Epigenetic Factors and ncRNAs in Testicular Cancer.

Testicular cancer is the most prevalent tumor among males aged 15 to 35, resulting in a significant number of newly diagnosed cases and fatalities annually. Non-coding RNAs (ncRNAs) have emerged as key regulators in various cellular processes and pathologies, including testicular cancer. Their involvement in gene regulation, coding, decoding, and overall gene expression control suggests their potential as targets for alternative treatment approaches for this type of cancer. Furthermore, epigenetic modifications, such as histone modifications, DNA methylation, and the regulation by microRNA (miRNA), have been implicated in testicular tumor progression and treatment response. Epigenetics may also offer critical insights for prognostic evaluation and targeted therapies in patients with testicular germ cell tumors (TGCT). This comprehensive review aims to present the latest discoveries regarding the involvement of some proteins and ncRNAs, mainly miRNAs and lncRNA, in the epigenetic aspect of testicular cancer, emphasizing their relevance in pathogenesis and their potential, given the fact that their specific expression holds promise for prognostic evaluation and targeted therapies.

Multiple endpoints of polyethylene microplastics toxicity in vascular plants of freshwater ecosystems: A study involving Salvinia auriculata (Salviniaceae).

More recently, the number of studies on the impacts of microplastics (MPs) on plants has drawn attention considerably. However, many of these studies focused on terrestrial plants, with vascular plants from freshwater ecosystems being little studied. Thus, we aimed to evaluate the possible effects of exposure of Salvinia auriculata, for 28 days, to different concentrations of polyethylene MPs (PE MPs - diameter: 35.46 ± 18.17 µm) (2.7 ×108 and 8.1 ×108 particles/m3), using different biomarkers. Our data indicated that exposure to PE MPs caused alterations in plant growth/development (inferred by the lower floating frond number, "root" length, and the number of "roots"), as well as lower dispersion of individuals in the experimental units. Plants exposed to PE MPs also showed lower epidermal thickness (abaxial leaf face) and a longer length of the central leaf vein and vascular bundle area. Ultrastructural analyses of S. auriculata exposed to MPs revealed rupture of some epidermal cells and trichomes on the adaxial and abaxial, leaf necrosis, and chlorosis. In the "roots", we observed dehydrated filamentous structures with evident deformations in plants exposed to the pollutants. Both on the abaxial leaf face and on the "roots", the adherence of PE MPs was observed. Furthermore, exposure to PE MPs induced lower chlorophyll content, cell membrane damage, and redox imbalance, marked by reduced catalase and superoxide dismutase activity and increased production of reactive oxygen and nitrogen species as well as malondialdehyde. However, in general, we did not observe the dose-response effect for the evaluated biomarkers. The values of the integrated biomarker response index, the principal component analysis (PCA) results and the hierarchical clustering analysis confirmed the similarity between the responses of plants exposed to different PE MPs concentrations. Therefore, our study sheds light on how PE MPs can affect S. auriculata and reinforces that putting these pollutants in freshwater environments might be hazardous from an ecotoxicological point of view.

Natural marine products as antiprotozoal agents against amitochondrial parasites.

The goal of this work is to compile and discuss molecules of marine origin reported in the scientific literature with anti-parasitic activity against Trichomonas, Giardia, and Entamoeba, parasites responsible for diseases that are major global health problems, and Microsporidial parasites as an emerging problem. The presented data correspond to metabolites with anti-parasitic activity in human beings that have been isolated by chromatographic techniques from marine sources and structurally elucidated by spectroscopic and spectrometric procedures. We also highlight some semi-synthetic derivatives that have been successful in enhancing the activity of original compounds. The biological oceanic reservoir offers the possibility to discover new biologically active molecules as lead compounds to develop new drug candidates. The molecular variety is extensive and must be correctly explored and managed. Also, it will be necessary to take some actions to preserve the source species from extinction or overharvest (e.g., by cryopreservation of coral spermatozoa, oocytes, embryos, and larvae) and coordinate appropriate exploitation to increase the chemical knowledge of the natural products generated in the oceans. Additional initiatives such as the total synthesis of complex natural products and their derivatives can help to prevent overharvest of the marine ecosystems and at the same time contribute to the discovery of new molecules.

Virus respiratorios detectados a través de biología molecular en niños hospitalizados por Infección respiratoria aguda en tiempos de SARS-CoV-2/COVID-19 / Respiratory viruses detected through molecular biology in childrenhospitalized for acute respiratory infection in times of SARS-CoV-2 / COVID-19

Resumen Introducción: las infecciones respiratorias agudas virales se consideran una de las principales causas de mortalidad y morbilidad en pediatría, El Síndrome Respira torio Agudo Severo o Grave 2 (SARS-CoV-2), se ha convertido en un importante problema para la salud pública mundial por su alta transmisibilidad, el objetivo del estudio es describir el comportamiento de los virus respiratorios detectados por RT-PCR en niños hospitalizados por infección respiratoria aguda (IRA) en tiempos de SARS-CoV-2/COVID-19 en un centro de atención pediátrica de Cali-Colombia. Metodología: Estudio observacional de corte transversal retrospectivo, donde se evaluaron 113 pacientes mayores de 28 días y menores de 18 años entre marzo y noviembre del 2020, hospitalizados con diagnostico confirmado IRA y con Reacción en cadena de la polimerasa en tiempo Real (RT-PCR) positiva para virus respiratorios. Resultados: Predominio del género masculino (64.6%). en 74.3% se diagnosticó con IRA baja, los principales síntomas fueron tos en 92% y fiebre 74.3% Se identificó SARS-CoV-2 en 53%, Human Rhinovirus/Enterovirus en 27.41% y Virus Respiratorio Sincitial en 15%. El 34.5% de los pacientes requirieron unidad de cuidados intensivos y 15.9% ventilación mecánica Conclusiones: La infección por SARS-CoV-2 fue más común en los pacientes hospitalizados tanto en salas generales como en la unidad de cuidados intensivos pediátricos

Abstract Introduction: viral acute respiratory infections have been considered of the main causes of mortality and morbidity in pediatrics, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has become an important problem for global public health for its high transmissibility. The objective of the study is to describe the behavior of respiratory viruses detected by RT-PCR in children hospitalized for acute respiratory infection (ARI) in times of SARS-CoV-2 / COVID19 in pediatric care center in Cali Colombia Methodology: observational with a retrospective cross-sectional study. 113 patients older than 28 days and under 18 years in March to November 2020, hospita lized with a confirmed diagnosis of ARI and Real Time Polymerase Chain Reaction (RT-PCR) positive for respiratory viruses. Results: Predominance of gender male 64.6%. 74.3% with a diagnosis of low ARI, main symptoms presented were cough 92% and fever 74.3%, SARS-CoV-2 identified 53%, Human Rhinovirus / Enterovirus 27.41% and Respiratory Syncytial Virus 15%. 34.5% of the patients required an intensive care unit with mechanical ventilation requirement 15.9% Conclusions: infection by SARS-CoV-2 was more common in hospitalized patients in both general wards as in the pediatric intensive care unit.

Kidney graft functionality 1 year after kidney transplantation.

OBJECTIVE: To determine the evolution, associated factors and the outcomes of transplanted people one year after the evolution of a cohort in Mexico. METHOD: Kidney transplant cohort from 2013 to 2017 in Mexico. 1118 patients were analyzed. Five outcomes were studied: overall survival, kidney graft, patient survival, delayed function, and acute dysfunction. Kaplan-Meier was used for kidney graft survival. For risk, bivariate and multivariate analyzes were performed with a significant value of p < 0.05. RESULTS: Of the 1118 kidney transplant patients, 57 (5.09%) had kidney graft loss, 52 (4.65%) died during the one-year follow-up; survival of the patient of 95.35% and of the graft 90.25%. CONCLUSIONS: The risk factors for the outcomes were transplantation from a deceased donor, recipient over 50 years of age and use of polyclonal agents. Infections and age are related to the death of the patient.

OBJETIVO: Determinar la funcionalidad del injerto renal a 1 año en una cohorte retrospectiva en México. MÉTODO: Cohorte de trasplante renal de 2013 a 2017 en México. Se analizaron 1118 pacientes. Se estudiaron cinco desenlaces: supervivencia global, supervivencia del injerto renal, supervivencia del paciente, función retardada y disfunción aguda. Para la supervivencia del injerto renal se usó Kaplan-Meier. Para el riesgo se realizó análisis bivariado y multivariado con valor significativo p < 0.05. RESULTADOS: De los 1118 pacientes con trasplante renal, 57 (5.09%) tuvieron pérdida del injerto, 52 (4.65 %) fallecieron durante el año de seguimiento; la supervivencia del paciente fue del 95.35% y la supervivencia del injerto fue del 90.25%. CONCLUSIONES: Los factores de riesgo para los desenlaces fueron trasplante de donante fallecido, receptor mayor de 50 años y uso de agentes policlonales. Las infecciones y la edad están relacionadas con la muerte del paciente.

Gastrointestinal hemorrhage as the first manifestation of metastatic choriocarcinoma in a male patient.

INTRODUCTION: Choriocarcinoma is a malignant tumor, it is more frequent in the female sex, rarely reported in the male sex. CLINICAL CASE: A 19-year-old male patient who was admitted with hematochezia and melenic evacuations, panendoscopy and colonoscopy were performed without documenting the bleeding site, exploratory laparotomy was performed finding tumor lesion in the jejunum, the histopathological examination reported Choriocarcinoma. CONCLUSIONS: Gastrointestinal bleeding as a presentation of choriocarcinoma is sometimes the only symptom that the patient presents. Metastatic choriocarcinoma to the gastrointestinal tract is rare, which makes the suspected diagnosis poor.

INTRODUCCIÓN: El coriocarcinoma es un tumor maligno, más frecuente en el sexo femenino, raramente reportado en el sexo masculino. CASO CLÍNICO: Varón de 19 años que ingresa con hematoquecia y evacuaciones melénicas. Se realiza panendoscopia y colonoscopia, sin documentar el sitio de sangrado. Se realiza laparotomía exploradora y se encuentra una lesión tumoral en el yeyuno, cuyo examen histopatológico reportó coriocarcinoma. CONCLUSIONES: La hemorragia de tubo digestivo como presentación de un coriocarcinoma es en ocasiones el único síntoma que muestra un paciente. El coriocarcinoma metastásico al tracto gastrointestinal es raro, lo que hace que la sospecha diagnóstica sea pobre.

Compendio Nacional de Insumos para la Salud: equidad y acceso universal / National Compendium of Health Commodities: equity and universal access

Resumen: México fue pionero en establecer catálogos para identificar y hacer asequibles insumos médicos para la atención de su población, incluyendo medicamentos, instrumental, equipos y material de curación. Hace medio siglo, en 1971, surgió en el Instituto Mexicano del Seguro Social la iniciativa del llamado Cuadro Básico, que se constituyó como una herramienta fundamental para el funcionamiento de las instituciones públicas de salud, con la cual se establecieron listados de insumos con probada eficacia y seguridad, con claves administrativas asignadas que permitieron su adquisición ordenada. En 2020 se llevó a cabo la transición del Cuadro Básico y Catálogo al Compendio Nacional de Insumos para la Salud, el cual recuperó el espíritu original de sus creadores como un documento vivo y en constante evolución, respaldado por una metodología rigurosa para la revisión de los insumos que se incluyen, basada en la evaluación de su efectividad, seguridad y calidad, y en criterios farmacoeconómicos y consensos interinstitucionales.

Abstract: Mexico pioneered the creation of catalogs for identification and access of the medical commodities necessary for public healthcare, including medicines, medical equipment and wound dressing supplies. Fifty years ago, in 1971, the Instituto Mexicano del Seguro Social started the initiative of the Basic Scheme (Cuadro básico), that became a fundamental tool for provision of healthcare in the public institutions through the establishment of listings of medical supplies with proved safety and efficacy, assigning administrative codes that allowed an orderly acquisition. On 2020, the Basic Scheme and Catalog underwent a transition towards the National Compendium of Health Commodities (Compendio Nacional de Insumos para la Salud), recovering the original spirit of their creators as a live document in constant evolution, supported by a rigorous methodology for the assessment of the medical commodities included, based on evaluations of effectiveness, safety and quality, pharmacoeconomic criteria and interinstitutional consensus.

EQ-5D-5L Health-State Values for the Mexican Population.

OBJECTIVE: To generate a value set for the Mexican adult general population to support and facilitate the inclusion of quality-adjusted life years (QALYs) into the health technology assessment process of the Mexican healthcare authorities. METHODS: A representative sample of the Mexican adult population stratified by age, sex and socio-economic status was used. Following version 2.0 of the EuroQol EQ-5D-5L valuation protocol, trained interviewers guided participants in completing composite time trade-off (cTTO) and discrete-choice experiment (DCE) tasks included in the EQ-VT software. Generalized least squares, Tobit and Bayesian models were used for cTTO data. The choice of value set model was based on criteria that included: theoretical considerations, parsimony, logical ordering of coefficients, and statistical significance. RESULTS: Based on quality control criteria and interviewer judgment, 1000 out of 1032 participants provided useable responses. Participants' demographic characteristics were similar to the 2010 Mexican Population Census and followed the socioeconomic structure defined by the Mexican Association of Marketing Research and Public Opinion Agencies (AMAI). The predicted index values in the final cTTO model (a heteroscedastic censored model with Bayesian estimation) ranged from - 0.5960 to 1, with 19.7% of all predicted health state scores less than 0 (i.e., worse than dead). CONCLUSION: This study has generated the first value set representing the stated preferences of the Mexican adult population for use in estimating QALYs. The resulting EQ-5D-5L value set is technically robust and will facilitate health economic analyses as well as quality-of-life studies.

Chemical Characterization of Plant Extracts and Evaluation of their Nematicidal and Phytotoxic Potential.

Nacobbus aberrans ranks among the "top ten" plant-parasitic nematodes of phytosanitary importance. It causes significant losses in commercial interest crops in America and is a potential risk in the European Union. The nematicidal and phytotoxic activities of seven plant extracts against N. aberrans and Solanum lycopersicum were evaluated in vitro, respectively. The chemical nature of three nematicidal extracts (EC50,48h ≤ 113 µg mL-1) was studied through NMR analysis. Plant extracts showed nematicidal activity on second-stage juveniles (J2): (≥87%) at 1000 µg mL-1 after 72 h, and their EC50 values were 71.4-468.1 and 31.5-299.8 µg mL-1 after 24 and 48 h, respectively. Extracts with the best nematicidal potential (EC50,48h < 113 µg mL-1) were those from Adenophyllum aurantium, Alloispermum integrifolium, and Tournefortia densiflora, which inhibited L. esculentum seed growth by 100% at 20 µg mL-1. Stigmasterol (1), ß-sitosterol (2), and α-terthienyl (3) were identified from A. aurantium, while 1, 2, lutein (4), centaurin (5), patuletin-7-ß-O-glucoside (6), pendulin (7), and penduletin (8) were identified from A. integrifolium. From T. densiflora extract, allantoin (9), 9-O-angeloyl-retronecine (10), and its N-oxide (11) were identified. The present research is the first to report the effect of T. densiflora, A. integrifolium, and A. aurantium against N. aberrans and chemically characterized nematicidal extracts that may provide alternative sources of botanical nematicides.

Patterns in utilization of carbon sources in soil microbial communities contaminated with mine solid wastes from San Luis Potosi, Mexico.

In San Luis Potosí, Mexico, the exploitation of minerals has historically been carried out as an activity that has left in its path environmental liabilities, with high concentrations of heavy metals. These metals have undergone weathering by rain and wind and have moved closer to inhabited locations as is the case of Cerro de San Pedro (CSP) and Villa de la Paz (VDP). The objective of this study is to show the biological alteration of soils due to the presence of heavy metals and metalloids like Cadmium (Cd), Copper (Cu), Lead (Pb) and Arsenic (As) and to find the relationship between contamination and risk indexes. Soil samples were obtained from sites with historical records of mining activity and their surroundings. Several analyses were performed, such as pH levels, organic matter, electrical conductivity, clays, heavy metals and As. Moreover, Community Level Physiological profiling (CLPP) were conducted. The obtained evidence showed high levels of contamination by As and heavy metals in both sites (CSP: 6485.1 mg/Kg of Pb and pH of 4.4; VDP: 7188.2 mg/Kg of As and pH of 7.8). According to the Metal Pollution Index (MPI), 607.0 in CSP and 1050.5 in VDP, presented a high environmental risk, apart from, risk to human health (SQGQI) 35.8 in CSP and 131.5 in VDP. At the same time, CLPPs showed that microbiological communities were selective in taking up substrate groups, in the following order: Carbohydrates > Polymers > Carboxylic acids > Amino acids > Amines/Amides. However, a positive correlation in CSP was only found between both indexes and Amines/Amides (r = 0.46, p < 0.05), and in VDP the D-Galactonic acid-γ-Lactone with the MPI (r = 0.49, p < 0.05), and with the SQGQI (r = 0.45, p < 0.05). Although this behavior was not homogeneous, it was possible to find negative correlations between both indexes and the AWCD with other substrates, influenced by the physicochemical characteristics presented in each studied site. Consequently, according to our findings, a combined effect between the physicochemical characteristics, As, and heavy metals took place, on the metabolic activity, causing alterations to soil functions.

Compendio Nacional de Insumos para la Salud: equidad y acceso universal.

México fue pionero en establecer catálogos para identificar y hacer asequibles insumos médicos para la atención de su población, incluyendo medicamentos, instrumental, equipos y material de curación. Hace medio siglo, en 1971, surgió en el Instituto Mexicano del Seguro Social la iniciativa del llamado Cuadro Básico, que se constituyó como una herramienta fun-damental para el funcionamiento de las instituciones públicas de salud, con la cual se establecieron listados de insumos con probada eficacia y seguridad, con claves administrativas asignadas que permitieron su adquisición ordenada. En 2020 se llevó a cabo la transición del Cuadro Básico y Catálogo al Compendio Nacional de Insumos para la Salud, el cual recuperó el espíritu original de sus creadores como un do-cumento vivo y en constante evolución, respaldado por una metodología rigurosa para la revisión de los insumos que se incluyen, basada en la evaluación de su efectividad, seguridad y calidad, y en criterios farmacoeconómicos y consensos interinstitucionales.

Nondestructive biomarkers in giant toad (Rhinella marina) to assess the effect of complex mixture of pollutants in Coatzacoalcos River, Mexico.

In this study, we evaluated the usefulness of nondestructive biomarkers approach in giant toads (Rhinella marina). We obtained blood samples and the residual condition index of toads from rural and industrial zones from Coatzacoalcos River, Mexico (COA). In the blood samples, we determined the activity of enzymes, lipid peroxidation, and the presence of cell death (apoptosis). We found that the activity of the enzyme delta-aminolevulinic dehydratase was lower. Still, the glutathione s-transferase activity and the percentage of apoptosis in erythrocytes were higher in the toads of COA than laboratory toads. Meanwhile, some biomarkers in toads showed differences when compared between Industrial and Rural zones. These results and correlations between biomarkers showed how the response changed in the toads living near the industrial zones. We demonstrate that a nondestructive biomarkers approach can be useful in environmental studies with anuran amphibians.

Integrated probabilistic risk assessment in sites contaminated with arsenic and lead by long-term mining liabilities in San Luis Potosi, Mexico.

Mining environmental liabilities (MEL) in San Luis Potosi are the result of more than 450 years of mining activity, which has contaminated the soil mainly with arsenic (As) and lead (Pb) in several areas. Risk assessments are used to estimate the possibility of the occurrence of adverse effects on human health or on ecological receptors; and the most accessible way of performing them is through probabilistic estimates such as the Latin Hypercube Sampling (LHS) model. Therefore, the aim of this study was to carry out an Integrated Probabilistic Environmental Risk Assessment (IPERA) for the estimation of health risks in infants and rodents. The mean concentrations of As and Pb in soil were significantly higher (p<0.05) in all contaminated sites than in their respective reference sites. Villa de la Paz was the site with the highest mean concentration of As (1374 mg/kg), while Charcas was the one with the highest level of Pb (12,929 mg/kg). The Hazard Quotient (HQ) was calculated and Villa de la Paz had the highest values of As in both rodents (11.994) and children (39.32), and Charcas showed the highest values of Pb in both (24.971 and 31.668 for rodents and children respectively). The cumulative hazard Index (HI) reveals there is a very significant health risk due to As and Pb exposure for both rodents and children in contaminated areas of these mining communities.

Clinical comparison of platelet-rich plasma injection and daily celecoxib administration in the treatment of early knee osteoarthritis: A randomized clinical trial.

BACKGROUND: Oral and topical nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics and intra-articular corticosteroid injections are the recommended first line of treatment for knee osteoarthritis (OA); however, they have serious side effects. Platelet-rich plasma (PRP) has been posited as an effective and safer alternative treatment for knee OA. Hitherto, there is only one study comparing the effectiveness of PRP against an NSAID. AIM OF THE STUDY: The aim of this study was to determine the effectiveness of PRP against celecoxib in the treatment of early knee OA. METHODS: 60 patients with knee OA grade II and III were randomly alocated in two groups. Group 1 received one injection of autologous PRP in each affected knee, with a reinjection after 15 days; Group 2 received 200 mg of oral celecoxib each 24 h for a year. Visual Analogue Scale (VAS), total Western Ontario and McMaster Universities Arthritis Index (WOMAC) and WOMAC subscales for pain, stiffness and function were measured at baseline and at 1, 3, 6 and 12 months after the start of the treatment. RESULTS: At the end of the study PRP was significantly better than celecoxib (p < 0.05) in improving VAS (40.40%), total WOMAC (58.95%) and WOMAC subscales of pain (50.60%), stiffness (34.13%) and function (51.90%). Significant differences remained after adjusting for age, sex or knee OA grade II or III. CONCLUSIONS: Intra-articular PRP is significantly better than celecoxib in improving pain, function and stiffness in early knee OA. This significant difference is independent of age, sex or knee OA grade II or III.

Syndromic Intellectual Disability Caused by a Novel Truncating Variant in AHDC1: A Case Report.

Mutations in the AHDC1 gene are associated with the Xia-Gibbs syndrome (XGS), a sporadic genetic disorder characterised by developmental delay, intellectual disability, hypotonia, obstructive sleep apnoea, dysmorphic facial features, and cerebral malformations with plagiocephaly. Here we report the case of a 13-year-old Colombian female patient with a history of developmental delay, speech delay, sleep disturbances, and dysmorphic craniofacial features. The whole exome sequencing (WES) test revealed a novel de novo heterozygous frameshift mutation in AHDC1. The present case report describes the second case of mutations in AHDC1 in a Latin American patient. A literature review showed that the clinical features were similar in all reported patients. The WES test enabled the identification of the causality of this disorder characterised by high clinical and genetic heterogeneity.

DNA damage in different wildlife species exposed to persistent organic pollutants (POPs) from the delta of the Coatzacoalcos river, Mexico.

The delta of the Coatzacoalcos river is a priority region for the biological conservation in the Gulf of Mexico. Environmental studies in the area have detected a complex mixture of contaminants where the presence of Persistent organic compounds (POPs) is highlighted. Deoxyribonucleic acid (DNA) integrity of biological populations are global concerns due to their ecological implications. The purpose of this study was to measure the exposure to POPs and DNA damage in nine species residing in the Coatzacoalcos river classified by taxonomic group, type of habitat and feeding habits. Total POPs concentrations (minimum and maximum) detected for all species were from 22.7 to 24,662.1 ng/g l.w; and the values of DNA damage (minimum and maximum) varied from 0.7 to 20.5 and from 6.5 to 56.8 µm (Olive tail moment and tail length respectively). Broadly speaking, reptiles, species residing in the wetland and the ones with a carnivorous diet showed higher levels of POPs and DNA damage. This study provides us with a baseline of the state of POPs contamination and shows the degree of environmental stress to which the different components of the ecosystem of the Coatzacoalcos river delta are subject to.

Intellectual performance of kidney transplant recipients' offspring: a cross-sectional, multicenter study.

OBJECTIVE: The number of successful pregnancies in kidney transplant (KT) recipients has increased in recent years. Little evidence is available about the risk of in utero immunosuppressive exposure for long-term cognitive consequences. The aim of this study was to evaluate the impact of immunosuppression during pregnancy on intellectual performance of children born to KT recipients. METHODS: Using a cross-sectional design, women who had undergone KT and their children (aged 4+ years) were recruited at the outpatient follow-up in five transplant centers. Women who did not receive immunosuppression during pregnancy with similar distributions of socioeconomic status and length of gestation and their children were also recruited. Children were assessed with Wechsler Intelligence Scales. RESULTS: The study sample included 50 exposed and 50 unexposed children. No differences between groups in all the proposed confounding factors were found. Full-scale IQ did not differ significantly between both groups. Also, significant differences in any index or subscale score were not observed, with the exception of time required to complete the Wechsler preschool and primary scale of intelligence (WPPSI) Zoo locations subtest, which was done quicker in the unexposed group (p = .007). Exposure to immunosuppression during pregnancy was not a significant predictor of low IQ in logistic regression after adjustment for other factors. CONCLUSIONS: Immunosuppression therapy during pregnancy of KT women did not affect global intellectual performance of their offspring, except maybe for visuospatial working memory in preschool children.

Optimizing the clinical utility of sirolimus-based immunosuppression for kidney transplantation.

While calcineurin inhibitors (CNIs) are effective for preventing acute rejection in kidney transplant recipients, long-term use may cause chronic kidney injury and is associated with increased risks of cardiovascular events, cancer, and infection-associated death. Immunosuppression strategies are needed to balance risks of acute and subclinical rejection with long-term benefits of improved kidney function. Sirolimus, an inhibitor of mammalian target of rapamycin, is used for immunosuppression in kidney transplantation. Its clinical utility has evolved, over more than 15 years, including de novo sirolimus with and without concomitant CNIs and conversion from CNI-based regimens to sirolimus. Sirolimus-containing regimens are associated with preservation of good renal function, with promising characteristics for improving long-term graft and patient survival, including antiviral and anticancer effects. Based on clinical evidence, use of low-dose sirolimus in a de novo approach with tacrolimus/steroids in the immediate posttransplantation period is appropriate. A feasible alternative is a long term, CNI-free combination with mycophenolate mofetil (following CNI-to-sirolimus conversion at 3-6 months). These strategies are appropriate for a broad range of patients with various levels of immunologic risk, including those receiving expanded criteria donor kidneys or at increased risk of delayed graft function, particular challenges in Latin America and other global regions.

The Most Common HLA Antigens Found in Patients With Renal Transplants at the Specialties Hospital of "La Raza" Medical Center, Mexico.

BACKGROUND: The knowledge to understand transplant acceptance or rejection derives directly from knowing its genetic material and the major histocompatibility complex involved in immune response, so it is essential to identify the most common alleles in the Mexican population. METHODS: In the northern areas of the Federal District (DF), Hidalgo, and Mexico State, we performed an analysis of HLA class I (A and B) and HLA class II (DRß1 and DQß1) with the use of the PCR-SSP process (Invitrogen). We performed measures of central tendency and percentages of common alleles in the study population. RESULTS: We analyzed 718 results of patients before renal transplantation: 313 pairs of recipients and living donors and 92 patients receiving cadaveric donation. HLA allele A 02 536 (37.32%) was the most common allele found. In HLA B, the most common allele corresponded to 35, in 321 (22.35%), which was the most polymorphic. In HLA DRß1 the most common was 04, in 447 (31.12%), which was the least polymorphic; the most common was 03, in 777 (54.10%). CONCLUSIONS: We corroborated the frequency of alleles found in the considered population, which corresponds to the northern part of Mexico City as well as the states of Mexico and Hidalgo. It was determined that there is no risk allele for developing chronic kidney disease.

[Modification of health-related quality of life in kidney transplant recipients]. / Modificación de la calidad de vida relacionada con la salud en receptores de trasplante renal.

INTRODUCTION: The assessment of health-related quality of life is essential to renal replacement therapies. We conducted a study to evaluate the change in quality of life at 6 and 12 months after renal transplantation and compared with healthy population and general population. METHODS: A prospective study in 278 renal transplant recipients using the SF-36 survey at 0, 6 and 12 months after transplantation. The results were compared with those obtained in healthy population (kidney donors) and general population. Student t test was employed for comparisons of means. A value of p<0.05 was considered statistically significant. RESULTS: The quality of life before transplantation was lower than that observed in healthy population and the general population (p<0.001). At 6 months of transplantation significant improvement over the baseline measurement (p<0.001) in the 8 domains and the two composite scales was obtained, but at 12 months, an additional benefit was not observed. The quality of life of recipients at 12 months of transplant was lower only in the concept of general health (p=0.035) compared with healthy population. However, it was higher than general population in physical and mental composite scales (p=0.013 and p=0.001 respectively). CONCLUSIONS: The health related quality of life improved significantly at 6 and 12 months after renal transplantation, achieving equated healthy population and general population.

Introducción: la evaluación de la calidad de vida relacionada con la salud es fundamental en las terapias de reemplazo renal. Realizamos un estudio para evaluar la modificación en la calidad de vida a los 6 y 12 meses del trasplante renal y compararla con población sana y población general. Métodos: se realizó un estudio prospectivo en 278 receptores renales aplicando la encuesta SF-36 a los 0, 6 y 12 meses del trasplante. Los resultados fueron comparados con los obtenidos en población sana (donantes renales) y población general. Se empleó prueba t de student para realizar las comparaciones de medias. Una p < 0.05 fue considerada estadísticamente significativa.Resultados: la calidad de vida previa al trasplante fue inferior a la observada en población sana y población general (p < 0.001). A los 6 meses de trasplante se obtuvo mejoría significativa con respecto a la medición basal (p < 0.001) en los 8 dominios y las dos escalas compuestas, pero a los 12 meses no se observó un beneficio adicional. La calidad de vida de los receptores a los 12 meses de trasplante fue inferior solo en el concepto de salud general (p = 0.035) al compararse con la población sana. No obstante, fue superior a la población general en las escalas compuestas física y mental (p = 0.013 y p = 0.001 respectivamente).Conclusiones: la calidad de vida relacionada con la salud mejora significativamente a los 6 y 12 meses del trasplante renal, logrando equipararse con población sana y población general.