Publications by authors named "M Cristina Pacheco"

769 Publications

Dynamics of RT-PCR and Serologic Test Results in Children with SARS-CoV-2 Infection.

J Pediatr 2021 Sep 24. Epub 2021 Sep 24.

Microbiology Department, UR Salud, Hospital Universitario Infanta Sofía, Madrid, Spain.

Objectives: To determine the time to RT-PCR negativity after the first positive RT-PCR test, factors associated with longer time to RT-PCR negativity, proportion of children seroconverting after proven SARS-CoV-2 infection, and factors associated with the lack of seroconversion.

Study Design: EPICO-AEP is a multicenter study conducted in Spanish children to assess the characteristics of COVID-19. In a subset of patients, three serial RT-PCR tests on nasopharyngeal swab specimens were performed after the first RT-PCR test, and IgG serology for SARS-CoV-2 antibodies was performed in the acute and follow up (<14 and ≥14 days after diagnosis) phase.

Results: In total, 324 patients were included in the study. Median [IQR] time to RT-PCR negativity was 17 [8-29] days, and 35% of patients remained positive >4 weeks after the first RT-PCR test. The probability of RT-PCR negativity did not differ across groups defined by sex, disease severity, immunosuppressive drugs, or clinical phenotype. Globally, 24% of children failed to seroconvert after infection. Seroconversion was associated with hospitalization, persistence of RT-PCR positivity and days of fever.

Conclusions: Time to RT-PCR negativity was long, regardless of severity of symptoms or other patients' features. This should be considered when interpreting RT-PCR results in a child with symptoms, especially those with mild symptoms. Seroprevalence and post-immunization studies should consider that one in four infected children fail to seroconvert.
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http://dx.doi.org/10.1016/j.jpeds.2021.09.029DOI Listing
September 2021

The clinical-epidemiological profile of malaria patients from Southern Venezuela, a critical hotspot in Latin America.

Malar J 2021 Sep 20;20(1):375. Epub 2021 Sep 20.

Biology Department/Institute of Genomics and Evolutionary Medicine (iGEM), Temple University, Philadelphia, PA, 19122-1801, USA.

Background: Venezuela accounted for 55% of the cases and 73% of the malaria deaths in the Americas in 2019. Bolivar state, in the southeast, contributes > 60% of the country's Plasmodium vivax and Plasmodium falciparum cases every year. This study describes the clinical-epidemiological characteristics of clinical malaria patients in this high-transmission area.

Methods: A prospective study was conducted on patients seeking medical attention in three medical centres in the state capital, Ciudad Bolivar, between June and October 2018. Malaria diagnosis was carried out using microscopy following national standards. Malaria-positive patients were examined for clinical symptoms, and haematological tests were performed at the time of diagnosis. Patients were followed up by telephone to evaluate malaria recurrences.

Results: Out of 287 patients, 200 (69.7%) were positive for P. vivax, 69 (24%) for P. falciparum, and 18 (6.3%) had mixed (P. vivax/P. falciparum) infections. Patients' median age was 33 years (IQR 20), 168 (69%) were men, and 40% practiced gold mining as the main occupation. Fever (96.5%), chills (91.3%), and headaches (90.6%) were the most frequent symptoms. At least one symptom associated with severe malaria was observed in 69 out of 161 patients with complete clinical evaluation (42.9%). Plasmodium vivax infections were found in 42 out of 69 (60.9%) severe cases; by contrast, P. falciparum and mixed malaria caused 34.8% (24/69) and 4.4% (3/69) of infections, respectively. Two patients died of cerebral malaria. Mean hemoglobin was lower in the patients infected with P. falciparum than those infected with P. vivax. Regardless of the parasite causing the infection, patients presented high levels of total bilirubin, aminotransferases (AST, ALT), and lactate dehydrogenase (LDH). Out of the 142 patients followed up by phone for three months (49.5% of the 287 patients), 35 (24.7%) reported recurrences.

Conclusions: The high malaria prevalence among young male adults practicing gold mining suggests that this occupation is a significant risk factor. The unexpected high prevalence of P. vivax patients with at least one criteria of severe clinical disease is a matter of concern. Whether it is the result of a lack of timely diagnosis and effective treatment should be explored.
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http://dx.doi.org/10.1186/s12936-021-03913-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453994PMC
September 2021

Evaluation of BioPlex 2200 tTG-IgA Diagnostic Performance for Serology-Based Diagnosis of Celiac Disease.

Am J Clin Pathol 2021 Sep 20. Epub 2021 Sep 20.

Department of Laboratories, Seattle, WA, USA.

Objectives: Forgoing biopsy for the diagnosis of celiac disease in children with tissue transglutaminase immunoglobulin A (tTG-IgA) levels greater than or equal to 10 times the upper limit of normal (≥10×ULN) has been advocated by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition.

Methods: Our retrospective study tested the specificity and positive predictive value (PPV) of the BioPlex 2200 assay (Bio-Rad Laboratories) in diagnosing celiac disease at the ≥10×ULN tTG-IgA threshold, which is ≥150 U/mL (negative <15 U/mL). We used the tTG-IgA and duodenal biopsy results within 6 months following tTG-IgA measurements from 542 patients who had any number of duodenal biopsy fragments, of whom 165 patients had 5 or more tissue fragments. Sensitivity and specificity of the test were calculated using histology as the gold standard for Marsh class 2 and above.

Results: For histopathologic findings in the duodenum with Marsh 2 and higher, the specificity and PPV of the BioPlex 2200 at ≥10×ULN tTG-IgA were 99.5% and 95.4% using all biopsies and 97.9% and 94.9% for biopsies with 5 or more tissue fragments.

Conclusions: Should clinical considerations preclude endoscopy, the BioPlex 2200 assay at ≥10×ULN TTG-IgA could be considered highly suggestive of disease.
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http://dx.doi.org/10.1093/ajcp/aqab104DOI Listing
September 2021

Copper-Binding Peptides Attenuate Microglia Inflammation Through Suppression of NF-kB Pathway.

Mol Nutr Food Res 2021 Sep 16:e2100153. Epub 2021 Sep 16.

Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.

Scope: Activation of microglia, the resident immune cells of the central nervous system, has been related to the etiology and progression of neurodegenerative diseases; thus, finding novel approaches to suppress the neuroinflammatory process is of utmost relevance.

Methods And Results: The anti-inflammatory activity of whey Cu-, Fe-, and Zn-binding peptides and their possible underlying mechanism of action were evaluated in microglia. Whey metal-binding peptides decreased nitric oxide production and TNF-α at mRNA and protein levels by stimulated BV-2 microglia in comparison to the control with no peptide treatment. The hydrophobicity, specific sequences, and possible synergistic effects seem to play a role. Cu-binding peptides (Cu-bp) presented anti-inflammatory activity both in BV-2 and primary microglia cultures. These peptides exert their action by suppressing NF-kB pathway since nuclear translocation of NF-kB p65 was decreased by roughly 30% upon Cu-bp treatment. Specific sequences identified in Cu-bp showed high affinity to bind NF-kB p65 by molecular docking (up to -8.8 kcal/mol), corroborating the immunofluorescence studies.

Conclusion: Cu-bp represent food-derived peptides that may be useful for neuroprotective purposes. Chelation of copper excess in the CNS and the bioavailability of such peptides, as well as their behavior in in vivo models, deserve further research for future applications. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1002/mnfr.202100153DOI Listing
September 2021

The relation between body mass index and body fat percentage in Brazilian adolescents: Assessment of variability, linearity, and categorisation.

Ann Hum Biol 2021 Sep 16:1-18. Epub 2021 Sep 16.

Federal University of Rondônia, Porto Velho, 76801-059 Brazil.

Reliable but accessible measures to capture body composition are highly important as the world is in an era of obesity-increase. The most used measure, the body mass index (BMI), nevertheless, has been judged as non-reliable to estimate body fat percentage (BF%). The present manuscript assessed the criticisms of BMI as a predictor of BF% and the BMI-based categories of nutritional status. 4164 children/adolescents from 9 to 18 years of age from Porto Velho, Brazil, had their anthropometric and skinfold measures taken. Controlling for socioeconomic status, school (private, public), sex and age, we compared proposed models/variables in the literature relating BMI and BF%. We evaluated the functions and the residual data to understand the variability of BF% estimate per BMI and evaluated three possible categorisations from BMI to predict BF% nutritional status. The function utilising (linear) BMI was the best to predict BF% ( = 0.70) with a variability of only 6.49% around the function. Nevertheless, no categorisation of nutritional status was reliable to predict the nutritional status of individuals. BMI is reliable to estimate BF%. Nevertheless, new normative values must be proposed; the original categorisation fails to capture the nutritional status of children/adolescents at this region.
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http://dx.doi.org/10.1080/03014460.2021.1982002DOI Listing
September 2021
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