Burnout Syndrome and Related Factors in Mexican Police Workforces.

Burnout (BO) is a response to prolonged exposure to work-related stressors characterized by emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). The police working environment includes continued critical life-threatening situations, violence, and injuries, among other related factors putting them at high risk of distress. The objective of this study was to evaluate the association between Burnout Syndrome and sociodemographic, occupational, and health factors in Mexican police officers. We applied the Maslach Burnout Inventory Human Services Survey (MBI-HSS) to 351 active members of the Mexican police workforce. In addition, a specific questionnaire identified the presence of chronic degenerative diseases, hypertension, diabetes, digestive diseases, self-perception of food quality, and hours of sleep. Furthermore, 23.36% of police workforces presented high levels of burnout; 44.16% of police were highly emotionally exhausted, 49.29% had lost empathy with people, and 41.03% presented low personal achievement. Moreover, the worst levels of the syndrome were present in people with a poor self-perceived health status, poor perception of diet quality, without regular mealtimes, bad sleep habits, and elevated Body Mass Index. Data suggest that in Mexican police officers, BO is dimensionally different from all other groups previously studied (DP > EE > PA).

Disorders in the function of Sertoli cells and arrest in the differentiation of gonocytes in patients with cryptochidism and microlithiasis.

PURPOSE: This study aimed to correlate the presence of microlithiasis (ML) in cryptorchidism (CO) patients with the functionality of Sertoli cells and the arrest of gonocyte differentiation. METHODS: Testicular biopsies were obtained from 21 inguinal CO pediatric patients and were classified in two groups as follows: patients with ML and those without ML. In both groups, the number of Sertoli cells/seminiferous cords and their functionality were determined, considering the concentrations of inhibin B. In addition, the area and the histological alterations of seminiferous epithelium were evaluated. The arrest of gonocyte differentiation was determined by immunoreactivity to SALL4, AP2É£, PLAP and POU5F1. RESULTS: We found a statistical correlation between the presence of ML with the alterations in the functionality of Sertoli cells without reflecting in the differentiation of the gonocytes. CONCLUSION: The study of this population suggests that the association between CO and ML shows a malfunction of the Sertoli cells without necessarily causing arrest in the differentiation of gonocytes in these patients.

Obesity subtypes, related biomarkers & heterogeneity.

Obesity is a serious medical condition worldwide, which needs new approaches and recognized international consensus in treating diseases leading to morbidity. The aim of this review was to examine heterogeneous links among the various phenotypes of obesity in adults. Proteins and associated genes in each group were analysed to differentiate between biomarkers. A variety of terms for classification and characterization within this pathology are currently in use; however, there is no clear consensus in terminology. The most significant groups reviewed include metabolically healthy obese, metabolically abnormal obese, metabolically abnormal, normal weight and sarcopenic obese. These phenotypes do not define particular genotypes or epigenetic gene regulation, or proteins related to inflammation. There are many other genes linked to obesity, though the value of screening all of those for diagnosis has low predictive results, as there are no significant biomarkers. It is important to establish a consensus in the terminology used and the characteristics attributed to obesity subtypes. The identification of specific molecular biomarkers is also required for better diagnosis in subtypes of obesity.

The Role of Platelets in Ischemic Conditioning.

Ischemic heart disease (IHD) is one of the leading causes of death and disability worldwide. Platelets, as the main regulators of hemostasis, are major players in acute myocardial ischemia/reperfusion injury (IRI). Additionally, platelets are modified by endogenous cardioprotective strategies such as ischemic preconditioning, postconditioning, and remote ischemic conditioning. In this article, we provide an overview of the functionional role of platelets in acute myocardial IRI, and highlight their potential as targets for cardioprotection to improve health outcomes in patients with IHD.

Giant Condyloma Acuminatum in the Genital, Perineal and Perianal Region in a Pediatric Patient. Literature Review and Case Report.

Condyloma acuminata is caused by the proliferation of squamous epithelial cells in the presence of human papilloma virus (HPV) infection. There are several treatment options available for anogenital warts, however, none have proven to be more efficacious. We present the case of a 3 year-8 months-old male, diagnosed with human immunodeficiency virus (HIV) infection, who presented with multiple warts in the anogenital region. Lesions were treated with imiquimod 5%, electrosurgical resection and interferon α-2b. Combination of electrofulguration and interferon α-2b is an effective treatment option for children with giant condyloma accuminatum although recurrence is expected within a short follow-up period.

Purification and Partial Characterization of ß-Glucosidase in Chayote (Sechium edule).

ß-Glucosidase (EC 3.2.1.21) is a prominent member of the GH1 family of glycoside hydrolases. The properties of this ß-glucosidase appear to include resistance to temperature, urea, and iodoacetamide, and it is activated by 2-ME, similar to other members. ß-Glucosidase from chayote (Sechium edule) was purified by ionic-interchange chromatography and molecular exclusion chromatography. Peptides detected by LC-ESI-MS/MS were compared with other ß-glucosidases using the BLAST program. This enzyme is a 116 kDa protein composed of two sub-units of 58 kDa and shows homology with Cucumis sativus ß-glucosidase (NCBI reference sequence XP_004154617.1), in which seven peptides were found with relative masses ranging from 874.3643 to 1587.8297. The stability of ß-glucosidase depends on an initial concentration of 0.2 mg/mL of protein at pH 5.0 which decreases by 33% in a period of 30 h, and then stabilizes and is active for the next 5 days (pH 4.0 gives similar results). One hundred µg/mL ß-D-glucose inhibited ß-glucosidase activity by more than 50%. The enzyme had a Km of 4.88 mM with p-NPG and a Kcat of 10,000 min(-1). The optimal conditions for the enzyme require a pH of 4.0 and a temperature of 50 °C.

[Efficacy and safety of ciprofloxacin treatment in urinary tract infections (UTIs) in adults: a systematic review with meta-analysis]. / Eficacia y seguridad de la ciprofloxacina en el tratamiento de las infecciones de las vías urinarias (IVU) en adultos: revisión sistemática con metaanálisis.

OBJECTIVES AND DESIGN: A systematic review with meta-analysis of randomized controlled trials (RGT) on the efficacy and safety of ciprofloxacin in the treatment of acute or complicated urinary tract infections in adults. Primary outcomes were bacteriological eradication, clinical cure, bacterial resistance, and adverse event rates. RESULTS: Initially, 111 RGTs were identified. We excluded 81 studies due to low quality methodology. An analysis of the remaining RGTs identified therapeutic equivalence of ciprofloxacin against other antimicrobials in terms of bacterial eradication and clinical cure at the end of treatment and in subsequent stages. The percentage of bacterial resistance was similar in both groups, while the percentage of related adverse events was significantly lower in the groups treated with ciprofloxacin. CONCLUSIONS: We conclude that ciprofloxacin is a safe and effective therapeutic alternative for the treatment of acute or complicated urinary tract infections in adults.

Purification and partial characterization of an agglutinin from Octopus maya serum.

A 66-kDa lectin (OmA) was purified from the serum of the Yucatan peninsula endemic octopus (Octopus maya) by a single step affinity chromatography on glutaraldehyde-fixed stroma from rat erythrocytes. OmA corresponds to 0.8% of the total circulating protein in the hemolymph; it is composed of three equal subunits of 22kDa each, and 7.4% of linked carbohydrates. The amino acids' composition indicated that agglutinin contained mainly aspartic and glutamic acids, and cysteine and methionine were identified in minor proportion. OmA agglutinates mainly rat, guinea pig, and rabbit erythrocytes, and this activity is partially inhibited by galactosamine, melobiose, galacturonic acid, mannose, and methyl alpha and beta galactosides. Hemagglutinating activity is not dependent on divalent cations, such as Ca(2+), Mg(2+), or Mn(2+). The OmA subunits showed no identity for any lectin in databases but partial identity with the type A hemocyanin from Octopus dolfleini hemolymph; the main similarities are related to tyrosinase domains and copper A and B sites that conform to the oxygen-binding site of hemocyanin.

Review: Immunity mechanisms in crustaceans.

Crustacean aquaculture represents a major industry in tropical developing countries. As a result of high culture densities and increasing extension of aquaculture farms, the presence of diseases has also increased, inducing economic losses. Invertebrates, which lack adaptive immune systems, have developed defense systems that respond against antigens on the surface of potential pathogens. The defense mechanisms of crustaceans depend completely on the innate immune system that is activated when pathogen-associated molecular patterns are recognized by soluble or by cell surface host proteins, such as lectins, antimicrobial, clotting, and pattern recognition proteins, which, in turn, activate cellular or humoral effector mechanisms to destroy invading pathogens. This work is aimed at presenting the main characteristics of the crustacean proteins that participate in immune defense by specific recognition of carbohydrate containing molecules, i.e. glycans, glycolipids, glycoproteins, peptidoglycans, or lipopolysaccharides from Gram-negative and Gram-positive bacteria, viruses, or fungi. We review some basic aspects of crustacean effector defense processes, like agglutination, encapsulation, phagocytosis, clottable proteins, and bactericidal activity, induced by these carbohydrate-driven recognition patterns.

The use of monoclonal antibodies anti-lectin from freshwater prawn Macrobrachium rosenbergii (DeMan, 1879) in the recognition of protein with lectin activity in Decapod's hemolymph.

We determined the cross-reactivity of a monoclonal antibody against the Macrobrachium rosenbergii lectin with proteins in the hemolymph from Procambarus clarkii (Pc), Procambarus americanus (Pa), Litopenaeus setiferus (Ls), and Pseudothelphusa americana (Psa). Crustaceans' hemolymph agglutinated erythrocytes from rat, mouse, guinea pig, and rabbit. Decapods' hemolymph hemagglutinating activity was inhibited by N-acetylated carbohydrates as well as by antibodies. Western blot assays indicated that the antibodies recognized two main proteins of 97.5 and 80.9 kDa in all hemolymphs studied; moreover, ELISA assays indicated that, in PSa, 7.2% of total proteins showed crossreactivity with antibodies in Pa, Pc, and Lc hemolymphs represented 4.2, 3.1%, and 2.5%, respectively. Our results suggested that antibodies recognize the lectin active site in the crustacean species tested; we propose the use of antibodies as an immunological marker for lectin identification and quantification among crustaceans.

Purification and characterization of a lectin from the white shrimp Litopenaeus setiferus (Crustacea decapoda) hemolymph.

A 291-kDa lectin (LsL) was purified from the hemolymph of the white shrimp Litopenaeus setiferus by affinity chromatography on glutaraldehyde-fixed stroma from rabbit erythrocytes. LsL is a heterotetramer of two 80-kDa and two 52-kDa subunits, with no covalently-liked carbohydrate, and mainly composed by aspartic and glutamic acids, glycine and alanine, with relatively lower methionine and cysteine contents. Edman degradation indicated that the NH2-terminal of the 80-kDa subunit is composed DASNAQKQHDVNFLL, whereas the NH2-terminal of the 52-kDa subunit is blocked. The peptide mass fingerprint of LsL was predicted from tryptic peptides from each subunit by MALDI-TOF, and revealed that each subunit showed 23 and 22%, respectively, homology with the hemocyanin precursor from Litopenaeus vannamei. Circular dichroism analysis revealed beta sheet and alpha helix contents of 52.7 and 6.1%, respectively. LsL agglutinate at higher titers guinea pig, murine, and rabbit erythrocytes its activity is divalent cation-dependent. N-acetylated sugars, such as GlcNAc, GalNAc, and NeuAc, were the most effective inhibitors of the LsL hemagglutinating activity. Sialylated O-glycosylated proteins, such as bovine submaxillary gland mucin, human IgA, and fetuin, showed stronger inhibitory activity than sialylated N-glycosylated proteins, such as human orosomucoid, IgG, transferrin, and lactoferrin. Desialylation of erythrocytes or inhibitory glycoproteins abolished their capacity to bind LsL, confirming the relevance of sialic acid in LsL-ligand interactions.

Concentraciones de DDT/DDE y riesgo de hipospadias: un estudio piloto de casos y controles / DDT/DDE concentrations and risk of hypospadias: a case-control pilot study

OBJETIVO: Evaluar la asociación entre los niveles séricos maternos de DDT/DDE y el riesgo de hipospadias. MATERIAL Y MÉTODOS: Estudio de casos y controles, efectuado en la Ciudad de México durante el periodo 1997-1999, con 41 casos de hipospadias y 28 controles. La informacion obtenida por cuestionario y las muestras sanguíneas fueron evaluadas mediante modelos multivariados de regresión logística. RESULTADOS: Las concentraciones materna de DDT y DDE no mostraron asociación con el riesgo de hipospadias (RM 1.13; IC 95 por ciento 0.24-5.29 y RM 0.48; IC 95 por ciento 0.15-1.60, respectivamente). Los predictores encontrados fueron hijos de madres con mayor edad (RM 8.69; IC 95 por ciento 1.69-44.9), y la actividad laboral durante el embarazo (RM, 4.68; IC 95 por ciento 1.15-18.9). CONCLUSIONES: Dado que se cuenta con escasa información sobre los efectos endocrinos a diferentes concentraciones de DDT/DDE en humanos, la dosis pudiera ser un factor determinante sobre el tipo de efecto.

OBJECTIVE: To evaluate the association between maternal serum DDT/DDE levels and risk of hypospadias. MATERIAL AND METHODS: A case-control study in Mexico City was conducted during 1997-1999 among 41 subjects with hypospadias and 28 controls. Blood samples were obtained from study subjects. Information was obtained using a standardized questionnaire. Data were analyzed using multivariate logistic regression models. RESULTS: Maternal DDT and DDE levels showed no association with hypospadias (OR 1.13; 95 percent CI 0.24-5.29 and OR=0.48; 95 percent CI 0.15-1.60, respectively). Associated factors were older age of mothers (OR 8.69; 95 percent CI 1.69-44.9), and working during pregnancy (OR 4.68; 95 percent CI 1.15-18.9). CONCLUSIONS: Information about the endocrine effects of different levels of DDT/DDE in human subjects is scarce; dosage may be a determinant factor of the type of effect.

[DDT/DDE concentrations and risk of hypospadias. Pilot case-control study]. / Concentraciones de DDT/DDE y riesgo de hipospadias. Un estudio piloto de casos y controles.

OBJECTIVE: To evaluate the association between maternal serum DDT/DDE levels and risk of hypospadias. MATERIAL AND METHODS: A case-control study in Mexico City was conducted during 1997-1999 among 41 subjects with hypospadias and 28 controls. Blood samples were obtained from study subjects. Information was obtained using a standardized questionnaire. Data were analyzed using multivariate logistic regression models. RESULTS: Maternal DDT and DDE levels showed no association with hypospadias (OR 1.13; 95% CI 0.24-5.29 and OR = 0.48; 95% CI 0.15-1.60, respectively). Associated factors were older age of mothers (OR 8.69; 95% CI 1.69-44.9), and working during pregnancy (OR 4.68; 95% CI 1.15-18.9). CONCLUSIONS: Information about the endocrine effects of different levels of DDT/DDE in human subjects is scarce; dosage may be a determinant factor of the type of effect. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Ileocecocistoplastia continente en niños con incontinencia irreversible / Continent ileocecocystoplasty in children with intractable urinary incontinence

En un estudio clínico, descriptivo y observacional, se analizaron la continencia urinaria, el impacto sobre la función renal y las complicaciones postoperatorias en niños operados de ileocecositoplastia continente en el servicio de Urología del Instituto Nacional de Pediatría, de agosto de 1992 a diciembre de 1993. Se analizaron las características clínicas más importantes al momento de la cirugía, el cuadro clínico, las pruebas de laboratorio y la continecia urinaria, preoperatoria y a los seis meses de la operación. También se analizaron, la longitud del segemento ileocecal utilizado y las complicaciones postoperatorias. Esta serie, que es la más numerosa descrita en niños, es de 13 pacientes entre tres y 17 años de edad, con alteración irreversible de la continencia urinaria. Las complicaciones postoperatorias fueron formación de cálculos en el reservorio en un caso, dehiscencia de la plicatura del ileon en otro y acidosis metabólica hiperclorémica en un caso. Consideramos que de las derivaciones urinarias continentes, la indicación más apropiada de la ileocecositoplastia es en niños con padecimiento congénitos que comprometen la continencia y cuya vejiga urinaria no necesita ser extirpada

Endopielotomía en niños con estenosis ureteropiélica: informe preliminar / Endopyelotomy in children with uretoropyelic stenosis: preliminar report

Se presenta un informe de los 4 primeros casos de estenosis UP operados por vía percutánea (endopielotomía) en el I.N.P. en el período de junio de 1993 a julio de 1994. Se mencionan los detalles de la técnica quirúrgica y los resultados que aunque exitosos, por su número aún pequeño y su tiempo de seguimiento corto, no son concluyentes para definir un criterio de abordaje en nuestra Institución; son similares a los resultados publicados por autores en otras partes del mundo

Ambigüedad de genitales I. Abordaje inicial del paciente / Ambigous genitalia. Initial diagnosis approach

Se presentan los criterios para el abordaje diagnóstico inicial de pacientes con alteraciones en la diferenciación sexual, de acuerdo a los lineamientos del Grupo Para el Estudio del Intersexo del Instituto Nacional de Pediatría. Una vez definidas las alteraciones genitales de cada paciente, así como sus antecedentes personales y familiares, se sugiere un protocolo de exámenes paraclínicos indispensables para iniciar el abordaje sindromático. Se hace énfasis en la necesidad de no establecer una asignación sexual social ni funcional hasta no haber esclarecido la etiología precisa del trastorno.

Tratamiento quirúrgico actual del megauréter / Current surgical treatment of megaurether

Presentamos una modificación a la técnica de Hedren para el tratamiento del magauréter. Realizamos ureteroplastía con reinplante vesicoureteral en 12 uréteres de siete pacientes. Los criterios para realizar la ureteroplastia fueron: 1) pacientes con historia de infeccioón de vías urinarias y deterioro de la función renal; 2) Imposibilidad de alcanzar una relación de 4:1 entre la luz ureteral y la longitud del túnel submucoso. Las diferencias con respecto a la técnica de Hendren son: a) no respetamos la irrigación medial del uréter; b) disecamos al uréter más allá de los vasos hipogástrico; c) hacemos énfasis especial en la disección de la adventicia; d) reinplantamos al uréter con la técnica de Cohen. Todos los pacientes mejoraron en la función renal, hubo disminución en la dilatación ureteral, ausencia de infecciones de vías urinarias y reflujo vesiculoureteral. No se han presentado otras complicaciones.

La histología en la criptorquidia / Histology in cryptorchism

En la actualidad no es posible encontrar una causa única demostrada de criptorquidea. Probablemente existe diversas causas, ya que algunos pacientes tienen como etiología una causa mecánica bien probada, en tanto que otras pueden explicarse mejor sobre bases genéticas, y otras más en endocrinas, ya sea por defecto o por exceso. Es muy dificil explicar los casos de criptorquidea unilateral sobre bases genéticas o endocrinas.

Estenosis ureteropiélica en niños: experiencia de 100 casos operados / Ureteropielic stenosis in children: Experience of 100 report cases

Se presentan 100 casos (87 pacientes) de estenosis uretopiélitica tratados quirúrgicamente en el Instituto Nacional de Pediatría entre los años de 1973-1986; un total de 87 casos fueron corregidos con éxito en la primera cirugía; 4 más en la segunda y otros dos en una tercera intervención con procedimientos más especializados y siete pacientes fueron nefrectomizados de primera intención por atrofia renal. Se comentan los puntos más importantes del diagnóstico clínico, de laboratorio y gabinete, así como un análisis de los resultados y tratamiento quirúrgico.