Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study.

Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.

Supervivencia del injerto y del receptor en el trasplante renal en el hospital Guillermo Gran Benavente (Concepción, Chile) / Survival of the graft and the host in renal transplant in the Guillermo Gran Benavente Hospital (Concepción, Chile)

Al ser el trasplante renal la mejor opción terapéutica para el tratamiento de la Insuficiencia Renal Terminal, en la ciudad de Concepción (Chile), se inició el programa de Trasplante Renal (TX) en el año 1994. El objetivo de este trabajo es caracterizar la supervivencia del injerto renal de los TX realizados un hospital, de dicha ciudad mediante un estudio descriptivo, transversal, correlacional y comparativo de los resultados obtenidos en dos periodos, A: de 1994 a 2003 y, B: de 2004 a 2012. El análisis estadístico se realizó con el software SPSSv20.0. La funcion de supervivencia con la prueba no-paramétrica de Kaplan-Meier; y para comparaciones de variables se utilizó el test log-rank. De los resultados obtenidos cabe destacar que la supervivencia del paciente trasplantado en el período A fue mejor el primer al año (96%), pero fue menor a los 3 (90%), 5 (86%) y 10 años (72%) respecto al período B en que los valores fueron al año 95%, a los 3 el 90% a los 5 y 10 años el 87% y a los 10 años. La supervivencia del injerto tambien fue mayor en el periodo A que en el B, y mejor cuando hubo un tiempo de isquemia inferior a 24 horas y sin diferencias en relación al sexo del donante y del receptor y al tipo de tratamiento inmunosupreso. Las infeciones fueron la primera causa de muerte del paciente y las complicaciones quirúrgicas la principal causa de la pérdida del injerto (AU)

As the renal transplant is the best therapeutic option for the treatment of End-Stage Renal Disease, in the city of Concepción (Chile), a Renal Transplant Program (TX) was started in 1994. The aim was to characterize the kidney graft survival of TX performed in our hospital, through a descriptive, transversal, correlational and comparative study of the results obtained in two periods, A: from 1994 to 2003 and, B: from 2004-2012. Statistical analysis was performed using the SPSSv20.0 software. The function of survival was calculated using the nonparametric Kaplan-Meier test; and to compare the variables we used the log-rank test. From the results, we emphasize that the survival of patients transplanted in the period A was better in the first year (96%), but was lower at 3 (90%), 5 (86%) and 10 years (72 %) compared to the period B in which the first year was 95%, at 3 of 90% at 5 and 10 years of 87%. Graft survival was also higher in the period A than in B, and better when the time of ischemia was less than 24 hours and no differences in relation to sex of the donor and recipient and type of immunosuppressive treatment. Infections were the first cause of death and surgical complications the main cause of graft loss (AU)

Case Report: Paroxysmal nocturnal hemoglobinuria in a woman heterozygous for G6PD A-.

We describe a case of paroxysmal nocturnal hemoglobinuria (PNH) in a woman who is heterozygous for the glucose-6-phosphate dehydrogenase A-   ( G6PDA-) allele. PNH is associated with one or more clones of cells that lack complement inhibition due to loss of function somatic mutations in the PIGA gene.  PIGA encodes the enzyme phosphatidylinositol glycan anchor biosynthesis, class A, which catalyses the first step of glycosylphosphatidylinisotol ( GPI)  anchor synthesis. Two GPI anchored red cell surface antigens regulate complement lysis. G6PD catalyses the first step of the pentose phosphate pathway and enzyme variants, frequent in some populations have been selected because they confer resistance to malaria, are associated with hemolysis in the presence of oxidizing agents including several drugs. The patient had suffered a hemolytic attack after taking co-trimoxazole, a drug that precipitates hemolysis in G6PD deficient individuals. Since both G6PD and PIGA are X-linked we hypothesized that the PIGA mutation was on the X-chromosome carrying the G6PDA- allele. Investigations showed that in fact the PIGA mutation was on the X-chromosome carrying the normal G6PD B allele. We speculate that complement activation on G6PD A- red cells exposed to Bactrim might have triggered complement activation inducing the lysis of G6PD B PNH Type II red blood cells or that the patient may have had a PNH clone expressing G6PDA- at the time of the hemolytic episode.

La pareja con igualdad de oportunidades

El informe presenta los resultados del proyecto de intervención aplicado a adolescentes de 13 a 18 años, grupo considerado como la más vulnerable, se trabajó con tres unidades educativas, donde por medio de un instrumento aplicado se registró casos de violencia en los adolescentes, no solo dentro la pareja, sinó también en la familia.