Asociación entre el hiperparatiroidismo secundario a la deficiencia de vitamina D en el embarazo y la frecuencia de preeclampsia / Association between hyperparathyroidism secondary to vitamin D deficiency in pregnancy and the frequency of preeclampsia

Resumen OBJETIVO: Establecer si existe asociación entre el hiperparatiroidismo secundario a una deficiencia de vitamina D en el embarazo y la frecuencia de preeclampsia. MATERIALES Y MÉTODOS: Estudio de casos y controles, prospectivo y longitudinal efectuado en pacientes con y sin preeclampsia que entre el 1 de enero y el 30 de junio del 2021 acudieron al Hospital Universitario de la Universidad Autónoma de Nuevo León para la atención del parto. Criterios de inclusión: pacientes embarazadas con diagnóstico de preeclampsia en el último trimestre de la gestación con tensión arterial igual o mayor a 140-90 mmHg y proteinuria igual o mayor a 30 mg/dL. Para el grupo control: embarazadas sanas, sin diagnóstico de preeclampsia en el último trimestre de la gestación. Criterios de exclusión: tabaquismo, alcoholismo y drogadicción y quienes no aceptaron entrar al estudio o tuvieran diagnóstico de enfermedades médicas crónicas. RESULTADOS: Se estudiaron 90 pacientes divididas en dos grupos: con preeclampsia (n = 45) y sin ésta (control, n = 45). Se encontró una relación entre la deficiencia de vitamina D, la hipocalcemia y la preeclampsia; no así entre la paratohormona y la preeclampsia en los rangos internacionales de la primera. La preeclampsia se encontró con mayor frecuencia en pacientes de 12 a 15 años. CONCLUSIONES: El hiperparatiroidismo secundario a la deficiencia de vitamina D en el embarazo no se observó en pacientes con preeclampsia, quienes sí la padecieron tuvieron concentraciones de paratohormona en límites normales. Se encontró una relación entre la deficiencia de vitamina D, la hipocalcemia y la preeclampsia.

Abstract OBJECTIVE: To establish whether there is an association between hyperparathyroidism secondary to vitamin D deficiency in pregnancy and the frequency of preeclampsia. MATERIALSAND METHODS: Case-control, prospective, longitudinal study performed in patients with and without preeclampsia who between January 1 and June 30, 2021 attended the Hospital Universitario of the Universidad Autónoma de Nuevo Leon for delivery care. Inclusion criteria: pregnant patients with a diagnosis of preeclampsia in the last trimester of gestation with blood pressure equal to or greater than 140-90 mmHg and proteinuria equal to or greater than 30 mg/dL. For the control group: healthy pregnant women without a diagnosis of preeclampsia in the last trimester of gestation. Exclusion criteria: smoking, alcoholism and drug addiction and those who did not agree to enter the study or had a diagnosis of chronic medical diseases. RESULTS: We studied 90 patients divided into two groups: with preeclampsia (n = 45) and without preeclampsia (control, n = 45). A relationship was found between vitamin D deficiency, hypocalcemia, and preeclampsia; a relationship was not found between parathormone and preeclampsia in the international parathormone ranges. Preeclampsia was found more frequently in patients aged 12 to 15 years. CONCLUSIONS: Hyperparathyroidism secondary to vitamin D deficiency in pregnancy was not observed in patients with preeclampsia; those who had it had parathormone concentrations in normal limits. A relationship was found between vitamin D deficiency, hypocalcemia, and preeclampsia.

Genome-wide identification of heat shock factors and heat shock proteins in response to UV and high intensity light stress in lettuce.

BACKGROUND: Heat shock factors (Hsfs) and Heat shock proteins (Hsps) belong to an essential group of molecular regulators involved in controlling cellular processes under normal and stress conditions. The role of Hsfs and Hsps is well known in model plant species under diverse stress conditions. While plants Hsfs are vital components of the signal transduction response to maintain cellular homeostasis, Hsps function as chaperones helping to maintain folding of damaged and newly formed proteins during stress conditions. In lettuce (Lactuca sativa), a highly consumed vegetable crop grown in the field and in hydroponic systems, the role of these gene families in response to artificial light is not well characterized. RESULTS: Using a genome-wide analysis approach, we identified 32 Hsfs and 22 small heat shock proteins (LsHsps) in lettuce, some of which do not have orthologs in Arabidopsis, poplar, and rice. LsHsp60s, LsHsp90s, and LsHsp100s are highly conserved among dicot and monocot species. Surprisingly, LsHsp70s have three times more members than Arabidopsis and two times more than rice. Interestingly, the lettuce genome triplication did not contribute to the increased number of LsHsp70s genes. The large number of LsHsp70s was the result of genome tandem duplication. Chromosomal distribution analysis shows larger tandem repeats of LsHsp70s genes in Chr1, Chr7, Chr8, and Chr9. At the transcriptional level, some genes of the LsHsfs, LsHsps, LsHsp60s, and LsHsp70s families were highly responsive to UV and high intensity light stress, in contrast to LsHsp90s and LsHsp100s which did not respond to a light stimulus. CONCLUSIONS: Our genome-wide analysis provides a detailed identification of Hsfs and Hsps in lettuce. Chromosomal location and syntenic region analysis together with our transcriptional analysis under different light conditions provide candidate genes for breeding programs aiming to produce lettuce varieties able to grow healthy under hydroponic systems that use artificial light.

Spectral effects of blue and red light on growth, anatomy, and physiology of lettuce.

Characterizing spectral effects of blue and red light ratios on plants could help expand our understanding of factors that regulate growth and development, which is becoming increasingly important as narrowband light-emitting diodes become common for sole-source lighting. Herein we report growth, physiological, and anatomical responses of two lettuce cultivars grown indoors under various blue and red ratios including monochromatic treatments. When used in combination with red, increasing the proportion of blue light generally reduced growth but increased chloroplast abundance and single-leaf photosynthetic efficiency. However, when used as single wavebands, both blue and red light increased leaf area and epidermal cell area, but reduced root dry mass, SPAD index, stomatal density, and leaf thickness compared to dichromatic light. In addition, chloroplast abundance and single-leaf physiological responses were higher in plants grown under monochromatic blue compared to red light, but the opposite trend was measured for shoot biomass. Our results show that spectral effects on morpho-anatomical leaf responses can largely influence plant growth and single-leaf physiological responses. However, a significant blue light reduction in radiation capture ultimately limits growth and productivity of lettuce plants when dichromatic blue and red light is used.

Silicon Alleviate Hypoxia Stress by Improving Enzymatic and Non-enzymatic Antioxidants and Regulating Nutrient Uptake in Muscadine Grape (Muscadinia rotundifolia Michx.).

Flooding induces low oxygen (hypoxia) stress to plants, and this scenario is mounting due to hurricanes followed by heavy rains, especially in subtropical regions. Hypoxia stress results in the reduction of green pigments, gas exchange (stomatal conductance and internal CO2 concentration), and photosynthetic activity in the plant leaves. In addition, hypoxia stress causes oxidative damage by accelerating lipid peroxidation due to the hyperproduction of reactive oxygen species (ROS) in leaf and root tissues. Furthermore, osmolyte accumulation and antioxidant activity increase, whereas micronutrient uptake decreases under hypoxia stress. Plant physiology and development get severely compromised by hypoxia stress. This investigation was, therefore, aimed at appraising the effects of regular silicon (Si) and Si nanoparticles (SiNPs) to mitigate hypoxia stress in muscadine (Muscadinia rotundifolia Michx.) plants. Our results demonstrated that hypoxia stress reduced muscadine plants' growth by limiting the production of root and shoot dry biomass, whereas the root zone application of both Si and SiNP effectively mitigated oxidative and osmotic cell damage. Compared to Si, SiNP yielded better efficiency by improving the activity of enzymatic antioxidants [including superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT)], non-enzymatic antioxidants [ascorbic acid (AsA) and glutathione contents], and accumulation of organic osmolytes [proline and glycinebetaine (GB)]. SiNP also regulated the nutrient profile of the plants by increasing N, P, K, and Zn contents while limiting Mn and Fe concentration to a less toxic level. A negative correlation between antioxidant activities and lipid peroxidation rates was observed in SiNP-treated plants under hypoxia stress. Conclusively, SiNP-treated plants combat hypoxia more efficiently stress than conventional Si by boosting antioxidant activities, osmoprotectant accumulation, and micronutrient regulation.

Analisis sobre elementos de contenido en Medicina Familiar para la identidad profesional del Médico Familiar / Analysis of content elements in Family Medicine for the professional identity of the Family Physician

Introducción: Diversos factores históricos, ormativos (en pre y postgrado) y del sistema laboral no han permitido, desde la construcción social, el desarrollo de la identidad proesional medico familiar. Objetivo Analizar los elementos de contenido de la medicina familiar que contribuyan a la construcción de la identidad profesional de los médicos familiares para el ejercicio de la especialidad. Material y métodos: Revisión bibliográfica y análisis hermenéutico con el que se descubrieron y organizaron elementos de contenidos propos a la Medicina Familiar.

Criterios para identificar pacientes vulnerables en Atención Primaria / Criteria for identifying primary care vulnerable patients

Objetivo: establecer los criterios para designar pacientes vulnerables en Atención Primaria y determinar el porcentaje de pacientes vulnerables en la consulta del Primer Nivel de acuerdo a criterios establecidos. Métodos: estudio descriptivo, prospectivo, basado en las visitas al consultorio de médicos de familia y los registros médicos en la consulta externa del Hospital Universitario del Programa de Residencia de Medicina Familiar, de la Facultad de Medicina de la Universidad Autónoma de Nuevo León, México. El universo estuvo constituido por los pacientes que asistieron a la consulta externa de Medicina Familiar en un período de cuatro meses en 2013. Se realizaron consultas de orden habitual y se revisó el expediente al momento de la consulta. Se clasificaron los pacientes de acuerdo a los criterios establecidos. Diagnóstico de consulta, Diagnósticos previos y número de consultas. Resultados: se brindó asistencia médica a un total de 460 pacientes durante el periodo establecido. Estos pacientes generaron 746 visitas al consultorio. El criterio de "paciente vulnerable" se hizo en 228 visitas (30,5 por ciento), las cuales correspondieron a 88 pacientes. Conclusiones: los pacientes vulnerables según los criterios establecidos son pacientes que requieren una atención integral con prioridad. Los médicos de familia pueden proporcionar una atención integral a los problemas personales o familiares de sus pacientes y especialmente a este grupo vulnerable(AU)

Objective: To establish the criteria for identifying primary care vulnerable patients and determine the percentage of vulnerable patients in the first level consultation according to the established criteria. Methods: Descriptive, prospective study based on the visits to the family doctor's offices and the medical records of the Family Medicine Residency Program in the outpatient consultation of the University Hospital, School of Medicine of Nuevo León Autonomous University (Mexico). The target group was made up of the patients who attended the Family Medicine outpatient consultation in a period of four months en 2013. Common consultations were held and the record at the time of the consultation was reviewed. The patients were classified according to the established criteria: consultation diagnosis, previous diagnosis and consultations number. Results: Medical assistance was provides to a sheer number of 460 patients in the established period. These patients performed 746 visits to the office. The criteria of "vulnerable patient" was appointed for 228 visits (30.5 percent), corresponding to 88 patients. Conclusions: The vulnerable patients, according to the established criteria, are those requiring comprehensive care with priority. Family doctors may provide comprehensive care to the personal and familial problems of their patients and especially to this vulnerable group(AU)

Criterios para identificar pacientes vulnerables en Atención Primaria / Criteria for identifying primary care vulnerable patients

Objetivo: establecer los criterios para designar pacientes vulnerables en Atención Primaria y determinar el porcentaje de pacientes vulnerables en la consulta del Primer Nivel de acuerdo a criterios establecidos. Métodos: estudio descriptivo, prospectivo, basado en las visitas al consultorio de médicos de familia y los registros médicos en la consulta externa del Hospital Universitario del Programa de Residencia de Medicina Familiar, de la Facultad de Medicina de la Universidad Autónoma de Nuevo León, México. El universo estuvo constituido por los pacientes que asistieron a la consulta externa de Medicina Familiar en un período de cuatro meses en 2013. Se realizaron consultas de orden habitual y se revisó el expediente al momento de la consulta. Se clasificaron los pacientes de acuerdo a los criterios establecidos. Diagnóstico de consulta, Diagnósticos previos y número de consultas. Resultados: se brindó asistencia médica a un total de 460 pacientes durante el periodo establecido. Estos pacientes generaron 746 visitas al consultorio. El criterio de paciente vulnerable se hizo en 228 visitas (30,5 por ciento), las cuales correspondieron a 88 pacientes. Conclusiones: los pacientes vulnerables según los criterios establecidos son pacientes que requieren una atención integral con prioridad. Los médicos de familia pueden proporcionar una atención integral a los problemas personales o familiares de sus pacientes y especialmente a este grupo vulnerable(AU)

Objective: To establish the criteria for identifying primary care vulnerable patients and determine the percentage of vulnerable patients in the first level consultation according to the established criteria. Methods: Descriptive, prospective study based on the visits to the family doctor's offices and the medical records of the Family Medicine Residency Program in the outpatient consultation of the University Hospital, School of Medicine of Nuevo León Autonomous University (Mexico). The target group was made up of the patients who attended the Family Medicine outpatient consultation in a period of four months en 2013. Common consultations were held and the record at the time of the consultation was reviewed. The patients were classified according to the established criteria: consultation diagnosis, previous diagnosis and consultations number. Results: Medical assistance was provides to a sheer number of 460 patients in the established period. These patients performed 746 visits to the office. The criteria of vulnerable patient was appointed for 228 visits (30.5 percent), corresponding to 88 patients. Conclusions: The vulnerable patients, according to the established criteria, are those requiring comprehensive care with priority. Family doctors may provide comprehensive care to the personal and familial problems of their patients and especially to this vulnerable group(AU)

Absence of antibodies against Bordetella pertussis in pregnant women and newborns in the state of Nuevo Leon.

AIMS: To assess placental transfer of antibodies to the child at birth and at 2 months of age. MATERIALS AND METHODS: For the quantification of anti-PT IgG antibodies, we used an indirect enzyme-linked immunosorbent assay standardized by The National Institute of Epidemiologic Diagnosis and Reference (InDRE). Samples were considered negative from 0 to 48 IU/mL, indeterminate from 49 to 93 IU/mL and positive at ≥94 IU/mL. We performed a cross-sectional assessment of anti-PT IgG antibody levels in the mother, umbilical cord, and child. RESULTS: There was a higher concentration of IgG anti-TP in the umbilical cord (4.3%) and in the mother (1.4%), but a total absence was observed in the child (0%). CONCLUSION: The vulnerability of children to Bordetella pertussis shows the need to implement effective immunization strategies, whether actively, in the child, or passively through the mother, adolescents, and adults who are in contact with the child.

Mortalidad materna en Nuevo León durante 1984: factores medicasociales / Maternal mortality in Nuevo León durign 1984: the sociomedical factors

Se registraron 45 muertes en el estado de Nuevo León durante 1984. La tasa de mortalidad materna fue de 4.85 por 10,000 nacidos vivos registrados. El total de nacidos vivos en Nuevo León durante 1984 fue de 80,351 registrados. Se investigaron: edad, siendo la más joven de 16 años y la de más edad 43; nivel socioeconómico, 32 casos tenían un nivel socioeconómico bajo o medio-bajo (82%); escolaridad, 27 casos (70%) pacientes cuyo grado máximo de estudio fue la primaria o menos; lugar de nacimiento, 34 pacientes (87%) vivieron en el área metropolitana de Monterrey o sus municipios aledaños. Once casos (28%) eran primigestas; 19 casos (48%) multíparas; 27 casos tuvieron antecedentes personales patológicos (70%), de ellos 26 se trataban de muy alto riesgo. En cuanto al número de consultas prenatales, 23 (59%) o no recibieron consulta prenatal o ésta fue muy deficiente (dos o menos consultas). A 22 casos (56%) se les practicó cesárea; sólo hubo un caso de aborto séptico. Las causas de muerte fueron; 10 por sepsis (26%); 8 por enfermedad hipertensiva asociada al embarazo (20%), 8 casos por hipovolemia por hemorragia (20%), siendo estas tres causales de 26 defunciones (66%). Se practicaron 14 autopsias (36%). Se encontraron 26 casos (66%) como muertes previsibles y 13 casos (34%) fueron muertes no previsibles