ABSTRACT
Chronic kidney disease (CKD) is a growing global public health challenge worldwide. In Mexico, CKD prevalence is alarmingly high and remains a leading cause of morbidity and mortality. Diabetic kidney disease (DKD), a severe complication of diabetes, is a leading determinant of CKD. The escalating diabetes prevalence and the complex regional landscape in Mexico underscore the pressing need for tailored strategies to reduce the burden of CKD. This narrative review, endorsed by the Mexican College of Nephrologists, aims to provide a brief overview and specific strategies for healthcare providers regarding preventing, screening, and treating CKD in patients living with diabetes in all care settings. The key topics covered in this review include the main cardiometabolic contributors of DKD (overweight/obesity, hyperglycemia, arterial hypertension, and dyslipidemia), the identification of kidney-related damage markers, and the benefit of novel pharmacological approaches based on Sodium-Glucose Co-Transporter-2 Inhibitors (SGLT2i) and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA). We also address the potential use of novel therapies based on Mineralocorticoid Receptor Antagonists (MRAs) and their future implications. Emphasizing the importance of multidisciplinary treatment, this narrative review aims to promote strategies that may be useful to alleviate the burden of DKD and its associated complications. It underscores the critical role of healthcare providers and advocates for collaborative efforts to enhance the quality of life for millions of patients affected by DKD.
ABSTRACT
This essay shows that the development of nephrology in recent years has been basically in dialysis and kidney transplantation, but access to the entire population that requires it is insufficient and limited, which is a universal phenomenon. In addition, the fragmentation of the specialty into other subspecialities has been generated. Among other reasons that prevent decision makers from deciding to expand tertiary nephrology care to a larger population, 12 intrinsic factors and four extrinsic factors are identified, together with limited resources dedicated to research; therefore, national societies of nephrology are encouraged to act and try to modify those factors that are obstacles to the development of the specialty and the expansion of nephrological care.
En este ensayo se muestra que el desarrollo de la nefrología en los últimos lustros ha sido básicamente en la diálisis y el trasplante renal, pero es insuficiente y limitado el acceso a toda la población que los requieren, lo cual es un fenómeno universal. Además, se ha generado la fragmentación de la especialidad en otras subespecialidades. Entre otros motivos que impiden que los tomadores de decisiones se decidan por ampliar la atención nefrológica terciaria a mayor población se identifican 12 factores intrínsecos y cuatro extrínsecos, aunado a limitados recursos destinados a la investigación, por lo que se invita a que las sociedades nacionales de nefrología actúen y traten de modificar esos factores que son obstáculos para el desarrollo de la especialidad y la ampliación de la atención nefrológica.
Subject(s)
Kidney Transplantation , Nephrology , Humans , Renal Dialysis , ConfusionABSTRACT
Resumen En este ensayo se muestra que el desarrollo de la nefrología en los últimos lustros ha sido básicamente en la diálisis y el trasplante renal, pero es insuficiente y limitado el acceso a toda la población que los requieren, lo cual es un fenómeno universal. Además, se ha generado la fragmentación de la especialidad en otras subespecialidades. Entre otros motivos que impiden que los tomadores de decisiones se decidan por ampliar la atención nefrológica terciaria a mayor población se identifican 12 factores intrínsecos y cuatro extrínsecos, aunado a limitados recursos destinados a la investigación, por lo que se invita a que las sociedades nacionales de nefrología actúen y traten de modificar esos factores que son obstáculos para el desarrollo de la especialidad y la ampliación de la atención nefrológica.
Abstract This essay shows that the development of nephrology in recent years has been basically in dialysis and kidney transplantation, but access to the entire population that requires it is insufficient and limited, which is a universal phenomenon. In addition, the fragmentation of the specialty into other subspecialities has been generated. Among other reasons that prevent decision makers from deciding to expand tertiary nephrology care to a larger population, 12 intrinsic factors and four extrinsic factors are identified, together with limited resources dedicated to research; therefore, national societies of nephrology are encouraged to act and try to modify those factors that are obstacles to the development of the specialty and the expansion of nephrological care.
ABSTRACT
Acute kidney injury (AKI), defined as an abrupt increase in serum creatinine, a reduced urinary output, or both, is experiencing considerable evolution in terms of our understanding of the pathophysiological mechanisms and its impact on other organs. Oxidative stress and reactive oxygen species (ROS) are main contributors to organ dysfunction in AKI, but they are not alone. The precise mechanisms behind multi-organ dysfunction are not yet fully accounted for. The building up of uremic toxins specific to AKI might be a plausible explanation for these disturbances. However, controversies have arisen around their effects in organs other than the kidney, because animal models usually depict AKI as a kidney-specific injury. Meanwhile, humans present AKI frequently in association with multi-organ failure (MOF). Until now, medium-molecular-weight molecules, such as inflammatory cytokines, have been proven to play a role in endothelial and epithelial injury, leading to increased permeability and capillary leakage, mainly in pulmonary and intestinal tissues.
Subject(s)
Acute Kidney Injury/metabolism , Multiple Organ Failure/metabolism , Uremic Toxins/metabolism , Animals , Humans , Protein BindingABSTRACT
A method of uncertainty quantification on a quantum circuit using three samples for the Rh(111)-catalyzed CO oxidation reaction is demonstrated. Three parametrized samples of a reduced, linearized microkinetic model populate a single block diagonal matrix for a quantum circuit. This approach leverages the logarithmic scaling of the number of qubits with respect to matrix size. The Harrow, Hassidim, and Lloyd (HHL) algorithm for solving linear systems is employed, and the results are compared with the classical results. This application area of uncertainty quantification in chemical kinetics can experience a quantum advantage using the method reported here, although issues related to larger systems are discussed.
ABSTRACT
Traumatic brain injury (TBI) causes cellular and molecular alterations that contribute to neuropsychiatric disease and epilepsy. GABAergic dysfunction figures prominently in the pathophysiology of TBI, yet the effects of TBI on tonic inhibition in hippocampus remain uncertain. We used a mouse model of severe TBI [controlled cortical impact (CCI)] to investigate GABAergic signaling in dentate gyrus granule cells (DGGCs). Basal tonic GABA currents were not affected by CCI. However, tonic currents induced by the δ subunit-selective GABAA receptor agonist 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridin-3-ol (THIP; 10 µm) were reduced by 44% in DGGCs ipsilateral to CCI (CCI-ipsi), but not in contralateral DGGCs. Reduced THIP currents were apparent one week after injury and persisted up to 15 weeks. The frequency of spontaneous IPSCs (sIPSCs) was reduced in CCI-ipsi cells, but the amplitude and kinetics of sIPSCs were unaffected. Immunohistochemical analysis showed reduced expression of GABAA receptor δ subunits and GABAB receptor B2 subunits after CCI, by 43% and 40%, respectively. Activation of postsynaptic GABAB receptors caused a twofold increase in tonic currents, and this effect was markedly attenuated in CCI-ipsi cells (92% reduction). GABAB receptor-activated K+ currents in DGGCs were also significantly reduced in CCI-ipsi cells, confirming a functional deficit of GABAB receptors after CCI. Results indicate broad disruption of GABAergic signaling in DGGCs after CCI, with deficits in both phasic and tonic inhibition and GABAB receptor function. These changes are predicted to disrupt operation of hippocampal networks and contribute to sequelae of severe TBI, including epilepsy.
Subject(s)
Brain Injuries, Traumatic , Dentate Gyrus , Animals , Dentate Gyrus/metabolism , Mice , Neurons/metabolism , Receptors, GABA-A/metabolism , gamma-Aminobutyric AcidABSTRACT
Resumen En este simposio se describen las principales características de seis revistas científicas mexicanas reconocidas por el Journal Citation Reports: Archives of Medical Research, Revista de Investigación Clínica-Clinical and Translational Investigation, Gaceta Médica de México, Salud Pública de México, Cirugía y Cirujanos y Salud Mental. Se hace énfasis en sus aspectos históricos y organizacionales, así como en sus logros principales ante la comunidad científica nacional e internacional.
Abstract This symposium describes the main characteristics of six Mexican scientific journals indexed in the Journal Citation Reports: Archives of Medical Research, Revista de Investigación Clínica-Clinical and Translational Investigation, Gaceta Médica de México, Salud Pública de México, Cirugía y Cirujanos and Salud Mental. Particular emphasis is given to their historical and organizational aspects, as on well as their main achievements recognized by the national and international scientific community.
Subject(s)
Humans , History, 19th Century , History, 20th Century , History, 21st Century , Periodicals as Topic/classification , Periodicals as Topic/history , Research , MexicoABSTRACT
This symposium describes the main characteristics of six Mexican scientific journals indexed in Journal Citation Reports: Archives of Medical Research, Revista de Investigación Clínica-Clinical and Translational Investigation, Gaceta Médica de México, Salud Pública de México, Cirugía y Cirujanos and Salud Mental. Particular emphasis is given to their historical and organizational aspects, as well as to their main achievements recognized by the national and international scientific community.En este simposio se describen las principales características de seis revistas científicas mexicanas reconocidas por el. Journal Citation Reports: Archives of Medical Research, Revista de Investigación Clínica-Clinical and Translational Investigation, Gaceta Médica de México, Salud Pública de México, Cirugía y Cirujanos y Salud Mental. Se hace énfasis en sus aspectos históricos y organizacionales, así como en sus logros principales ante la comunidad científica nacional e internacional.
