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Background: Type 2 diabetes (T2D) is a complex metabolic ailment marked by a global high prevalence and significant attention in primary healthcare settings due to its elevated morbidity and mortality rates. The pathophysiological mechanisms underlying the onset and progression of this disease remain subjects of ongoing investigation. Recent evidence underscores the pivotal role of the intricate intercellular communication network, wherein cell-derived vesicles, commonly referred to as extracellular vesicles (EVs), emerge as dynamic regulators of diabetes-related complications. Given that the protein cargo carried by EVs is contingent upon the metabolic conditions of the originating cells, particular proteins may serve as informative indicators for the risk of activating or inhibiting signaling pathways crucial to the progression of T2D complications. Methods: In this study, we conducted a systematic review to analyze the published evidence on the proteome of EVs from the plasma or serum of patients with T2D, both with and without complications (PROSPERO: CRD42023431464). Results: Nine eligible articles were systematically identified from the databases, and the proteins featured in these articles underwent Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. We identified changes in the level of 426 proteins, with CST6, CD55, HBA1, S100A8, and S100A9 reported to have high levels, while FGL1 exhibited low levels. Conclusion: These proteins are implicated in pathophysiological mechanisms such as inflammation, complement, and platelet activation, suggesting their potential as risk markers for T2D development and progression. Further studies are required to explore this topic in greater detail.
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This research aimed to chemically synthesize and evaluate the antiproliferative and anti-inflammatory potential of ozopromide (OPC), a novel compound recently isolated from O. vulgaris ink. After chemical synthesis, OPC structural characterization was confirmed by COSY2D, FTIR, and C-/H-NMR. OPC inhibited the growth of human breast (MDA-MB-231), prostate (22Rv1), cervix (HeLa), and lung (A549) cancerous cells, being the highest effect on the latter (IC50: 53.70 µM). As confirmed by flow cytometry, OPC induced typical apoptosis-derived morphological features on A549 cells, mostly at early and late apoptosis stages. OPC generated a dose-dependent effect inhibiting IL-6 and IL-8 on LPS-stimulated peripheral mononuclear cells (PBMCs). A major affinity of OPC to Akt-1 and Bcl-2 proteins in silico agreed with the observed pro-apoptotic mechanisms. Results suggested that OPC has the potential to alleviate inflammation and be further studied for anticancer activity. Marine-derived food products such as ink contains bioactive metabolites exhibiting potential health benefits.
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Antineoplásicos , Neoplasias , Octopodiformes , Masculino , Feminino , Animais , Humanos , Antineoplásicos/química , Linhagem Celular Tumoral , Células A549 , Tinta , Apoptose , Proliferação de CélulasRESUMO
In this work we use Mimosa tenuiflora (MtE) extracts as reducing agents to synthesize silver nanoparticles (AgMt NPs) which were characterized by DPPH and Total Polyphenols Assays, UV-visible, X-ray diffractometer (XRD), high-resolution transmission electron microscopy (HRTEM), X-ray photoelectron spectroscopy (XPS) and Thermogravimetric analysis (TGA). AgMt NPs possess average sizes of 21 nm and fcc crystalline structure, it was also confirmed that the MtE is present in the AgMt NPs even after the cleaning protocol applied. Subsequently, carbopol hydrogels were made and the MtE and the synthesized AgMt NPs were dispersed in different gels (MtE-G and AgMt NPs-G, respectively) at 100 µg/g concentration. The gels were characterized by UV-Vis, IR, and rheology. Antimicrobial tests were performed using Staphylococcus aureus and Escherichia coli. Burn wound healing was evaluated in a second-degree burn injury on a Wistar rats model for 14 days and additional skin biopsies were examined with histopathological analysis. Gel with commercial silver nanoparticles (Ag NPs) was prepared and employed as a control on the biological assays. Hydrogel system containing silver nanoparticles synthesized with Mimosa tenuiflora (AgMt NPs-G) is a promising therapeutic strategy for burn wound healing, this due to bactericidal and anti-inflammatory effects, which promotes a more effective recovery (in percentage terms) by damaged area.
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Queimaduras/tratamento farmacológico , Mimosa/química , Extratos Vegetais/administração & dosagem , Prata/administração & dosagem , Animais , Avaliação Pré-Clínica de Medicamentos , Hidrogéis/química , Hidrogéis/uso terapêutico , Masculino , Nanopartículas Metálicas/química , Nanopartículas Metálicas/ultraestrutura , Fitoterapia , Casca de Planta/química , Extratos Vegetais/química , Ratos Wistar , Prata/química , Cicatrização/efeitos dos fármacosRESUMO
AIMS: This pilot study aimed to determine if increased serum ferritin (SF) is associated with cardiovascular risk factors in patients with prediabetes. METHODS: Eighteen patients with prediabetes and 36 subjects without prediabetes (control), non-white Hispanic, non-indigenous origin, Mexican mestizo descent were included. Participants had no inflammation, or vascular complications. SF and metabolic markers were evaluated in both groups. RESULTS: SF and oxidized low-density lipoprotein (oxLDL) were increased in prediabetes subjects. Moreover, in prediabetes and control groups as a whole, natural logarithm (ln)-SF correlated with oxLDL and ln-oxLDL/LDL after adjustment for sex, ln-age, ln-fasting plasma glucose (FPG), ln-body mass index, ln-triglyceride (TG), total cholesterol (TC), and high-density lipoproteins. Finally, ln-SF was an independent contributor to ln-oxLDL/LDL ratio in control and prediabetes subjects (ß = 0.2915) after the introduction of potential confounders such as FPG, TC, TG, and hypertension. CONCLUSIONS: The results of this study indicate that hyperferritinemia is associated with oxLDL, considered one of the main cardiovascular risk factors, which allows us to suggest that an increase in SF could contribute to the progression of prediabetes, prior to the appearance of diabetes. Further research is required to establish a causal relationship of iron disruption metabolism in oxLDL generation under prediabetes conditions.
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We investigated the phenotypic and molecular characteristics of Extended-Spectrum-ß-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae clinical isolates from four health-care institutions in Hermosillo, Sonora, Mexico. ESBL-producing isolates were collected from February to August 2016. The prevalence of ESBL-producing E. coli and K. pneumoniae was 11.9 and 8.7%, respectively. High dissemination of resistance to ciprofloxacin (88%), trimethoprim/sulfamethoxazole (72%) and aminoglycosides (59%) were detected, as well as susceptibility to meropenem, amikacin and tigecycline. The ESBL found variants were CTX-M-1 (88%) and CTX-M-9 (5%). The plasmid-mediated quinolone resistance (PMQR) gene aac(6´)-Ib-cr was identified in 62% of a representative sample, whereas the qnrB and qnrS genes were detected in 49% of the isolates. PFGE analyses detected many unrelated clones among the hospital or community isolates. A constant programme of epidemiological surveillance is recommended to understand the dynamics of bacterial resistance to both cephalosporin as well as the fluoroquinolone family of antibiotics.
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Escherichia coli/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , beta-Lactamases/biossíntese , Farmacorresistência Bacteriana Múltipla/genética , Farmacorresistência Bacteriana Múltipla/fisiologia , Escherichia coli/isolamento & purificação , Humanos , Klebsiella pneumoniae/isolamento & purificação , México , Testes de Sensibilidade Microbiana , FenótipoRESUMO
Obesity and its comorbidities have become the most important public health problems for Latin America. In Mexico obesity has increased dramatically to the point where the government has declared it an epidemiological emergency. The most recent national data showed overweight and obesity affects 72.5% of adults, or around 56 million Mexicans. Most Mexican adults with obesity are undiagnosed. According to data derived from a national representative survey, only 20% of adults with BMI >30 kg/m2 were diagnosed with obesity by a health provider. Likewise, only 8% of individuals with obesity had received treatment for obesity. Interventions offered in the Mexican health care delivery system generally consist of traditional consultations with recommendations on diet and exercise, visits are monthly to quarterly, and validated behavior change protocols are not used. Evidence from clinical trials has shown that weight loss with this type of treatment is generally less than 1 kg per year. In contrast, intensive lifestyle interventions - protocols focusing on achieving changes in diet, physical activity, and moderate weight loss using behavioral strategies with weekly or bi-weekly sessions for the first 3 to 6 months, and a maintenance phase with trained interventionists - as implemented in the Diabetes Prevention Program and the Look AHEAD studies achieved weight loss of 7-9% at one year. Additionally, translation studies of these interventions to the community and to real-world clinical practice have achieved weight loss of around 4%. Adaptations of intensive lifestyle interventions have been implemented in the United States, both in clinical practice and in the community, and this type of intervention represents a potential model to combat obesity in Mexico and other Latin American countries. It is essential that primary care providers in Mexico implement clinical practice guidelines based on the best evidence available as discussed here to effectively treat obesity. The authors make recommendations to improve the treatment of obesity in the clinical care delivery system in Mexico using intensive lifestyle interventions.
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Resistência Microbiana a Medicamentos , Hospitais Urbanos , Vigilância da População , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla , Escherichia coli/efeitos dos fármacos , Hospitais Urbanos/estatística & dados numéricos , Humanos , México/epidemiologia , Pseudomonas aeruginosa/efeitos dos fármacosRESUMO
Background: Rocky Mountain spotted fever (RMSF) is a tick-borne disease with a high case-fatality rate unless diagnosed promptly and treated timely with doxycycline. Physician knowledge about presentation and treatment can improve outcomes of RMSF in endemic regions, such as Sonora in northern Mexico, where RMSF has caused 1348 non-fatal cases and 247 deaths from 2003 to 2016. Methods: A cross-sectional study was conducted with 343 physicians working in medical facilities in Sonora, Mexico. A 25-item questionnaire explored physician knowledge of clinical, epidemiological and preventive aspects of RMSF. Results: Only 62% of physicians agreed that doxycycline should be used as the first choice treatment for children under 8 years with suspected RMSF. Additionally, 40% of primary care physicians correctly identified the time to initiate doxycycline, and 32% correctly identified the case-fatality rate of untreated RMSF in all patients. Conclusions: Inadequate medical knowledge may adversely affect how patients infected with Rickettsia rickettsii are diagnosed and treated. Educational programs that improve the risk perception and medical knowledge about RMSF should be targeted at physicians most likely to have initial contact with diseased patients.
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Antibacterianos/uso terapêutico , Testes Diagnósticos de Rotina/estatística & dados numéricos , Doxiciclina/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Padrões de Prática Médica/estatística & dados numéricos , Rickettsia rickettsii/isolamento & purificação , Febre Maculosa das Montanhas Rochosas/diagnóstico , Febre Maculosa das Montanhas Rochosas/tratamento farmacológico , Adulto , Animais , Estudos Transversais , Educação Médica , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Médicos , Febre Maculosa das Montanhas Rochosas/epidemiologia , Carrapatos/microbiologia , Fatores de TempoAssuntos
Humanos , Hospitais Urbanos/estatística & dados numéricos , Resistência Microbiana a Medicamentos , Vigilância da População , Pseudomonas aeruginosa/efeitos dos fármacos , Infecção Hospitalar/microbiologia , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana Múltipla , Escherichia coli/efeitos dos fármacos , México/epidemiologiaRESUMO
We present a series of four pregnant women with Rocky Mountain spotted fever (RMSF) that occurred in Sonora, Mexico, during 2015-2016. Confirmatory diagnoses were made by polymerase chain reaction or serological reactivity to antigens of Rickettsia rickettsii by using an indirect immunofluorescence antibody assay. Each patient presented with fever and petechial rash and was treated successfully with doxycycline. Each of the women and one full-term infant delivered at 36 weeks gestation survived the infection. Three of the patients in their first trimester of pregnancy suffered spontaneous abortions. RMSF should be suspected in any pregnant woman presenting with fever, malaise and rash in regions where R. rickettsii is endemic.
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Complicações Infecciosas na Gravidez/epidemiologia , Febre Maculosa das Montanhas Rochosas/epidemiologia , Adolescente , Feminino , Humanos , México/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/patologia , Febre Maculosa das Montanhas Rochosas/patologia , Adulto JovemRESUMO
OBJECTIVE: Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. MATERIALS AND METHODS: Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF) in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. RESULTS: An upward trend was observed in RMSF morbidity and mortality. Fatality rate was 30%.Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (ORa= 2.95, 95% CI 1.10-7.95), acute renal failure ((ORa= 8.79, 95% CI 3.46-22.33) and severe sepsis (ORa= 3.71, 95% CI 1.44-9.58). CONCLUSIONS: RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.
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Febre Maculosa das Montanhas Rochosas/epidemiologia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/mortalidade , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Morbidade/tendências , Mortalidade/tendências , Fatores de Risco , Febre Maculosa das Montanhas Rochosas/complicações , Febre Maculosa das Montanhas Rochosas/mortalidade , Sepse/etiologia , Sepse/mortalidadeRESUMO
Resumen: Objetivo: Caracterizar las manifestaciones clínicas y predictores de mortalidad en niños hospitalizados por fiebre maculosa de las Montañas Rocosas (FMMR). Material y métodos: Estudio transversal en 210 sujetos hospitalizados por FMMR en un hospital pediátrico de Sonora, entre el 1 de enero de 2004 y el 30 de junio de 2015. El análisis se sustentó en estadística descriptiva y regresión logística multivariada. Resultados: Se apreció un incremento en la incidencia y mortalidad en los casos hospitalizados por FMMR, con una letalidad de 30%.Tres variables se asociaron con el riesgo de muerte: retraso ≥ 5 días en el inicio del uso de doxiciclina (RMa=2.95, IC95% 1.10-7.95), falla renal aguda (RMa=8.79, IC95% 3.46-22.33) y sepsis severa (RMa=3.71, IC95% 1.449.58). Conclusión: La FMMR provoca resultados fatales en niños, que puede evitarse con la administración oportuna de doxiciclina. La falla renal aguda y la sepsis severa son dos predictores de muerte en niños con FMMR.
Abstract: Objective: Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. Materials and methods: Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF) in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: An upward trend was observed in RMSF morbidity and mortality. Fatality rate was 30%.Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (ORa= 2.95, 95% CI 1.10-7.95), acute renal failure ((ORa= 8.79, 95% CI 3.46-22.33) and severe sepsis (ORa= 3.71, 95% CI 1.44-9.58). Conclusions: RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.
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Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Febre Maculosa das Montanhas Rochosas/epidemiologia , Febre Maculosa das Montanhas Rochosas/complicações , Febre Maculosa das Montanhas Rochosas/mortalidade , Estudos Transversais , Fatores de Risco , Morbidade/tendências , Mortalidade/tendências , Sepse/etiologia , Sepse/mortalidade , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/mortalidade , México/epidemiologiaRESUMO
El comportamiento epidemiológico de la fiebre manchada por Rickettsia rickettsii constituye un desafío para los sistemas de salud del continente americano. Es un padecimiento de relevancia médica por la letalidad que provoca si no es diagnosticado ni tratado oportunamente. Aunque cualquier persona es susceptible a la infección, algunos grupos poblacionales son más vulnerables debido a un mayor contacto con la garrapata transmisora, entre ellos los niños, quienes tienen mayor morbilidad por lo que se asocian con resultados fatales. En su origen participa una multitud de factores biológicos, ecológicos y sociales, interrelacionados complejamente, y cuyo abordaje requiere de intervenciones integradas y multidisciplinarias. La incidencia de la enfermedad puede continuar aumentando en la región, de modo que su ocurrencia actual constituye un llamado urgente para la acción regional. Acciones preventivas que disminuyan el contacto con garrapatas e incrementen la sospecha temprana de la enfermedad, son prioritarias en la agenda de salud de varias naciones de las Américas.
Rocky mountain spotted fever is a public health problem in America. The disease remains as a challenge for Health Systems at regional level. It is an illness of medical relevance due to its high case-fatality rate when it is not diagnosed and treated early. Although anyone is susceptible to infection, some groups are more vulnerable due to increased exposure to ticks, including children who have higher morbidity and fatal outcomes. A myriad of biological, ecological and social factors, complexly interrelated, are associated with its epidemiological pattern, which requires integrated and multidisciplinary interventions at different levels. The incidence of the disease may continue to increase in the region and its actual occurrence required an urgent call for regional action. Preventive actions that reduce contact with ticks and increase early disease suspicion should be priorities in the health agenda of various nations in America.
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Humanos , Pré-Escolar , Criança , Adolescente , Rickettsia , América do Sul , Febre Maculosa das Montanhas Rochosas , América Central , Saúde Pública , Doenças Transmitidas por CarrapatosRESUMO
Mycobacterium bovis is the major causative agent of bovine tuberculosis, one of the most relevant zoonoses in the world, and affects a wide range of wild and domesticated animals. Development of screening panels in mycobacterial genotyping, according to specific geographical regions, is strongly needed. The aim of this study is to select a panel, constituted by highly polymorphic MIRU-VNTR loci, to discriminate clinical isolates of M. bovis in Mexico. In this study, 65 isolates of M. bovis obtained from clinical bovine samples proceeding from different geographic regions of Mexico were identified by phenotypic and genotypic tests and subsequently genotyped by a 24-locus MIRU-VNTR panel. The most polymorphic loci were selected to build a panel with a high discriminatory power similar to the 24-locus panel results. A panel of seven elements (QUB 11a, MIRU 26, ETR-A, QUB 26, MIRU 16, MIRU 27, and MIRU 39) with the highest allelic diversity showed an appropriate differentiation. The selected MIRU-VNTR elements, according to the regional allelic variability, may be used in the preliminary genotyping of Mycobacterium bovis isolates in Mexico.
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Genótipo , Repetições Minissatélites/genética , Mycobacterium bovis/genética , Tuberculose Bovina/genética , Animais , Técnicas de Tipagem Bacteriana , Bovinos , Variação Genética , Mycobacterium bovis/patogenicidade , Tuberculose Bovina/microbiologiaRESUMO
INTRODUCTION: Tuberculosis is a public health problem across Mexico. This paper aims to select a panel, with a minimum number of repetitive elements (MIRU-VNTR) for genotypic characterization of Mycobacterium tuberculosis (M. tuberculosis) clinical isolates. METHOD: In this study, a full panel of 24 MIRU-VNTR loci was used to discriminate 65 clinical isolates of M. tuberculosis from three different geographical regions of Mexico. Those loci with the highest discriminatory power were subsequently selected. RESULTS: The panel, including five loci, was obtained by selecting the highest values of allelic diversity among the genotypes obtained. The dendrogram, generated by the panel MIRU-VNTR 5, showed a high discriminatory power with 65 unique genotype profiles and formed clusters according to the geographical region of origin. CONCLUSIONS: The panel MIRU-VNTR 5 can be useful for characterizing clinical isolates of M. tuberculosis in Mexico.
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DNA Bacteriano/genética , Genes Bacterianos , Técnicas de Genotipagem , Sequências Repetitivas Dispersas , Programas de Rastreamento/métodos , Repetições Minissatélites , Mycobacterium tuberculosis/classificação , Tuberculose/microbiologia , Técnicas de Tipagem Bacteriana , Variação Genética , Genótipo , Geografia Médica , Humanos , México/epidemiologia , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Filogenia , Tuberculose/epidemiologiaRESUMO
BACKGROUND: Rocky Mountain spotted fever (RMSF) is an increasingly important cause of preventable mortality in children in Sonora, Mexico. Although early treatment with tetracycline has shown to prevent fatal outcome, the disease remains a life-threatening condition, particularly for children. This study describes the clinical factors associated with pediatric mortality due to RMSF in Sonora, in order to guide healthcare practices. METHODS: This is a retrospective analysis of 104 children consecutively hospitalized at the major pediatric hospital of Sonora, diagnosed with RMSF between January 2004 and December 2013. Descriptive statistics and multiple logistic regression were used to identify risk factors for fatal outcome. RESULTS: The case fatality ratio in this cohort was 20.2%. Children were hospitalized after a median of 6 days from onset of symptoms including fever (100%), rash involving palms and soles (88.5%) and headache (79.8%); 90.4% of fatal cases had low platelet counts (<50,000/µL) and 33.3% showed serum creatinine concentrations above the normal value. Acute kidney injury increased mortality, odds ratio (OR(adj)) = 4.84, 95% confidence interval (CI): 1.2-16.2, as well as delay in treatment (≥ 5th day from onset) with doxycycline, OR(adj) = 2.62, 95% CI: 1.24-5.52 and hemorrhage, OR(adj) = 6.11, 95% CI: 1.89-19.69. CONCLUSIONS: RMSF is a public health problem in Sonora. Clinically, fatal cases differ from non-fatal cases in renal function and hemorrhagic manifestations, although these findings may occur too late for a timely intervention. First-line providers must be educated to harbor a timely suspicion of RMSF, and should provide empiric treatment with doxycycline when febrile patients first present for care.
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Insuficiência Renal/mortalidade , Insuficiência Renal/patologia , Febre Maculosa das Montanhas Rochosas/mortalidade , Febre Maculosa das Montanhas Rochosas/patologia , Adolescente , Animais , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Doxiciclina/uso terapêutico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México , Mortalidade , Prognóstico , Insuficiência Renal/tratamento farmacológico , Estudos Retrospectivos , Fatores de Risco , Febre Maculosa das Montanhas Rochosas/complicações , Febre Maculosa das Montanhas Rochosas/tratamento farmacológico , Adulto JovemRESUMO
Objective. To evaluate the efficacy of the [(13)C]glucose breath test for measuring insulin resistance in Mexican adults with different glycemic states. Research Design and Methods. Fifty-eight adults underwent a [(13)C]glucose breath test with simultaneous measurement of total CO(2) production by indirect calorimetry, at baseline and 90 minutes after the ingestion of 15 g of dextrose and 25 mg of [(13)C]glucose. HOMA was used as a marker of insulin resistance. Results. We found an inverse correlation between HOMA and the breath test δ(13)CO(2) (), r = -0.41 (P = 0.001). After adjusting for total CO(2) production, correlations between HOMA and fasting glucose were less strong but remained significant. An ROC curve was constructed using δ(13)CO(2) () and HOMA values; the cut-off point was 9.99 δ(13)CO(2), corresponding to a sensitivity of 80.0 (95% CI: 51.9, 95.7) and a specificity of 67.4 (95% CI: 51.5, 80.9). Conclusions. The [(13)C]glucose breath test is a simple noninvasive procedure but was not sufficiently robust for an accurate diagnosis of insulin resistance. Our findings suggest that the test might be helpful in identifying individuals who are not IR, which in turn may contribute to improved diabetes prevention.