standardized-protocol-for-early-cardiometabolic-assessment-metabolic

Standardized Protocol for Early Cardiometabolic Assessment in Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with chronic low-grade inflammation and an increased risk of cardiovascular ...

Experimental Metabolism and Clinical Research Laboratory

Parkinson's Disease (PD) is a neurodegenerative disease in which non-motor symptoms may appear before motor phenomena, which include Impulse Control Disorders (ICDs). The objective of this study is to identify factors associated with the development of ICDs in PD. An analytical, cross-sectional study was conducted using clinical records from patients diagnosed with PD, both genders, from 40 to 80 years old. Clinical and demographic data were collected: 181 patients were recruited; 80 of them showed PD and ICDs, and they constituted the study group, whereas 101 patients with PD without ICDs constituted the control reference group. The duration of PD was longer in the group with ICDs ( < 0.008), and all patients showed at least one ICD: binge eating (61.29%), compulsive shopping (48.75%), hypersexuality (23.75%), gambling behavior (8.75%), and punding (3.75%). After logistic regression analysis, only the use of dopamine agonists remained associated with ICDs ( < 0.001), and the tremorgenic form was suggested to be a protective factor ( < 0.001). Positive associations were observed between the rigid-akinetic form and compulsive shopping ( < 0.007), between male and hypersexuality ( < 0.018), and between dopamine agonists and compulsive shopping ( < 0.004), and negative associations were observed between motor fluctuations and compulsive shopping ( < 0.031), between Deep Brain Stimulation and binge eating ( < 0.046), and between levodopa consumption and binge eating ( < 0.045). Binge eating, compulsive shopping, and hypersexuality were the most frequent ICDs. Complex forms and motor complications of PD were associated with the development of ICDs.

Analysis of Impulse Control Disorders (ICDs) and Factors Associated with Their Development in a Parkinson's Disease Population.

We analyzed the neurological manifestations in Mexican patients hospitalized with pneumonia due to COVID-19 and investigated the association between demographic, clinical, and biochemical variables and outcomes, including death. A retrospective, analytical study was conducted using the electronic records of patients hospitalized between 1 April 2020 and 30 September 2020. Records of 1040 patients were analyzed: 31.25% died and 79.42% had neurological symptoms, including headache (80.62%), anosmia (32.20%), ageusia (31.96%), myopathy (28.08%), disorientation (14.89%), encephalopathy (12.22%), neuropathy (5.4%), stroke (1.3%), seizures (1.3%), cerebral hemorrhage (1.08%), encephalitis (0.84%), central venous thrombosis (0.36%), and subarachnoid hemorrhage (0.24%). Patients also had comorbidities, such as hypertension (42.30%), diabetes mellitus (38.74%), obesity (61.34%), chronic obstructive pulmonary disease (3.17%), and asthma (2.01%). Factors associated with neurological symptoms were dyspnea, chronic obstructive pulmonary disease, advanced respiratory support, prolonged hospitalization, and worsening fibrinogen levels. Factors associated with death were older age, advanced respiratory support, amine management, chronic obstructive pulmonary disease, intensive care unit management, dyspnea, disorientation, encephalopathy, hypertension, neuropathy, diabetes, male sex, three or more neurological symptoms, and obesity grade 3. In this study we designed a profile to help predict patients at higher risk of developing neurological complications and death following COVID-19 infection.

Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile.

COVID-19 has affected millions of children and, while it was previously considered as a respiratory disease, neurologic involvement has also been documented. The objective of this study was to identify the neurological manifestations (NMs) and the outcomes of children with COVID-19 who attended the National Medical Center "20 de Noviembre".

Neurological Manifestations in Pediatric Patients Hospitalized for COVID-19: Experiences of the National Medical Center "20 de Noviembre" in Mexico City.

Alcohol withdrawal syndrome (AWS) represents an adverse consequence of chronic alcohol use that may lead to serious complications. Therefore, AWS requires timely attention based on its early recognition, where easy-to-apply diagnostic tools are desirable. Our aim was to characterize the performance of a short-scale AST (Anxiety, Sweats, Tremors) in patients from public general hospitals. We conducted a cross-sectional study of patients attended at the Emergency Department diagnosed with AWS. Three scales were applied: CIWA-Ar (Clinical Institute Retirement Assessment Scale-Revised), GMAWS (Glasgow Modified Alcohol Withdrawal Syndrome) and AST. Cronbach’s alpha and Cohen’s kappa tests were used for reliability and concordance. Factorial analysis and diagnostic performance including ROC curve were carried out. Sixty-eight males with a mean age of 41.2 years old, with high school education and robust alcohol consumption, were included. Mean scores for CIWA-Ar, GMWAS and AST were 17.4 ± 11.2, 3.9 ± 2.3 and 3.8 ± 2.6, respectively, without significant differences. The AST scale showed an acceptable reliability and concordance (0.852 and 0.439; p < 0.0001) compared with CIWA-Ar and GMAWS. AST component analysis evidenced tremor (77.5% variance), sweat (12.1% variance) and anxiety (10.4% variance). Diagnostic performance of the AST scale was similar to the GMAWS scale, evidencing a sensitivity of 84%, specificity of 83.3% and Area Under the Curve (AUC) of 0.837 to discriminate severe AWS, according to CIWA-Ar. The performance of the AST scale to evaluate AWS is comparable with the commonly used CIWA-Ar and GMAWS scales. AST further represents an easy-to-apply instrument.

Diagnostic Performance of AST Scale in Mexican Male Population for Alcohol Withdrawal Syndrome.

Major depressive disorder (MDD) is a mood disorder with a high prevalence worldwide that causes disability and, in some cases, suicide. Although environmental factors play a crucial role in this disease, other biological factors may predispose individuals to MDD. Genetic and environmental factors influence mental disorders; therefore, a potential combined effect of / gene variants may be a target for the study of susceptibility to MDD. This study aimed to evaluate the effects of  and  gene variants when combined with adverse childhood experiences (ACEs) on the susceptibility and severity of symptoms in MDD.

Individual and Combined Effect of / Gene Variants and Adverse Childhood Experiences on the Severity of Major Depressive Disorder.

Sexual addiction is associated with serious health problems. Due to that fact, it is quite important to perform a comprehensive assessment. The Sex Addiction Screening Test (SAST-R) is a self-administered questionnaire with good psychometric properties used in several countries. Our study conducts a cross-cultural adaptation of the SAST-R on the Mexican population. The original version of the SAST-R was translated into Mexican Spanish, and we performed a pilot with 23 participants to be sure that the participants understood the meaning of the items. The final version was administered to 370 adults who completed the SAST-R, and measures of impulsivity (the Kirby questionnaire), reward/punishment responsivity (BIS-BAS scale), personality (BIG-Five), and psychological distress (SCL-90). The confirmatory factor analysis (CFA) with a five-factor model with one second-order factor model had the best fit. Reliability analysis suggests acceptable internal consistency ( = 0.80). The SAST-R scores exhibited significant correlations with several variables. Specifically, they showed a positive correlation with the neuroticism scale ( = 0.11,  < 0.05), a negative correlation with the conscientiousness scale ( = -0.21,  < 0.01), a negative correlation with the BIS scale ( = -0.11,  < 0.05), and a positive correlation with psychological distress ( = 0.34,  < 0.01). Notably, there were no significant correlations observed with variables that we initially expected to have a substantial association, such as impulsivity ( = -0.004,  > 0.05) and the three BAS subscales ( > 0.05). We found with an algorithm that psychological distress, impulsivity, neuroticism, and agreeableness were the good predictors to identify high scores of hypersexuality. Our results confirmed that the Mexican Spanish version of the SAST-R has good psychometric properties to be used in future research.

Article	Year
Analysis of Impulse Control Disorders (ICDs) and Factors Associated with Their Development in a Parkinson's Disease Population. Healthcare (Basel, Switzerland)\| PubMed ID: 34682943	2021
Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile. Healthcare (Basel, Switzerland)\| PubMed ID: 34828547	2021
Neurological Manifestations in Pediatric Patients Hospitalized for COVID-19: Experiences of the National Medical Center "20 de Noviembre" in Mexico City. Children (Basel, Switzerland)\| PubMed ID: 35626923	2022
Diagnostic Performance of AST Scale in Mexican Male Population for Alcohol Withdrawal Syndrome. International journal of environmental research and public health\| PubMed ID: 35954565	2022
Individual and Combined Effect of / Gene Variants and Adverse Childhood Experiences on the Severity of Major Depressive Disorder. Behavioral sciences (Basel, Switzerland)\| PubMed ID: 37887445	2023
Impulsivity and sexual addiction: factor structure and criterion-related validity of the sexual addiction screening test in Mexican adults. Frontiers in psychiatry\| PubMed ID: 38076695	2023

Christian Gabriel Toledo-Lozano

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