Effectiveness of BNT162b2 COVID-19 Vaccine in Preventing Severe Symptomatic Infection among Healthcare Workers

Background and Objectives: This study aims to evaluate the effectiveness of the BNT162b2 COVID-19 (coronavirus disease 2019) in preventing severe symptomatic laboratory-confirmed infection among healthcare workers in a real-world scenario. Materials and Methods: A cross-sectional analysis of a prospective cohort study was conducted. Subjects with onset illness from January to February 2021 were eligible and classified according to the number of vaccine doses received (single-shot, n = 8; two-shot, n = 12; unvaccinated, n = 290). Results: The vaccine effectiveness against severe illness was 100% in the single and two-shot group. The presented results suggest that vaccination reduces the frequency of severe symptomatic COVID-19 in working-age adults. Conclusions: Efforts focusing on maximizing the number of immunized subjects in the study population may reduce associated economic and social burdens.

COVID-19 mortality among pregnant women in Mexico: A retrospective cohort study

Background

Pregnant women have been classified as at risk for COVID-19 due to previous experience with influenza and other coronaviruses. The objective of this study was to identify risk factors for the complications and death in women of childbearing age and pregnant women with suspected COVID-19.

Methods

This retrospective cohort study was conducted from the beginning of the epidemic in Mexico until May 25, 2020. All women of childbearing age (13-49 years) from the open national COVID-19 database from the Ministry of Health of Mexico were considered for eligibility. SARS-COV-2 infection was confirmed or ruled out by RT-qPCR. We performed a bivariate and multivariable analysis to estimate mortality risk.

Results

Ten (2.2%) pregnant women with confirmed COVID-19 died. Positive pregnant patients did not have a higher risk of complications (admission to the ICU, pneumonia, or requirement for mechanical ventilation) or death than the controls. In the multivariate analysis, only history of diabetes and chronic kidney disease remained independently associated with death in the positive cohort. Seven (0.6%) pregnant women with a negative test died. In bivariate analysis, pregnant patients with a positive test had a higher risk of death than pregnant patients with a negative test (relative risk (RR) = 3.87, 95% confidence interval (CI) = 1.48-10.12), but no higher risk was found than in non-pregnant women with a positive test (RR = 0.82, 95% CI = 0.44-1.53), and 60-day mortality did not significantly differ among pregnant patients with or without a positive test (hazard ratio (HR) = 0.40, 95% CI = 0.12-1.30) or between COVID-19-positive patients who were pregnant or not pregnant (HR = 0.74, 95% CI = 0.35-1.56).

Conclusions

Pregnant patients do not have a greater risk of complications or death from COVID-19 than non-pregnant patients. The presence of diabetes mellitus and chronic disease increases the risk of death in women of childbearing age, but not specifically in pregnant patients.

Male gender and kidney illness are associated with an increased risk of severe laboratory-confirmed coronavirus disease

BACKGROUND

To identify factors predicting severe coronavirus disease 2019 (COVID-19) in adolescent and adult patients with laboratory-positive (quantitative reverse-transcription polymerase chain reaction) infection.

METHOD

A retrospective cohort study took place, and data from 740 subjects, from all 32 states of Mexico, were analyzed. The association between the studied factors and severe (dyspnea requiring hospital admission) COVID-19 was evaluated through risk ratios (RRs) and 95% confidence intervals (CIs).

RESULTS

Severe illness was documented in 28% of participants. In multiple analysis, male gender (RR = 1.13, 95% CI 1.06-1.20), advanced age ([reference: 15-29 years old] 30-44, RR = 1.02, 95% CI 0.94-1.11; 45-59, RR = 1.26, 95% CI 1.15-1.38; 60 years or older, RR = 1.44, 95% CI 1.29-1.60), chronic kidney disease (RR = 1.31, 95% CI 1.04-1.64) and thoracic pain (RR = 1.16, 95% CI 1.10-1.24) were associated with an increased risk of severe disease.

CONCLUSIONS

To the best of our knowledge, this is the first study evaluating predictors of COVID-19 severity in a large subset of the Latin-American population. Male gender and kidney illness were independently associated with the risk of severe COVID-19. These results may be useful for health care protocols for the early detection and management of patients that may benefit from opportune and specialized supportive medical treatment.

Anthropometric and dietary differences among Mexican older adults with and without adequate body image perception

OBJECTIVE

We compared anthropometric and dietary indicators between groups of older Mexican adults with accurate or inaccurate body image perception (BIP).

METHODS

A cross-sectional study was carried out with 201 older adults (age ≥ 60 years) of both sexes who completed the Stunkard scale for BIP, which consists of nine silhouettes with an equivalent of body mass index (BMI) status, then, the accuracy with their real BMI was calculated and reported energy and macronutrient intake through a 24-h dietary recall directed by different geriatric centers in Colima, Mexico. Basic anthropometry and bioelectrical impedance analyses were performed.

RESULTS

We found that 71.1% of the older adults had inaccurate BIP; 66.6% underestimated their body mass and 4.5% overestimated their body mass, the other 28.9% hat accurate BIP. The overall concordance between the real nutritional status and BIP was poor (kappa coefficient = 0.03). The inaccurate BIP group had a significantly higher mean body mass index, body fat percentage, muscle mass, and arm and calf circumference compared to the accurate BIP group (p < .001); only 4.3% of the older adults who were overweight and 6.2% who were obese had an accurate BIP. Regarding dietary consumption, we found significant differences only in energy and carbohydrate intake between the two groups. Finally, excess body fat was associated with an inaccurate BIP (OR: 2.8, 95% CI: 1.5-5.5).

CONCLUSION

In older adults, an inaccurate BIP is generally associated with high anthropometric values and less than adequate dietary intake.

Gestational Diabetes Triggers Oxidative Stress in Hippocampus and Cerebral Cortex and Cognitive Behavior Modifications in Rat Offspring: Age- and Sex-Dependent Effects

Gestational diabetes (GD) has been linked with an increased risk of developing metabolic disorders and behavioral abnormalities in the offspring. Oxidative stress is strongly associated with neurodegeneration and cognitive disruption. In the offspring brains in a GD experimental rat model, increased oxidative stress in the prenatal and postnatal stages was reported. However, long-term alterations to offspring behavior and oxidative stress, caused by changes in the cerebral cortex and hippocampus, remain unclear. In this study, we evaluated the effect of GD on young and adult male and female rat offspring in metabolic parameters, cognitive behavior, and oxidative stress. GD was induced using streptozotocin in dams. Next, the offspring were evaluated at two and six months of age. Anxiety-like behavior was evaluated using the elevated plus maze and open field maze; spatial learning and short-term memory were evaluated using the Morris water maze and radial maze, respectively. We determined oxidative stress biomarkers (reactive oxygen species (ROS), lipid peroxidation and glutathione status) and antioxidant enzymes (superoxide dismutase and catalase) in the brain of offspring. We observed that male GD offspring showed a reduced level of anxiety at both ages as they spent less time in the closed arms of the elevated plus maze at adult age ((P = 0.019, d = 1.083 ( size effect)) and spent more time in the open area of an open field (P = 0.0412, d = 0.743) when young and adult age (P = 0.018, d = 0.65). Adult female GD offspring showed a reduced level of anxiety (P = 0.036; d = 0.966), and young female GD offspring showed a deficiency in spatial learning (P = 0.0291 vs. control, d = 3.207). Adult male GD offspring showed a deficiency in short-term memory (P = 0.017, d = 1.795). We found an increase in ROS and lipid peroxidation, a disruption in the glutathione status, and decreased activity of catalase and superoxide dismutase (P < 0.05 vs. control, d > 1.0), in the cerebral cortex and hippocampus of male and female GD offspring. GD altered metabolism; male offspring of both ages and adult females showed a high level of triglycerides and a lower level of high-density lipoprotein-cholesterol (P < 0.05 vs. control, d > 1.0). Young and adult female offspring displayed higher insulin levels (P < 0.05, d > 1.0). These results suggest that gestational diabetes modifies oxidative stress and cognitive behavior in an age- and sex-dependent manner.

[Obstetric complications of dengue and chikungunya in the pregnant patient: case-control study]

BACKGROUND

Dengue and chikungunya infections are transmitted by the Aedes aegypti vector; they can affect the pregnant woman and her gestation product.

OBJECTIVE

To identify if dengue and chikungunya infections during pregnancy are factors associated with the presence of obstetric complications, in Colima, Mexico.

METHODS

We included in this study 45 patients with obstetric complications and 90 without complications, selected by a two-stage sampling. We collected the sociodemographic, anthropometric, gynecological, and obstetric complications’ data. Descriptive statistics, non-parametric significance tests and crude and adjusted risk estimates (odds ratio [OR] and 95% confidence intervals [95% CI]) were calculated.

RESULTS

Out of 135 patients included, 15 had a diagnosis of dengue and 20 of chikungunya. There were obstetric complications in 60% of infected patients with chikungunya, 46.7% with dengue and 26% of non-infected (p = 0.007). Chikungunya infection (adjusted OR = 1.6) and antecedents of abortion and cesarean section (adjusted OR = 2.2) were independent risk factors associated with the presence of complications. Dengue had an adjusted OR = 1.3 without a statistically significant difference.

CONCLUSIONS

Chikungunya infection and antecedents of abortion and cesarean section are risk factors associated with obstetric complications. Their timely detection is a priority as a preventive strategy.

The Comparative Effect of Nopal and Mucilage in Metabolic Parameters in Rats with a High-Fructose Diet

Nopal is used in Mexico as both food and traditional medicine for metabolic diseases. Our aim was to analyze the effect of the chronic administration of mucilage fiber extracted from nopal (Opuntia ficus indica; 500 mg/kg body weight per day) on male Wistar rats on a high-fructose diet (HFD). After which three groups were administered one of the following for 30 days: whole-fresh nopal mixed in water, mucilage, and control. Metabolic and hemodynamic parameters (triglycerides, cholesterol, fasting glucose, oral glucose tolerance test, blood pressure, and abdominal circumference) were determined. Rats administered nopal and mucilage had lower levels of triglycerides and diastolic arterial pressure than control, but only nopal had significant differences. Furthermore, systolic and diastolic pressure were higher in the control group. Thus, whole nopal and mucilage improve metabolic parameters in rats fed a HFD.

Effects of Moringa oleifera leaf powder on metabolic syndrome induced in male Wistar rats: a preliminary study

Objective To evaluate the preventive effects of Moringa oleifera on metabolic syndrome (MS) in male Wistar rats. Methods MS was induced by feeding rats a high-fat diet and drinking water containing 10% fructose for 6 weeks. In the preventive group, M. oleifera was orally administered for 3 weeks prior to the induction of MS, while in the treatment group, M. oleifera was administered for 3 weeks after the onset of MS. The treatment groups were compared with a control group of untreated rats with induced MS. Fasting glucose, oral glucose tolerance, insulin tolerance, total cholesterol, triglycerides, abdominal circumference, and systolic and diastolic blood pressure were measured before and after MS induction and/or M. oleifera treatment. Results After the induction of MS, the control group had higher fasting glucose levels than the preventive group. No significant differences were observed in insulin tolerance, oral glucose tolerance, cholesterol, triglycerides, abdominal circumference, or systolic or diastolic blood pressure. Compared with untreated controls, rats in the treatment group had significantly improved glucose tolerance, triglycerides, and abdominal circumference. Conclusions M. oleifera treatment attenuates MS in Wistar rats.

[Associated factors with sarcopenia among Mexican elderly: 2012 National Health and Nutrition Survey]

BACKGROUND

Sarcopenia involves the loss of skeletal muscle mass and age-related functionality; it diminishes physical independence, health and quality of life. In 2016 it was added to the International Classification of Diseases (ICD-10). Information about the frequency of sarcopenia among Mexican older adults is scarce. The objective was to analyze associated factors with sarcopenia in Mexican older adults through the 2012 National Health and Nutrition Survey data.

METHODS

Cross-sectional study which included subjects of 60 years of age or more with simultaneous information on health and anthropometry questionnaires from the 2012 National Health and Nutrition Survey. Sarcopenia was diagnosed through a gait speed test and calf circumference. It was assessed the prevalence of sarcopenia and its association with sociodemographic characteristics and variables related to health, tobacco use and alcohol consumption. The analysis was performed with SPSS v. 16.

RESULTS

We analyzed a sample of 5046 older adults who represented 7 439 686 older adults nationwide. Among subjects 53.9% (n = 2718) were women (mean age 69.92 ± 7.56 years) and 46.1% (n = 2328), men (mean age 70.43 ± 7.73 years). Prevalence of presarcopenia was 8.70% and sarcopenia, 13.30%.

CONCLUSION

Sarcopenia was more prevalent in women and it increases with age. It has a significant relationship with falls, cognitive impairment, central obesity and high levels of marginalization.

The Effects of Dietary Iron and Capsaicin on Hemoglobin, Blood Glucose, Insulin Tolerance, Cholesterol, and Triglycerides, in Healthy and Diabetic Wistar Rats

Objective

Our aim was to assess the effects of dietary iron, and the compound capsaicin, on hemoglobin as well as metabolic indicators including blood glucose, cholesterol, triglycerides, insulin, and glucose tolerance.

Materials and Methods

Our animal model was the Wistar rat, fed a chow diet, with or without experimentally induced diabetes. Diabetic males were fed control, low, or high-iron diets, the latter, with or without capsaicin. Healthy rats were fed identical diets, but without the capsaicin supplement. We then measured the parameters listed above, using the Student t-test and ANOVA, to compare groups.

Results

Healthy rats fed a low-iron diet exhibited significantly reduced total cholesterol and triglyceride levels, compared with rats fed a control diet. Significantly reduced blood lipid was also provoked by low dietary iron in diabetic rats, compared with those fed a control diet. Insulin, and glucose tolerance was only improved in healthy rats fed the low-iron diet. Significant increases in total cholesterol were found in diabetic rats fed a high-iron diet, compared with healthy rats fed the same diet, although no statistical differences were found for triglycerides. Hemoglobin levels, which were not statistically different in diabetic versus healthy rats fed the high-iron diet, fell when capsaicin was added. Capsaicin also provoked a fall in the level of cholesterol and triglycerides in diabetic animals, versus diabetics fed with the high iron diet alone. In conclusion, low levels of dietary iron reduced levels of serum triglycerides, hemoglobin, and cholesterol, and significantly improved insulin, and glucose tolerance in healthy rats. In contrast, a high-iron diet increased cholesterol significantly, with no significant changes to triglyceride concentrations. The addition of capsaicin to the high-iron diet (for diabetic rats) further reduced levels of hemoglobin, cholesterol, and triglycerides. These results suggest that capsaicin, may be suitable for the treatment of elevated hemoglobin, in patients.

Models Predictive of Metabolic Syndrome Components in Obese Pediatric Patients

BACKGROUND AND AIMS

Components of metabolic syndrome (MetS) are complications caused by abdominal obesity and insulin resistance (IR). Diagnosis of MetS by clinical indicators could help to identify patients at risk of cardiovascular disease and type 2 diabetes. We undertook this study to propose predictive indicators of MetS in obese children and adolescents.

METHODS

A cross-sectional study was carried out. After obtaining informed consent and the registration of the study with an institutional research committee, 172 obese patients from an Obesity Clinic, aged 6-15 years, were included. Variables included were waist circumference (WC), glucose, high-density lipoprotein (HDL), triglycerides (TGL), blood pressure, insulin resistance (by homeostatic model assessment HOMA-index), acanthosis nigricans (AN), uric acid, serum glutamic oxaloacetic transaminase (GOT) and alanine transaminase, and hepatic sonogram. International standards for age and sex variables were used. Multivariate analysis was applied.

RESULTS

Variables predicted components of MetS in children: HOMA-IR (insulin resistance by HOMA index) was increased by 2.4 in hepatic steatosis, by 0.6 for each unit of SUA (serum uric acid), and by 0.009 for every mg/dL of triglycerides. In adolescents, every cm of waist circumference increased systolic blood pressure by 0.6 mmHg, and each unit of SUA increased it by 2.9 mmHg.

CONCLUSIONS

Serum uric acid and waist circumference are useful and accessible variables that can predict an increased risk of cardiovascular disease in obese pediatric patients.

Presence and colocalization of type-1 cannabinoid receptors with acetylcholine receptors in the motor end-plate of twitch skeletal muscle fibers in the frog

Using polyclonal and monoclonal antibodies to visualize under a confocal microscope type-1 cannabinoid receptors (CB1) and acetylcholine (ACh) receptors, respectively, or α-bungarotoxin conjugated to Alexa-Fluor 555 for Ach receptors, we found that they colocalize on twitch muscle fibers in the frog (Rana pipiens). We show that both the CB1 and ACh receptors are present on the fast skeletal muscle motor end-plate. The CB1 receptor is present along the entire membrane of the muscle fiber, whereas the ACh receptor is expressed primarily at the motor end-plate. Analysis of the colocalization produced a cross-correlation coefficient of 0.519 ± 0.021 (n = 9) for both receptors at the muscle motor end-plate. This study suggests a close proximity between these two types of receptor proteins and that they could interact. CB1 could function at some stage of excitation-contraction coupling in these muscle fibers. However, further investigation is needed in order to clarify these issues.

Cannabinoid receptor type 1 activation by arachidonylcyclopropylamide in rat aortic rings causes vasorelaxation involving calcium-activated potassium channel subunit alpha-1 and calcium channel, voltage-dependent, L type, alpha 1C subunit

Cannabinoids are key regulators of vascular tone, some of the mechanisms involved include the activation of cannabinoid receptor types 1 and 2 (CB); the transient receptor potential cation channel, subfamily V, member 1 (TRPV1); and non-(CB(1))/non-CB2 receptors. Here, we used the potent, selective CB(1) agonist arachidonylcyclopropylamide (ACPA) to elucidate the mechanism underlying vascular tone regulation. Immunohistochemistry and confocal microscopy revealed that CB(1) was expressed in smooth muscle and endothelial cells in rat aorta. We performed isometric tension recordings in aortic rings that had been pre-contracted with phenylephrine. In these conditions, ACPA caused vasorelaxation in an endothelium-independent manner. To confirm that the effect of ACPA was mediated by CB(1) receptor, we repeated the experiment after blocking these receptors with a selective antagonist, AM281. In these conditions, ACPA did not cause vasorelaxation. We explored the role of K(+) channels in the effect of ACPA by applying high-K(+) solution to induce contraction in aortic rings. In these conditions, the ACPA-induced vasorelaxation was about half that observed with phenylephrine-induced contraction. Thus, K(+) channels were involved in the ACPA effect. Furthermore, the vasorelaxation effect was similarly reduced when we specifically blocked calcium-activated potassium channel subunit alpha-1 (KCa1.1) (MaxiK; BKCa) prior to adding ACPA. Finally, ACPA-induced vasorelaxation was also diminished when we specifically blocked the calcium channel, voltage-dependent, L type, alpha 1C subunit (Ca(v)1.2). These results showed that ACPA activation of CB(1) in smooth muscle caused vasorelaxation of aortic rings through a mechanism involving the activation of K(Ca)1.1 and the inhibition of Ca(v)1.2.