Pub Date : 2025-03-11DOI: 10.1016/j.arcmed.2025.103205
Magdalena Budzyń , Agata Kubicka , Elżbieta Kaja , Witold Kycler , Joanna Załuska-Kusz , Jacek J. Brzeziński , Marcelina Sperling , Alicja Bukowska , Joanna Grupińska
Background
The monocyte CCR2-CCL2 axis appears to play a crucial role in the generation of tumor-associated macrophages (TAMs), which subsequently promotes tumor metastasis and resistance to therapy.
Aims
Our study assessed the monocyte CCR2-CCL2 axis in triple-negative breast cancer (TNBC) and its ability to predict tumor response to neoadjuvant chemotherapy (NAC).
Methods
The study included 42 female patients diagnosed with TNBC and eligible for NAC. Response to neoadjuvant chemotherapy was based on pathological complete response (pCR). Surface expression of CCR2 on monocytes was evaluated by flow cytometry. Circulating CCL2 was measured by Luminex X-Map technology.
Results
Increased monocyte CCR2 expression and higher circulating CCL2 levels were observed in the patients with TNBC. After dividing the patients according to their response to NAC, a significant difference in CCL2 levels was found only between patients who achieved pCR and those who did not. ROC curves showed that the optimum diagnostic cut-off value of CCL2 ≤89.61 pg/mL better discriminated patients with TNBC who achieved pCR better than the Ki-67 index. Univariate analysis demonstrated that circulating. CCL2 ≤89.61 pg/mL was significantly associated with pCR. However, this correlation lost statistical significance in the multivariate model.
Conclusions
Our study demonstrated the activation of the monocyte CCR2-CCL2 axis in TNBC for the first time. This activation occurs mainly in patients who do not respond to NAC. Circulating CCL2 levels ≤89.61 pg/mL were found to predict, to some extent, the achievement of pCR in patients with TNBC receiving NAC.
{"title":"Significance of the monocyte CCR2-CCL2 axis in triple-negative breast cancer","authors":"Magdalena Budzyń , Agata Kubicka , Elżbieta Kaja , Witold Kycler , Joanna Załuska-Kusz , Jacek J. Brzeziński , Marcelina Sperling , Alicja Bukowska , Joanna Grupińska","doi":"10.1016/j.arcmed.2025.103205","DOIUrl":"10.1016/j.arcmed.2025.103205","url":null,"abstract":"<div><h3>Background</h3><div>The monocyte CCR2-CCL2 axis appears to play a crucial role in the generation of tumor-associated macrophages (TAMs), which subsequently promotes tumor metastasis and resistance to therapy.</div></div><div><h3>Aims</h3><div>Our study assessed the monocyte CCR2-CCL2 axis in triple-negative breast cancer (TNBC) and its ability to predict tumor response to neoadjuvant chemotherapy (NAC).</div></div><div><h3>Methods</h3><div>The study included 42 female patients diagnosed with TNBC and eligible for NAC. Response to neoadjuvant chemotherapy was based on pathological complete response (pCR). Surface expression of CCR2 on monocytes was evaluated by flow cytometry. Circulating CCL2 was measured by Luminex X-Map technology.</div></div><div><h3>Results</h3><div>Increased monocyte CCR2 expression and higher circulating CCL2 levels were observed in the patients with TNBC. After dividing the patients according to their response to NAC, a significant difference in CCL2 levels was found only between patients who achieved pCR and those who did not. ROC curves showed that the optimum diagnostic cut-off value of CCL2 ≤89.61 pg/mL better discriminated patients with TNBC who achieved pCR better than the Ki-67 index. Univariate analysis demonstrated that circulating. CCL2 ≤89.61 pg/mL was significantly associated with pCR. However, this correlation lost statistical significance in the multivariate model.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated the activation of the monocyte CCR2-CCL2 axis in TNBC for the first time. This activation occurs mainly in patients who do not respond to NAC. Circulating CCL2 levels ≤89.61 pg/mL were found to predict, to some extent, the achievement of pCR in patients with TNBC receiving NAC.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 5","pages":"Article 103205"},"PeriodicalIF":4.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-10DOI: 10.1016/j.arcmed.2025.103197
Xiujuan Chen , Jiaqi Sun , Huixian Li , Miao Lin , Xiaolan Mo , Huiying Liang
Aims
This study aimed to establish a phenotypic clustering model for critically ill patients with comorbid type 2 diabetes mellitus (CIP T2DM), define distinct subtypes, and analyze differences in clinical characteristics and treatment response.
Methods
Patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were phenotyped based on demographic, physiological, and biochemical parameters, along with critically ill scores, using a consensus clustering algorithm. Subtype validity was assessed using the eICU Collaborative Research Database (eICU). High-frequency combination drug regimens were then extracted to reveal therapeutic heterogeneity among subtypes.
Results
Three subtypes were identified in the MIMIC-IV cohort (n = 6349). The in-group proportions of 0.957, 0.898, and 0.836 in the eICU cohort (n = 1425) show high consistency. These three subtypes are: a) CIP T2DM with severe infection (CIP T2DM-SI) with a mortality of 16.7 % and a post-medication blood glucose (PMBG, first measured 24 h after medication administration) of 8.25 mmol/L; b) CIP T2DM with organ failure (CIP T2DM-OF) with 18.6 % mortality and 8.03 mmol/L PMBG; and c) CIP T2DM under monitoring for continuous observation and evaluation (CIP T2DM-UM) with 8.87 % mortality and 6.98 mmol/L PMBG. Moreover, the three subtypes showed different in-hospital mortality risks under the same medication regimen.
Conclusions
Three phenotypes were identified in CIP T2DM, showing significant heterogeneity in clinical characteristics and prognosis. Personalized interventions for these subtypes may help reduce adverse events and guide precise treatment in practice.
{"title":"Phenotypic Consensus Clustering and Treatment Heterogeneity Analysis in Critically Ill Patients with Comorbid Type 2 Diabetes Mellitus","authors":"Xiujuan Chen , Jiaqi Sun , Huixian Li , Miao Lin , Xiaolan Mo , Huiying Liang","doi":"10.1016/j.arcmed.2025.103197","DOIUrl":"10.1016/j.arcmed.2025.103197","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to establish a phenotypic clustering model for critically ill patients with comorbid type 2 diabetes mellitus (CIP T2DM), define distinct subtypes, and analyze differences in clinical characteristics and treatment response.</div></div><div><h3>Methods</h3><div>Patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were phenotyped based on demographic, physiological, and biochemical parameters, along with critically ill scores, using a consensus clustering algorithm. Subtype validity was assessed using the eICU Collaborative Research Database (eICU). High-frequency combination drug regimens were then extracted to reveal therapeutic heterogeneity among subtypes.</div></div><div><h3>Results</h3><div>Three subtypes were identified in the MIMIC-IV cohort (<em>n</em> = 6349). The in-group proportions of 0.957, 0.898, and 0.836 in the eICU cohort (<em>n</em> = 1425) show high consistency. These three subtypes are: a) CIP T2DM with severe infection (CIP T2DM-SI) with a mortality of 16.7 % and a post-medication blood glucose (PMBG, first measured 24 h after medication administration) of 8.25 mmol/L; b) CIP T2DM with organ failure (CIP T2DM-OF) with 18.6 % mortality and 8.03 mmol/L PMBG; and c) CIP T2DM under monitoring for continuous observation and evaluation (CIP T2DM-UM) with 8.87 % mortality and 6.98 mmol/L PMBG. Moreover, the three subtypes showed different in-hospital mortality risks under the same medication regimen.</div></div><div><h3>Conclusions</h3><div>Three phenotypes were identified in CIP T2DM, showing significant heterogeneity in clinical characteristics and prognosis. Personalized interventions for these subtypes may help reduce adverse events and guide precise treatment in practice.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 5","pages":"Article 103197"},"PeriodicalIF":4.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-24DOI: 10.1016/j.arcmed.2025.103184
Francilene Maria Azevedo , Ariane Ribeiro de Freitas Rocha , Núbia de Souza de Morais , Sarah Aparecida Vieira Ribeiro , Silvia Eloiza Priore , Jackson Martins Rodrigues , Sylvia do Carmo Castro Franceschini
Introduction
SARS-CoV-2 infection during pregnancy causes maternal health complications.
Objective
To investigate the relationship between comorbidities and sociodemographic factors with COVID-19 outcome (death/healing) among hospitalized pregnant women in Brazil.
Methodology
A longitudinal study, based on secondary data from the SIVEP Gripe. All hospitalizations of adult pregnant women with COVID-19 were assessed, with a total sample of 16,202 women. The dependent variable was the evolution of COVID-19 hospitalizations (death/healing), and the independent variables were age, ethnicity, gestational trimester, immunization, and comorbidities. R software version 4.3.2 was used to analyze the data. Descriptive statistics, the χ2 test, and Poisson regression were used. Joinpoint regression analysis was used to assess trends in lethality during the pandemic.
Results
The median age of the pregnant women assessed was 30 years (P25- 25; P75- 35). Lethality was 7.62 % (n = 1,236), and death was associated with the group of women who did not receive any dose of vaccine in the second trimester of pregnancy, were aged ≥35 years, and had black/brown skin color. The risk of death was higher among unvaccinated women (RR: 4.29; CI: 2.97–6.50), those aged ≥35 years (RR: 1.37; CI: 1.13–1.67), and those with obesity (RR: 2.08; CI: 1.66–2.58). In the temporal analysis, the monthly percentage change (MPC) in lethality was significant in three periods.
Conclusion
Black ethnicity, obesity, and lack of vaccination were the main factors that increased the risk of death from COVID-19 among pregnant women.
{"title":"Comorbidities and Sociodemographic Factors as Determinants of COVID-19 Outcome in Hospitalized Pregnant Women in Brazil","authors":"Francilene Maria Azevedo , Ariane Ribeiro de Freitas Rocha , Núbia de Souza de Morais , Sarah Aparecida Vieira Ribeiro , Silvia Eloiza Priore , Jackson Martins Rodrigues , Sylvia do Carmo Castro Franceschini","doi":"10.1016/j.arcmed.2025.103184","DOIUrl":"10.1016/j.arcmed.2025.103184","url":null,"abstract":"<div><h3>Introduction</h3><div>SARS-CoV-2 infection during pregnancy causes maternal health complications.</div></div><div><h3>Objective</h3><div>To investigate the relationship between comorbidities and sociodemographic factors with COVID-19 outcome (death/healing) among hospitalized pregnant women in Brazil.</div></div><div><h3>Methodology</h3><div>A longitudinal study, based on secondary data from the SIVEP Gripe. All hospitalizations of adult pregnant women with COVID-19 were assessed, with a total sample of 16,202 women. The dependent variable was the evolution of COVID-19 hospitalizations (death/healing), and the independent variables were age, ethnicity, gestational trimester, immunization, and comorbidities. R software version 4.3.2 was used to analyze the data. Descriptive statistics, the χ<sup>2</sup> test, and Poisson regression were used. Joinpoint regression analysis was used to assess trends in lethality during the pandemic.</div></div><div><h3>Results</h3><div>The median age of the pregnant women assessed was 30 years (P25- 25; P75- 35). Lethality was 7.62 % (<em>n</em> = 1,236), and death was associated with the group of women who did not receive any dose of vaccine in the second trimester of pregnancy, were aged ≥35 years, and had black/brown skin color. The risk of death was higher among unvaccinated women (RR: 4.29; CI: 2.97–6.50), those aged ≥35 years (RR: 1.37; CI: 1.13–1.67), and those with obesity (RR: 2.08; CI: 1.66–2.58). In the temporal analysis, the monthly percentage change (MPC) in lethality was significant in three periods.</div></div><div><h3>Conclusion</h3><div>Black ethnicity, obesity, and lack of vaccination were the main factors that increased the risk of death from COVID-19 among pregnant women.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 4","pages":"Article 103184"},"PeriodicalIF":4.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.arcmed.2025.103183
Rosa Maria Wong-Chew , Daniel E. Noyola , Fortino Solórzano-Santos , Sarbelio Moreno-Espinosa , Maria Guadalupe Miranda-Novales , Eric Ochoa Hein , Arturo Galindo-Fraga , Diana Vilar-Compte , Gerardo Martinez-Aguilar , Rodolfo Norberto Jiménez-Juárez , Gilberto Tena- Alavez , Dina Villanueva-García , Martha Eugenia Valdivia-Proa , Pedro Antonio Martinez-Arce , Alejandro Ernesto Macías-Hernández , Francisco Javier Espinosa-Rosales , Daniel Ibarra-Rios , Guillermo Ruiz Palacios y Santos , Martha Josefina Avilés-Robles , Emilia Josefina Patiño-Bahena , Patricia Cornejo-Juarez
Background
Respiratory syncytial virus (RSV) is a common cause of respiratory illness in children and adults in Latin America and Mexico. RSV circulates with seasonal peaks in fall and winter. Individuals at highest risk for severe infection are premature infants and those with comorbidities, as well as older adults with cardiopulmonary pathologies and/or varying degrees of immunocompromise.
Objective
To provide an updated landscape of the epidemiology, risk groups, diagnostic methods, and prevention of RSV infection in Mexico.
Methods
Convened by the Asociación Mexicana de Infectología y Microbiología Clínica, 28 interdisciplinary experts participated in a consensus meeting held in November 2023. Four groups, each with seven experts and a medical writer, were formed to discuss epidemiology and diagnosis, risk groups, vaccines, and monoclonal antibodies (mABs). Predefined questions, formulated by a team of four experts, were discussed within each group, and consensus was reached on the answers. These responses were then analyzed and organized into recommendations based on national and international evidence.
Results
Evidence-based recommendations for epidemiological surveillance, diagnosis, and prevention of RSV infection were proposed. Future perspectives regarding the usefulness of new vaccines and passive immunoprophylaxis were analyzed.
Conclusions
Timely identification of at-risk populations, diagnosis and treatment of RSV infection, and particularly the rational use of mABs and vaccines are key strategies to reduce the clinical and epidemiological burden of RSV infection.
{"title":"Mexican Interdisciplinary Consensus on the Diagnosis and Preventive Measures for Respiratory Syncytial Virus Infections","authors":"Rosa Maria Wong-Chew , Daniel E. Noyola , Fortino Solórzano-Santos , Sarbelio Moreno-Espinosa , Maria Guadalupe Miranda-Novales , Eric Ochoa Hein , Arturo Galindo-Fraga , Diana Vilar-Compte , Gerardo Martinez-Aguilar , Rodolfo Norberto Jiménez-Juárez , Gilberto Tena- Alavez , Dina Villanueva-García , Martha Eugenia Valdivia-Proa , Pedro Antonio Martinez-Arce , Alejandro Ernesto Macías-Hernández , Francisco Javier Espinosa-Rosales , Daniel Ibarra-Rios , Guillermo Ruiz Palacios y Santos , Martha Josefina Avilés-Robles , Emilia Josefina Patiño-Bahena , Patricia Cornejo-Juarez","doi":"10.1016/j.arcmed.2025.103183","DOIUrl":"10.1016/j.arcmed.2025.103183","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory syncytial virus (RSV) is a common cause of respiratory illness in children and adults in Latin America and Mexico. RSV circulates with seasonal peaks in fall and winter. Individuals at highest risk for severe infection are premature infants and those with comorbidities, as well as older adults with cardiopulmonary pathologies and/or varying degrees of immunocompromise.</div></div><div><h3>Objective</h3><div>To provide an updated landscape of the epidemiology, risk groups, diagnostic methods, and prevention of RSV infection in Mexico.</div></div><div><h3>Methods</h3><div>Convened by the Asociación Mexicana de Infectología y Microbiología Clínica, 28 interdisciplinary experts participated in a consensus meeting held in November 2023. Four groups, each with seven experts and a medical writer, were formed to discuss epidemiology and diagnosis, risk groups, vaccines, and monoclonal antibodies (mABs). Predefined questions, formulated by a team of four experts, were discussed within each group, and consensus was reached on the answers. These responses were then analyzed and organized into recommendations based on national and international evidence.</div></div><div><h3>Results</h3><div>Evidence-based recommendations for epidemiological surveillance, diagnosis, and prevention of RSV infection were proposed. Future perspectives regarding the usefulness of new vaccines and passive immunoprophylaxis were analyzed.</div></div><div><h3>Conclusions</h3><div>Timely identification of at-risk populations, diagnosis and treatment of RSV infection, and particularly the rational use of mABs and vaccines are key strategies to reduce the clinical and epidemiological burden of RSV infection.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 4","pages":"Article 103183"},"PeriodicalIF":4.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.arcmed.2025.103182
David Camacho , Pamela Tella-Vega , Fernando A. Wagner , Carolina Santamaría-Ulloa , Amanda Lehning , Joseph J. Gallo , Carmen García-Peña
English language systematic reviews with samples from high-income countries have found an inverse relationship between loneliness and cognitive function. Considering that cultural and contextual resources influence the experience of loneliness and cognitive health, we conducted a systematic review analyzing quantitative studies exploring the relationship between loneliness and cognitive function in older adults in Latin America. Following PRISMA guidelines, we used five databases (PubMed, PsycInfo, Scopus, LILACS, and SciELO). Inclusion criteria were: a) quantitative research examining the relationship between loneliness and cognitive health, b) descriptions of loneliness and measures of cognitive function, c) English or Spanish language peer-reviewed articles, and d) a sample of older adults in Latin America (≥60 years). We assessed bias using the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices. Seven of the 1,887 studies (all cross-sectional) met the inclusion criteria, comprising 26,440 participants from Brazil or Mexico. Most, but not all, found a significant inverse association between loneliness and cognitive function after controlling for salient health and psychosocial factors. Measures and conceptualizations of loneliness and cognitive function, as well as theoretical explanations linking these concepts, varied. Two studies had a high risk of bias. Current evidence suggests a possible cross-sectional association between loneliness and cognitive function in older adults in these countries. Further research is needed to examine the possible bidirectional relationship using representative samples and longitudinal designs; test pathways linking dimensions of loneliness (e.g., chronicity) to cognitive function (e.g., Alzheimer's disease continuum), and explore Latin American diversity (e.g., countries, indigenous peoples, sexual minorities).
{"title":"Loneliness and cognitive function in older adults living in Latin America: A systematic review","authors":"David Camacho , Pamela Tella-Vega , Fernando A. Wagner , Carolina Santamaría-Ulloa , Amanda Lehning , Joseph J. Gallo , Carmen García-Peña","doi":"10.1016/j.arcmed.2025.103182","DOIUrl":"10.1016/j.arcmed.2025.103182","url":null,"abstract":"<div><div>English language systematic reviews with samples from high-income countries have found an inverse relationship between loneliness and cognitive function. Considering that cultural and contextual resources influence the experience of loneliness and cognitive health, we conducted a systematic review analyzing quantitative studies exploring the relationship between loneliness and cognitive function in older adults in Latin America. Following PRISMA guidelines, we used five databases (PubMed, PsycInfo, Scopus, LILACS, and SciELO). Inclusion criteria were: a) quantitative research examining the relationship between loneliness and cognitive health, b) descriptions of loneliness and measures of cognitive function, c) English or Spanish language peer-reviewed articles, and d) a sample of older adults in Latin America (≥60 years). We assessed bias using the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices. Seven of the 1,887 studies (all cross-sectional) met the inclusion criteria, comprising 26,440 participants from Brazil or Mexico. Most, but not all, found a significant inverse association between loneliness and cognitive function after controlling for salient health and psychosocial factors. Measures and conceptualizations of loneliness and cognitive function, as well as theoretical explanations linking these concepts, varied. Two studies had a high risk of bias. Current evidence suggests a possible cross-sectional association between loneliness and cognitive function in older adults in these countries. Further research is needed to examine the possible bidirectional relationship using representative samples and longitudinal designs; test pathways linking dimensions of loneliness (e.g., chronicity) to cognitive function (e.g., Alzheimer's disease continuum), and explore Latin American diversity (e.g., countries, indigenous peoples, sexual minorities).</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 4","pages":"Article 103182"},"PeriodicalIF":4.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastroesophageal reflux disease (GERD) is a common chronic condition characterized by abnormal reflux and regurgitation of stomach contents into the esophagus. Its prevalence is increasing worldwide and poses a high economic burden.
Aim
To explore the potential correlation between galectin-1, galectin-3, galectin-8, galectin-9, and GERD, highlighting their potential role as biomarkers in disease diagnosis, and pathogenesis.
Materials and Methods
A prospective cross-sectional study was conducted on 40 patients with GERD disease and 40 healthy control subjects from January 2023–May 2024 at Al-Kindy Teaching Hospital-Gastroenterology Unit. Venous blood was collected from patients and controls. Serums of both groups were quantified for galectin-1, galectin-3, galectin-8, and galectin-9 using a human ELISA kit.
Results
Galectin-1 showed no statistically significant difference in the median levels between patients with GERD and controls (p = 0.567). A significant difference was found in the median levels of galectin-3, with higher levels in patients with GERD compared to controls (p = 0.0037). The most significant was galectin-3, AUC = 0.684 (95% CI: 0.570–0.784), p = 0.003, had a significant moderate discriminatory ability in differentiating between patients with GERD and healthy controls with cutoff value <13.682, sensitivity = 74.4%, specificity = 55%, and accuracy = 61.7%.
Conclusions
This study suggests that serum galectin-3 is the best potential noninvasive diagnostic biomarker for the prediction and identification of GERD.
{"title":"Galectins: A New Frontier in Gastroesophageal Reflux Disease Research","authors":"Huda Saleem Hantoosh Hameed Al-khalidy , Wafaa Hazim Salih , Batool Mutar Mahdi","doi":"10.1016/j.arcmed.2025.103195","DOIUrl":"10.1016/j.arcmed.2025.103195","url":null,"abstract":"<div><h3>Background</h3><div>Gastroesophageal reflux disease (GERD) is a common chronic condition characterized by abnormal reflux and regurgitation of stomach contents into the esophagus. Its prevalence is increasing worldwide and poses a high economic burden.</div></div><div><h3>Aim</h3><div>To explore the potential correlation between galectin-1, galectin-3, galectin-8, galectin-9, and GERD, highlighting their potential role as biomarkers in disease diagnosis, and pathogenesis.</div></div><div><h3>Materials and Methods</h3><div>A prospective cross-sectional study was conducted on 40 patients with GERD disease and 40 healthy control subjects from January 2023–May 2024 at Al-Kindy Teaching Hospital-Gastroenterology Unit. Venous blood was collected from patients and controls. Serums of both groups were quantified for galectin-1, galectin-3, galectin-8, and galectin-9 using a human ELISA kit.</div></div><div><h3>Results</h3><div>Galectin-1 showed no statistically significant difference in the median levels between patients with GERD and controls (<em>p</em> = 0.567). A significant difference was found in the median levels of galectin-3, with higher levels in patients with GERD compared to controls (<em>p</em> = 0.0037). The most significant was galectin-3, AUC = 0.684 (95% CI: 0.570–0.784), <em>p</em> = 0.003, had a significant moderate discriminatory ability in differentiating between patients with GERD and healthy controls with cutoff value <13.682, sensitivity = 74.4%, specificity = 55%, and accuracy = 61.7%.</div></div><div><h3>Conclusions</h3><div>This study suggests that serum galectin-3 is the best potential noninvasive diagnostic biomarker for the prediction and identification of GERD.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 4","pages":"Article 103195"},"PeriodicalIF":4.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-11DOI: 10.1016/j.arcmed.2024.103171
Emmanuel Aguilar-Zamora , Cesar Rodríguez , Javier Torres , Nayeli Ortiz-Olvera , Gerardo Aparicio-Ozores , Lourdes Flores-Luna , Carlos Quesada-Gómez , Margarita Camorlinga-Ponce
Aims
Clostridioides difficile is a major cause of antibiotic-associated diarrhea. This study investigated the diversity, clonality, and antimicrobial resistance of C. difficile isolates from Mexican children and adults with diarrhea.
Methods
Between 2014 and 2016, we isolated 37 C. difficile strains in three hospitals in Mexico City. C. difficile strains were typed by PCR-ribotyping and pulsed-field gel electrophoresis (PFGE). Antimicrobial susceptibility to eleven antibiotics was determined. Whole-genome sequencing (WGS) was used to investigate the presence of antimicrobial resistance genes (ARG) and perform a pangenome analysis of 53 genomes from Mexico and 137 publicly available C. difficile genomes.
Results
Toxigenic strains comprised six isolates from children and 31 from adults. While NAP1/RT027 isolates were found in three children, they were predominant in adults (n = 31, 90.3 %) and showed the 1058 and 008 PFGE macrorestriction patterns. All isolates were susceptible to vancomycin and metronidazole but resistant to ciprofloxacin, and over 90 % of the isolates were resistant to linezolid and carried cfr(E). The pangenome of these isolates contained 4,852 genes, of which 3,455 (81.2 %) were categorized as core genes and 801 (18.8 %) as accessory genes. In addition, our isolates demonstrated a close relationship with strains from the United States, Canada, and France.
Conclusions
Our work provides, for the first time, genomic insights into C. difficile strains present in Mexico. In our hospital setting, the predominant strains were primarily NAP1/RT027 and exhibited resistance to linezolid, a pattern observed in both pediatric and adult populations. This unique combination of characteristics has not been previously reported in Latin America.
{"title":"Predominance of FQR1 NAP1/RT027 Clostridioides difficile Among Mexican Children and Adult Patients, and its Resistance to Eleven Antibiotics","authors":"Emmanuel Aguilar-Zamora , Cesar Rodríguez , Javier Torres , Nayeli Ortiz-Olvera , Gerardo Aparicio-Ozores , Lourdes Flores-Luna , Carlos Quesada-Gómez , Margarita Camorlinga-Ponce","doi":"10.1016/j.arcmed.2024.103171","DOIUrl":"10.1016/j.arcmed.2024.103171","url":null,"abstract":"<div><h3>Aims</h3><div><em>Clostridioides difficile</em> is a major cause of antibiotic-associated diarrhea. This study investigated the diversity, clonality, and antimicrobial resistance of <em>C. difficile</em> isolates from Mexican children and adults with diarrhea.</div></div><div><h3>Methods</h3><div>Between 2014 and 2016<em>,</em> we isolated 37 <em>C. difficile</em> strains in three hospitals in Mexico City. <em>C. difficile</em> strains were typed by PCR-ribotyping and pulsed-field gel electrophoresis (PFGE). Antimicrobial susceptibility to eleven antibiotics was determined. Whole-genome sequencing (WGS) was used to investigate the presence of antimicrobial resistance genes (ARG) and perform a pangenome analysis of 53 genomes from Mexico and 137 publicly available <em>C. difficile</em> genomes.</div></div><div><h3>Results</h3><div>Toxigenic strains comprised six isolates from children and 31 from adults. While NAP1/RT027 isolates were found in three children, they were predominant in adults (<em>n</em> = 31, 90.3 %) and showed the 1058 and 008 PFGE macrorestriction patterns. All isolates were susceptible to vancomycin and metronidazole but resistant to ciprofloxacin, and over 90 % of the isolates were resistant to linezolid and carried <em>cfr</em>(E). The pangenome of these isolates contained 4,852 genes, of which 3,455 (81.2 %) were categorized as core genes and 801 (18.8 %) as accessory genes. In addition, our isolates demonstrated a close relationship with strains from the United States, Canada, and France.</div></div><div><h3>Conclusions</h3><div>Our work provides, for the first time, genomic insights into <em>C. difficile</em> strains present in Mexico. In our hospital setting, the predominant strains were primarily NAP1/RT027 and exhibited resistance to linezolid, a pattern observed in both pediatric and adult populations. This unique combination of characteristics has not been previously reported in Latin America.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 4","pages":"Article 103171"},"PeriodicalIF":4.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.arcmed.2025.103194
Shabnam Pirnezhad Talatapeh , Jafar Rezaie , Vahid Nejati
Background
Due to their unique properties, extracellular vesicles (EVs) are promising nanocarriers for exogenous drug delivery.
Aim
We prepared a drug delivery system based on large EVs (LEVs) containing paclitaxel (PTX) (LEVs-PTX) to investigate anticancer effects on lung cancer cells with a focus on autophagy.
Methods
LEVs-PTX were isolated from lung cancer cells by ultracentrifugation and characterized using different techniques. Rhodamine B dye (Rh B) was used to label LEVs-PTX for cell tracking. MTT assay was performed to investigate the cellular toxicity of PTX and LEVs-PTX for 24 h and 48 h. The uptake of LEVs-PTX was monitored by immunofluorescence microscopy in breast and lung cancer cells. A colorimetric assay was performed to evaluate apoptosis, while Western blotting assays were used to investigate autophagy proteins. Real-time PCR was used to measure mitophagy genes.
Results
Characterization techniques showed that LEVs were isolated and loaded with PTX. Rh B labeled LEVs, which was confirmed by a fluorescence spectrophotometer. Immunofluorescence microscopy showed that the lung and breast cancer cells had captured LEVs. Cell viability was decreased in LEVs-PTX cells which coincided with an increase in caspase-3 activity in LEVs-PTX cells. The Beclin-1 protein level and LC3 II/I ratio decreased, while the P62 protein level was increased in LEVs-PTX cells. The mitophagy genes such as Pink-1 and Parkin were upregulated in LEVs-PTX cells.
Conclusion
The data show that LEVs-PTX induced apoptosis, which inhibited the autophagy pathway and increased mitophagy markers, suggesting damage to cell organelles through intracellular delivery of PTX.
{"title":"Extracellular Vesicle-based Delivery of Paclitaxel to Lung Cancer Cells: Uptake, Anticancer Effects, Autophagy and Mitophagy Pathways","authors":"Shabnam Pirnezhad Talatapeh , Jafar Rezaie , Vahid Nejati","doi":"10.1016/j.arcmed.2025.103194","DOIUrl":"10.1016/j.arcmed.2025.103194","url":null,"abstract":"<div><h3>Background</h3><div>Due to their unique properties, extracellular vesicles (EVs) are promising nanocarriers for exogenous drug delivery.</div></div><div><h3>Aim</h3><div>We prepared a drug delivery system based on large EVs (LEVs) containing paclitaxel (PTX) (LEVs-PTX) to investigate anticancer effects on lung cancer cells with a focus on autophagy.</div></div><div><h3>Methods</h3><div>LEVs-PTX were isolated from lung cancer cells by ultracentrifugation and characterized using different techniques. Rhodamine B dye (Rh B) was used to label LEVs-PTX for cell tracking. MTT assay was performed to investigate the cellular toxicity of PTX and LEVs-PTX for 24 h and 48 h. The uptake of LEVs-PTX was monitored by immunofluorescence microscopy in breast and lung cancer cells. A colorimetric assay was performed to evaluate apoptosis, while Western blotting assays were used to investigate autophagy proteins. Real-time PCR was used to measure mitophagy genes.</div></div><div><h3>Results</h3><div>Characterization techniques showed that LEVs were isolated and loaded with PTX. Rh B labeled LEVs, which was confirmed by a fluorescence spectrophotometer. Immunofluorescence microscopy showed that the lung and breast cancer cells had captured LEVs. Cell viability was decreased in LEVs-PTX cells which coincided with an increase in caspase-3 activity in LEVs-PTX cells. The Beclin-1 protein level and LC3 II/I ratio decreased, while the P62 protein level was increased in LEVs-PTX cells. The mitophagy genes such as Pink-1 and Parkin were upregulated in LEVs-PTX cells.</div></div><div><h3>Conclusion</h3><div>The data show that LEVs-PTX induced apoptosis, which inhibited the autophagy pathway and increased mitophagy markers, suggesting damage to cell organelles through intracellular delivery of PTX.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 4","pages":"Article 103194"},"PeriodicalIF":4.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143357048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.arcmed.2025.103196
Hid Felizardo Cordero-Franco , Ana María Salinas-Martínez , Francisco Javier Guzmán-de la Garza
Introduction
The General Work Stress Scale (GWSS) explores how a worker's feelings, thoughts, and motivations are affected by work pressure. We aimed to evaluate the validity and reliability of the Spanish version of the GWSS in Mexican medical residents.
Methods
Cross-sectional study of medical residents of all specialties in a public health institution in Nuevo León, Mexico. They were invited to participate by filling out an anonymous and voluntary online questionnaire (n = 772). Content validity (relevance and usefulness) was evaluated using the Lawshe index (LCVI), while construct validity was assessed with exploratory (EFA) and confirmatory (CFA) factor analysis. The CFA fit indices were RMSEA (root mean square error of approximation), the comparative fit index (CFI), the Tucker-Lewis index (TLI), and the standardized root mean square residual (SRMR). The Spearman correlation coefficient between the GWSS and the Oldenburg Burnout Inventory (OLBI) was estimated for concurrent validity and Cronbach's α for reliability.
Results
The GWSS showed content validity (LCVI 0.96 ± 0.08 and 0.90 ± 0.10 for relevance and usefulness, respectively). The EFA showed a unifactorial structure (74.3 % of the variance). The CFA showed a good fit (RMSEA = 0.122 (95 % CI 0.105, 0.140), CFI = 0.958, TLI = 0.942 and SRMR = 0.028). A Cronbach's α of 0.96 and a correlation of 0.65 (p < 0.0001) were obtained.
Conclusions
The Spanish version of the GWSS showed content, construct, and concurrent validity, as well as reliability in Mexican medical residents. Testing the GWSS in other specialties and the private sector is recommended.
{"title":"Validity and Reliability of the Spanish Version of the General Work Stress Scale in Mexican Medical Residents","authors":"Hid Felizardo Cordero-Franco , Ana María Salinas-Martínez , Francisco Javier Guzmán-de la Garza","doi":"10.1016/j.arcmed.2025.103196","DOIUrl":"10.1016/j.arcmed.2025.103196","url":null,"abstract":"<div><h3>Introduction</h3><div>The General Work Stress Scale (GWSS) explores how a worker's feelings, thoughts, and motivations are affected by work pressure. We aimed to evaluate the validity and reliability of the Spanish version of the GWSS in Mexican medical residents.</div></div><div><h3>Methods</h3><div>Cross-sectional study of medical residents of all specialties in a public health institution in Nuevo León, Mexico. They were invited to participate by filling out an anonymous and voluntary online questionnaire (<em>n</em> = 772). Content validity (relevance and usefulness) was evaluated using the Lawshe index (LCVI), while construct validity was assessed with exploratory (EFA) and confirmatory (CFA) factor analysis. The CFA fit indices were RMSEA (root mean square error of approximation), the comparative fit index (CFI), the Tucker-Lewis index (TLI), and the standardized root mean square residual (SRMR). The Spearman correlation coefficient between the GWSS and the Oldenburg Burnout Inventory (OLBI) was estimated for concurrent validity and Cronbach's α for reliability.</div></div><div><h3>Results</h3><div>The GWSS showed content validity (LCVI 0.96 ± 0.08 and 0.90 ± 0.10 for relevance and usefulness, respectively). The EFA showed a unifactorial structure (74.3 % of the variance). The CFA showed a good fit (RMSEA = 0.122 (95 % CI 0.105, 0.140), CFI = 0.958, TLI = 0.942 and SRMR = 0.028). A Cronbach's α of 0.96 and a correlation of 0.65 (<em>p</em> < 0.0001) were obtained.</div></div><div><h3>Conclusions</h3><div>The Spanish version of the GWSS showed content, construct, and concurrent validity, as well as reliability in Mexican medical residents. Testing the GWSS in other specialties and the private sector is recommended.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 3","pages":"Article 103196"},"PeriodicalIF":4.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.arcmed.2024.103154
Christine Leyns , Carla Ascarrunz , Shirley Rasguido , Patricia Rodriguez , Daniel Eid , Javier Guitian
Background
Most people in low- and middle-income countries work in the informal sector and lack social protection. In Bolivia, the unified family, community, and intercultural health model established universal health coverage for informal workers and their families in 2019. The COVID-19 pandemic, which occurred soon after, exposed both the vulnerabilities and the strengths of this health policy.
Aim
To describe the community-based design of a health promotion strategy based on people-centered and participatory research within a vulnerable community of informal market vendors during the COVID-19 pandemic.
Methods
As part of participatory action research during the COVID-19 pandemic, market vendors collaborated with a multidisciplinary research team, local authorities, and the health network to promote health and safety in their markets. Market vendors developed a health promotion strategy facilitated by a highly structured mixed qualitative-quantitative concept mapping approach and reached a consensus on an operational health strategy with measurable goals, actions, timelines, and actors.
Results
A community health diagnosis together with health education and individualized clinical care, created a common understanding of health and built trust between the community and the research/health team. Market vendors identified health needs related to care access, self-care, market organization, and the social determinants of health, including strategies to prevent infections, reduce cardiometabolic risk, and improve mental health.
Conclusions
Effective strategies to promote health or to manage health crises such as a pandemic can be developed by organized communities in primary care supported by individual and collective health data, health education, and the integration of social scientists, epidemiologists, and health professionals.
{"title":"Engaging communities in health promotion through community-based primary care and participatory research during the COVID-19 pandemic in Bolivia","authors":"Christine Leyns , Carla Ascarrunz , Shirley Rasguido , Patricia Rodriguez , Daniel Eid , Javier Guitian","doi":"10.1016/j.arcmed.2024.103154","DOIUrl":"10.1016/j.arcmed.2024.103154","url":null,"abstract":"<div><h3>Background</h3><div>Most people in low- and middle-income countries work in the informal sector and lack social protection. In Bolivia, the unified family, community, and intercultural health model established universal health coverage for informal workers and their families in 2019. The COVID-19 pandemic, which occurred soon after, exposed both the vulnerabilities and the strengths of this health policy.</div></div><div><h3>Aim</h3><div>To describe the community-based design of a health promotion strategy based on people-centered and participatory research within a vulnerable community of informal market vendors during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>As part of participatory action research during the COVID-19 pandemic, market vendors collaborated with a multidisciplinary research team, local authorities, and the health network to promote health and safety in their markets. Market vendors developed a health promotion strategy facilitated by a highly structured mixed qualitative-quantitative concept mapping approach and reached a consensus on an operational health strategy with measurable goals, actions, timelines, and actors.</div></div><div><h3>Results</h3><div>A community health diagnosis together with health education and individualized clinical care, created a common understanding of health and built trust between the community and the research/health team. Market vendors identified health needs related to care access, self-care, market organization, and the social determinants of health, including strategies to prevent infections, reduce cardiometabolic risk, and improve mental health.</div></div><div><h3>Conclusions</h3><div>Effective strategies to promote health or to manage health crises such as a pandemic can be developed by organized communities in primary care supported by individual and collective health data, health education, and the integration of social scientists, epidemiologists, and health professionals.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 3","pages":"Article 103154"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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