Muscular Strength and Quality of Life in Older Adults: The Role of ACTN3 R577X Polymorphism.

As longevity is increasing, the 65-year-old and older population is projected to increase in the next decades, as are the consequences of age-related muscle deterioration on the quality of life. The purpose of this study was to examine the associations of the ACTN3R577X polymorphism with quality of life and muscular strength in an older Spanish population. In total, 281 older adults participated in this study. Anthropometric measurements, chronic diseases, prescribed medications, quality of life, hand grip strength, and physical activity and nutritional status data were collected. ACTN3 R577X genotyping was determined using Taqman probes. Multivariate regression analysis revealed in adjusted model that, in men, the ACTN3 R577X genotype was significantly associated with hand grip strength (HGS), regression coefficient (ß) = 1.23, p = 0.008, dimension 1 of the five-dimension questionnaire EuroQoL (EQ-5D, mobility), (ß) = -1.44, p = 0.006, and clinical group risk (CGR) category (ß) = -1.38, p = 0.006. In women, a marginal association between the ACTN3 R577X genotype and the CGR category was observed, with a regression coefficient of (ß) = -0.97, (p = 0.024). Our findings suggest that the ACTN3 R577X genotype may influence the decline in muscle strength and quality of life in older Spanish adult males.

Glucose modulates proliferation in root apical meristems via TOR in maize during germination.

The Glucose-Target of Rapamycin (Glc-TOR) pathway has been studied in different biological systems, but scarcely during early seed germination. This work examines its importance for cell proliferation, expression of cell cycle key genes, their protein levels, besides morphology and cellularization of the root apical meristem of maize (Zea mays) embryo axes during germination under the influence of two simple sugars, glucose and sucrose, and a specific inhibitor of TOR activity, AZD 8055. The two sugars promote germination similarly and to an extent, independently of TOR activity. However, the Glc-TOR pathway increases the number of cells committed to proliferation, increasing the expression of a cell cycle gene, ZmCycD4;2, a putative G1/S regulator. Also, Glc-TOR may have influence on the protein stability of another G1/S cyclin, ZmCycD3, but had no influence on ZmCDKA;1 or ZmKRP3 or their proteins. Results suggest that the Glc-TOR pathway participates in the regulation of proliferation through different mechanisms that, in the end, modify the timing of seed germination.

[Risk factors related to allergic diseases at Mexico City]. / Factores de riesgo relacionados con enfermedades alérgicas en la Ciudad de México.

BACKGROUND: Several studies suggest that the prevalence of allergic diseases has been increasing worldwide in recent years; then it is very important to identify some risk factors that could be related. OBJECTIVE: To know some hereditary and environmental risk factors that could be related to the development of allergic diseases in open population from Mexico City. PATIENTS AND METHOD: It was an open-population, cross-sectional trial, in two phases with a random sample size of 4272 individuals in 214 public health centers. A questionnaire was applied by health workers. Statistical analysis was made with Excel 97-2004 using the Mann-Whitney U test for continuous variables and chi-square-test for discrete variables. p < 0.001 was considered statistically significant. RESULTS: The prevalence of allergic diseases in Mexico City was 42.6%, allergic rhinitis was the most frequent. The most important risk factors for allergic diseases were: family history of atopy in first and second degree; early consumption of cow's milk; early weaning with cereal, egg, beef, fish and pulses; living with some animals, indoor plants, active and passive smoking, to keep stuffed toys in the rooms, as well as living in dwellings with dust, cold temperatures, wall saltpeter and with dampness (mold growth). CONCLUSION: Because genetic factors can not be modified, it is important to identify environmental factors related to the development of allergic diseases in order to promote preventive measures.

Comportamiento de la retinopatía diabética en salas de medicina del Hospital Dr. Salvador Allende 2003-2005 / Behavior of diabetic retinopathy in rooms of medicine of the Dr. Salvador Allende Hospital 2003-2005

Se realizó un estudio descriptivo retrospectivo en 100 pacientes diabéticos del Hospital Dr. Salvador Allende, con el objetivo de determinar el comportamiento de la Retinopatía Diabética en salas de Medicina de esta Institución y su relación con el sexo, raza, edad, hábito de fumar, Hipertensión Arterial, índice de masa corporal, tipo clínico de Diabetes, tratamiento recibido, años de evolución y control metabólico. Comprobamos su presencia en 26 por ciento de los pacientes. El mal control metabólico y los años de evolución fueron las variables que guardaron mayor asociación con la presencia de esta complicación. Los diabéticos tipo 1 y los tratados con Insulina fueron los más afectados.

It was carried out a descriptive retrospective study in 100 diabetic patients of the Dr. Salvador Allende Hospital, with the objective of determining the behavior of diabetic retinopathy in rooms of Medicine of this institution and their relationship with the sex, the race, the age, the habit of smoking, the arterial hypertension, the index of corporal mass, the clinical type of diabetes, the received treatment, the years of evolution and the metabolic control. We check their presence in 26 percent of the patients. The metabolic bad control and the years of evolution were the variables that you/they kept bigger association with the presence of this complication. The diabetic type 1 and the treaties with Insulin were those most affected ones.

Comportamiento de la retinopatía diabética en salas de medicina del Hospital Dr Salvador Allende 2003-2005 / Behavior of diabetic retinopathy in rooms of medicine of the Dr. Salvador Allende Hospital 2003-2005

Se realizó un estudio descriptivo retrospectivo en 100 pacientes diabéticos del Hospital Dr Salvador Allende, con el objetivo de determinar el comportamiento de la Retinopatía Diabética en salas de Medicina de esta Institución y su relación con el sexo, raza, edad, hábito de fumar, Hipertensión Arterial, índice de masa corporal, tipo clínico de Diabetes, tratamiento recibido, años de evolución y control metabólico. Comprobamos su presencia en 26 por ciento de los pacientes. El mal control metabólico y los años de evolución fueron las variables que guardaron mayor asociación con la presencia de esta complicación. Los diabéticos tipo 1 y los tratados con Insulina fueron los más afectados(AU)

It was carried out a descriptive retrospective study in 100 diabetic patients of the Dr. Salvador Allende Hospital, with the objective of determining the behavior of diabetic retinopathy in rooms of Medicine of this institution and their relationship with the sex, the race, the age, the habit of smoking, the arterial hypertension, the index of corporal mass, the clinical type of diabetes, the received treatment, the years of evolution and the metabolic control. We check their presence in 26 percent of the patients. The metabolic bad control and the years of evolution were the variables that you/they kept bigger association with the presence of this complication. The diabetic type 1 and the treaties with Insulin were those most affected ones(AU)

[Basis to modify the immunotherapy regimen at the Allergy Service, General Hospital of Mexico]. / Fundamentos para modificar el esquema de la inmunoterapia en el servicio de Alergia del Hospital General de México.

BACKGROUND: In Mexico, the way allergen immunotherapy is performed has remained without changes for many years. Here we present the modifications that have been performed in the General Hospital of Mexico to make immunotherapy more effective. OBJECTIVE: To show the changes implemented to make immunotherapy faster and more effective by changing the volume of allergy vaccines from 5 or 10 mL to 3 mL, and the theoretical and practical support for the change. MATERIAL AND METHOD: The amount of protein delivered in each immunotherapy shot was computed to show how they change along the treatment. Results for schedules for 3, 5 and 10 mL were compared. RESULTS: Results showed serial rises and falls in protein amount injected every time a new vaccine flask starts to be used. However, in the case for 3 mL vaccines schedules, those changes are less pronounced. CONCLUSIONS: Due to these results we suggest a schedule of immunotherapy with 3 mL vaccines that allow getting the maintenance doses in a shorter time and at lower cost.

[Prevalence of allergic diseases in Mexico City]. / Prevalencia de las enfermedades alérgicas en la Ciudad de México.

BACKGROUND: There is a considerable variation in the prevalence of allergic disorders in developing countries. These differences may be attributable to different methodological problems and to the lack of operational definitions. Several studies suggest that the prevalence of allergic diseases has been increasing worldwide in recent years. However, in Mexico, there is no data in open population. OBJECTIVE: To know in open population the prevalence of allergic diseases in the counties of Mexico City, the frequence of symptoms in each allergic disease, the therapeutic modalities that patients seek, the school and work annual absences and the amount of money that each patient spends in antiallergic drugs. PATIENTS AND METHODS: It was an open-population, cross-sectional trial, in two phases with a random sample size of 8,000 individuals from 214 public health centers. Statistical analysis was made with Excel 97-2004: Mann-Whitney U test for continuous variables and chi-square-test for discrete variables, p < 0.05 was considered statistically significant. RESULTS: The prevalence of allergic diseases in Mexico City was 42.6%, allergic rhinitis was the most frequent. Children are the largest age group affected. The highest prevalence was found in Tlahuac county. Coexistence of allergic diseases was found in 19.9%. The 44.2% of allergic patients attended to their general practitioner. 20.4% of all patients spent 10-20% of their income in medicines and 26% do not have money to buy antiallergic drugs. School and work annual absences are 3.37 +/- 3.86 and 6.2 +/- 12.84 days, respectively. CONCLUSION: Allergic diseases must be considered a public-health problem in Mexico City.

[Sensitization to pollens of Oleaceae family in a group of patients from Mexico City]. / Sensibilización a pólenes de la familia Oleaceae en un grupo de pacientes de la Ciudad de México.

BACKGROUND: In Mexico City, where the Olive trees are scarce, the Oleaceae family has been recognized as one of the most important causes of pollen allergy, possibly related to cross-reactivity with other pollens of the Oleaceae family, as Fraxinus excelsior, Ligustrum vulgaris and Osmanthus americanus. OBJECTIVE: To know the prevalence of sensitization to the Oleaceae family in Mexico City, cross-reactivity, as well as concurrent sensitizations, and vegetables and fruits associated to oral allergy syndrome (OAS). PATIENTS AND METHOD: A prospective, longitudinal study was carried out during two months, among patients who attended the outpatient allergy clinic of the General Hospital of Mexico with symptoms suggestive of respiratory allergy. A questionnaire to search OAS was used, and skin Prick tests to pollens were performed. RESULTS: Among 279 patients, 164 (58.8%) had respiratory allergy and positive skin prick test (SPT) to pollens. Olea europaea had the highest prevalence of SPT reactivity (52.4%), followed by Fraxinus excelsior (43.3%), Ligustrum vulgaris (36.6%) and Osmanthus americanus (15.9%). There were OAS in 53.5%, 50.7%, 50% and 53.8%, respectively, mainly related to peach, apple, kiwi, pear and banana. Olive monosensitization was found in 5.5%. CONCLUSION: In this study, Olea europaea had the highest prevalence of positive reactivity to pollens in Mexico City, then its sensitization must be determined routinely.

[Transanesthetic anaphylactic shock induced by propofol and fentanyl: case report]. / Choque anafiláctico transanestésico por propofol y fentanil: comunicación de un caso.

We report an anaphylactic shock case secondary to propofol and fentanyl exposition, demonstrated by skin tests. A male patient, 19 years old, was admitted in the operating room for resection of residual juvenile nasal angyofibroma. The anesthetic induction was done with atropin 800 microg, midazolam 2 mg, fentanyl 200 microg, propofol 150 mg, and neuromuscular block with rocuronium 30 mg. One minute after the application of drugs, hypotension of 60/30 mmHg and tachycardia of 130 was observed. By the second minute the blood pressure dropped to 40/20 mmHg, tachycardia got 135, facial edema and generalized wheals occurred and the plestimography and oxymetry record were absent. Once resolved the event and the patient recovered, skin tests were performed with positive results to propofol and fentanyl, so that they were excluded in the next surgical intervention that concluded without incidents and with success.

[Sutureless thyroidectomy with local anesthesia plus conscious sedation. Two clinical cases]. / Tiroidectomía sin suturas con anestesia local más sedación consciente. Dos casos clínicos.

OBJECTIVE: We proposed a modification of thyroid surgery and have reported two operations carried out with sutureless surgery and local anesthesia. Our study setting was Unit 305 of the General Hospital of Mexico in Mexico City. With regard to study design, two patients are presented with sutureless thyroid surgery in what we believe is the first publication of its kind in Mexico and probably the first publication in the world that reports the combination of both sutureless technique and local anesthesia. MATERIAL AND METHODS: Patient number 1 is 41 years of age with a 10-year history. Fine-needle biopsy denoted nodular goiter but definitive diagnosis was Hashimoto thyroiditis, for which we performed subtotal resection. Patient number 2 is 46 years of age, and has a history of 1 year of thyroid mass; final diagnosis was colloid goiter. Lobectomy and isthmus resection was done. We proceeded under local anesthesia plus sedation with the patient conscious, in combination with no stitches for hemostasia using a tissue-sealing system ligasure. RESULTS: Both patients had good results without postoperative complications. Surgical time was 120 min in first case and 71 min for the second. Patient 1 had transient hoarseness for 3 weeks, and the healing was spontaneous. CONCLUSION: Outcome was adequate in these two cases with local anesthesia and no stitches.

Frecuencia de la patología quirúrgica tiroidea / Frequency of the thyroid pathology

Introducción: Una pieza importante en el diagnóstico, tratamiento, pronóstico y prevención de la patología quirúrgica tiroidea es conocer la frecuencia de la misma. Objetivo: Determinar la frecuencia actual de la patología quirúrgica tiroidea. Material y métodos: Estudio descriptivo, transversal no comparativo en 1,038 pacientes intervenidos quirúrgicamente por patología tiroidea de 1992 a 1996. Fueron recopilados los siguientes datos: diagnóstico histopatológico (variable dependiente), así como sexo, edad y presentación clínica (variables independientes); los cuales fueron analizados por medidas de tendencia central. Resultados: El predomino del sexo femenino fue de 15:1 y edad promedio de 39.9 años. El cáncer representó el 20.1 por ciento, siendo el más frecuente el papilar (85.2 por ciento), seguido por el medular (6.7 por ciento). El bocio eutiroideo representó el 39.1 por ciento, siendo el nodular el más común 87.1 por ciento. Los adenomas representaron el 6.2 por ciento, el más frecuente folicular (86 por ciento). Los padecimientos autoinmunes que requirieron cirugía para diagnóstico y tratamiento representaron el 34.6 por ciento. La presentación clínica más frecuente fue el nódulo tiroideo con 60.7 por ciento y, de éstos, el cáncer representó el 33 por ciento. Conclusiones: 1) El predomino femenino se ha incrementado. 2) La presentación clínica más frecuente es nódulo tiroideo. 3) La frecuencia de cáncer en nódulo tiroideo es de 33 por ciento. 4) El cáncer medular tiene un incremento en su frecuencia.

Vigilancia epidemiológica de infección del sitio operatorio superficial: estudio comparativo de tres años / Superficial surgical site infection epidemiologic surveillance: a three year comparative study

Objetivo: comparar el número de infecciones del sitio operatorio superficial de 1,930 pacientes, divididos en tres grupos a quienes se siguió vigilancia epidemiológica. Sede: Unidad 305 del Hospital General de México. Diseño: estudio prospectivo, longitudinal, comparativo de tres grupos de operados: el grupo uno del año 1995, el dos de 1996 y el tres de 1997. Método: se registraron todos los casos, sin excluir ninguno, se clasificaron por el método tradicional basado en heridas limpias, limpias contaminadas, contaminadas y sucias. El análisis estadístico fue por Ji cuadrada y cuadros de contingencia. Resultados: hubo reducción del porcentaje de infecciones, del sitio operatorio superficial, con valor estadístico, en heridas limpias, en el grupo dos comparado contra el grupo uno, lo mismo ocurrió en el grupo tres comparado con el dos y contra el uno. En este trabajo se mostró reducción gradual del número de infecciones en heridas limpias en años sucesivos, a expensas de descenso de la flora fecal. Las infecciones fueron más comunes en mayores de 40 años de edad. La mejoría en las cifras de infecciones fue mejor en el turno matutino.

¿Es útil la vigilancia epidemiológica de la herida quirúrgica para disminuir la incidencia de infección? / Is the epidemiological suveillance useful in surgical wounds in order to decrease the incidence of infection?

Objetivo. Observar el efecto de la vigilancia epidemiológica de infección de la herida quirúrgica en una unidad de cirugía general. Sede. Unidad 305 del Hospital General de México. México, D.F. Diseño. Estudio prospectivo, longitudinal, comparativo de dos grupos de pacientes; formaron el grupo 1 los operados durante el año 1995 y el grupo 2 los operados en 1996. Se registraron los casos procedentes de herida limpia, limpia contaminada, contaminada y sucia. Resultados. El grupo 1 lo conformaron 700 pacientes operados de cirugía electiva y el 2 estuvo compuesto por 667 pacientes. En el primer grupo la cifra total de infecciones fue de 28/700 = 4.0 por ciento, en cirugía limpia 16/413 = 3.87 por ciento; limpia contaminada 5/197 = 2.54 por ciento, en el grupo 2 el número fue de 9/667 = 1.34 por ciento, cirugía limpia 7/401 = 1.74 por ciento y limpia contaminada 2/212 = 0.94 por ciento; en la prueba exacta de Fisher hubo reducción con validez estadística en cifra total con valor de 0.001 y no significativas en herida limpia (0.08) y limpia contaminada (0.26). En el grupo 2 se registró cambio en las bacterias causales al disminuir el guarismo de casos infectados por gérmenes procedentes de flora fecal. Conclusión. En el segundo grupo la vigilancia epidemiológica ejerció efecto de reducción de la cifra global de infección de herida quirúrgica y se observó cambio en la flora bacteriana

Conjuntivitis alérgicas / Allergic conjunctivitis

las conjutivitis alérgicas son padecimientos que en general se presentan frecuentemente asociadas a otras enfermedades atópicas, por eso es de suma importancia conocer sus diversos tipos, su fisiopatología, los factores desencadenantes, cuadro clínico y tratamiento

Eczema, dermatitis y atopia: confusión y conceptos / Eczema, dermatitis and atopy: confusion and concepts

Considerando como trastorno atópico junto con el asma y la rinitis, el eczema carece de definición. Se usa como sinónimo de dermatitis especialmente de la atópica. En 1982 Ackerman y Ragaz propusieron eliminar el uso de excema por su carencia de definición reproducible y criterios para su identificación y clasificación. El eczema es un síndrome que puede ocurrir en las dermatitis agudas. Cuando hay presencia de hipersensibilidad específica mediada por IgE en una dermatitis, se puede decir que ésta es atópica. Si la dermatitis "atópica" está en fase aguda puede tener eczema, pero no en la fase crónica que muestra datos del síndrome de dermatitis crónica. El eczema, la dermatitis y la atopia son entidades independientes que pueden ocurrir simultáneamente en algunos individuos genéticamente predispuestos, pero no están necesariamente relacionados. En este trabajo analizamos las confusiones y los conceptos fundamentales de una patología muy frecuente cuyo conocimiento es de interés para pediatras, alergólogos, dermatólogos e inmunólogos