Transfer Learning with Active Sampling for Rapid Training and Calibration in BCI-P300 Across Health States and Multi-centre Data.

Machine learning and deep learning advancements have boosted Brain-Computer Interface (BCI) performance, but their wide-scale applicability is limited due to factors like individual health, hardware variations, and cultural differences affecting neural data. Studies often focus on uniform single-site experiments in uniform settings, leading to high performance that may not translate well to real-world diversity. Deep learning models aim to enhance BCI classification accuracy, and transfer learning has been suggested to adapt models to individual neural patterns using a base model trained on others' data. This approach promises better generalizability and reduced overfitting, yet challenges remain in handling diverse and imbalanced datasets from different equipment, subjects, multiple centres in different countries, and both healthy and patient populations for effective model transfer and tuning. In a setting characterized by maximal heterogeneity, we proposed P300 wave detection in BCIs employing a convolutional neural network fitted with adaptive transfer learning based on Poison Sampling Disk (PDS) called Active Sampling (AS), which flexibly adjusts the transition from source data to the target domain. Our results reported for subject adaptive with 40% of adaptive fine-tuning that the averaged classification accuracy improved by 5.36% and standard deviation reduced by 12.22% using two distinct, internationally replicated datasets. These results outperformed in classification accuracy, computational time, and training efficiency, mainly due to the proposed Active Sampling (AS) method for transfer learning.

National priorities for oral health research, Peru 2022-2026: process, experiences and perspectives. / Prioridades nacionales de investigación en salud bucal, Perú 2022-2026: proceso, experiencias y perspectivas.

The National Institute of Health has, for the first time, identified National Priorities for Oral Health Research, this process was carried out by the Subdirectorate of Research and Laboratories of Noncommunicable Diseases of the National Center for Public Health with the technical advice of the Directorate of Research and Innovation in Health and in coordination with the Executive Directorate of Oral Health of the General Directorate of Strategic Interventions in Public Health of the Ministry of Health, using a participatory methodology with three key actors: researchers/specialists, experts and decision-makers. This article aims to describe the process used to identify these priorities, which consisted of five phases: i) identification of the strategic objectives of the Ministry of Health, ii) identification of needs in oral health research, iii) review by experts and assessment of needs according to criteria and v) presentation of the priorities. As a result, 12 priorities were obtained, which were subsequently approved by Ministerial Resolution No. 262-2022/MINSA, for a period of 2022-2026. In addition, we provide recommendations for future processes.

El Instituto Nacional de Salud, ha llevado a cabo por primera vez el proceso de identificación de Prioridades Nacionales de Investigación en Salud Bucal a cargo de la Subdirección de Investigación y Laboratorios de Enfermedades No Transmisibles del Centro Nacional de Salud Pública con la asesoría técnica de la Dirección de Investigación e Innovación en Salud y en coordinación con la Dirección Ejecutiva de Salud Bucal de la Dirección General de Intervenciones Estratégicas en Salud Pública del Ministerio de Salud mediante metodología participativa de tres actores claves: investigadores/especialistas, expertos y decisores. El objetivo de este artículo es describir el proceso seguido para la identificación de estas prioridades, el cual comprendió cinco fases: i) identificación de objetivos estratégicos del MINSA, ii) identificación de necesidades de investigación en salud bucal, iii) revisión por expertos y valoración de las necesidades según criterios, iv) priorización (valoración de la lista de prioridades según calificación) y v) presentación de las prioridades. Como resultado se obtuvieron las 12 prioridades que posteriormente fueron aprobadas por Resolución Ministerial N.° 262-2022/MINSA, con un periodo de vigencia 2022-2026. Además, se brindaron recomendaciones para futuros procesos.

Prioridades nacionales de investigación en salud bucal, Perú 2022-2026: proceso, experiencias y perspectivas / National priorities for oral health research, Peru 2022-2026: process, experiences and perspectives

El Instituto Nacional de Salud, ha llevado a cabo por primera vez el proceso de identificación de Prioridades Nacionales de Investigación en Salud Bucal a cargo de la Subdirección de Investigación y Laboratorios de Enfermedades No Transmisibles del Centro Nacional de Salud Pública con la asesoría técnica de la Dirección de Investigación e Innovación en Salud y en coordinación con la Dirección Ejecutiva de Salud Bucal de la Dirección General de Intervenciones Estratégicas en Salud Pública del Ministerio de Salud mediante metodología participativa de tres actores claves: investigadores/especialistas, expertos y decisores. El objetivo de este artículo es describir el proceso seguido para la identificación de estas prioridades, el cual comprendió cinco fases: i) identificación de objetivos estratégicos del MINSA, ii) identificación de necesidades de investigación en salud bucal, iii) revisión por expertos y valoración de las necesidades según criterios, iv) priorización (valoración de la lista de prioridades según calificación) y v) presentación de las prioridades. Como resultado se obtuvieron las 12 prioridades que posteriormente fueron aprobadas por Resolución Ministerial N.° 262-2022/MINSA, con un periodo de vigencia 2022-2026. Además, se brindaron recomendaciones para futuros procesos.

The National Institute of Health has, for the first time, identified National Priorities for Oral Health Research, this process was carried out by the Subdirectorate of Research and Laboratories of Noncommunicable Diseases of the National Center for Public Health with the technical advice of the Directorate of Research and Innovation in Health and in coordination with the Executive Directorate of Oral Health of the General Directorate of Strategic Interventions in Public Health of the Ministry of Health, using a participatory methodology with three key actors: researchers/specialists, experts and decision-makers. This article aims to describe the process used to identify these priorities, which consisted of five phases: i) identification of the strategic objectives of the Ministry of Health, ii) identification of needs in oral health research, iii) review by experts and assessment of needs according to criteria and v) presentation of the priorities. As a result, 12 priorities were obtained, which were subsequently approved by Ministerial Resolution No. 262-2022/MINSA, for a period of 2022-2026. In addition, we provide recommendations for future processes.

Aortic Perforation and Ascending Dissection Due to Intra-Aortic Balloon Counterpulsation Implantation in Cardiac Surgery.

The intra-aortic balloon pump continues to be a useful ventricular assist device in cardiac surgery. Complications are estimated to be 7% to 40%, significantly high to catastrophic. We describe an aortic injury associated with the use of the device and an interdisciplinary management for the diagnostic and therapeutic approach. (Level of Difficulty: Intermediate.).

The sum of kidney donor profile index and estimated post-transplant survival scale and their correlation with egfr decline in deceased donor kidney recipients

Background: The impact of donor quality on post-kidney transplant survival may vary by candidate condition. Objective: Analyzing the combined use of the Kidney Donor Profile Index (KDPI) and the estimated post-transplant survival (EPTS) scale and their correlation with the estimated glomerular filtration rate (eGFR) decline in deceased-donor kidney recipients (DDKR). Methods: This was a retrospective, observational cohort study. We included DDKRs between 2015 and 2017 at a national third-level hospital. Results: We analyzed 68 DDKR. The mean age at transplant was 41 ± 14 years, 47 (69%) had sensitization events, 18 (26%) had delayed graft function, and 16 (23%) acute rejection. The graft survival at 12 and 36 months was 98.1% (95% CI 94-100) and 83.7% (95% CI 65-100), respectively. The Pearson correlation coefficient between the percentage reduction in the annual eGFR and the sum of EPTS and KDPI scales was r = 0.61, p < 0.001. The correlation coefficient between the percentage reduction in the annual eGFR and the EPTS and KDPI scales separately was r = 0.55, p < 0.001, and r = 0.53, p < 0.001, respectively. Conclusions: The sum of EPTS and KDPI scales can provide a better donor-recipient relationship and has a moderately positive correlation with the decrease in eGFR in DDKR.

Nephrologist Interventions to Avoid Kidney Replacement Therapy in Acute Kidney Injury.

BACKGROUND: Based on the pathophysiology of acute kidney injury (AKI), it is plausible that certain early interventions by the nephrologist could influence its trajectory. In this study, we investigated the impact of 5 early nephrology interventions on starting kidney replacement therapy (KRT), AKI progression, and death. METHODS: In a prospective cohort at the Hospital Civil of Guadalajara, we followed up for 10 days AKI patients in whom a nephrology consultation was requested. We analyzed 5 early interventions of the nephrology team (fluid adjustment, nephrotoxic withdrawal, antibiotic dose adjustment, nutritional adjustment, and removal of hyperchloremic solutions) after the propensity score and multivariate analysis for the risk of starting KRT (primary objective), AKI progression to stage 3, and death (secondary objectives). RESULTS: From 2017 to 2020, we analyzed 288 AKI patients. The mean age was 55.3 years, 60.7% were male, AKI KDIGO stage 3 was present in 50.5% of them, sepsis was the main etiology 50.3%, and 72 (25%) patients started KRT. The overall survival was 84.4%. Fluid adjustment was the only intervention associated with a decreased risk for starting KRT (odds ratio [OR]: 0.58, 95% confidence interval [CI]: 0.48-0.70, and p ≤ 0.001) and AKI progression to stage 3 (OR: 0.59, 95% CI: 0.49-0.71, and p ≤ 0.001). Receiving vasopressors and KRT were associated with mortality. None of the interventions studied was associated with reducing the risk of death. CONCLUSIONS: In this prospective cohort study of AKI patients, we found for the first time that early nephrologist intervention and fluid prescription adjustment were associated with lower risk of starting KRT and progression to AKI stage 3.

The Sum of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scale and Their Correlation with eGFR Decline in Deceased Donor Kidney Recipients.

BACKGROUND: The impact of donor quality on post-kidney transplant survival may vary by candidate condition. OBJECTIVE: Analyzing the combined use of the Kidney Donor Profile Index (KDPI) and the estimated post-transplant survival (EPTS) scale and their correlation with the estimated glomerular filtration rate (eGFR) decline in deceased-donor kidney recipients (DDKR). METHODS: This was a retrospective, observational cohort study. We included DDKRs between 2015 and 2017 at a national third-level hospital. RESULTS: We analyzed 68 DDKR. The mean age at transplant was 41 ± 14 years, 47 (69%) had sensitization events, 18 (26%) had delayed graft function, and 16 (23%) acute rejection. The graft survival at 12 and 36 months was 98.1% (95% CI 94-100) and 83.7% (95% CI 65-100), respectively. The Pearson correlation coefficient between the percentage reduction in the annual eGFR and the sum of EPTS and KDPI scales was r = 0.61, p < 0.001. The correlation coefficient between the percentage reduction in the annual eGFR and the EPTS and KDPI scales separately was r = 0.55, p < 0.001, and r = 0.53, p < 0.001, respectively. CONCLUSIONS: The sum of EPTS and KDPI scales can provide a better donor-recipient relationship and has a moderately positive correlation with the decrease in eGFR in DDKR.

Type 2 Diabetes Alters Vascular Cannabinoid Receptor 1 Expression, Phosphorylation Status, and Vasorelaxation in Rat Aorta.

Previous studies have suggested a role of the endocannabinoid system in metabolic diseases, such as diabetes. We investigated the effect of diabetes on cannabinoid receptor type 1 (CB1) expression and cannabinoid-induced vasorelaxation in rat aorta rings. Aortas from healthy rats and from rats with experimentally induced diabetes were used to compare the vasorelaxant effect of the cannabinoid agonist arachidonylcyclopropylamide (ACPA) and CB1 expression and localization. After 4-8 weeks of diabetes induction, CB1 receptor expression and CB1 phosphorylation were higher in aortic rings, in association with greater vasorelaxation induced by the CB1 agonist ACPA compared to healthy rats. The vasorelaxant effect observed in healthy rats is similar throughout the study. Further studies are needed to elucidate the implications of CB1 receptor overexpression in diabetes and its influence on the progression of the cardiovascular complications of this metabolic disease.

Stochastic excitation for high-resolution atomic force acoustic microscopy imaging: a system theory approach.

In this work, a high-resolution atomic force acoustic microscopy imaging technique is developed in order to obtain the local indentation modulus at the nanoscale level. The technique uses a model that gives a qualitative relationship between a set of contact resonance frequencies and the indentation modulus. It is based on white-noise excitation of the tip-sample interaction and uses system theory for the extraction of the resonance modes. During conventional scanning, for each pixel, the tip-sample interaction is excited with a white-noise signal. Then, a fast Fourier transform is applied to the deflection signal that comes from the photodiodes of the atomic force microscopy (AFM) equipment. This approach allows for the measurement of several vibrational modes in a single step with high frequency resolution, with less computational cost and at a faster speed than other similar techniques. This technique is referred to as stochastic atomic force acoustic microscopy (S-AFAM), and the frequency shifts of the free resonance frequencies of an AFM cantilever are used to determine the mechanical properties of a material. S-AFAM is implemented and compared with a conventional technique (resonance tracking-atomic force acoustic microscopy, RT-AFAM). A sample of a graphite film on a glass substrate is analyzed. S-AFAM can be implemented in any AFM system due to its reduced instrumentation requirements compared to conventional techniques.

Embarazos y sus resultados en las participantes de ensayos clínicos de fase III y IV en el Perú / Pregnancies and their results in phase III and IV clinical trial participants in Peru

Resumen Objetivos: Identificar la ocurrencia de casos de embarazo, nacimientos y aborto en participantes de ensayos clinicos en fases III y IV, en Perú. Material y métodos: Estudio de análisis de datos secundarios, retrospectivo, de todos los casos de embarazo ocurridos durante la realización de ensayos clínicos, en el periodo 2010 al 2015. Los datos se obtuvieron del sistema virtual REAS-NET, del Instituto Nacional de Salud para el reporte de eventos adversos serios. Se utilizó la prueba de Fisher y Chi cuadrado para el análisis de las variables. Resultados: Se encontraron 30 casos de embarazos de pacientes enroladas en los ensayos clínicos, 24 de ellos en ensayos de fase III. El rango de edad fue 19 a 44 años, 21 casos terminaron en aborto. Ninguna de las variables estudiadas presentó asociación significativa con el resultado del embarazo: aborto y nacido vivo normal. Conclusiones: Se encontraron embarazos en las participantes en ensayos clínicos de fase III y IV, la edad correspondió a la edad fértil de las mujeres.

Summary Objectives: To identify the occurrence of cases of pregnancy, births and abortion in participants of clinical trials in phases III and IV, in Peru. Methods: Retrospective secondary data analysis study of all cases of pregnancy that occurred during clinical trials, in the period 2010 to 2015. The data were obtained from the virtual system REAS-NET, of the National Institute of Health for the report of serious adverse events. The Fisher and Chi square test was used to analyze the variables. Results: 30 cases of pregnancies of patients enrolled in clinical trials were found, 24 of them in phase III trials. The age range was 19 to 44 years, 21 cases ended in abortion. None of the variables studied presented a significant association with the outcome of pregnancy: abortion and normal live birth. Conclusions: Pregnancies were found in the participants in phase III and IV clinical trials, the age corresponded to the fertile age of the women.

A Bespoke Social Network for Deaf Women in Ecuador to Access Information on Sexual and Reproductive Health.

Many deaf women face the lack of numerous resources related to their personal development. The unavailability of proper information on Sexual and Reproductive Health (SRH), in particular, causes problems of sexually transmitted infections, unwanted pregnancy in adolescence, sexual violence, complications during pregnancy, etc. In response to this, we have created a social network that delivers SRH content (verified and validated by experts) to women with different degrees of hearing loss. The site features a recommender system that selects the most relevant pieces of content to deliver to each woman, driven by her individual preferences, needs and levels of knowledge on the different subjects. We report experiments conducted in Cuenca, Ecuador, between 2017 and 2018 with 98 volunteers from low- and middle-income settings, aiming to evaluate the quality and appeal of the contents, the coherence of the methodology followed to create them, and the effectiveness of the content recommendations. The positive results encourage the frequent creation of new content and the refinement of the recommendation logic as the cohort of users expands over time.

The antinociceptive effect of resveratrol in bone cancer pain is inhibited by the Silent Information Regulator 1 inhibitor selisistat.

OBJECTIVES: To study the antinociceptive effect of single and repeated doses of resveratrol in a bone cancer pain model, and whether this effect is prevented by the Silent Information Regulator 1 (SIRT1) inhibitor selisistat. METHODS: The femoral intercondylar bone of BALB/c mice was injected with 1 000 000 BJ3Z cancer cells. Bone resorption and tumour mass growth (measured by in vivo X-ray and fluorescence imaging), as well as mechanical nociceptive thresholds (von Frey device) and dynamic functionality (rotarod machine), were evaluated during the following 4 weeks. Acute resveratrol (100 mg/kg i.p.) and/or selisistat (10 mg/kg s.c.) were administered on day 14. Chronic resveratrol (100 mg/kg i.p., daily) and/or selisistat (0.5 µg/h s.c., Alzet pump) were administered between days 14 and 20. KEY FINDINGS: Tumour growth gradually incremented until day 31, while mechanical hyperalgesia started on day 3 after cancer cell injection. Acute resveratrol increased the mechanical threshold of pain (peaking at 1.5 h), while the dynamic functionality decreased. Chronic resveratrol produced a sustained antinociceptive effect on mechanical hyperalgesia and improved the loss of dynamic functionality induced by the bone cancer tumour. Selisistat prevented all the effects of resveratrol. CONCLUSIONS: Acute and chronic resveratrol induces antinociceptive effect in the model of metastatic osseous oncological pain, an effect that would be mediated by SIRT1 molecular signalling.

Insuficiencia cardíaca: desafíos en la terapia farmacológica / Heart failure: challenges in pharmacological therapy

La Insuficiencia Cardíaca (IC) es una entidad clínica de gran importancia, por su elevada incidencia y mortalidad, por ende la inquietud de realizar constantes y actualizadas revisiones para optimizar su tratamiento y así impactar la morbimortalidad de los pacientes. Objetivo: analizar críticamente la literatura médica, en el tratamiento farmacológico de la insuficiencia cardíaca para ofrecer una mejor calidad de vida al paciente. Métodos: investigación documental a través de la revisión sistemática de artículos primarios en revistas científicas en bases de datos bibliográficas en ciencias de la salud: Pub Med, Google Académico, Elsevier, ScienceDirect, Biblioteca Virtual en Salud (BVS) OPS y Scielo, entre los años de 2014 y 2018, para ello se determinaron los siguientes descriptores: insuficiencia cardiaca, tratamiento, desafíos, calidad de vida. Se revisaron 28 artículos digitales actualizados y cotejados. Resultados: En el tratamiento actual de la insuficiencia cardiaca, prevalece la combinación Sacubitril/Valsartán, ya que disminuye el riesgo de muerte cardiovascular en un 20% y de hospitalización en 21%; además, disminuye los efectos adversos en relación al tratamiento convencional con (IECA). Conclusión: Las nuevas terapias farmacológicas en insuficiencia cardíaca, permiten sustituir las terapias convencionales y optimizar calidad de vida(AU)

Heart Failure (HF) is a clinical entity of great importance, due to its high incidence and mortality, therefore the concern of conducting constant and updated reviews to optimize their treatment and thus impact the morbidity and mortality of patients. Objective: to critically analyze the medical literature, in the pharmacological treatment of heart failure to offer a better quality of life to the patient. Methods: documentary research through the systematic review of primary articles in scientific journals in bibliographic databases in health sciences: Pub Med, Google Scholar, Elsevier, ScienceDirect, Virtual Health Library (VHL) PAHO and Scielo, among the years of 2014 and 2018, for this the following descriptors were determined: heart failure, treatment, challenges, quality of life. 28 updated and collated digital articles were reviewed. Results: In the current treatment of heart failure, the Sacubitril / Valsartan combination prevails, since it reduces the risk of cardiovascular death by 20% and hospitalization by 21%; In addition, it reduces adverse effects in relation to conventional treatment with (ACEI). Conclusion: the new pharmacological therapies in heart failure, allow to replace conventional therapies and optimizing quality of life(AU)

Linking hepatitis C virus infection to pre-1994 blood transfusions in female patients. / Asociación del antecedente transfusional antes de 1994 con hepatitis vírica tipo C en mujeres.

INTRODUCTION: Most blood transfusions occur in female patients. The introduction of serologic screening practices by blood banks reduced the transfusion-related rate of infection with hepatitis C virus (HCV). In Mexico patients with pre-1994 transfusion history are at high risk of being detected with HCV infection. We aimed at establishing an interrelationship between two variables: pre-1994 transfusion history and rate of infection in women treated in the Guadalajara Metropolitan Area hospitals, in Mexico. METHODS: Analytical observational case-control study which included both non-infected women and patients diagnosed with hepatitis C virus infection, in whom the pre-1994 transfusion history was determined. The cases were 150 women with confirmed hepatitis C virus serologic diagnosis. The controls were 150 women whose hepatitis C virus-detection serologic tests had yielded negative results. RESULTS: An odds ratio of 9.07 (95% CI: 5.37 ­ 15.3; p< 0.001) was found where the rate of infection for the case group was 0.72 while the control group had a ratio of 0.22; population attributable risk (PAR) was 0.64 (95% CI: 0.53 ­ 0.73), while etiologic fraction was 0.88 (95% CI: 0.81 ­ 0.93). CONCLUSIONS: Among women, having been exposed to pre-1994 blood transfusion means a risk 9.07 times higher than not being exposed to blood transfusion in the same time frame.

La mayor parte de las transfusiones se llevan a cabo en mujeres. La introducción en los bancos de sangre de las técnicas serológicas disminuyó la incidencia de infección por virus de hepatitis C después de una transfusión. En México, las pacientes que se transfundieron antes de 1994 están en riesgo de presentar una infección por virus de hepatitis C. El objetivo de este estudio fue medir la asociación entre el antecedente transfusional antes de 1994 e infección por virus de hepatitis C en mujeres atendidas en la zona metropolitana de Guadalajara, México.

Efecto del extracto etanólico de las hojas de Annona muricata L (guanábana) sobre Síndrome metabólico inducido en ratas / Effect of ethanolic extract of the leaves of Annona muricata L (soursop) on metabolic syndrome induced in rats

Objetivo: Evaluar el efecto del extracto etanólico de hojas de guanábana (EEA) administrado en ratas con síndrome metabólico experimental. Materiales y Métodos: Estudio Experimental. 90 ratas machos de 2 meses, cepa Holtzmann de 175±25g de peso fueron divididos en nueve grupos: I) normal (Suero salino fisiológico-SSF-2mL/kg); II) EEA 200mg/kg; III) 200mg/kg de colesterol y 100mg/kg de fructosa (CF) para inducción de síndrome metabólico (SM); IV-VI) CF + EEA 50, 100 y 200mg/kg respectivamente; VII) CF + atorvastatina 20mg/kg; VIII) CF + enalapril 20mg/kg; IX) CF + enalapril 20mg/kg + atorvastatina 20mg/kg. corporal. Estos grupos fueron intervenidos por 90 días, donde se midieron: peso corporal (g), niveles de glicemia (mg/dL), hemoglobina glicosilada (HbA1c), presión arterial (mmHg) y perfil lipídico (Colesterol total, triglicéridos, HDL-c y LDL-c en mg/dL). Resultados: Se encontraron diferencias significativas en comparación, en los valores de glicemia (-23.9 mg/ml; IC95%: -36.7 a -11.0), HbA1c (-0.8%; IC95%: -1.2 a -0.4) y Triglicéridos (-68.1; IC95% -96.0 a -40.1) en la dosis de EEAM 200mg/kg en comparación con el grupo III. La dosis de 100mg/kg logró presiones arteriales: sistólica (-6.8 mmHg; IC95%: -17.5 a 3.9, p=0.397), diastólica (-3.9 mmHg; IC95%: -14.0 a 6.2, p=0.861) y media (-9.9 mmHg; IC95%: -31.1 a 11.3, p=0.720); parecidas al grupo I. Asimismo, esta dosis logró diferencias en colesterol total (-57.6 mg/dl; IC 95% -75.7 a -39.4) y LDL-c (-56.5 mg/dl; IC 95% -75.7 a -37.3) en comparación con el grupo III. Conclusiones: El extracto etanólico de las hojas de Annona muricata L. (guanábana) a dosis de 200 mg/Kg mostró un mejor efecto ante la inducción de síndrome metabólico experimental.

Efecto preventivo del extracto etanólico de las hojas de Annona muricata L. (guanábana) sobre el síndrome metabólico inducido en ratas / Preventive effect of the ethanol extract of the leaves of Annona muricata L. (soursop) on the metabolic syndrome induced in rats

Introducción: Annona muricata L. (Guanábana), planta medicinal con diversos beneficios terapéuticos. Objetivos: Evaluar el efecto preventivo del extracto etanólico de hojas de guanábana (EEA) administrado en ratas con síndrome metabólico. Diseño: Experimental, Pre-clínico, "In vivo". Lugar: Laboratorio de Farmacología Experimental, Facultad de Medicina Humana-UNMSM, Lima, Perú. Material biológico: Hojas de guanábana, ratas machos de 2 meses, cepa Holtzmann de 175±25g. Intervenciones: La mezcla de colesterol 200mg/kg y fructosa 1000 mg/día (CF) indujo la patología concomitantemente se administró (EEA) por un periodo de 90 días. Noventa animales fueron divididos en nueve grupos: 1) normal (SSF 2mL/kg); 2) EEA 200mg/kg; 3) CF 200mg/kg; 4- 6) CF + EEA 50, 100 y 200mg/kg respectivamente; 7) CF + atorvastatina 20mg/kg; 8) CF + enalapril 20mg/kg; 9) CF + enalapril 20mg/kg + atorvastatina 20mg/kg. Principales medidas de resultado: peso corporal (g), niveles de glicemia (mg/dL), presión arterial (mmHg) y colesterol (mg/dL). Resultados: Hubo mejor disminución del peso corporal en 10.2 por ciento; glicemia y HbA1c en 21.5 por ciento en ambas a 200mg/kg (p<0.0001); disminuyo la presión sistólica (35.7 por ciento), diastólica (34.9 por ciento) y media (37 por ciento) a 100mg/kg (p<0.0001); el colesterol bajo (35.4 por ciento) y el HDL aumento (28.7 por ciento) ambos con 100mg/kg (p<0.0001). Conclusiones: El extracto etanólico de las hojas de Annona muricata L. (Guanábana) mostro el efecto preventivo del síndrome metabólico inducido en ratas por colesterol más fructosa.

Introduction: Annona muricata L (Soursop) is a medicinal plant that is attributed many therapeutic benefits. Objective: To evaluate preventive effect of ethanolic extract from leaves of soursop (EEA) administered in rats with metabolic syndrome. Design: Experimental, Pre-clinic, "in vivo". Setting: Laboratory of Experimental Pharmacology, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biological Material: Soursop leaves, male rats of two months, Holtzman strain of 175 ± 25g. Interventions: The mixture cholesterol 200 mg/kg and fructose 1000mg/day (CF) induced pathology was co-administered (EEA) for 90 days. Ninety animals were divided into nine groups: 1) normal (SSF 2mL/kg); 2) EEA 200mg/kg; 3) CF 200mg/kg; 4-6) CF + EEA 50, 100 y 200mg/kg respectively; 7) CF + atorvastatin 20mg/kg; 8) CF + enalapril 20mg/kg; 9) CF + enalapril 20mg/kg + atorvastatin 20 mg/kg. Main outcome measures: body weight (g), glycemic levels (mg/dL), blood pressure (mmHg) and cholesterol (mg/dL). Results: There was better decrease of body weight in 10.2 per cent; blood glucose and HbA1c in 21.5 per cent both 200mg/kg (p<0.0001); decreased systolic blood pressure (35.7 per cent), diastolic (34.9 per cent) and medium (37 per cent) to 100mg/kg (p<0.0001); low cholesterol (35.4 per cent) and; increase HDL (28.7 per cent) both with 100mg/kg (p<0.0001). Conclusions: The ethanolic extract of the leaves of A. muricata L (soursop) showed the preventive effect in rats developing the metabolic syndrome in rats induced by fructose more cholesterol.

Polymorphisms in the genes related to angiogenesis are associated with uterine cervical cancer.

INTRODUCTION: The expression of plasminogen activator inhibitor type 1 (PAI-1), vascular endothelial growth factor (VEGF), and transforming growth factor ß1 (TGF-ß1) participates in the angiogenesis of several cancer types. The goal of this study was to investigate polymorphisms in genes related to angiogenesis (PAI-1-675 4G/5G, VEGF C936T, and TGF-ß1 G-800A) to evaluate the risk for developing uterine cervical cancer (UCC). METHODS: In a case-control study, 100 healthy subjects and 100 patients with UCC from Mexico were included. We determined the genetic profile of the polymorphic markers, which were evaluated by polymerase chain reaction using a sequence-specific primer. RESULTS: There was no statistical difference in the allele distribution from the intergroup comparisons of PAI-1 675 4G/5G and VEGF C936T data; however, a significant difference was observed within TGF-ß1 G-800A. The linkage disequilibrium analysis revealed that PAI-1 -675 4G and TGF-ß1 -800A pair-haplotype was in strong linkage disequilibrium with a significantly increased risk (odds ratio, 3.44; 95% confidence interval, 1.66-7.25) to UCC. CONCLUSIONS: The polymorphisms in the genes related to angiogenesis -675 4G/5G PAI-1 and G-800A TGF-ß1, segregated solely or combined, might contribute to the increased susceptibility to UCC in a Mexican population.

Treatment outcomes and prognostic factors in mexican patients with endometrial carcinoma with emphasis on patients receiving radiotherapy after surgery: an institutional perspective.

Aim. To analyze the clinical characteristics and treatment outcomes in patients with endometrial carcinoma treated in a Latin American institute with emphasis in patients receiving adjuvant radiotherapy. Methods. A total of 412 patients with endometrial carcinoma admitted to our hospital between 1998 and 2008 were evaluated, retrospectively. The mean age was 55 years (28-87). Two hundred seventy patients received RT following surgery. Stage distribution was as follows: 221 patients (54%) stage I, 86 patients (21%) stage II, and 103 patients (24.5%) stage III and 2 patients (0.5%) stage IVA. Results. Overall survival rate was 95% at 2 years, 84% at 5 years, and 79% at 10 years. By the end of followup, 338 patients (82%) were disease-free, and 13 (3%) were alive with disease. Univariate and multivariate analyses identified age, grade, serosal and adnexial involvement as significant predictors for overall survival. Conclusion. The results of our study suggests that early-stage, low-grade endometrial cancer with no risk factors should not receive external beam radiotherapy, intermediate risk patients should receive only vaginal vault brachytherapy, and the use of chemotherapy with radiotherapy for patients high-risk and advanced-stage carcinoma the addition of radiotherapy is associated with a better survival being an effective therapeutic option.

Differential regulation of immature articular cartilage compressive moduli and Poisson's ratios by in vitro stimulation with IGF-1 and TGF-beta1.

Mechanisms of articular cartilage growth and maturation have been elucidated by studying composition-function dynamics during in vivo development and in vitro culture with stimuli such as insulin-like growth factor-1 (IGF-1) and transforming growth factor-beta 1 (TGF-beta1). This study tested the hypothesis that IGF-1 and TGF-beta1 regulate immature cartilage compressive moduli and Poisson's ratios in a manner consistent with known effects on tensile properties. Bovine calf articular cartilage from superficial-articular (S) and middle-growth (M) regions were analyzed fresh or following culture in medium with IGF-1 or TGF-beta1. Mechanical properties in confined (CC) and unconfined (UCC) compression, cartilage matrix composition, and explant size were assessed. Culture with IGF-1 resulted in softening in CC and UCC, increased Poisson's ratios, substantially increased tissue volume, and accumulation of glycosaminoglycan (GAG) and collagen (COL). Culture with TGF-beta1 promoted maturational changes in the S layer, including stiffening in CC and UCC and increased concentrations of GAG, COL, and pyridinoline crosslinks (PYR), but little growth. Culture of M layer explants with TGF-beta1 was nearly homeostatic. Across treatment groups, compressive moduli in CC and UCC were positively related to GAG, COL, and PYR concentrations, while Poisson's ratios were negatively related to concentrations of these matrix components. Thus, IGF-1 and TGF-beta1 differentially regulate the compressive mechanical properties and size of immature articular cartilage in vitro. Prescribing tissue growth, maturation, or homeostasis by controlling the in vitro biochemical environment with such growth factors may have applications in cartilage repair and tissue engineering.