.5% patients were underweighted, 34.2% had normal weight, 22.9% were overweight, 25.4% had obesity, and 15% had severe obesity.

Conclusions: The prevalence of overweight and obesity was 22.9% and 40.4%, respectively. The suspicion of NAFLD was higher than other cohorts.

Background: Limited information is available regarding the risk factors and microorganisms associated with healthcare-associated pneumonia (HCAP) in patients with Guillain-Barré syndrome (GBS).

Objective: To analyze the clinical factors related to HCAP and identify the predominant microorganisms.

Materials and methods: A cross-sectional study was conducted on patients with GBS treated between March 2020 and June 2022. HCAP was defined based on clinical, radiological, or laboratory findings after 48 hours of hospitalization. Risk factors were analyzed using a multivariable model, expressed as odds ratios (OR) with 95% confidence intervals (95% CI). Model performance was evaluated using the area under the curve (AUC) analysis.

Results: A total of 134 patients were included, 75.4% of whom were male, with a mean age of 44.7 years. Mechanical invasive ventilation (MIV) was required in 28.4% of cases, and 18.6% developed nosocomial pneumonia. Significant risk factors included an MRC score ≤ 20 (OR, 5.5; 95% CI, 1.5-20.1; p = 0.009) and the use of MIV (OR, 95; 95% CI, 12-749; p < 0.001). The model demonstrated an AUC of 0.94 (95% CI, 0.90-0.98; p < 0.001). The most frequently isolated microorgan-isms were Staphylococcus aureus (52%) and Pseudomonas aeruginosa (13%).

Conclusions: An MRC score ≤ 20 and the use of MIV are risk factors for HCAP in patients with GBS. S. aureus was the predominant microorganism.

Michael Servetus, a 16th-century Spanish physician and theologian, is considered one of the precursors of the discovery of pulmonary circulation. In his work Christianismi Restitutio (1553), Servetus accurately described the circulation of blood from the heart to the lungs and vice versa, thus anticipating William Harvey's theory on blood circulation. Although Servetus was a passionate theologian and his main work has a strong religious component, his contribution to medicine is undeniable. His description of the pulmonary circulation demonstrates a deep understanding of human physiology and laid the groundwork for future research in the field of cardiology. Importantly, Servetus' work not only represents a contribution to medicine, but also a reflection of his search for truth and his desire to understand divine creation.

Type 2 diabetes (T2DM) is a public health problem and the second leading cause of death in Mexico. More than 20 years after the human genome project was completed, the development of innovative technologies and methodologies to determine the genetic risk factors that predispose an individual to develop this and other pathologies, have made the implementation of genomic medicine as part of clinical practice become a reality. Although in Mexico genomic studies are still in the beginning, these have generated knowledge about the etiopathogenesis of T2DM. In this review, we will address genomic knowledge applications in clinical practice, as well as the advances in the genomics of T2DM in Mexico.