ABSTRACT
PURPOSE: To track body size and proportions, arm dimensions and grip strength in children, adolescents, and adults resident in an indigenous community in Oaxaca who were measured on two or three occasions across surveys in 1968, 1978, and 2000. METHODS: The three cross-sectional surveys included measures of height, weight, sitting height, arm circumference, triceps skinfold, and grip strength in surveys of schoolchildren in 1968 and of schoolchildren, adolescents and adults in 1978 and 2000. Cross-checks of surnames, forenames and ages/dates of birth of participants in the three surveys identified three samples of individuals measured on two occasions (1968-1978, two age groups in 1978-2000) and a subsample of individuals measured in the three surveys. Partial correlations controlling for age at each observation were calculated for each variable in the three sex-specific samples measured on two occasions, and for the subsamples of males and females measured on three occasions. RESULTS: Allowing for variation in age among subsamples, inter-age correlations were moderate to high for stature, moderate for sitting height and estimated leg length, and low to moderate for weight, BMI, arm and estimated arm muscle circumference, triceps skinfold, and grip strength. CONCLUSION: Allowing for the relatively broad chronological age intervals, the inter-age correlations for height, weight and BMI were at the low end, while those for grip strength and for strength per unit body weight for males (though not females) were generally in the range of correlations noted in studies of European samples. Likely associated with improved health, nutritional, and sanitation conditions, obesity and overweight were emerging among adults by 2000. Obesity and overweight in adults paralleled the introduction of mechanized agriculture that reduced routine physical work. Among children, the association of obesity and overweight is likely with increased nutritional availability, but poor choices in diet.
Subject(s)
Anthropometry , Hand Strength , Humans , Male , Adolescent , Female , Child , Mexico , Hand Strength/physiology , Adult , Cross-Sectional Studies , Young Adult , Middle Aged , Body Size/physiology , Arm/anatomy & histology , Arm/physiologyABSTRACT
OBJECTIVE: To evaluate the effectiveness of weekly vitamin D supplementation in reducing the number of acute respiratory infections (ARI) in preschool children. STUDY DESIGN: Randomized, double-blind, placebo-controlled trial in 303 children aged 1.5-3.5 years from 2014 to 2105 in 3 Chilean cities at different latitudes: Santiago (33°S, n = 101), Talcahuano (37°S, n = 103), and Punta Arenas (53°S, n = 99). Participants were allocated (1:1:1) to receive placebo, cholecalciferol (vitamin D3 (VD3)) 5600 IU/week (low-dose), or 11 200 IU/week (high-dose) for 6 months. Primary outcome was parent-reported number of ARI; secondary outcomes included number of ARI hospitalizations, change of serum 25-hydroxyvitamin D (25(OH)D) and LL-37/cathelicidin levels, and adverse events. RESULTS: The mean age of participants was 26 ± 6 months; 45% were female. Baseline 25(OH)D was 24.9 ± 6.1 ng/ml, with 23% having 25(OH)D <20 ng/ml. No significant baseline clinical or laboratory differences were observed among groups. Overall, 64% (n = 194) completed study participation, without baseline differences between subjects lost to follow-up vs those completing participation or differences in completion rates across groups. After 6 months, a dose-dependent increase in serum 25(OH)D was observed from the VD3 intervention (P < .001), with a higher proportion of subjects ending the trial with 25(OH)D <20 ng/ml in the placebo group (30.8%) vs the low-dose (7.4%) and high-dose groups (5.1%). However, no group differences were observed in number of ARI (P = .85), ARI hospitalizations (P = .20), LL-37/cathelicidin change (P = .30), or adverse events (P = .41). CONCLUSIONS: While weekly VD3 supplementation, in doses equivalent to 800 IU and 1600 IU daily, was associated with improved 25(OH)D levels in preschoolers, we did not find a reduced number of ARI in this sample.
ABSTRACT
Photodynamic therapy (PDT) treats nonmelanoma skin cancer. PDT kills cells through reactive oxygen species (ROS), generated by interaction among cellular O2, photosensitizer and specific light. Protoporphyrin IX (PpIX) is a photosensitizer produced from methyl aminolevulinate (MAL) by heme group synthesis (HGS) pathway. In PDT-resistant cells, PDT efficacy has been improved by addition of epigallocatechin gallate (EGCG). Therefore, the aim of this work is to evaluate the effect of EGCG properties over MAL-TFD and PpIX production on A-431 cell line. EGCG's role over cell proliferation (flow cytometry and wound healing assay) and clonogenic capability (clonogenic assay) was evaluated in A-431 cell line, while the effect of EGCG over MAL-PDT was determined by cell viability assay (MTT), PpIX and ROS detection (flow cytometry), intracellular iron quantification and gene expression of HGS enzymes (RT-qPCR). Low concentrations of EGCG (<50 µM) did not have an antiproliferative effect over A-431 cells; however, EGCG inhibited clonogenic cell capability. Furthermore, EGCG (<50 µM) improved MAL-PDT cytotoxicity, increasing PpIX and ROS levels, exerting a positive influence on PpIX synthesis, decreasing intracellular iron concentration and modifying HGS enzyme gene expression such as PGB (upregulated) and FECH (downregulated). EGCG inhibits clonogenic capability and modulates PpIX synthesis, enhancing PDT efficacy in resistant cells.
Subject(s)
Catechin , Cell Proliferation , Heme , Photosensitizing Agents , Protoporphyrins , Reactive Oxygen Species , Catechin/analogs & derivatives , Catechin/pharmacology , Protoporphyrins/pharmacology , Protoporphyrins/metabolism , Humans , Heme/metabolism , Reactive Oxygen Species/metabolism , Photosensitizing Agents/pharmacology , Cell Line, Tumor , Cell Proliferation/drug effects , Photochemotherapy/methods , Cell Survival/drug effects , Aminolevulinic Acid/pharmacology , Aminolevulinic Acid/analogs & derivativesABSTRACT
BACKGROUND: This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n â 90 000) of the Indigenous population in Oaxaca. Mexico. OBJECTIVE: This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence. METHODS AND MATERIALS: Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829). RESULTS: T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age-adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%-5.5% among males (p < .53) and 7.1%-13.6% among females (p < .001). Sex-specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (-0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%-27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high-carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017. CONCLUSIONS: An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high-carbohydrate Western diet.
Subject(s)
Diabetes Mellitus, Type 2 , Obesity , Overweight , Humans , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/etiology , Mexico/epidemiology , Male , Female , Middle Aged , Adult , Overweight/epidemiology , Obesity/epidemiology , Prevalence , Aged , Hypertension/epidemiology , Hypertension/etiology , Environment , Indians, North American/statistics & numerical dataABSTRACT
Cancer remains a global health challenge, prompting a search for effective treatments with fewer side effects. Thymol, a natural monoterpenoid phenol derived primarily from thyme (Thymus vulgaris) and other plants in the Lamiaceae family, is known for its diverse biological activities. It emerges as a promising candidate in cancer prevention and therapy. This study aims to consolidate current research on thymol's anticancer effects, elucidating its mechanisms and potential to enhance standard chemotherapy, and to identify gaps for future research. A comprehensive review was conducted using databases like PubMed/MedLine, Google Scholar, and ScienceDirect, focusing on studies from the last 6 years. All cancer types were included, assessing thymol's impact in both cell-based (in vitro) and animal (in vivo) studies. Thymol has been shown to induce programmed cell death (apoptosis), halt the cell division cycle (cell cycle arrest), and inhibit cancer spread (metastasis) through modulation of critical signaling pathways, including phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), extracellular signal-regulated kinase (ERK), mechanistic target of rapamycin (mTOR), and Wnt/ß-catenin. It also enhances the efficacy of 5-fluorouracil (5-FU) in colorectal cancer treatments. Thymol's broad-spectrum anticancer activities and non-toxic profile to normal cells underscore its potential as an adjunct in cancer therapy. Further clinical trials are essential to fully understand its therapeutic benefits and integration into existing treatment protocols.
ABSTRACT
BACKGROUND: The number of individuals diagnosed with Alzheimer's disease (AD) has increased, and it is estimated to continue rising in the coming years. The diagnosis of this disease is challenging due to variations in onset and course, its diverse clinical manifestations, and the indications for measuring deposit biomarkers. Hence, there is a need to develop more precise and less invasive diagnostic tools. Multiple studies have considered using electroencephalography (EEG) entropy measures as an indicator of the onset and course of AD. Entropy is deemed suitable as a potential indicator based on the discovery that variations in its complexity can be associated with specific pathologies such as AD. METHODOLOGY: Following PRISMA guidelines, a literature search was conducted in 4 scientific databases, and 40 articles were analyzed after discarding and filtering. RESULTS: There is a diversity in entropy measures; however, Sample Entropy (SampEn) and Multiscale Entropy (MSE) are the most widely used (21/40). In general, it is found that when comparing patients with controls, patients exhibit lower entropy (20/40) in various areas. Findings of correlation with the level of cognitive decline are less consistent, and with neuropsychiatric symptoms (2/40) or treatment response less explored (2/40), although most studies show lower entropy with greater severity. Machine learning-based studies show good discrimination capacity. CONCLUSIONS: There is significant difficulty in comparing multiple studies due to their heterogeneity; however, changes in Multiscale Entropy (MSE) scales or a decrease in entropy levels are considered useful for determining the presence of AD and measuring its severity.
Subject(s)
Alzheimer Disease , Electroencephalography , Entropy , Alzheimer Disease/diagnosis , Alzheimer Disease/physiopathology , Humans , Electroencephalography/methodsABSTRACT
AIM: To comprehensively analyze trends in myelodysplastic neoplasm (MDS) mortality across Spain (1999-2022), examining sex and regional differences. METHODS: We analyzed nationwide death records and population data, calculating age-standardized mortality rates (ASMRs) and standardized mortality ratios (SMRs) stratified by sex and Autonomous Community (AC). Joinpoint regression identified significant shifts in trends. RESULTS: Across Spain, MDS mortality risk varied among men, with rates ranging from 1.08 to 4.38 per 100,000 across regions, while women's rates ranged from 1.23 to 2.02. Five regions had higher risks than the national average, while six had lower risks. Joinpoint analysis revealed three periods nationally: a decline until 2008, and an increase until 2017, followed by a significant decrease. Despite the overall stable national trend (-0.5% annual change), significant regional variations emerged. Andalusia stood out with a worrying increase in MDS mortality, while Aragon and Murcia demonstrated promising declines. Extremadura displayed a unique trajectory with an initial rise followed by stabilization, while Galicia exhibited a contrasting trend with an initial decline and subsequent increase. Notably, men consistently faced a higher risk of MDS mortality compared to women, with significant disparities across regions. Extremadura, in particular, showed a marked difference in risk between genders. CONCLUSION: MDS mortality trends in Spain are complex, and influenced by gender, region, and time. Further research is needed to understand regional disparities, recent national decline, and higher risk in specific demographics. Tailored interventions based on local factors and targeted research are crucial to address these complexities and improve patient outcomes.
Subject(s)
Myelodysplastic Syndromes , Humans , Spain/epidemiology , Myelodysplastic Syndromes/mortality , Female , Male , Aged , Middle Aged , Aged, 80 and over , Sex Factors , Mortality/trends , AdultABSTRACT
Gastric cancer (GC) ranks fifth globally in cancer diagnoses and third for cancer-related deaths. Chemotherapy with 5-fluorouracil (5-FU), a primary treatment, faces challenges due to the development of chemoresistance. Tumor microenvironment factors, including C-C motif chemokine receptor 3 (CCR3), can contribute to chemoresistance. The present study evaluated the effect of CCR3 receptor inhibition using the antagonist SB 328437 and the molecular dynamics of this interaction on resistance to 5-FU in gastric cancer cells. The 5-FU-resistant AGS cell line (AGS R-5FU) demonstrated notable tolerance to higher concentrations of 5-FU, with a 2.6-fold increase compared with the parental AGS cell line. Furthermore, the mRNA expression levels of thymidylate synthase (TS), a molecular marker for 5-FU resistance, were significantly elevated in AGS R-5FU cells. CCR3 was shown to be expressed at significantly higher levels in these resistant cells. Combining SB 328437 with 5-FU resulted in a significant decrease in cell viability, particularly at higher concentrations of 5-FU. Furthermore, when SB 328437 was combined with 5-FU at a high concentration, the relative mRNA expression levels of CCR3 and TS decreased significantly. Computational analysis of CCR3 demonstrated dynamic conformational changes, especially in extracellular loop 2 region, which indicated potential alterations in ligand recognition. Docking simulations demonstrated that SB 328437 bound to the allosteric site of CCR3, inducing a conformational change in ECL2 and hindering ligand recognition. The present study provides comprehensive information on the molecular and structural aspects of 5-FU resistance and CCR3 modulation, highlighting the potential for therapeutic application of SB 328437 in GC treatment.
ABSTRACT
Cytokines are proteins that act in the immune response and inflammation and have been associated with the development of some types of cancer, such as gastric cancer (GC). GC is a malignant neoplasm that ranks fifth in incidence and third in cancer-related mortality worldwide, making it a major public health issue. Recent studies have focused on the role these cytokines may play in GC associated with angiogenesis, metastasis, and chemoresistance, which are key factors that can affect carcinogenesis and tumor progression, quality, and patient survival. These inflammatory mediators can be regulated by epigenetic modifications such as DNA methylation, histone protein modification, and non-coding RNA, which results in the silencing or overexpression of key genes in GC, presenting different targets of action, either direct or mediated by modifications in key genes of cytokine-related signaling pathways. This review seeks insight into the relationship between cytokine-associated epigenetic regulation and its potential effects on the different stages of development and chemoresistance in GC.
Subject(s)
Stomach Neoplasms , Humans , Stomach Neoplasms/drug therapy , Stomach Neoplasms/genetics , Stomach Neoplasms/metabolism , Epigenesis, Genetic , Cytokines/metabolism , Drug Resistance, Neoplasm/genetics , AngiogenesisABSTRACT
Phytochemical study of the species Kaunia lasiophthalma enabled the isolation of three undescribed and three known guaianolide-type sesquiterpene lactones, and one new benzofuran. The bioguided fractionation methodology was successful in detecting antimicrobial metabolites against Staphylococcus aureus strains and permitted the description of undescribed guaianolide-type sesquiterpene lactones with substitution patterns matching all those described in the Oxylobinae subtribe.
Subject(s)
Asteraceae , Sesquiterpenes , Anti-Bacterial Agents/pharmacology , Phytochemicals , Lactones/pharmacology , Sesquiterpenes/pharmacologyABSTRACT
INTRODUCCIÓN: El virus del papiloma humano de alto riesgo (VPH-AR) es responsable del cáncer de cuello uterino y sus lesiones preneoplásicas. Los genotipos VPH16 y VPH18 son los más frecuentes en este cáncer. La integración del VPH-AR en el genoma de la célula hospedera es crucial en la carcinogénesis cervical, pero la etapa en que ocurre en la población chilena es incierta. OBJETIVO: Evaluar la integración de VPH16 y VPH18 en lesiones pre-neoplásicas de cuello uterino. MÉTODOS: Se analizaron 108 muestras de raspados cervicales. El VPH se genotipificó mediante reacción de polimerasa en cadena (RPC) e hibridación no radiactiva. La integración de VPH16 y VPH18 se determinó por presencia del gen E2 mediante RPC. RESULTADOS: VPH16 y VPH18 se detectaron en 36,1% y 12,0% de las muestras, respectivamente. El VPH16 se integró en 23,1% de los casos de VPH16, mientras que VPH18 se integró en 100% de las muestras positivas para este genotipo. CONCLUSIONES: La integración VPH-AR es un evento temprano en la carcinogénesis cervical que ocurre en casi la mitad de las lesiones pre-neoplásicas y es más frecuente en VPH18 que en VPH16. La evaluación de la integración VPH-AR puede ser una herramienta útil para detectar el virus en la población chilena.
BACKGROUND: High-risk Human Papillomaviruses (HR-HPVs) are the etiological agents of cervical cancer and its preneoplastic lesions. HPV16 and 18 are the most frequent HR-HPV genotypes detected in cervical cancer. HR-HPV genome integration into the host cell is an important event in the carcinogenic process. However, it remains uncertain which stage of cervical carcinogenesis HPV16 and 18 integration occurs in the Chilean population. AIM: The goal of this study was to evaluate HPV16 and HPV18 integration in preneoplastic lesions of the cervix. METHODS: DNA was extracted from 108 cervical scrape samples with preneoplastic lesions. HPV was genotyped using PCR and non-radioactive hybridization. The integration status of HPV16 and HPV 18 was determined by evaluating the E2 gene presence through PCR. RESULTS: HPV16 and HPV18 tested positive in 36.1% and 12.0% of samples, respectively. HPV16 was found integrated in 23.1% of HPV 16 cases, while HPV 18 in 100% of samples positive for this viral genotype. CONCLUSIONS: HR-HPV integration is an early event in cervical carcinogenesis, occurring in nearly half of preneoplastic lesions and being more frequent in HPV18 than in HPV16. The evaluation of HR-HPV integration can be utilized as a complementary tool for detecting HPV in the Chilean population.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Precancerous Conditions/virology , Cervix Uteri/virology , Virus Integration/genetics , Papillomaviridae/isolation & purification , Papillomaviridae/genetics , Precancerous Conditions/genetics , DNA, Viral/genetics , Cervix Uteri/pathology , Chile , Polymerase Chain Reaction , Cross-Sectional Studies , Human papillomavirus 16/isolation & purification , Human papillomavirus 16/genetics , Human papillomavirus 18/isolation & purification , Human papillomavirus 18/genetics , Genotyping Techniques , GenotypeABSTRACT
OBJECTIVE: The present study aims to assess the mortality trends in myelodysplastic syndromes (MDS) in Spain from 1980 to 2021. METHODS: Deaths and mid-year population data were collected from the National Institute of Statistics. We estimated age-standardised mortality rates (ASMRs) per 100,000 person-years for all ages and ages 35-64. Joinpoint regression identified significant changes in mortality trends. The independent effects of age, period and birth cohort on MDS mortality were also examined. RESULTS: MDS-related deaths gradually increased from 36 in 1980 to 1118 in 2021, with an overall increase of 6.6% in age-standardised mortality rates (ASMRs) for both men and women. Joinpoint analysis identified four periods for both men and women: 1980-1987 (stable rates), 1987-1990 (sharp increase), 1990-1999 (slower increase) and 1999-2021 (stable rates). ASMRs (35-64 years) increased by 2.5% over the study period, with a turning point identified in 1996 when rates decreased. Mortality from MDS increases with age and is higher in men. The cohort's relative risk increased until the mid-1950s and then stabilised, whilst the period relative risk increased between 1982 and 1996 and then stabilised. CONCLUSION: The results of this study indicate a progressive increase in MDS-related deaths in Spain between 1980 and 2021. Notably, this increase was more pronounced in men than in women. Analysis of birth cohort trends revealed shifts in MDS risk, characterised by an increase until the mid-twentieth century, followed by a stabilisation. Using joinpoint analysis, four distinct periods were identified, shedding light on the changing patterns of mortality over time. These findings help to shape future research directions and inform public health strategies. They also provide optimism for advances in MDS treatment and potential reductions in mortality.
Subject(s)
Myelodysplastic Syndromes , Plastic Surgery Procedures , Male , Humans , Female , Spain/epidemiology , MortalityABSTRACT
La ictiosis epidermolítica es una genodermatosis de herencia autosómica dominante poco frecuente que requiere un diagnóstico oportuno, idealmente prenatal, para así brindar una asistencia neonatal adecuada, iniciar un tratamiento precoz y de esta manera disminuir su morbimortalidad. Se caracteriza por la formación de ampollas, múltiples erosiones y descamación con eritrodermia desde el nacimiento. Todos los tipos de ictiosis queratinopáticas son causadas por mutaciones en los genes de la familia de queratina KRT1, KRT2 y KRT10. Se presenta el caso clínico de un neonato de 9 días de vida, nacido en el interior del país, con diagnóstico de ictiosis epidermolítica y antecedente familiar de primer grado con la misma enfermedad. El interés de esta publicación radica en la descripción de una genodermatosis de baja frecuencia, reconocer la importancia del diagnóstico precoz, conocer el manejo, las complicaciones y destacar la importancia de la atención por un equipo multidisciplinario conformado por neonatólogo, dermatólogos, genetistas y pediatras.
Epidermolytic ichthyosis is a rare genodermatosis with autosomal dominant inheritance, which requires timely diagnosis, ideally prenatal diagnosis, in order to provide adequate neonatal care, start early treatment and thus reduce morbidity and mortality. It is characterized by the formation of blisters, multiple erosions and scaling with erythroderma from birth. All types of keratinopathic ichthyoses are caused by mutations in the genes of the keratin family KRT1, KRT2 and KRT10. We present the clinical case of a 9-day-old newborn from the interior of the country, with diagnosis and family history of epidermolytic ichthyosis. The interest of this publication lies in the description of a low-frequency genodermatosis, recognizing the importance of early diagnosis, understanding the management, complications and highlighting the importance of a multidisciplinary care team integrated by a neonatologist, dermatologists, geneticists and pediatricians.
A ictiose epidermolítica é uma genodermatose autossômica dominante rara que requer diagnóstico oportuno, idealmente pré-natal, para fornecer cuidados neonatais adequados, iniciar o tratamento precoce e, assim, reduzir sua morbidade e mortalidade. Caracteriza-se pela formação de bolhas, múltiplas erosões e descamação com eritrodermia desde o nascimento. Todos os tipos de ictioses queratinopáticas são causados por mutações nos genes da família da queratina KRT1, KRT2 e KRT10. É apresentado o caso clínico de um recém-nascido de 9 dias, nascido no interior do país, com diagnóstico de ictiose epidermolítica e história familiar de primeiro grau com a mesma doença. O interesse desta publicação reside na descrição de uma genodermatose de baixa frequência, reconhecendo a importância do diagnóstico precoce, conhecendo o manejo, as complicações e destacando a importância do atendimento por uma equipe multidisciplinar composta por neonatologistas, dermatologistas, geneticistas e pediatras.
Subject(s)
Humans , Infant, Newborn , Ichthyosis/diagnosis , Ichthyosis/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Case Management , Rare Diseases , Ichthyosis/genetics , MutationABSTRACT
El presente documento se realizó gracias a la activa participación de diferentes profesionales de la salud, entre ellos, médicos dermatólogos, residentes de dermatología, neonatólogos, licenciadas y enfermeras del Servicio de Neonatología del Centro Hospitalario Pereira Rossell. Se hizo una búsqueda sistemática de la literatura, sin embargo, debido a que la EA es una condición poco frecuente, con un pequeño número de pacientes, la gran mayoría de trabajos publicados son estudios no analíticos o recomendaciones basadas en opinión de expertos (nivel de evidencia 3-4 o D). De esos estudios se han realizado guías y consensos en diferentes países e instituciones. Dicha literatura también ha sido evaluada y analizada por los autores de estas pautas. Este documento busca servir como una guía práctica y no intenta reemplazar el juicio clínico que el profesional debe emplear para cada paciente o situación en particular. Se presenta una variedad de materiales con los que contamos en el medio y alternativas mediante un pautado de estrategia de tratamiento.
Subject(s)
Humans , Infant, Newborn , Skin/injuries , Skin Diseases/therapy , Frailty , Patient Care ManagementABSTRACT
OBJETIVO: Conocer las prevalencias nacionales de dificultad del funcionamiento de niñas, niños, adolescentes y adultos. Material y métodos. La Encuesta Nacional de Salud y Nutrición 2022 utilizó los módulos de discapacidad del Fondo de las Naciones Unidas para la Infancia (Unicef) y el Grupo Washington. Se calcularon las prevalencias de dificultad del funcionamiento e intervalos de confianza al 95%. RESULTADOS: El 14.4% de la población de 2-17 años presentó al menos una dificultad del funcionamiento, 3.9% entre 2-4 años y 16.7% para 5-17 años. El 9.7% de los adultos presentaron dificultad del funcionamiento, siendo más frecuente en mujeres (11.3%) y en índice de bienestar bajo (12.2%). Conclusión. Una de cada diez personas adultas en México experimentan dificultades de funcionamiento y es mayor en mujeres adultas y personas con índice de bienestar bajo. El Estado Mexicano debe detectar los problemas de funcionamiento potencialmente tratables y establecer programas de adecuación de los entornos para facilitar el funcionamiento de las personas.
ABSTRACT
OBJETIVO: Conocer la prevalencia de desarrollo infantil temprano (DIT), sus determinantes y la exposición a métodos de disciplina en la niñez mexicana en 2022. Material y métodos. Se estimaron los indicadores de DIT, sus determinantes y la exposición a métodos de disciplina siguiendo la metodología de las Encuestas de Indicadores por Conglomerados (MICS). Para cada indicador se estimaron las prevalencias e intervalos de confianza al 95% y se desagregaron por características infantiles y sociodemográficas. RESULTADOS: El 19.3% de las niñas y niños de 24 a 59 meses no alcanzó su máximo potencial de DIT. Existe baja asistencia a programas de aprendizaje temprano (7.1%) y preescolar (62.4%). En el grupo de cinco años, 41.7% no tenía libros y 8.1% recibió cuidado inadecuado. El 55.5% de las niñas y niños de 1 a 14 años fue expuesto a disciplina violenta. Conclusión. Los resultados nos permiten conocer la situación de la niñez y orientar la política pública de esta población.
ABSTRACT
[ABSTRACT]. The objectives of this article are to reflect on the rationale behind the use of echocardiographic screening for rheumatic heart disease and to provide key recommendations about steps needed to implement and improve echocardiographic screening programs in Latin America. Rheumatic heart disease remains a public health problem affecting mainly low-income and lower-middle-income countries and populations. Latin America is an area with economic inequalities, and the epidemiology of rheumatic heart disease remains largely unknown. Echocardiographic screening is useful for updating the epidemiology and providing early diagnosis of the disease. We discuss different approaches used in successful echocardiographic screening programs worldwide and in Latin America. We then identify the key elements needed to establish successful echocardiographic screening programs in Latin America, including increased awareness and involvement from multiple sectors (e.g. the community, health care professionals, scientific organizations and public health entities), identifica- tion of areas in need, development of a plan and structure that include different screening approaches, and how to ensure appropriate follow up for those who screen positive.
[RESUMEN]. Los objetivos de este artículo son reflexionar sobre los fundamentos que justifican el uso del tamizaje ecocardiográfico para detectar la cardiopatía reumática y ofrecer algunas recomendaciones importantes sobre los pasos que habría que dar para poner en marcha programas de tamizaje ecocardiográfico y mejorar los existentes en América Latina. La cardiopatía reumática sigue siendo un problema de salud pública que afecta principalmente a países y grupos poblacionales de ingresos bajos y medianos bajos. América Latina es una región de grandes desigualdades económicas y las características epidemiológicas de la cardiopatía reumática siguen siendo desconocidas en gran medida. El tamizaje ecocardiográfico resulta útil para actualizar los datos epidemiológicos y posibilitar un diagnóstico temprano de la enfermedad. En este artículo se analizan los diferentes enfoques empleados en algunos programas de tamizaje ecocardiográfico eficaces de distintas partes del mundo, incluida América Latina. A continuación se determinan los elementos clave necesarios para establecer programas eficaces de tamizaje ecocardiográfico en América Latina, incluida una mayor concientización y participación de diversos sectores (p. ej., la comunidad, los profesionales de salud, las organizaciones científicas y las entidades de salud pública), la identificación de las zonas más necesitadas, la elaboración de un plan y una estructura que incluyan diferentes abordajes del tamizaje, y el modo de garantizar un seguimiento adecuado de aquellas personas con un resultado positivo en el tamizaje.
[RESUMO]. Os objetivos deste artigo são oferecer observações sobre a fundamentação do uso da triagem ecocardiográfica para doença cardíaca reumática e fornecer recomendações importantes sobre as etapas necessárias para implementar e melhorar os programas de triagem ecocardiográfica na América Latina. A doença cardíaca reumática continua sendo um problema de saúde pública que afeta principalmente países e populações de renda baixa e média-baixa. A América Latina é uma área com desigualdades econômicas, e a epidemiologia da doença cardíaca reumática continua amplamente desconhecida. A triagem ecocardiográfica serve para atualizar a epidemiologia e proporcionar o diagnóstico precoce da doença. Examinamos as diferentes abordagens usadas em programas de triagem ecocardiográfica bem-sucedidos em todo o mundo e na América Latina. Em seguida, identificamos os principais elementos necessários para estabelecer programas de triagem ecocardiográfica com sucesso na América Latina. Tais programas incluiriam maior conscientização e envolvimento de vários setores (por exemplo, a comunidade, profissionais de saúde, organizações científicas e entidades de saúde pública), identificação de áreas carentes, desenvolvimento de um plano e estrutura abrangendo diferentes abordagens de triagem e formas de garantir o seguimento adequado de pessoas com resultado positivo na triagem.
Subject(s)
Rheumatic Heart Disease , Heart Valve Diseases , Echocardiography , Early Diagnosis , Latin America , Rheumatic Heart Disease , Heart Valve Diseases , Echocardiography , Early Diagnosis , Latin America , Heart Valve Diseases , Early DiagnosisABSTRACT
Demonstrate the histological remodeling changes in the turbinates, identify the frequency of the two forms of rhinitis in the samples studied and determine the remodeling differences found in the two variants. Patients attended an otolaryngology service at the Social Security Hospital of city Sangolqui-Ecuador from February 2016 to June 2017. The allergic variant was determined when eosinophils were found by higher magnification field and non-allergic when they were not found in the submucosal segment. Epithelial, inflammatory, and stromal markers were analyzed. One hundred twenty histopathological samples were analyzed, 75% presented allergic rhinitis, the age averaged 36.2 years. When we compared between the allergic and non-allergic variants: epithelial and stromal markers we had significant differences, as well as between each of its components; except fibrosis. In relation to the inflammatory pattern, there were significant differences between the number of mast cells and stromal markers with eosinophils > 10 by field. The allergic type corresponded to 75% of patients with persistent severe rhinitis who underwent turbinectomy. Regarding remodeling, there was a statistically significant difference in favor of the allergic variant. Eosinophilia greater than 10 was directly related to mastocytosis and subepithelial edema.
ABSTRACT
Cashew nutshells from the northern region of Colombia were prepared to assess their potential use as a filler in polymer matrix filaments for 3D printing. After drying and grinding processes, cashew nutshells were characterized using scanning electron microscopy (SEM), attenuated total reflectance Fourier-transform infrared (ATR-FTIR), and thermogravimetric analyses (TGA). Three different filaments were fabricated from polylactic acid pellets and cashew nutshell particles at 0.5, 1.0, and 2.0 weight percentages using a single-screw extruder. Subsequently, single-filament tensile tests were carried out on them. SEM images showed rough and porous particles composed of an arrangement of cellulose microfibrils embedded in a hemicellulose and lignin matrix, the typical microstructure reported for natural fibers. These characteristics observed in the particles are favorable for improving filler-matrix adhesion in polymer matrix composites. In addition, their low density of 0.337 g/cm3 makes them attractive for lightweight applications. ATR-FTIR spectra exhibited specific functional groups attributed to hemicellulose, cellulose, and lignin, as well as a possible transformation to crystalline cellulose during drying treatment. According to TGA analyses, the thermal stability of cashew nutshell particles is around 320 °C. The three polylactic acid-cashew nutshell particle filaments prepared in this work showed higher tensile strength and elongation at break when compared to polylactic acid filament. The characteristics displayed by these cashew nutshell particles make them a promising filler for 3D printing filaments.
ABSTRACT
Background: Rotator cuff injury occurs over tendons that insert into the humeral tuberosity. Ultrasonography detects the size and extent of tendon tears. Its sensitivity and specificity range from 91-100% and 85-86%, respectively. It has been shown that a trained orthopedic surgeon can perform shoulder ultrasonography for the accurate diagnosis of rotator cuff pathology. Objective: To determine the concordance between ultrasound-arthroscopy of the shoulder in rotator cuff injuries at the Unidad Médica Atención Ambulatoria No. 55 (Ambulatory Care Unit No. 55) in León, Guanajuato, Mexico. Material and methods: Experimental study of a sample of 37 patients with a diagnosis of rotator cuff injury, in whom preoperative ultrasound and later shoulder arthroscopy of the same side were performed. The data were subjected to concordance with Cohen's Kappa Index. Results: There were 37 patients in whom we identified an overall concordance of 81%. Cohen's Kappa index was 0.76, considered a good concordance. Out of the 7 patients without correlation, in 1 patient the ultrasound showed partial rupture and by arthroscopy showed complete rupture of the supraspinatus. In 2 patients ultrasonography showed complete rotator cuff tear; during arthroscopy, both showed massive rotator cuff tear. Conclusions: Preoperative shoulder ultrasonography performed by traumatology presents a good concordance in the diagnosis of rotator cuff tears confirmed by arthroscopy.
Introducción: la lesión del mango rotador ocurre sobre tendones que se insertan en la tuberosidad humeral. La ecografía detecta el tamaño y la extensión de los desgarros del tendón. Su sensibilidad y especificidad oscila entre 91-100% y 85-86%, respectivamente. Se ha demostrado que un cirujano ortopédico capacitado puede hacer la ecografía del hombro para el diagnóstico preciso de la patología del manguito rotador. Objetivo: determinar la concordancia entre ecografía-artroscopía de hombro en lesiones del mango rotador en la Unidad Médica Atención Ambulatoria No. 55 de León, Guanajuato, México. Material y métodos: estudio experimental de una muestra de 37 pacientes con diagnóstico de lesión del mango rotador, en los que se realizó ecografía preoperatoria y posteriormente artroscopía de hombro del mismo lado. Los datos se sometieron a concordancia con el Índice de Kappa de Cohen. Resultados: fueron 37 pacientes en los que se identificó la concordancia global de 81%. El Índice de Kappa de Cohen fue de 0.76, considerada una buena concordancia. De los 7 pacientes sin correlación, en un paciente la ecografía mostró rotura parcial y por artroscopía mostró rotura completa del supraespinoso. En 2 pacientes la ecografía mostró rotura completa de mango rotador; durante la artroscopía, ambos mostraron rotura masiva del mango rotador. Conclusiones: la ecografía preoperatoria de hombro realizada por traumatología presenta una buena concordancia en el diagnóstico de roturas del mango rotador confirmadas por artroscopía.