The second Mexican consensus on hepatocellular carcinoma. Part II: Treatment.

Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this second part of the document, the topics related to the treatment of HCC are presented.

The second Mexican consensus on hepatocellular carcinoma. Part I: Epidemiology and diagnosis.

Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this first part of the document, the topics related to epidemiology and diagnosis are presented.

Conducta sexual y riesgo de embarazo temprano en adolescentes de cd. Victoria, Tamaulipas / Sexual behavior and risk of early adolescent pregnancy Cd. Victoria, Tamaulipas

Introducción: La proporción de adolescentes que han iniciado relaciones sexuales va en aumento y la edad de inicio está disminuyendo, sin embargo, la capacidad para evitar el embarazo no acompaña este comportamiento. En la Jurisdicción Sanitaria No. 1 de Cd. Victoria, Tamaulipas, en el año 2008 se atendieron 15,137 embarazadas, y de estas el 22.0% son menores de 20 años,1 afectándoles de manera importante los planes de vida y futuro de las madres adolescentes. El propósito de esta investigación fue describir las características de la conducta sexual de los adolescentes, variables que se relacionan con el inicio de la actividad sexual, y practicas de riesgo para embarazo. Metodología: Se realizo un estudio observacional, descriptivo, transversal, correlacional.2. En 1212 adolescentes de 12 a 19 años ambos sexos, mediante un muestreo no probabilístico, por disponibilidad. Utilizando un instrumento con un alpha de cronbach de 0.82. Resultados. La mitad de los participantes en el estudio se encuentra en el rango de 15 a 17 años con una media de 16 años. El 97% conoce métodos anticonceptivos, mas no su funcionamiento la información la adquirieron de la escuela y amigos. El 22 % tiene vida sexual activa iniciando entre los 14-15 años, no utilizaron método anticonceptivo por no planear la relación sexual. El 50% tiene más de una pareja, no se encontró asociación entre la edad y el número de parejas ni entre la edad y la última vez en que se tuvo relación sexual. Discusión: Los datos obtenidos sobre conducta sexual no difieren con lo reportado en la revisión de la literatura, la actividad sexual inicia más tempranamente entre los hombres que en las mujeres, el uso de métodos anticonceptivos no es generalizable ni en la primera ni en la última relación sexual. Conclusiones: Un porcentaje alto no tiene conocimiento sobre métodos anticonceptivos y su funcionamiento, considerándose estas variables como riesgo para la presentación de embarazo en la adolescencia.

Introduction: The proportion of adolescents who have initiated sexual relations is increasing and they are beginning at an earlier age, nevertheless the ability to avoid pregnancy does not accompany this behavior. At the Sanitary Jurisdiction number 1,in Cd. Victoria, Tamaulipas; year 2008. they took care of 15,137 pregnant women, and of these, 22.0% are pregnancies in subjects who are younger than 20 years, affecting them in a considerable way in relation to life plans and the future of the adolescent mothers. Objetive: The aim of this research was to describe the characteristics of the adolescent sexual behavior, variables related to the beginning of sexual activity and risk practices for pregnancy. Methodology: A correlational, transversal, descriptive and observational study was carried out (Polit & Hungler, 1999) in adolescents of 12 to 19 years of age, both sexes, through a non-probabilistic sampling by availability, using an instrument with a Cronbach's alpha of 0.82 Results: The sampling was of 1212, half of the cases are in the rank of 15 to 17 years and the mean is 16 years. 97% know about contraceptive methods but they do not know how they work. The information was acquired in school and from friends. 22% have active sexual life beginning between 14 and 15 years. They did not use a contraceptive method because the sexual relation was not planned. 50% have more than one couple. There was no association between age and the number of couples or between the age and the last time that they had sexual relations. Discussion: The information that we obtained about sexual behavior do not differ from the one that was reported on the literature revision. Sexual activity begins earlier in men than in women. The use of contraceptive methods is not generalizable, neither in the first nor in the last sexual relation. Conclusions: A high percentage do not know about contraceptive methods and how they work, considering these variables as a risk of pregnancy in adolescents.

Bovine babesiosis in northern Mexico.

The occurrence of Boophilus microplus infections accompanied by bovine babesiosis was confirmed for 2 locations in northern Mexico. The confirmation at one location was made by transferring whole blood to a splenectomised calf which subsequently developed an acute Babesia bovis infection. Examination of thin blood smears from a suspect animal at the second location revealed B. bovis-infected erthrocytes. A serological survey of other herd members at both locations showed antibody activity against both Babesia and Anaplasma spp.

Mortality, weight loss and anaemia in Bos taurus calves exposed to Boophilus microplus ticks in the tropics of Colombia.

One hundred and sixteen pure-bred Normandy calves previously immunised against babesiosis and anaplasmosis were transported to the Caribbean Coast of Colombia where they divided into 2 equal groups and placed in separate pastures. One group sustained heavy infestation with Boophilus microplus ticks. The second group became lightly infested. The heavily infested calves suffered average losses in body weight of 38 kg and a 48% decrease in mean packed cell volume. Twenty-three (40%) died 16 to 39 days following arrival from severe ixodiasis and babesiosis. Mortality did not occur nor were significant weight losses observed in the group of lightly infested calves.