The Effect of Oral Adenosine Triphosphate (ATP) Supplementation on Anaerobic Exercise in Healthy Resistance-Trained Individuals: A Systematic Review and Meta-Analysis.

Adenosine triphosphate (ATP) is an energy and signaling molecule. It is synthesized endogenously and can be taken as an oral supplement. This review aimed to identify the effects of oral ATP supplementation on anaerobic exercise in healthy resistance-trained adults. A systematic review and meta-analysis were performed based on the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) criteria. The inclusion criteria were articles published from 2000 to 2022, with anaerobic variables (maximal strength, maximum repetitions, and maximum anaerobic power) measurable in healthy adults with experience in resistance training, only randomized placebo-controlled clinical trials (RCTs), and with the acute (a single dose 30 min to 24 h before the tests) and/or chronic (>1 day) oral supplementation of ATP. A total of five RCTs with 121 adult men were included. The oral ATP supplementation achieved significantly greater gains in maximal strength compared with the placebo (PL) (MD = 8.13 kg, 95%CI [3.36-12.90], p < 0.001). Still, no differences were observed in the maximum number of repetitions or the maximum anaerobic power. Furthermore, 400 mg of ATP showed improvement in anaerobic exercise regardless of the duration of the supplementation protocol. In conclusion, supplementation with 400 mg of ATP doses can improve maximal muscle strength in resistance-trained men.

Assessing HIV knowledge in Mexican people living with HIV: development and validation of CC-VIH questionnaire.

The level of knowledge that people living with human immunodeficiency virus (HIV) have about their disease can impact their adherence to treatment. The aim of this study was to develop a tool to assess the knowledge about HIV among people receiving treatment at a specialized clinic in Mexico City. To establish content validity, expert judges were invited to conceptualize the tool and propose items for the defined dimensions. A total of 490 individuals living with HIV completed the 91-item questionnaire, with 82.2% being male and a mean age of 36.1 years. We conducted an exploratory factor analysis, resulting in a reduced questionnaire of 45 questions. A three-factor solution explained 36.2% of the variance in HIV knowledge. The total scale had a reliability coefficient of 0.937, and each subscale had reliabilities of 0.828, 0.856 and 0.859. Lower educational level (F(336) = 8.488, p < 0.001) and female gender (t(399) = 2.003, p = 0.046) were associated with lower scores on the HIV knowledge questionnaire. This tool appears suitable for measuring HIV knowledge in people living with HIV, although future studies are required to confirm its structure and reduce its extension.

Meeting Treatment Goals in Patients on Extramural Dialysis in Health Social Security in Mexico.

INTRODUCTION: For the majority of renal replacement therapy history, the main treatment option for patients with end-stage renal disease (ESRD) in Mexico has been peritoneal dialysis. However, the use of hemodialysis is overwhelmingly increasing, driving public health care institutions to subrogate this service. Even when the actual hiring model for subrogation is accurate, there is a lack of quality control points in the hemodialysis prescription, poor adherence to clinical practice guidelines, and a few or no record of outcomes in hemodialysis patients of these subrogated services. The objective of this work is to fill this information gap to allow for uniform and safe hemodialysis for patients of Mexico. MATERIAL AND METHODS: An observational and cross-sectional study was performed, including all patients receiving chronic hemodialysis treatment in subrogated units of Mexican Social Security Institute (IMSS) in the northern region of Mexico City. Clinical and biochemical data as well as hemodialysis dose by Kt/V and urea reduction rate were collected and evaluated. To determine distribution, mean or median and SD or interquartile range were used; for nominal variables, the difference in proportions was estimated using the χ2 test; proportions were analyzed for biochemical values using the statistical package SPSS version 25. RESULTS: In our study, >60% (485) of the patients were anemic with an average hemoglobin of 9.39 mg/dL (SD ± 1.83); serum calcium was found below 8.4 mg/dL in 51.3% (383) of patients, and only in 45.8% (342) was at an optimal level of this parameter. Only 33.5% of patients have arteriovenous fistula for dialysis access. The hemodialysis dose was optimal in >75% of patients. CONCLUSIONS: It is necessary to enhance and monitor treatment of comorbidities in patients with ESRD in subrogated hemodialysis units in México. We observed adequate prescription of hemodialysis in a majority of patients, achieving quality control points for removal of nitrogen products. Yet, there is a lack of quality control of comorbidities; therefore, we should aim to optimize treatment for mineral-bone disorder, anemia, and nutritional status.

Survival of Vascular Accesses in Chronic Hemodialysis Patients.

BACKGROUND/AIMS: Vascular access (VA) is the highest risk factor for blood infections, hospitalization, and mortality of patients undergoing hemodialysis (HD). The risk of mortality while using a catheter is greater than that while using grafts. The objective of this article is to know the survival rate in relation to the type of VA. METHODS: A retrospective cohort of HD patients was studied. The data gathered included age, gender, first VA at the surrogate site, days between the first and second access, number of accesses, and anatomical site of VA placement. Mean differences were estimated using χ2 or Student's t test. Survival was calculated using the Kaplan-Meier curves and included in tables. Statistical significance was established as p < 0.05. The statistical computer software package SPSSw v25 was used for the analysis. RESULTS: A total of 896 patients were included with a mean age of 47.88 years (SD ± 16.52), the duration of the first VA was 398.81 days (±565.79), the mean number of VAs used was 2.26 (±1.15), and the median time undergoing HD was 728.73 days. The duration of catheter placement was 330.42 days, and 728.60 days for fistula use (p = 0.001). The mean number of days of renal replacement was 611.59 days for catheter and 1,495.25 days for internal arteriovenous fistula (IAVF) patients (p = 0.001). CONCLUSIONS: The survival of the initial VA is greater for the IAVF, followed by the tunneled catheters and the lowest by the non-tunneled catheters, which continue to be frequently used in our setting.

Holter heart rhythm disorders in patients with acute kidney injury during hemodialysis / Trastornos del ritmo cardiaco por Holter en pacientes con lesión renal aguda durante hemodiálisis

BACKGROUND: The presence of acute renal injury has been associated with increased cardiovascular morbidity and mortality (sudden death and arrhythmias). OBJECTIVE: To know the frequency of heart rhythm disorders documented by Holter in patients in need of intermittent hemodialysis due to acute renal injury. MATERIAL AND METHODS: A prospective observational study was conducted including patients with a diagnosis of acute renal injury who received intermittent hemodialysis; demographic, clinical and laboratory data were collected from 28 patients. Monitoring was carried out through Holter before, during and after the hemodialysis session. Nonparametric statistics were used, with a significant value of p < 0.05. Risks were established with logistic regression. RESULTS: There was a significant difference in supraventricular extra systoles (82.1% vs. 57.1%), ventricular extra systoles (26.7% vs. 3.6%), and supraventricular tachycardia (6.7% vs. 3.6%). The rest of the rhythm alterations without significance. CONCLUSIONS: Intermittent hemodialysis is a factor associated with the appearance of heart rhythm disorders. The death of patients with acute renal injury and substitution was related to ventricular extra systole detected by transhemodialysis Holter.

INTRODUCCIÓN: La presencia de lesión renal aguda se ha asociado a unas mayores morbilidad y mortalidad de causa cardiovascular (muerte súbita y arritmias). OBJETIVO: Conocer la frecuencia de trastornos del ritmo cardiaco documentado por Holter en pacientes con necesidad de hemodiálisis intermitente por lesión renal aguda. MATERIAL Y MÉTODOS: Se realizó un estudio observacional, prospectivo, en pacientes con diagnóstico de lesión renal aguda que recibieron hemodiálisis intermitente; se recabaron datos demográficos, clínicos y de laboratorio de 28 pacientes. Se realizó monitoreo mediante Holter, previo, durante y posterior a la sesión de hemodiálisis. Se utilizó estadística no paramétrica, con un valor significativo de p < 0.05. Se establecieron riesgos con regresión logística. RESULTADOS: Hubo diferencia significativa en extrasístoles supraventriculares (82.1% frente a 57.1%), extrasístoles ventriculares (26.7% frente a 3.6%) y taquicardia supraventricular (6.7% frente a 3.6%). El resto de las alteraciones del ritmo no mostraron significancia. CONCLUSIONES: La hemodiálisis intermitente es un factor asociado a la aparición de trastornos del ritmo cardiaco. La muerte de los pacientes con lesión renal aguda y sustitución estuvo relacionada con la extrasístole ventricular detectada por Holter transhemodiálisis.

Identifying risk factors for HIV-positive test results in walk-in and hospitalized patients in a Mexico City HIV clinic: a descriptive study.

The objective of this study was to analyze risk factors for HIV-positive tests in walk-in users and in hospitalized patients in a Mexico City hospital. We undertook a cross-sectional study based on routine HIV testing and counseling service data in adults undergoing an HIV test from January 2015 to July 2017. Multivariate analysis was performed to determine risk factors for walk-in and hospitalized patients. The results showed that 2040 people tested during the period; hospitalized patients were more likely to test HIV-positive than walk-in users (18 versus 15%; p < 0.05). HIV risk factors for hospitalized patients included being men who have sex with men (MSM) (adjusted odds ratio [aOR] 7.2, 95% CI 2.0-26.5), divorced (aOR 4.4, 95% CI 1.3-14.4), having 3-5 lifetime sexual partners (aOR 2.7, 95% CI 1.0-7.4), and being in the emergency room (aOR 3.6, 95% CI 1.1-11.3), intensive care (aOR 27.2, 95% CI 3.4-217.2), or clinical pneumology wards (aOR 33.4, 95% CI 9.7-115.2). In the walk-in group, HIV risk factors included being male (aOR 2.8, 95% CI 1.3-5.9), being MSM (aOR 4.3, 95% CI 2.0-9.5), having sex while using drugs (aOR 2.3, 95% CI 1.3-4.0), being referred by a physician for testing (aOR 3.2, 95% CI 1.6-6.3), and perceiving oneself at risk (aOR 3.8, 95% CI 2.3-6.3). Differential risk factors found among hospitalized patients and walk-in testers can be helpful in designing better HIV testing strategies to increase early diagnosis and linkage to care.

Design, validation and testing of short text messages for an HIV mobile-health intervention to improve antiretroviral treatment adherence in Mexico.

Mobile Health (mHealth) interventions have become effective strategies to increase adherence to antiretroviral treatment (ART) in people living with HIV (PLWH). mHealth interventions use phone calls, e-mails, smartphone apps or short text messages (SMS) as reminders of medical appointments or ART adherence. SMS are a highly accepted mHealth strategy. Systematized processes to validate SMS tailored to end-user preferences are required to increase the effectiveness of mHealth interventions. We describe a structured approach to develop a set of SMS tailored to Mexican HIV+ individuals, focused on improving ART adherence and healthcare appointments. The process included three sequential phases: SMS design by HIV-healthcare professionals, validation by expert referees, and testing by PLWH. A set of 108 SMS in four categories (motivational self-healthcare messages, ART-collection, medical and laboratory-appointment reminders) was designed. Expert referees assessed 94.5% of messages as adequate, 65.7% as useful. Seventy-one SMS were further tested by PLWH, who considered 100% of SMS to be understandable and 57.7% useful. SMS had adequate intra-judge agreement scores for clarity and acceptability (ICC-2 = .08-.49). Qualitative feedback from expert referees and PLWH was incorporated into SMS. A final set of 41 highest-rated SMS was obtained. Careful validation of SMS could increase the effectiveness of mHealth interventions.

Coping and emotional discomfort in primary caregivers of cancer patients.

OBJECTIVES: To assess the psychometric properties of the Carer's Assessment of Managing Index. To compare coping styles in caregivers of patients with terminal cancer (CPTC) and caregivers of patients on oncologic treatment (CPOT). To revise the association between coping styles, socio-demographic variables, and emotional discomfort in caregivers. MATERIAL AND METHODS: A cross-sectional and correlational study was conducted, in which 133 caregivers, 59 CPOT and 74 CPTC, were interviewed. Emotional discomfort (depression, anxiety, caregiver's burden) and coping styles were measured. RESULTS: The instrument was defined by three factors (alternate perception of events, active coping, and emotional regulation), with an internal consistency of α = 0.78. The alternate perception of events was the only coping style with statistically significant difference between CPOT and CPTC, and CPOT score higher in this regard. Different coping styles allow for more accurate prediction of emotional discomfort in CPTC, which showed more symptoms of anxiety, depression, caregiver's burden and physical illness. The study found a high occurrence of behaviors such as crying, screaming, smoking, anxiety eating and alcohol consumption in both CPOT and CPTC, all of which related to intense emotional discomfort. Active coping scores were higher when the caregivers had social support and a higher level of education (bachelor's degree or postgraduate studies). Active coping scores went down when different aspects of the caregiver's life were affected, when physical or psychological symptoms were present, and when the caregivers had more time in their role.

SCL-90 R: Distrés psicológico, género y conductas de riesgo / SCL-90 R: Psychological Distress, Gender and Risky Behaviors

Con base en una muestra probabilística de 466 estudiantes universitarios mexicanos, se explora la relación entre distrés psicológico y conductas de riesgo (consumo de sustancias, conductas sexuales, y ambas), en hombres y mujeres. Los resultados indican que el distrés psicológico presenta diferencias con mayor frecuencia en el caso de las mujeres que presentan consumo de drogas, tabaco y alcohol, o conductas que mezclan sexo y alcohol, y sexo y consumo de drogas, que en el caso de los hombres. Los hombres con actividad sexual ocasional presentan mayor distrés que aquellos que no presentan esta conducta. Como punto de partida, se explora la estructura factorial del SCL-90-R, coincidiendo en los resultados con los obtenidos por investigadores de otras latitudes; al parecer, el análisis factorial no soporta la estructura propuesta por los autores del instrumento.

Based on a probability sample of 466 Mexican college students, we want to find out if there is a relationship between psychological distress and risky behavior (drug-consuming, sexual behavior or both) between men and women. Results show that psychological distress presents more differences with women who consume drugs, tobacco and alcohol and who present behaviors which combine sex and alcohol more than men. Men with occasional sexual activity preset more distress than those who don't show this behavior. To begin, we explore the factorial structure of SCL-90-R observing the same results of those obtained by other researchers. It seems that the factor analysis doesn't support the structure proposed by the authors of the instrument.

Ultrastructural alterations during embryonic rats' lung development caused by ozone.

Ozone (O3) is an oxidizing agent that acts on phospholipids, proteins and sugars of cellular membranes producing free radicals, which cause oxidative damages. The O3 exposure has been used as a model to study oxidative stress, in which the respiratory airways represent the entrance to the organism. In this study, ultrastructural alterations were identified at the bronchiolar level during the intra-uterine lung development, using an O3 exposure model in pregnant rats during 18, 20 and 21 days of gestation. Twelve pregnant Wistar rats, six controls and six exposed to 1 ppm O3 inhalation during 12 h per day, were used. The rats were sacrificed at gestational days 18, 20 and 21; the fetuses were obtained and their lungs dissected. The ultrastructural analysis evidenced swollen mitochondria, cytoplasmic vacuolization of the epithelial cells and structural disorder caused by the oxidative stress. At gestation day 20, flake-off epithelial cells and laminar bodies in the bronchiolar lumen were observed. In the 21-gestation-day group, the mitochondria were edematous and their cristae were disrupted by the damage caused in mitochondrial membranes.

Nasal cytology and genotoxic damage in nasal epithelium and leukocytes: asthmatics versus nonasthmatics.

BACKGROUND: The best example of a chronic inflammatory respiratory disease is asthma, a disease which has an increasing prevalence worldwide. This chronic inflammation is also related to the generation of oxidative stress since the cells involved in the allergic reaction are capable of producing reactive oxygen species (ROS), and this might predispose asthmatics to increased genotoxic damage. METHODS: A respiratory symptomatology questionnaire was self-applied by asthmatic and nonasthmatic students. A single cell gel electrophoresis assay in two different cell types (nasal epithelial cells and leukocytes) was performed, and the cytology of the nasal smears stained with HE was evaluated. RESULTS: Both groups reported having a runny nose. Asthmatics had greater DNA damage in the nasal epithelial cells in contrast to nonasthmatics. In leukocytes no statistical significance in DNA damage was identified. Metaplasia was evident in asthmatics that also showed eosinophils and neutrophils as well as goblet cells and mucus at a higher frequency compared with nonasthmatics. CONCLUSIONS: Nasal symptoms did not correlate with genotoxic damage, since they were reported in both groups. Nasal epithelial cells of asthmatics are more sensitive to genotoxic damage, and chronic inflammatory response. Also the activity of eosinophils might mediate the DNA damage through the generation of ROS.

Single-cell gel electrophoresis assay of nasal epithelium and leukocytes from asthmatic and nonasthmatic subjects in Mexico City.

The prevalence of asthma--a chronic inflammatory respiratory disease--is increasing worldwide. One hypothesis suggests that this trend is related to enhanced exposure to air pollutants. Chronic inflammation generates oxidative stress, and cells involved in an allergic reaction are capable of producing reactive oxygen species that may predispose asthmatics to increased deoxyribonucleic acid (DNA) damage. The authors estimated DNA strand breaks by use of single-cell gel electrophoresis assay on 2 different cell types (i.e., nasal epithelial cells and leukocytes) sampled from asthmatic and nonasthmatic medical students in Mexico City. The authors found that asthmatic subjects had more DNA breaks in their nasal epithelial cells than did their nonasthmatic counterparts. In contrast, asthmatic subjects had less damage in their leukocytes than did nonasthmatic individuals. These findings suggest that the hyperreactivity of the nasal epithelium prevents systemic effects from air pollutants, as reflected by less DNA injury to leukocytes of the asthmatic group. Asthmatic's nasal epithelial cells were more sensitive to DNA damage than were those of nonasthmatics--perhaps as a consequence of increased fragility induced either by air pollution or by a chronic inflammatory response.

Vanadium in ambient air: concentrations in lung tissue from autopsies of Mexico City residents in the 1960s and 1990s.

Vanadium concentrations in lung tissue were determined by atomic absorption spectrometry from autopsy specimens taken from residents of Mexico City during the 1960s and 1990s (20 males and 19 females, and 30 males and 18 females, respectively). Samples from the 1990s had significantly increased mean vanadium concentrations (mean +/- standard deviation: 1.36 +/- 0.08), compared with those from the 1960s (1.04 +/- 0.05). Concentrations were not correlated with gender, smoking habit, age, cause of death, or occupation. These findings suggest that vanadium in ambient air is increasing and it represents a potential health hazard for Mexico City residents. Air pollution monitoring efforts should include vanadium concentrations in suspended particles to follow-up the findings reported herein. Researchers need to acquire a better knowledge of the levels of airborne vanadium exposure at which risk to human health occurs.

Filtro sanitario en las urgencias médicas. Un problema a reajustar / Helath filter in medical emeregencies. A problem to be readjusted

Se realizó un estudio descriptivo analítico de la demanda asistencial en el área de medicina interna de los Servicios de Urgencia, del Hospital "Dr. Luis Díaz Soto" y el Policlínico "Dr. Mario Escalona". Dicho estudio se realizó durante el período comprendido desde el 29/5/95 hasta el 3/6/95. Se estudió la distribución de la demanda para conocer su comportamiento en cuanto a la gravedad de las emergencias clasificadas en: urgencias hospitalarias, urgencias primarias y no urgencias, la forma en que acudieron los pacientes (remitidos o por decisión propia), destino después de su valoración y los grupos diagnósticos y afecciones más frecuentes de las urgencias primarias. Se concluyó que el mayor porcentaje de la demanda estaba formado por las urgencias primarias y las no urgencias de pacientes que acudían al hospital por decisión propia y con afecciones que no requerían atención hospitalaria pues tenían solución en el nivel primario

Demandas de urgencias clínicas. Algunas variables de interés / Demands of clinical emergencies. Some variables of interest

Se realizó un estudio descriptivo analítico de la demanda asistencial en el área de medicina interna de los Servicios de Urgencia, en el Hospital "Dr. Luis Díaz Soto" y el Policlínico "Dr. Mario Escalona Reguera", durante el período comprendido entre las 8:00 h del día 29/5/95 y las 7:59 h del 3/6/95. Con el objetivo de conocer el comportamiento de la demanda se estudió su distribución en cuanto a edad, sexo, grupos horarios (laboral y extralaboral) y días de la semana. Se concluyó que no existe asociación estadística entre la edad y el sexo, según la distribución de la demanda, no así entre las otras variables y los grupos horarios, donde se observaron diferencias altamente significativas con un predominio de pacientes en edades jóvenes que asistían principalmente durante el horario laboral. El día de mayor carga de trabajo fue el lunes

Urgencias clínicas. Comportamiento según su gravedad / Clinical emergencies. Behavior according to their severity

Se realizó un estudio descriptivo analítico de la demanda asistencial en el área de medicina interna de los Servicios de Urgencia, en el Hospital "Dr Luis Díaz Soto" y el Policlínico "Dr Mario Escalona Reguera", durante el período comprendido entre las 8:00 h del día 29/5/95 y las 7:59 h del día 3/6/95. Con el objetivo de conocer el comportamiento de la demanda se estudió su distribución en cuanto a edad, sexo, grupos horarios (laboral y extralaboral) y la gravedad de las patologías clasificadas en emergencias, urgencias hospitalarias, urgencias primarias y no urgencias. Se concluyó que existía una asociación, con muy alta significación estadística, entre la edad y el tipo de demanda y se demostró un predominio de urgencias primarias y no urgencias a expensas de pacientes jóvenes, los cuales asistían, fundamentalmente, en horario de trabajo

Categorias de interes epidemiologico en la incidencia de la infeccion intrahospitalaria en pacientes manejados con nutricion parenteral / Categories of epidemiological interest in the incidence of the intrahospitalary infection in patients managed with parenteral nutrition.

Se revisaron las historias clinicas de los pacientes que ingresaron al servicio de lactantes del Hospital infantil, entre 1986 y junio de 1987, para conocer la distribucion de las infecciones intrahospitalarias. El presente estudio demuestra que dicho servicio esta dentro de los 3 en los cuales hay mas infecciones. De las historias analizadas, se seleccionaron 31 que correspondian a pacientes que habian recibido NP y cumplian con los requisitos del estudio. En este grupo se encontraron 10 pacientes que presentaron infeccion en el sitio de insercion del cateter. Con mas frecuencia fueron lactantes menores del sexo femenino, procedentes del hogar y con DNT moderada a grave. La mayor parte estuvo hospitalizado mas de 11 dias y recibio NP durante 8-10 dias por cateteres centrales colocados por venodiseccion y que permanecieron in situ un promedio de 7 dias. Todos los pacientes recibieron antibioticos tipo ampicilina y garamicina simultaneamente con la alimentacion parenteral. Se enuncian los posibles factores predisponentes y se revisan los estandares y protocolos de manejo de los cateteres para alimentacion parenteral