Association of Congenital Heart Defects (CHD) with Factors Related to Maternal Health and Pregnancy in Newborns in Puerto Rico

Background:Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States,there is a compelling need to investigate the intricate interplay among body mass index(BMI),pregesta-tional,and gestational maternal diabetes,and their potential impact on the occurrence of congenital heart defects(CHD)during neonatal development.Methods:Using the comprehensive System of Vigilance and Surveillance of Congenital Defects in Puerto Rico,we conducted a focused analysis on neonates diagnosed with CHD between 2016 and 2020.Our assessment encompassed a range of variables,including maternal age,gestational age,BMI,pregestational diabetes,gestational diabetes,hypertension,history of abortion,and presence of preeclampsia.Results:A cohort of 673 patients was included in our study.The average maternal age was 26 years,within a range of 22 to 32 years.The mean gestational age measured 39 weeks,with a median span of 38 to 39 weeks.Of the 673 patients,274(41%)mothers gave birth to neonates diagnosed with CHD.Within this group,22 cases were linked to pre-gestational diabetes,while 202 were not;20 instances were associated with gestational diabetes,compared to 200 without;and 148 cases exhibited an overweight or obese BMI,whereas 126 displayed a normal BMI.Conclusion:We identified a statistically significant correlation between pre-gestational diabetes mellitus and the occurrence of CHD.However,our analysis did not show a statistically significant association between maternal BMI and the likelihood of CHD.These results may aid in developing effective strategies to prevent and manage CHD in neonates.

Key genes and drug delivery systems to improve the efficiency of chemotherapy

Cancer cells can develop resistance to anticancer drugs,thereby becoming tolerant to treatment through different mechanisms.The biological mechanisms leading to the generation of anticancer treatment resistance include alterations in transmembrane proteins,DNA damage and repair mechanisms,alterations in target molecules,and genetic responses,among others.The most common anti-cancer drugs reported to develop resistance to cancer cells include cisplatin,doxorubicin,paclitaxel,and fluorouracil.These anticancer drugs have different mechanisms of action,and specific cancer types can be affected by different genes.The development of drug resistance is a cellular response which uses differential gene expression,to enable adaptation and survival of the cell to diverse threatening environmental agents.In this review,we briefly look at the key regulatory genes,their expression,as well as the responses and regulation of cancer cells when exposed to anticancer drugs,along with the incorporation of alternative nanocarriers as treatments to overcome anticancer drug resistance.