Laura Flores-Cisneros

Background: Right ventricular dysfunction (RVD) is characterized by abnormal RV structure or function and is associated with worse outcomes. In subjects with RVD, cardiac cachexia and sarcopenia were associated with intestinal congestion. However, the prognostic impact and prevalence of body composition phenotypes and phase angle (PhA) in RVD have been insufficiently studied. Objective: To assess the prognostic impact and prevalence of body composition phenotypes and PhA in RVD, Methods: A prospective cohort study was conducted. Outpatient subjects over 18 years old with a confirmed diagnosis of RVD were included. Dynapenia, muscle wasting, and sarcopenia, according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), while cachexia was defined according to Evans criteria. Results: A total of 212 subjects with RVD were included. The mean age of the subjects was 64.47 ± 13.99 years, and 58.96% were men. The prevalence of dynapenia was 28.30%, muscle wasting was 10.38, sarcopenia was 21.70%, and cachexia was 4.25%. The independent risk factors for mortality were PhA < 5° (HR: 2.29, 95% CI: 1.27 to 4.15, p = 0.006), low performance (HR:2.69, 95% CI: 1.25 to 5.81, p = 0.011), sarcopenia (HR: 2.58, 95% CI 1.05 to 6.34; p = 0.038), and cachexia (HR: 4.29, 95% CI 1.29 to 14.24; p = 0.017). Conclusion: In subjects with RVD, there is a higher prevalence of muscle disorders such as dynapenia, sarcopenia, and cachexia. Besides PhA, sarcopenia and cachexia were associated with a worse prognosis.

Objective: During the COVID-19 pandemic, the Indigenous population in Mexico was subject to several factors that caused them to have a higher mortality risk than the non-Indigenous population. These risk factors included language barriers, poverty, comorbidities, inadequate access to health services, lack of social security, limited education, and substandard housing, inter alia. This study aims to determine the factors associated with COVID-19 mortality in the Indigenous population in Mexico. Study Design: Cohort study. Methods: This study utilized data from the National Epidemiological Surveillance System for Viral Respiratory Disease (SISVER) collected during 2020 and 2021 to examine the population recognized as Indigenous. Results: A total of 506,956 COVID-19 cases were reported, with 0.75% identified as Indigenous. The logistic regression assessed the combined effect of Indigenous status and each risk factor. Adjusted odds ratios (aORs) with or without interaction terms were reported. The identified risk factors were the following: age of > 60 years × Indigenous (aOR 9.19, CI 95% 6.38–13.2, p < 0.001); male × Indigenous (aOR 3.38, CI 95% 2.72–5.53, p < 0.001); and time from symptom onset to seeking care > 7 days × Indigenous (aOR 5.86, CI 95% 4.10–8.37, p < 0.001). Conclusions: Belonging to the Indigenous population is a significant risk factor for COVID-19 mortality in Mexico. Although both Indigenous and non-Indigenous groups share common risk factors, the combined effect of Indigenous status and each risk factor reveals greater vulnerability among the former. Significant interactions were observed with age over 60 years, sex, and delays in seeking medical care after the onset of symptoms.

Background and Objective: Fibrotic interstitial lung disease (ILD) is associated with high morbidity and mortality. Patients often exhibit impaired nutritional status and alterations in body composition, such as dynapenia and sarcopenia, which correlate with poor pulmonary function, reduced exercise tolerance and diminished quality of life. However, the impact of dynapenia and sarcopenia on prognosis has not been examined extensively in ILD patients.We assessed the impact of dynapenia and sarcopenia as risk factors for mortality and their prevalence in ILD.Methods: Prospective cohort study. ILD was classified into idiopathic pulmonary fibrosis (IPF), connective tissue disease‐related ILD (CTD‐ILD) and chronic hypersensitivity pneumonitis (CHP). Patients over 18 years old with a confirmed diagnosis of ILD were included, while those with diagnoses of cancer, human immunodeficiency virus and neurological disease were excluded. Dynapenia and sarcopenia were determined according to EWGSOP2 criteria.Results: Ninety‐eight ILD patients were included; 33.66% had IPF, 47.96% had CTD‐ILD, and 18.37% had CHP. The mean age was 63.89 ± 12.02 years; 37.76% were male.The risk factors associated with mortality included dynapenia (HR: 2.04, 95% CI: 1.10–3.77, p = 0.022), sarcopenia (HR: 1.88, 95% CI; 1.00–3.33, p = 0.049) and exercise tolerance (HR: 0.99, 95% CI; 0.99–0.99, p = 0.023), adjusted for confounding variables.The prevalence of dynapenia was 45% in ILD; 51% in IPF, 35% in CTD‐ILD and 61% in CHP. The prevalence of sarcopenia was 29%; both IPF (39%) and CHP (50%) had a higher prevalence of sarcopenia than CTD‐ILD (14%).Conclusion: Sarcopenia and dynapenia are independent risk factors for mortality in ILD. image

In April 2024, the Instituto Nacional de Enfermedades Respiratorias of Mexico City identified a case of unsubtypeable Influenza A in a 58-year-old immunocompromised patient with renal failure due to diabetic nephropathy and bacterial peritonitis. Through sequencing the M, NS, NA, NP, and HA complete segments, we identified an H5N2 influenza virus with identity of 99% with avian influenza A(H5N2) from Texcoco, Mexico, in 2024. This case is the first reported with direct evidence of human infection caused by the H5N2 influenza virus; the relationship of the virus with the severity of his condition remains unknown.

Background: The most frequent body composition alterations in post-COVID-19 syndrome include low muscle mass, dynapenia, sarcopenia, and obesity. These conditions share interconnected pathophysiological mechanisms that exacerbate each other. The relationship between body composition phenotypes and metabolic abnormalities in post-COVID-19 syndrome remains unclear. Objective: To evaluate the association between body composition phenotypes and insulin resistance (IR) and metabolic abnormalities in non-diabetic individuals with post-COVID-19 syndrome. Methods: A cross-sectional, single-center study involving 483 subjects with post-COVID-19 syndrome following moderate to severe acute COVID-19 requiring hospitalization. Individuals with diabetes, those who declined to participate, or those who could not be contacted were excluded. Body composition phenotypes were classified as normal weight, dynapenia, sarcopenia, dynapenic obesity, and sarcopenic obesity (SO). Results: The average age was 52.69 ± 14.75 years; of note, 67.08% were male. The prevalence of body composition phenotypes was as follows: 13.25% were of normal weight, 9.52% had dynapenia, 9.94% had sarcopenia, 43.69% had obesity, 18.84% had dynapenic obesity, and 4.76% had SO. Additionally, 58.18% had IR. Obesity (OR: 2.98, CI95%; 1.64–5.41) and dynapenic obesity (OR: 4.98, CI95%; 1.46–6.88) were associated with IR. Conclusion: The most common body composition phenotypes were obesity, dynapenic obesity, and dynapenia. Furthermore, obesity and dynapenic obesity were associated with IR in post-COVID-19 syndrome.

Background: The SARS-CoV2 pandemic impacted many critically ill patients, causing sequelae, affecting lung function, and involving the musculoskeletal system. We evaluated the association between lung function and muscle quality index in severely ill post-COVID-19 patients. Methods: A cross-sectional study was conducted on a post-COVID-19 cohort at a third-level center. The study included patients who had experienced severe-to-critical COVID-19. Anthropometric measurements, such as body mass index (BMI) and handgrip strength, were obtained to calculate the muscle quality index (MQI). Additionally, spirometry, measurements of expiratory and inspiratory pressure, and an assessment of DLCO in the lungs were performed. The MQI was categorized into two groups: low-MQI (below the 50th percentile) and high-MQI (above the 50th percentile), based on sex. Group differences were analyzed, and a multivariate linear regression analysis was performed to assess the association between respiratory function and MQI. Results: Among the 748 patients analyzed, 61.96% required mechanical ventilation, and the median hospital stay was 17 days. In patients with a low MQI, it was observed that both mechanical respiratory function and DLCO were lower. The multivariate analysis revealed significantly lower findings in mechanical respiratory function among patients with a low MQI. Conclusion: The Low-MQI is an independent predictor associated with pulmonary function parameters in subjects with Post-COVID-19 syndrome.

Objective Cervical cancer is the fourth most frequent neoplasm among women in terms of incidence and mortality. Health-related quality of life (HRQL) is an important outcome in oncology. The QLQ-CX24 instrument was developed to measure HRQL in patients with cervical cancer, and its Mexican-Spanish version had not been validated. Methods Between March 2018 and May 2019, Mexican women older than 18, with any-stage cervical cancer were invited to participate in the study. Patients answered the QLQ-C30 and QLQ-CX24 questionnaires. Current tests for psychometric and clinical validation were performed. Results Three hundred and thirty patients with cervical cancer were included in this study. All women invited to participate accepted and were included. The QLQ-CX24 internal consistency test demonstrated adequate convergent (Spearman correlation coefficient 0.001–0.847) and divergent validity (Spearman correlation coefficient 0.7 (minimum 0.76, maximum 0.89). Four scales of the QLQ-CX24 distinguished patients in different clinical stages. The evaluation of responsiveness demonstrated that the peripheral neuropathy scale was sensitive to change over time during chemo-radiation therapy. Six scales of the QLQ-CX24 instrument were associated with survival. Conclusion The Mexican-Spanish version of the QLQ-CX24 questionnaire is reliable and valid for the assessment of HRQL in patients with cervical cancer.

The objective was to evaluate body composition and nutritional status in women with locally advanced cervical cancer (LACC) before receiving oncologic treatment. Women with cervical cancer diagnoses in clinical stage IB2 to IIIB were studied. Body composition was measured with bioimpedance, sarcopenia determined according to the European Consensus, and nutritional status according to the Patient-Generated Subjective Global Assessment. A total of 155 women with age 50.4 +/- 13.7, 29 clinical stage I, 82 II, and 44 III, were studied. Patients in advanced clinical stage III, compared with patients in stage II and stage I, lower phase angle (III: 5.2 +/- 0.98 vs. II: 5.7 +/- 1.9 and I: 5.8 +/- 0.69, p = 0.007). Impedance vector distribution was different in patients in clinical stage III vs. those in clinical stage II (p = 0.014) and I (p = 0.039). LACC patients in advanced stages had worse body composition and nutritional status before treatment.