Detection of anti-HCV antibodies and risk factors in a population with access to public healthcare in Mexico.

INTRODUCTION AND AIM: Timely detection and diagnosis of hepatitis C virus (HCV) involves identifying the population that is predisposed to treatment and prevention, thus limiting complications and preventing infection. The aim of this study was to analyze and describe risk factors associated with anti-HCV antibody detection in a population with access to public healthcare that participated in a national screening program. MATERIAL AND METHODS: An analytic cross-sectional study was conducted that utilized data related to rapid tests carried out between September 2021 and October 2022 in 26 of the 32 states of Mexico. Anti-HCV reactive tests were selected, according to age and sex, for analyzing and comparing possible risk factors through descriptive and inferential statistics. The geographic distribution and density of the screening program at the state and municipal levels was analyzed. RESULTS: There were 75,185 anti-HCV antibody detections, 2,052 reactive tests, and mean participant age was 44.3 years (±15.1). Occupation: 32.3% were employees, 19% were housewives, and 18.2% were healthcare workers. Five out of every 10 cases had no indication of risk factors, but there was a 1.4 and 5-times greater likelihood of anti-HCV detection in men with a history of sharps injury or intravenous psychoactive substance use, compared with women. Regarding place of residence, 80% of the reactive tests were concentrated in the State of Mexico, Mexico City, and Guanajuato. CONCLUSIONS: The evidence herein helps determine the population and risk factors that should be focused on in carrying out the HCV microelimination strategy of continuous screening, diagnosis, medical treatment access, and epidemiologic surveillance.

Chitosan Coatings Modified with Nanostructured ZnO for the Preservation of Strawberries.

Strawberries are highly consumed around the world; however, the post-harvest shelf life is a market challenge to mitigate. It is necessary to guarantee the taste, color, and nutritional value of the fruit for a prolonged period of time. In this work, a nanocoating based on chitosan and ZnO nanoparticles for the preservation of strawberries was developed and examined. The chitosan was obtained from residual shrimp skeletons using the chemical method, and the ZnO nanoparticles were synthesized by the close-spaced sublimation method. X-ray diffraction, scanning electron microscopy, electron dispersion analysis, transmission electron microscopy, and infrared spectroscopy were used to characterize the hybrid coating. The spaghetti-like ZnO nanoparticles presented the typical wurtzite structure, which was uniformly distributed into the chitosan matrix, as observed by the elemental mapping. Measurements of color, texture, pH, titratable acidity, humidity content, and microbiological tests were performed for the strawberries coated with the Chitosan/ZnO hybrid coating, which was uniformly impregnated on the strawberries' surface. After eight days of storage, the fruit maintained a fresh appearance. The microbial load was reduced because of the synergistic effect between chitosan and ZnO nanoparticles. Global results confirm that coated strawberries are suitable for human consumption.

Apendicitis aguda en hernia epigástrica: Caso clínico

Objetivo: Reporte de caso clínico de una presentación poco común de apendicitis aguda sin reporte en la literatura actual. Material y Método: revisión de expediente clínico en hospital general regional 196 del instituto mexicano del seguro social. Resultados: Masculino de 47 años con dolor abdominal en epigastrio. Clínicamente se palpa defecto hemiario, encontrando apéndice vermiforme edematosa en saco herniario. Discusión: La presentación de apendicitis aguda en sacos hemiarios epigástricos es extremadamente rara encontrando, solamente, un reporte de caso en la literatura.

Objective: Clinical case report of an uncommon presentation of acute appendicitis with no report in the current literature. Material and Method: review of the clinical record at Hospital General Regional 196 of the Mexican Social Security Institute. Results: 47 year old male with abdominal pain in epigastrium clinically palpated hernial defect, finding edematous vermiform appendix in hernial sac. Discussion: The presentation of acute appendicitis in epigastric hernial sac is extremely rare finding only one case report in the literature.

Impacts of an early childhood obesity prevention program in Mexico.

The Healthy Change Program aimed to improve the accuracy of maternal perceptions of children's weight (MPCW), maternal feeding style (MFS) and feeding practices. Using a randomized control trial design, the intervention group received 4-weekly group sessions focusing on MPCW, MFS and healthy behaviors. The control group received the same dose of attention-control sessions on food hygiene. Data were collected at the baseline and at the end of the program via self-administered questionnaires and anthropometric measurements. Participants included 294 mother-child dyads with 149 in the intervention group and 145 in the control group. The accuracy of MPCW significantly increased at the study end point in the intervention group (57.0-67.1%, P < 0.05) but not in the control group (67.6-69.7%, P > 0.05), with no between-group difference in pre- and post-change (P > 0.05). At the study end point, more mothers of overweight and obese children in the intervention group had accurate MPCW than their control counterparts (31.4% versus 11.1%, P < 0.01). The intervention group had a shift toward an authoritative style at the study end point (17.4% versus 26.2%, P < 0.001) and favorable changes in feeding practices. The Healthy Change Program contributed to improving the accuracy of MPCW and shifts toward favorable MFS and feeding practices.

Development of Anxiolytic and Depression-like Behavior in Mice Infected with Mycobacterium lepraemurium.

Murine leprosy is a systemic infectious disease of mice caused by Mycobacterium lepraemurium (MLM) in which the central nervous system (CNS) is not infected; nevertheless, diseased animals show measurable cognitive alterations. For this reason, in this study, we explored the neurobehavioral changes in mice chronically infected with MLM. BALB/c mice were infected with MLM, and 120 days later, the alterations in mice were evaluated based on immunologic, histologic, endocrine, neurochemical, and behavioral traits. We found increases in the levels of IL-4 and IL-10 associated with high bacillary loads. We also found increase in the serum levels of corticosterone, epinephrine, and norepinephrine in the adrenal gland, suggesting neuroendocrine deregulation. Mice exhibited depression-like behavior in the tail suspension and forced swimming tests and anxiolytic behavior in the open field and elevated plus maze tests. The neurobehavioral alterations of mice were correlated with the histologic damage in the prefrontal cortex, ventral hippocampus, and amygdala, as well as with a blood-brain barrier disruption in the hippocampus. These results reveal an interrelated response of the neuroimmune--endocrinological axis in unresolved chronic infections that result in neurocognitive deterioration.

[Acquired flat foot of the adult by posterior tibial dysfunction. Options for surgical treatment]. / Pie plano adquirido del adulto por disfunción del tibial posterior. Opciones para el tratamiento quirúrgico.

We present the possible etiopatogenic causes of posterior tibial dysfunction or painful flat foot of the adult and the cause-and-effect relationship that may exist. We also expose the gradation of the lesion and the different therapeutic options for the surgical treatment of the deformity. Since 1939, multiple articles have been published, which have been endorsed by clinical, experimental, electromyographic and biomechanical studies; publications that have been consulted and evaluated for the development of this review. In our opinion: the dysfunction of the posterior tibial is caused in principle by a failure of the plantar navicular calcaneus ligament (spring ligament), the main passive stabilizer of the internal plantar arch. This failure would, in time, mean an increase in work of the posterior tibial tendon, in itself "insufficient", which would go into fatigue, until it reached a partial or total rupture. Published work on soft-part procedures acting on the posterior tibial tendon in stage II has not had the expected result in the natural history of deformity. Arthrodesis, on the other hand, has been effective in other stages, but is associated with a loss of movement dynamics in the back foot and increased pressure on adjacent joints.

Presentamos la posible causa etiopatogénica de la disfunción del tibial posterior o pie plano doloroso del adulto y la relación causa-efecto que puede existir. También exponemos la clasificación de la lesión y las diferentes opciones para el tratamiento quirúrgico de la deformidad. Desde 1939, múltiples artículos han sido publicados, avalados por la clínica, así como por estudios experimentales, electromiográficos y biomecánicos; publicaciones consultadas y evaluadas para el desarrollo de esta revisión, según nuestro criterio: el primum movens de la disfunción del tibial posterior es ocasionado por un fallo del ligamento en hamaca o calcáneo navicular plantar (spring ligament), principal estabilizador pasivo del arco plantar interno. Este fallo supondría en el tiempo un aumento de trabajo del tendón tibial posterior, de por sí "insuficiente", que entraría en fatiga hasta llegar a la rotura parcial o total. Los trabajos publicados en relación con los procedimientos de partes blandas que actúan sobre el tendón tibial posterior en el estadio II no han tenido el resultado esperado en la historia natural de la deformidad. La artrodesis por el contrario, ha sido efectiva en otros estadios, pero está asociada a una pérdida de la dinámica del movimiento en el retropié y a un aumento de la presión en las articulaciones adyacentes.

Estado actual del condrosarcoma en un centro de referencia / Current status of chondrosarcoma in a reference center

Resumen: Introducción: El condrosarcoma es el segundo tumor óseo maligno primario más frecuente, se caracteriza por la formación de matriz condroide, es más común en edades avanzadas y su pronóstico guarda relación directa con el subtipo histológico y el grado tumoral. El objetivo de este artículo es presentar el perfil demográfico y de tratamiento en un centro de referencia. Material y métodos: Se realizó un estudio retrospectivo, descriptivo, observacional, analítico de tipo cohorte en un centro de referencia entre el 01 de Enero de 2005 y el 31 de Diciembre de 2019, se analizaron las variables demográficas y se contrastaron con las variables de desenlace que fueron supervivencia global y período libre de enfermedad. Resultados: Se incluyeron 85 pacientes, la media edad de presentación fue 43.3 años, la etapa clínica al momento de la presentación fue mayormente IIa y IIb abarcando 54.1%, 35 pacientes tuvieron metástasis con etapa clínica IV. El principal sitio de metástasis fue el pulmón en 32 pacientes (37.6%). De los pacientes, 36 (42.3%) presentaron mortalidad cáncer específica, 35 (41.2%) fallecieron como consecuencia de la enfermedad metastásica a pulmón u otros órganos y un paciente falleció por extensión directa del tumor en columna cervical. Conclusión: Los factores pronósticos importantes hallados en nuestra serie que influyen en la supervivencia global son: la presencia de metástasis y la localización axial.

Abstract: Introduction: Chondrosarcoma is the second most frequent primary malignant bone tumor, is characterized by the formation of a chondroid matrix, is more frequent in advanced ages and its prognosis is directly related to the histological subtype and tumor grade. The objective of this article is to present the demographic and treatment profile in a reference center. Material and methods: A retrospective, descriptive, observational, analytical cohort-type study was conducted in a reference center between January 1, 2005 and December 31, 2019, the demographic variables were analyzed and contrasted with the outcome variables that were overall survival and disease-free period. Results: 85 patients were included, the mean age of presentation was 43.3 years, the clinical stage at the time of presentation was mostly IIa and IIb covering 54.1%. 35 patients had metastases with clinical stage IV. The main site of metastasis was the lung in 32 patients (37.6%). Thirty-six patients (42.3%) had specific mortality. 35 patients (41.2%) died as a result of metastatic disease to lung or other organs, one patient died from direct extension of the tumor in the cervical spine. Conclusion: The important prognostic factors found in our series that influence global survival are: the presence of metastases and axial localization.

[Current status of chondrosarcoma in a reference center]. / Estado actual del condrosarcoma en un centro de referencia.

INTRODUCTION: Chondrosarcoma is the second most frequent primary malignant bone tumor, is characterized by the formation of a chondroid matrix, is more frequent in advanced ages and its prognosis is directly related to the histological subtype and tumor grade. The objective of this article is to present the demographic and treatment profile in a reference center. MATERIAL AND METHODS: A retrospective, descriptive, observational, analytical cohort-type study was conducted in a reference center between January 1, 2005 and December 31, 2019, the demographic variables were analyzed and contrasted with the outcome variables that were overall survival and disease-free period. RESULTS: 85 patients were included, the mean age of presentation was 43.3 years, the clinical stage at the time of presentation was mostly IIa and IIb covering 54.1%. 35 patients had metastases with clinical stage IV. The main site of metastasis was the lung in 32 patients (37.6%). Thirty-six patients (42.3%) had specific mortality. 35 patients (41.2%) died as a result of metastatic disease to lung or other organs, one patient died from direct extension of the tumor in the cervical spine. CONCLUSION: The important prognostic factors found in our series that influence global survival are: the presence of metastases and axial localization.

INTRODUCCIÓN: El condrosarcoma es el segundo tumor óseo maligno primario más frecuente, se caracteriza por la formación de matriz condroide, es más común en edades avanzadas y su pronóstico guarda relación directa con el subtipo histológico y el grado tumoral. El objetivo de este artículo es presentar el perfil demográfico y de tratamiento en un centro de referencia. MATERIAL Y MÉTODOS: Se realizó un estudio retrospectivo, descriptivo, observacional, analítico de tipo cohorte en un centro de referencia entre el 01 de Enero de 2005 y el 31 de Diciembre de 2019, se analizaron las variables demográficas y se contrastaron con las variables de desenlace que fueron supervivencia global y período libre de enfermedad. RESULTADOS: Se incluyeron 85 pacientes, la media edad de presentación fue 43.3 años, la etapa clínica al momento de la presentación fue mayormente IIa y IIb abarcando 54.1%, 35 pacientes tuvieron metástasis con etapa clínica IV. El principal sitio de metástasis fue el pulmón en 32 pacientes (37.6%). De los pacientes, 36 (42.3%) presentaron mortalidad cáncer específica, 35 (41.2%) fallecieron como consecuencia de la enfermedad metastásica a pulmón u otros órganos y un paciente falleció por extensión directa del tumor en columna cervical. CONCLUSIÓN: Los factores pronósticos importantes hallados en nuestra serie que influyen en la supervivencia global son: la presencia de metástasis y la localización axial.

Polycystin-1 mitigates damage and regulates CTGF expression through AKT activation during cardiac ischemia/reperfusion.

During ischemia/reperfusion (I/R), cardiomyocytes activate pathways that regulate cell survival and death and release factors that modulate fibroblast-to-myofibroblast differentiation. The mechanisms underlying these effects are not fully understood. Polycystin-1 (PC1) is a mechanosensor crucial for cardiac function. This work aims to assess the role of PC1 in cardiomyocyte survival, its role in profibrotic factor expression in cardiomyocytes, and its paracrine effects on I/R-induced cardiac fibroblast function. In vivo and ex vivo I/R and simulated in vitro I/R (sI/R) were induced in wild-type and PC1-knockout (PC1 KO) mice and PC1-knockdown (siPC1) neonatal rat ventricular myocytes (NRVM), respectively. Neonatal rat cardiac fibroblasts (NRCF) were stimulated with conditioned medium (CM) derived from NRVM or siPC1-NRVM supernatant after reperfusion and fibroblast-to-myofibroblast differentiation evaluated. Infarcts were larger in PC1-KO mice subjected to in vivo and ex vivo I/R, and necrosis rates were higher in siPC1-NRVM than control after sI/R. PC1 activated the pro-survival AKT protein during sI/R and induced PC1-AKT-pathway-dependent CTGF expression. Furthermore, conditioned media from sI/R-NRVM induced PC1-dependent fibroblast-to-myofibroblast differentiation in NRCF. This novel evidence shows that PC1 mitigates cardiac damage during I/R, likely through AKT activation, and regulates CTGF expression in cardiomyocytes via AKT. Moreover, PC1-NRVM regulates fibroblast-to-myofibroblast differentiation during sI/R. PC1, therefore, may emerge as a new key regulator of I/R injury-induced cardiac remodeling.

Unraveling the effects on lithium-ion cathode performance by cation doping M-Li2CuO2 solid solution samples (M = Mn, Fe and Ni).

Cation doping is one of the most dynamic strategies to enhance the electrochemical properties of cathode materials for lithium-ion batteries. Nevertheless, the maximum partial substitution capacity depends on the solubility of each metal ion, and so the formation of impurities is a very common consequence. Thus, the correlation between electrochemical performance and the doping effect is frequently unknown. In this study, the effect of the partial substitution of copper by manganese, iron or nickel in Li2CuO2 is evaluated, as well as the effect on the electrochemical performance of the modified Li2CuO2 samples as lithium ion battery cathode materials. XRD characterization confirmed single phase formation for all samples, and the incorporation of the transition metal in the Li2CuO2 structure was evaluated by XRD profile fitting, EPR and 7Li-NMR. The results showed modifications in intra- and inter-chain interactions, associated with the variations in the Cu-O-Cu bond angle and changes in magnetic order, due to the presence of the doping transition metal. Among all samples, only manganese partial substitution reveals a drastic improvement in the electrochemical stability during the charge/discharge processes even at potentials higher than 3.9 V. It was corroborated that the higher stability is attributed to (i) the increase in the superexchange interactions between the copper sites and manganese, directly modifying lithium diffusivity and electronic conductivity, both inferred from dynamic thermogravimetric analysis for CO2 sorption and conductivity tests, respectively and (ii) the lower propensity to enable O2 evolution during several charge cycles. These results are totally attributed to manganese cation partial substitution, which has a huge impact on the utilization of copper-based materials in real applications.

[Measurement, monitoring and knowledge of blood pressure: May Measurement Month, Colombia 2017]. / Medición, control y conocimiento de la presión arterial: Iniciativa Mayo Mes de la Medición Colombia 2017.

AIM: To describe the findings of implementing May Measurement Month 2017 in the adult Colombian population to raise awareness of the importance of blood pressure measuring, monitoring, and awareness. MATERIALS AND METHODS: May Measurement Month is a cross-sectional survey that follows the directives of the International Society of Hypertension and the World Hypertension League, which gathers information on cardiovascular risk factors and blood pressure readings. Its implementation in Colombia was lead by the Santander Ophthalmological Foundation (FOSCAL) and the Latin American Society of Hypertension (LASH) with the support of the Colombian Network for the Prevention of Cardiovascular Diseases and Diabetes (RECARDI). RESULTS: Data was collected from 11 departments on 21,797 people, 58.7% of whom were female, with an average age of 40.5±17.7 years. The overall prevalence of high blood pressure (HBP) was 20.8% (self-reported antihypertensive treatment or systolic blood pressure reading [systolic blood pressure≥140mmHg]). Of the total number of hypertensives, 46.5% had systolic blood pressure readings classified as uncontrolled (systolic blood pressure<140mmHg), and 26.4% were unaware that they were hypertensive who, in this report, we consider to be new cases of HBP. CONCLUSION: The prevalence of (elevated) blood pressure is high in this young adult population, whose lack of awareness of HBP is also high, and HBP in those aware of their condition is poorly controlled. These results highlight the need to implement effective detection programmes for hypertensive patients and to establish standardised treatments to improve HBP control as a strategy to reduce cardiovascular events.

Study of the Thermal Annealing on Structural and Morphological Properties of High-Porosity A-WO3 Films Synthesized by HFCVD.

High-porosity nanostructured amorphous tungsten OXIDE (a-WO3) films were synthesized by a Hot Filament Chemical Vapor Deposition technique (HFCVD) and then transformed into a crystalline WO3 by simple thermal annealing. The a-WO3 films were annealed at 100, 300, and 500 °C for 10 min in an air environment. The films were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), micro-Raman spectroscopy, high-resolution transmission electron microscopy (HR-TEM), and UV-vis spectroscopy. Results revealed that the a-WO3 films were highly porous, composed of cauliflower-like structures made of nanoparticles with average sizes of 12 nm. It was shown that the effect of annealing on the morphology of the a-WO3 films leads to a sintering process. However, the morphology is conserved. It was found that at annealing temperatures of 100 °C, the a-WO3 films are of an amorphous nature, while at 300 °C, the films crystallize in the monoclinic phase of WO3. The calculated bandgap for the a-WO3 was 3.09 eV, and 2.53 eV for the film annealed at 500 °C. Finally, the results show that porous WO3 films preserve the morphology and maintain the porosity, even after the annealing at 500 °C.

Capacidad de marcha y dependencia funcional en adultos mayores con alteración visual / Gait capacity and functional dependency among older adults with vision disturbances / Capacidade de marcha e dependência funcional em idosos com alteração visual

Resumen Introducción La alteración visual puede producir cambios en la marcha y afectar la autonomía del adulto mayor, entendida como la necesidad de ayuda de otras personas o aditamentos para realizar, adecuadamente, sus actividades de la vida diaria. Objetivo Conocer la relación entre la capacidad de marcha y dependencia funcional en adultos mayores con alteración de la agudeza visual. Material y métodos Estudio descriptivo y correlacional, en una población de adultos mayores con alteración de la agudeza visual, muestra conformada por 94 adultos mayores. La marcha se midió con el sistema GAITRite, para la dependencia en Actividades Básicas de la Vida Diaria, se utilizó el Índice de Barthel, para las Actividades Instrumentales de la Vida Diaria el índice de Lawton y Brody. Resultados La capacidad de marcha y dependencia funcional, presentó relación positiva entre la velocidad de marcha (p = 0.000) y longitud del paso (p = 0.000) con las ABVD; la velocidad de marcha (p = 0.000), cadencia (p = 0.023) y longitud del paso (p = 0.000) con las AIVD y relación negativa entre la amplitud del paso (p = 0.012) y AIVD. Conclusión La valoración de la marcha en los AM con alteración en la agudeza visual, desde el primer nivel de atención, permitirá desarrollar intervenciones y programas encaminados a preservar la independencia del adulto mayor, reducir las tasas de morbilidad, disminuir costos en salud y contribuir en una mejor calidad de vida.

Abstract Introduction Disturbances in the visual function of the elderly can lead to gait changes which can have an impact on their autonomy, leading to the need of appliances and help of other persons in order for them to adequately perform their daily activities. Objective To gain understanding on the relationship between gait capacity and functional dependence among older adults with vision disturbances. Materials and Methods This is a descriptive and correlational study on a sample of 94 older adults with vision disturbances. The gait was measured using the GAITRite System. The functional status in terms of Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) were estimated using the Barthel, and the Lawton & Brody scales respectively. Results The gait capacity and functional dependence showed a positive relationship in terms of velocity (p = 0.000) and steps (p = 0.000) regarding the ADL; and in terms of velocity (p = 0.000), cadence (p = 0.023), and steps (p = 0.000) regarding the IADL. A negative relationship between step amplitude (p = 0.012) and IADL was also found. Conclusion From the primary healthcare point of view, accurate gait assessments on the older adults with vision disturbances will allow the development of programs and interventions aimed at preserving the independence, reducing the morbidity rates and costs, and contributing to maintain a better quality of life among older adults.

Resumo Introdução A alteração visual pode produzir câmbios na marcha e afetar a autonomia do idoso, entendida como a necessidade de ajuda de outras pessoas ou aditamentos para realizar, adequadamente, suas atividades da vida diária. Objetivo Conhecer a relação entre a capacidade de marcha e dependência funcional em idosos com alteração da agudeza visual. Material e métodos Estudo descritivo e correlacional, em uma população de idosos com alteração da agudeza visual, amostra conformada por 94 idosos. A marcha mediu-se com o sistema GAITRite, para dependência em Atividades Básicas da Vida Diária, utilizou-se o Índice de Barthel, para as Atividades Instrumentais da Vida Diária o índice de Lawton e Brody. Resultados A capacidade de marcha e dependência funcional, apresentou relação positiva entre a velocidade de marcha (p = 0.000) e longitude de passo (p = 0.000) com as ABVD; a velocidade de marcha (p = 0.000), cadência (p = 0.023) e longitude do passo (p = 0.000) com as AIVD e relação negativa entre a amplitude do passo (p = 0.012) e AIVD. Conclusão A valoração da marcha nos AM com alteração na agudeza visual, desde o primeiro nível de atenção, permitirá desenvolver intervenções e programas encaminhados a preservar a independência do idoso, reduzir as taxas de morbilidade, diminuir custos em saude e contribuir em uma melhor qualidade de vida.

Correlación entre el grado de hipertensión arterial y el índice de estrés oxidativo. Estudio de cohorte en una población de pacientes hipertensos sistémicos en República Dominicana / Correlation between the arterial hypertension degree and oxidative stress index. Cohort study in a population of systemic hypertensive patients in Dominican Republic

Introducción: la hipertensión arterial (HTA) es una de las mayores cargas de enfermedad y riesgo para infarto cardíaco, la insuficiencia cardíaca y el fallo renal. Se reconoce que el estrés oxidativo (EO) es un determinante en el desarrollo de complicaciones y el progreso de la HTA. Se determinó el índice de EO (IEO) en individuos con HTA y en un grupo sano control, para evaluar su posible correlación. Materiales y métodos: se midió IEO en una población de 112 individuos con HTA de distintos grados entre 50 y 70 años escogidos al azar y se comparó con los valores de un grupo control de voluntarios sanos, con la intención de definir el grado de correlación entre los niveles del IEO y la severidad de HTA, mediante la medición de biomarcadores para el EO en lisado de eritrocitos. Resultados: a pesar de que los beneficios de la terapia antioxidante (TAO) no han sido definitivamente probadas, en gran parte porque las enfermedades complejas no dependen de un solo componente fisiopatogénico, el EO sigue siendo una piedra angular en el desarrollo de complicaciones y el empeoramiento de los cuadros clínicos de muchos padecimientos. La demostración de biomarcardores específicos mejora la posibilidad de una TAO dirigida. El presente ensayo demostró que la edad, el género y la etnia no influyen en el IEO y que el EO fue severo en los casos de HTA iii, moderado en HTA ii y estuvo ausente en el subgrupo con HTA grado i. Conclusiones: estos resultados sugieren una relación entre los niveles de EO y severidad de HTA y sustenta evidencias para diseñar nuevos ensayos clínicos que evalúen la eficacia de una TAO adyuvante en el manejo de la HTA

Introduction: Arterial hypertension (AHT) is one of the major burdens of disease and risk for cardiac infarction, heart failure and renal failure. It is recognized that the oxidative stress (OS) is a determining factor in the development of complications and the progress of the AHT. OS Index (OSI) in individuals with AHT and a healthy control group, was determined to assess their possible correlation. Methods: OSI was measured in a population of 112 individuals with AHT of different levels between 50 and 70 years old, chosen at random and compared with the values of healthy volunteers control group with the aim of defining the degree of correlation between the levels of the OSI and the AHT severity, by measuring biomarkers for OS in a red cell lysate. Discussion: Despite the benefits of an antioxidant therapy (AOT) have not been definitely proven, largely because the complex diseases do not depend on a single pathophysiological component, OS remains as a cornerstone in the development of complications and the worsening of the clinical pictures of many ailments. The demonstration of specific biomarkers improve the possibility of an addressed AOT. This trial showed th at the age, gender and ethnicity do not influence the OSI and that OS was severe in HTA iii cases, moderate in HTA ii cases and was absent in the subgroup with HTA i. Conclusions: These results suggest a relationship between levels of EO and severity of hypertension and support evidence to design new clinical trials assessing the efficacy of an adjuvant AOT in the management of HTA

Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte / Installed Capacity Perception Survey for the Training of Resident's Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico

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Abstract: Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. Material and methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients ˂ 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients ˃ 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and ˃ 90% without regular scientific production.

[Installed Capacity Perception Survey for the Training of Residents Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico]. / Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte.

INTRODUCTION: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. MATERIAL AND METHODS: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. RESULTS: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. CONCLUSIONS: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.

INTRODUCCIÓN: Es fundamental que los médicos residentes de ortopedia (traumatología) sean altamente competentes en todos los aspectos, considerando el equilibrio entre la oferta, demanda, necesidad y contexto. Es primordial identificar la capacidad y calidad instalada para su formación en México. MATERIAL Y MÉTODOS: Estudio observacional, transversal, muestreo no probabilístico-conglomerados, en dos fases. El instrumento tiene ocho dominios, 57 variables y 4,867 ítems. Sesenta profesores de postgrado de 20 estados, 50 sedes hospitalarias, 22 programas universitarios. RESULTADOS: 1,038 años de experiencia (inteligencia colectiva), 17 años de experiencia/profesor (01 a 50 años). Se identificó: patología aguda 30 (2 a 90%), patología crónica 30 (5 a 96%), pacientes 15 años, 10 (3 a 30%), pacientes entre 15 y 65 años, 47 (2 a 78%), pacientes 65 años, 20 (2 a 60%), número de camas/sede 20 (2 a 510), número de consultorios 3 (1 a 48), el número de procedimientos quirúrgicos/sede al año a nivel nacional fue de 960 (50 a 24,650). La media nacional por médico residente es de 362 cirugías/año con 1,450 momentos quirúrgicos/año. CONCLUSIONES: Las necesidades y recursos para la formación de médicos especialistas en ortopedia/traumatología son en alto grado heterogéneos, por lo cual se debería adaptar a las necesidades epidemiológicas de la región de influencia, en un ámbito de transición epidemiológica. Sesenta y dos punto dos por ciento expresó no tener o tener deficiente infraestructura académica y científica en su sede, más de 50% sin rotación al extranjero y 90% sin producción científica regular.

Obesidad en adolescentes y criterios para el desarrollo de síndrome metabólico / Adolescent obesity and related metabolic syndrome development criteria / Obesidade em adolescentes e critérios para o desenvolvimento de síndrome metabólica

Objetivo El objetivo de este trabajo es determinar los criterios para síndrome metabólico (SM) de mayor influencia en adolescentes con obesidad. Método El estudio fue de tipo descriptivo y transversal, la muestra la conformaron 122 adolescentes de nivel preparatoria, seleccionados por un muestreo aleatorio simple. Se realizó somatometría (peso, talla y circunferencia de cintura), así como medición de la presión arterial y toma de muestra sanguínea. Resultados Predominó la obesidad grado I (68%), el principal criterio para el diagnóstico de síndrome metabólico fue la obesidad abdominal en el 98.4% de los participantes; el 25.4% de estos presentaron tres o más criterios alterados por lo que se consideran con SM, además se encontró asociación entre los niveles de glicemia con la obesidad (p < 0.01). Conclusiones Los hallazgos de esta investigación mostraron elevada prevalencia de SM en los participantes. La obesidad abdominal es un claro signo de problemas relacionados con el peso y se presenta muy frecuentemente en la población joven con obesidad. La adolescencia es una etapa temprana para educar a las personas y fomentar una vida más sana que permita mantenerlos lejos del desarrollo de enfermedades crónico degenerativas.

Objective To identify the main metabolic syndrome (MS) criteria in adolescents with obesity. Methods This is a descriptive and transversal study. The sample was constituted by 122 high school level adolescents selected by simple aleatory sampling. Weight, size, waist circumference, artery pressure, and a blood sample were taken. Results Obesity of degree I was prevalent (68%). The main criterion for the diagnosis of metabolic syndrome was the abdominal obesity, which was found in 98.4% of the sample. 25.4% of these participants also showed 3 or more metabolic syndrome related criteria. An association between the levels of glycaemia and obesity was also found (p < 0.01). Conclusions The findings revealed a high metabolic syndrome prevalence among the participants. Having abdominal obesity is a clear sign of problems related to weight which, frequently, is present among young populations with obesity. The adolescence is an early stage when people can be educated to live a healthy life and prevent chronic-degenerative illnesses.

Objetivo O objetivo deste trabalho é determinar os critérios para síndrome metabólica (SM) de maior influência em adolescentes com obesidade. Método El estudo foi de tipo descritivo e transversal, a amostra a conformaram 122 adolescentes de ensino médio, selecionados por uma amostra aleatória simples. Realizou-se somatometria (peso, tamanho e circunferência de cinto), assim como medição da pressão arterial e tomada de amostra sanguínea. Resultados Predominou a obesidade grau I (68%), o principal critério para o diagnóstico de síndrome metabólica foi a obesidade abdominal no 98.4% dos participantes; o 25.4% destes apresentaram três ou mais critérios alterados pelo que se consideram com SM, além disso encontrou-se associação entre os níveis de glicemia com a obesidade (p < 0.01). Conclusões Os achados desta pesquisa mostraram elevada prevalência de SM nos participantes. A obesidade abdominal é um claro signo de problemas relacionados com o peso e se apresenta muito frequentemente na população jovem com obesidade. A adolescência é uma fase inicial para educar às personas e fomentar uma vida mais saudável que permita mantê-los longe do desenvolvimento de doenças crónico degenerativas.

[Shoulder arthroplasty complications: case report]. / Complicaciones de la artroplastía de hombro: reporte de un caso.

BACKGROUND: Infection and instability are the complications of prosthetic shoulder surgery of more difficult management. Instability builds up to half of the cases, while the fungal infection accounts for less than 1% of all and can cause severe damage to bone and soft tissue. METHODS: In this case clinical fungal infection by Candida parapsilosis is presented in a shoulder hemiarthroplasty indicated by a fracture of the proximal humerus. He received surgical treatment in two-stages and administration of fluconazole for eight weeks prior to the second surgical time. In revision surgery was placed a reverse prosthesis as definitive treatment; however, the patient suffered several episodes of dislocation in the postoperative period; a second revision prosthetic surgery was necessary to use more stable components. During this surgery, we extracted samples that were analyzed, obtaining negative results for infection. RESULTS: Now after three years of follow-up, the patient is well, no limitations in their daily work and has a Constant Score of 50.5. DISCUSSION: We report our experience in this exceptional situation. We know, this is one of the first cases where the fungal infection and dislocation prosthetics in the same patient meet. This situation is a challenge for the surgeon, which has to treat complications two practically at the same time; we do not have scientific evidence to establish a criterion unified for the treatment of complications after surgery for revision of arthroplasty of the shoulder, especially in reverse or mega-denture prosthesis.

ANTECEDENTES: La infección e inestabilidad se encuentran entre las complicaciones de más difícil manejo en la cirugía protésica de hombro. La inestabilidad acumula hasta la mitad de los casos, mientras que la infección por hongos representa menos de 1% del total de infecciones y pueden causar daño severo a nivel óseo y de partes blandas. MÉTODOS: En este caso clínico se presenta una infección fúngica por Candida parapsilosis en una hemiartroplastía de hombro indicada por una fractura de húmero proximal. Se dio tratamiento quirúrgico en dos tiempos y administración de fluconazol durante ocho semanas previo al segundo tiempo quirúrgico. En la revisión se colocó una prótesis reversa como tratamiento definitivo; sin embargo, el paciente sufrió varios episodios de luxación en el postoperatorio. Fue necesaria una segunda cirugía de revisión protésica para sustituir por componentes de mayor estabilidad. Durante la misma, se extrajeron muestras que fueron analizadas, obteniéndose resultados negativos para infección. RESULTADOS: Actualmente tras tres años de seguimiento, el paciente se encuentra bien, sin limitaciones en su labor diaria y tiene un Constant Score de 50.5. DISCUSIÓN: Reportamos nuestra experiencia en esta situación excepcional. A nuestro conocer, éste es uno de los primeros casos en los que la infección fúngica y la luxación protésica coinciden en un mismo paciente. Esta situación es un reto para el cirujano, el cual tiene que tratar las dos complicaciones prácticamente a la vez. No se dispone de una evidencia científica para establecer un criterio unificado para el tratamiento de las complicaciones tras cirugía de revisión de artroplastía de hombro, especialmente en la prótesis reversa o megaprótesis.

[Haiti, new immigrant community in Chile]. / Haití, la nueva comunidad inmigrante en Chile.

Migration is a growing phenomenon in Latin America influenced by several factors such as economic stability, employment, social welfare, education and health system. Currently Chile has a positive migration flow rate. Particularly, a significant number of Haitian immigrants has been observed du ring the last years, especially after earthquake of 2010. These immigrants present a different cultural background expressed in relevant aspects of living including parenting and healthcare. Knowing the Haitian culture and its health situation is relevant for a better understanding of their health needs. Haitian people come to Chile looking for a cordial reception and willing to find a place with better perspectives of wellbeing in every sense. Immigration represents a major challenge for Chilean health system that must be embraced. Integration efforts in jobs, health, education system and community living should be enhanced to ensure a prosper settlement in our country. A new immigration law is crucial to solving major problems derived from current law created in 1975.

Haití, la nueva comunidad inmigrante en Chile / Haiti, new immigrant community in Chile

Las migraciones constituyen un fenómeno creciente en América Latina, influido por factores económicos, laborales, búsqueda de bienestar social, educación y salud, entre otros. Chile presenta una tasa neta de migración positiva, y en el último tiempo ha destacado el gran número de inmigrantes haitianos que han llegado a nuestro país, especialmente luego del terremoto que le afectó el 2010. Provenientes de una cultura diferente, donde el estilo de crianza y las características de atención en salud, entre otros aspectos, difieren a la de nuestro país, conocer la cultura haitiana y su situación de salud es relevante para una mejor apreciación de sus necesidades y enfrentar de mejor forma la programación de la atención sanitaria de esta población que busca en Chile un lugar de acogida y mayor bienestar. Para profundizar los esfuerzos de integración en trabajo, salud, educación y en la comunidad parece aconsejable actualizar la legislación referente a migraciones, tal que permita abordar los problemas actuales a través de una ley migratoria que data de 1975.

Migration is a growing phenomenon in Latin America influenced by several factors such as economic stability, employment, social welfare, education and health system. Currently Chile has a positive migration flow rate. Particularly, a significant number of Haitian immigrants has been observed du ring the last years, especially after earthquake of 2010. These immigrants present a different cultural background expressed in relevant aspects of living including parenting and healthcare. Knowing the Haitian culture and its health situation is relevant for a better understanding of their health needs. Haitian people come to Chile looking for a cordial reception and willing to find a place with better perspectives of wellbeing in every sense. Immigration represents a major challenge for Chilean health system that must be embraced. Integration efforts in jobs, health, education system and community living should be enhanced to ensure a prosper settlement in our country. A new immigration law is crucial to solving major problems derived from current law created in 1975.