Association Between Changes in Sleep, Nap Duration and Bone Mineral Density in Mexican Adults.

Studies have found associations between sleep, nap duration, and bone mineral density (BMD). However, the longitudinal relationship between sleep, nap duration, and BMD has not been explored. We evaluated the association between the change in sleep and nap duration and BMD in Mexican adults. Data come from 1,337 adult participants of the Health Workers Cohort Study (341 were men and 996 were women, including 450 women < 45 years old and 546 ≥ 45 years old), with two study waves. At each wave, sleep and nap duration was assessed using self-administered questionnaires and BMD in g/cm2 was determined by dual X-ray absorptiometry. We used fixed-effect regression models stratified by sex and adjusted for BMI, diet, physical activity, vitamin supplements, and hormone replacement therapy. Women who changed from < 7 to ≥ 7 h/day of sleep from baseline to follow-up were associated with increases in the total hip (ß = 0.012 g/cm2; 95% CI: 0.002, 0.022) and lumbar spine BMD (ß = 0.024 g/cm2; 95% CI: 0.009, 0.039). Furthermore, most of these associations were observed in women ≥ 45 years. For women, a changing from 0 to > 60 min/day of napping was associated with a significant increase in total hip BMD of 0.012 g/cm2 (95% CI: 0.004, 0.024) and lumbar spine BMD of 0.027 g/cm2 (95% CI: 0.009, 0.045). No significant associations were observed for men. Our results suggest that increased sleep and nap duration are associated with gains in BMD in Mexican women, emphasizing sleep's role in promoting bone health and supporting established recommendations.

Isolation of Primary Human Decidual Cells from the Fetal Membranes of Term Placentae.

The maternal decidua is a transient and dynamic tissue that functions as an immunoprivileged matrix related to nutritional and endocrine processes. The function of decidual cells is key to the success of embryo implantation and the maintenance of pregnancy with a positive maternal-fetal outcome. Therefore, establishing a method to optimize the isolation of primary decidual cells is essential. Our protocol described here provides a good yield of decidual cells in an optimized time.

Performance of urine samples compared to cervical samples for detection of precancer lesions among HPV-positive women attending colposcopy clinic in Mexico City.

BACKGROUND: High-risk human papillomavirus (hrHPV) detection in self-collected urine samples (SeCUS) may be a promising alternative for cervical cancer screening because of its greater acceptability, as long as it can offer comparable sensitivity to clinician-collected cervical samples (CCoS) for detecting precancer lesions. OBJECTIVE: To evaluate the performance of the SeCUS compared to that of the CCoS for cervical intraepithelial neoplasia grade 3 (CIN3) detection among hrHPV-positive women receiving colposcopy in Mexico City using different specific extended HPV typing procedures: HPV16/18, HPV16/18/35/39/68 or HPV16/18/35/39/68/31. METHODS: From March 2017 to August 2018, 4,158 female users of the cervical cancer screening program at Tlalpan Sanitary Jurisdiction in Mexico City were invited to participate in the FRIDA-Tlalpan study. All participants provided ≥ 30 mL of SeCUS, and then a CCoS was obtained with Cervex-Brush®, which was used for hrHPV typing. Participants who tested positive for hrHPV in CCoS were referred for colposcopy for diagnostic confirmation, and all SeCUS of these women were also tested for hrHPV typing. RESULTS: In total, 561 hrHPV-positive women were identified by CCoS via colposcopy, and 82.2% of the SeCUS of these women were also hrHPV positive. From both CCoS and SeCUS, 7 cases of CIN3 were detected. Considering HPV16/18 typing, CCoS and SeCUS detected 4 cases of CIN3, but after HPV16/18/35/39/68/31 extension typing, both CCoS and SeCUS detected all 7 of the CIN3 cases among the hrHPV-positive women. CONCLUSIONS: Using extended hrHPV typing based on HPV16/18/35/39/68/31, our results suggest that the performance of SeCUS may be equivalent to that of CCoS for detecting CIN3 lesions. Although our results are inconclusive, they support the hypothesis that SeCUS may be an attractive alternative worthy of further research.

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Tlaxcala, Mexico.

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widely recognised as two prevalent sexually transmitted infections that can have detrimental effects on women's reproductive health. Previous research has concentrated on studying high-risk populations, resulting in limited epidemiological data regarding the general population. Therefore, the objective of this study was to estimate the prevalence of CT and NG among women attending public primary health care in Tlaxcala, Mexico. The study sample included 2,396 women already participating in the cervical cancer screening programme, from July to November 2014. After obtaining informed consent, the CT and NG tests were conducted on cervical samples, using a nucleic acid amplification test. We estimate the prevalence with 95% confidence intervals (CIs). Women who tested positive were promptly notified and provided with appropriate treatment. In our study population, CT and NG prevalences were 3.2 (95% CI: 2.6-4.0) and 0.01 (95% CI: 0.01-0.03), respectively. CT prevalence was higher in younger women (age < 40), although the results indicate a low prevalence; due to the potentially significant impact of CT and NG on women's health, we require adequate surveillance, and guaranteeing rapid referral to the correct treatment is a priority for the control of these diseases.

Clinical Performance of hrHPV Primary Screening Using Vaginal versus Cervical Samples to Detect High-grade Intraepithelial Lesions.

High-risk human papillomavirus (hrHPV) testing is now the most recommended primary method for cervical cancer screening worldwide. Clinician-collected cervical sampling continues to be the main sampling method, but hrHPV vaginal self-sampling is an appealing alternative because of its greater acceptability and potentially higher cost-effectiveness. This study aimed to determine whether hrHPV vaginal self-sampling is comparable with clinician-collected cervical sampling for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN2/3) as part of a cervical cancer screening program in Mexico. We analyzed data from 5,856 women screened during a hrHPV-based screening study. Clinical performance and diagnostic efficiency metrics were estimated for the two sampling methods for the CIN3 and CIN2+ endpoints, using three triage strategies: HPV16/18 genotyping, HPV16/18/33/58 extended genotyping, and HPV16/18/31/33/58 extended genotyping. hrHPV-positivity was found in 801 (13.7%) cervical and 897 (15.3%) vaginal samples. All women with hrHPV-positive samples were referred to colposcopy, which detected 17 total CIN3 cases before considering retrospective triage strategies. Using the HPV16/18/31/33/58 extended genotyping strategy, 245 women had hrHPV-positive cervical samples and 269 had hrHPV-positive vaginal samples. Ten CIN3 cases were detected each among women with hrHPV-positive cervical samples and among those with hrHPV-positive vaginal samples when using this strategy, with no significant differences in sensitivity and specificity observed. We observe that self- and clinician-collected sampling methods are comparable for detecting CIN3 and CIN2+ regardless of the triage strategy used. These findings can help public health officials to develop more cost-effective cervical cancer screening programs that maximize participation. PREVENTION RELEVANCE: We found that hrHPV vaginal self-sampling is comparable with hrHPV clinician cervical sampling when using any triage strategy to refer women to colposcopy, so self-sampling is a viable cervical screening method. Therefore, policymakers should consider incorporating self-sampling into cervical screening programs to increase screening coverage and reduce cervical cancer burden. See related Spotlight, p. 649.

Estrategias no farmacológicas para el manejo del dolor en pacientes en terapia de diálisis

Contexto: el manejo del dolor es una de las prioridades en la atención en salud y para tratarlo se debe trabajar de forma interdisciplinaria y así brindar a los pacientes las mejores opciones para su calidad de vida. Objetivo: esta investigación tiene como objetivo identificar el impacto de estrategias no farmacológicas para el manejo del dolor en pacientes que toman terapia de diálisis en una unidad renal Bogotá. Metodología: esta es una investigación piloto cuasiexperimental que cuenta con la participación de 11 pacientes que respondieron el inventario breve acerca del dolor y asistieron a las capacitaciones de manejo del dolor. Los datos se analizaron con el paquete estadístico SPSS versión 24. Resultados: se encuentra impacto en los ítems de "peor dolor en las últimas 24 horas" y "disfrute de la vida", según las mediciones pre y pos de las capacitaciones de manejo del dolor cuando los pacientes perciben el dolor más bajo, además de considerar una menor influencia del dolor en el disfrute de la vida. Conclusiones: las estrategias no farmacológicas tienen un impacto en aspectos de la calidad de vida de los pacientes en terapia de reemplazo renal. La capacitación en manejo del dolor con estrategias no farmacológicas son seguras, no invasivas y de bajo costo, incluso realizándolas de manera virtual.

Background: Pain management is one of the priorities in health care, work must be done in an interdisciplinary way to provide patients with better options for their quality of life. Purpose: This research aims to identify the impact of non-pharmacological strategies for pain management in patients receiving dialysis therapy in a Bogotá kidney unit. Methodology: It is a pilot investigation, quasi-experimental. It has the participation of 11 patients who respond to the brief pain inventory and attend pain management training. The data was analyzed with the statistical package SPSS version 24. Results: impact is found in the items of worst pain in the last 24 hours and enjoyment of life, according to pre and post measurements of pain management training, patients perceive lower pain, in addition to considering less influence of pain in the Enjoy life. Conclusions: Non-pharmacological strategies have an impact on aspects of the quality of life of patients undergoing renal replacement therapy. Training in pain management with non-pharmacological strategies is safe, non-invasive and low-cost, even carried out virtually.

Resistin Modulates Low-Density Lipoprotein Cholesterol Uptake in Human Placental Explants via PCSK9.

Maternal metabolic status influences pregnancy and, consequently, the perinatal outcome. Resistin is a pro-inflammatory adipokine predominantly expressed and secreted by mononuclear cells, adipose tissue, and placental trophoblastic cells during pregnancy. Recently, we reported an inverse association between maternal resistin levels and fetal low-density lipoprotein cholesterol (LDL-C). Then, in this work, we used a human placental explant model and the trophoblast cell line JEG-3 to evaluate whether resistin affects placental LDL-C uptake. Resistin exposure induced the transcription factor SREBP-2, LDLR, and PCSK9 mRNA expression, and changes at the protein level were confirmed by immunohistochemistry and Western blot. However, for LDLR, the changes were not consistent between mRNA and protein levels. Using a labeled LDL-cholesterol (BODIPY FL LDL), uptake assay demonstrated that the LDL-C was significantly decreased in placental explants exposed to a high dose of resistin and a lesser extent in JEG-3 cells. In summary, resistin induces PCSK9 expression in placental explants and JEG-3 cells, which could be related to negative regulation of the LDLR by lysosomal degradation. These findings suggest that resistin may significantly regulate the LDL-C uptake and transport from the maternal circulation to the fetus, affecting its growth and lipid profile.

Mitochondrial DNA Copy Number Adaptation as a Biological Response Derived from an Earthquake at Intrauterine Stage.

An altered mitochondrial DNA copy number (mtDNAcn) at birth can be a marker of increased disease susceptibility later in life. Gestational exposure to acute stress, such as that derived from the earthquake experienced on 19 September 2017 in Mexico City, could be associated with changes in mtDNAcn at birth. Our study used data from the OBESO (Biochemical and Epigenetic Origins of Overweight and Obesity) perinatal cohort in Mexico City. We compared the mtDNAcn in the umbilical cord blood of 22 infants born before the earthquake, 24 infants whose mothers were pregnant at the time of the earthquake (exposed), and 37 who were conceived after the earthquake (post-earthquake). We quantified mtDNAcn by quantitative real-time polymerase chain reaction normalized with a nuclear gene. We used a linear model adjusted by maternal age, body mass index, socioeconomic status, perceived stress, and pregnancy comorbidities. Compared to non-exposed newborns (mean ± SD mtDNAcn: 0.740 ± 0.161), exposed and post-earthquake newborns (mtDNAcn: 0.899 ± 0.156 and 0.995 ± 0.169, respectively) had increased mtDNAcn, p = 0.001. The findings of this study point at mtDNAcn as a potential biological marker of acute stress and suggest that experiencing an earthquake during pregnancy or before gestation can have programing effects in the unborn child. Long-term follow-up of newborns to women who experience stress prenatally, particularly that derived from a natural disaster, is warranted.

Gestational Weight Gain Influences the Adipokine-Oxidative Stress Association during Pregnancy.

INTRODUCTION AND OBJECTIVE: The weight gained during pregnancy could determine the immediate and future health of the mother-child dyad. Excessive gestational weight gain (EGWG) due to abnormal adipose tissue (AT) accumulation is strongly associated with adverse perinatal outcomes as gestational diabetes, macrosomia, obesity, and hypertension further in life. Dysregulation of adipokine, AT dysfunction, and an imbalance in the prooxidant-antioxidant systems are critical features in altered AT accumulation. This study was aimed to investigate the association between adipokines and oxidative stress markers in pregnant women and the influence of the GWG on this association. METHODS: Maternal blood samples were obtained in the third trimester of pregnancy (n = 74) and serum adipokines (adiponectin, leptin, and resistin), oxidative damage markers: 8-oxo-2'-deoxyguanosine (8-oxodG), lipohydroperoxides (LOOH), malondialdehyde (MDA), and carbonylated proteins (CP), and glucose a metabolic marker were measured. RESULTS: Women with EGWG had low adiponectin levels than women with adequate weight gain (AWG) or insufficient weight gain (IWG). Multiple linear regression models revealed a positive association between adiponectin and 8-oxodG in women with AWG (B = 1.09, 95% CI: 164-222, p = 0.027) and IWG (B = 0.860, 95% CI: 0.199-1.52, p = 0.013) but not in women with EGWG. In women with EGWG, leptin was positively associated with LOOH (p = 0.018), MDA (p = 0.005), and CP (p = 0.010) oxidative markers. CONCLUSION: Our findings suggest that concurrent mechanisms regulate adipokine production and oxidative stress in pregnant women and that this regulation is influenced by GWG, probably due to an excessive AT accumulation.

High Plasmatic Levels of Advanced Glycation End Products are Associated with Metabolic Alterations and Insulin Resistance in Preeclamptic Women.

AIMS: The purpose of this study was to investigate the association between plasmatic levels of advanced end glycation products (AGEs) and the metabolic profile in subjects diagnosed with preeclampsia, due to the known relation of these molecules with oxidative stress and inflammation, which in turn are related with PE pathogenesis. BACKGROUND: It has been reported that increased levels of AGEs are observed in patients with preeclampsia as compared with healthy pregnant subjects, which was mainly associated with oxidative stress and inflammation. Besides, in women with preeclampsia, there are metabolic changes such as hyperinsulinemia, glucose intolerance, dyslipidemia, among others, that are associated with an exacerbated insulin resistance. Additionally, some parameters indicate the alteration of hepatic function, such as increased levels of liver enzymes. However, the relationship of levels of AGEs with altered lipidic, hepatic, and glucose metabolism parameters in preeclampsia has not been evaluated. OBJECTIVE: To investigate the association between plasmatic levels of AGEs and hepatic, lipid, and metabolic profiles in women diagnosed with preeclampsia. METHODS: Plasma levels of AGEs were determined by a competitive enzyme-linked immunosorbent assay (ELISA) in 15 patients diagnosed with preeclampsia and 28 normoevolutive pregnant subjects (control group). Hepatic (serum creatinine, gammaglutamyl transpeptidase, aspartate transaminase, alanine transaminase, uric acid, and lactate dehydrogenase), lipid (apolipoprotein A, apolipoprotein B, total cholesterol, triglycerides, low-density lipoproteins, and high-density lipoproteins), and metabolic variables (glucose, insulin, and insulin resistance) were assessed. RESULTS: Plasmatic levels of AGEs were significantly higher in patients with preeclampsia as compared with the control. A positive correlation between circulating levels of AGEs and gamma-glutamyl transpeptidase, uric acid, glucose, insulin, and HOMA-IR levels was found in patients with preeclampsia. In conclusion, circulating levels of AGEs were higher in patients with preeclampsia than those observed in healthy pregnant subjects. Besides, variables of hepatic and metabolic profile, particularly those related to insulin resistance, were higher in preeclampsia as compared with healthy pregnant subjects. Interestingly, there is a positive correlation between AGEs levels and insulin resistance. CONCLUSIONS: Circulating levels of AGEs were higher in patients with preeclampsia than those observed in healthy pregnant subjects. Besides, hepatic and metabolic profiles, particularly those related to insulin resistance, were higher in preeclampsia as compared with healthy pregnant subjects. Interestingly, there is a positive correlation between AGEs levels and insulin resistance, suggesting that excessive glycation and an impaired metabolic profile contribute to the physiopathology of preeclampsia.

Utilizing the radiometric and seismic methods for hydrocarbons prospecting in the Rancheria sub-basin in Colombia.

An onshore radiometric survey sampled in situ the isotopes U238, Th232, K40, and Rn222 to build maps of normalized values for each element containing negative and positive radiometric anomalies, which could associate with hydrocarbon deposits in the subsoil. The vertical migration of hydrocarbon, water or other gases would have generated the different isotope anomalies. In four 2D seismic sections of the study area, three on dip direction and another in strike direction, we interpreted unconformities, flooding surface, and maximum flooding surfaces, as well as Cretaceous tops. In structural contour maps made from aforementioned seismic sections, we observe structural highs and structures such as truncations of strata. These structures in-depth coincide with uranium, thorium, potassium and radon anomalies seen on the surface. This oil and gas exploration approach that integrates radiometric and emanometric integrated with seismic prospecting can help to reduce the risk in hydrocarbons projects (however, radiometric anomalies are not uniquely associated with hydrocarbons). This work shows a correlation between radiometric (uranium, thorium, and potassium) and emanometric (radon) data in the surface with structures in the subsurface suck like truncation, that could present hydrocarbon, however, on this sub-basin, there has not been found commercial hydrocarbon.

Effect of Nicotine on CYP2B1 Expression in a Glioma Animal Model and Analysis of CYP2B6 Expression in Pediatric Gliomas.

Cyclophosphamide (CPA) is a pro-drug commonly used in the chemotherapeutic schemes for glioma treatment but has high toxicity and the side effects include brain damage and even death. Since CPA is activated mainly by CY2B6, over-expression of the enzyme in the tumor cells has been proposed to enhance CPA activation. In this study, we explored the induction of the Cyp2b1 (homologous to CYP2B6) by nicotine in an animal rat model with glioma. Gene expression and protein levels were analyzed by RT-PCR and Western blot. Nicotine treatment increased CYP2B1 protein levels in the healthy animals' brain tissue. In the brain tissue of animals with glioma, the CYP2B1 showed a high expression, even before nicotine treatment. Nicotine did not increase significantly the CYP2B1 protein expression in the tumor, but increased its expression in the tumor vicinity, especially around blood vessels in the cortex. We also explored CY2B6 expression in glioma samples derived from pediatric patients. Tumor tissue showed a variable expression of the enzyme, which could depend on the tumor malignancy grade. Induction of the CYP2B6 in pediatric gliomas with lower expression of the enzyme, could be an alternative to improve the antitumoral effect of CPA treatment.

Aves del Santuario Nacional Tabaconas Namballe, vertiente oriental de los Andes del Norte Peruano / Birds of the National Sanctuary Tabaconas Namballe, eastern slope of the Peruvian Northern Andes

El Santuario Nacional Tabaconas Namballe (SNTN) se encuentra en el límite de distribución de muchas especies endémicas de los Andes del Norte, en un área amenazada por la deforestación y con muchos vacíos de información ornitológica. Reportamos una lista actualizada de la diversidad de aves del Santuario, así como de sus especies de interés de conservación. Para lo cual se evaluaron tres localidades representativas: Páramos, Chichilapa y El Sauce, durante la época seca (setiembre, octubre - 2014) y de lluvia (marzo, abril - 2015). Se aplicaron varios métodos complementarios: puntos de conteo, capturas con redes de niebla, transectos nocturnos y registros asistemáticos. Se registró 197 (40 familias) y 153 (39 familias) especies en época seca y de lluvia respectivamente, con un total de 226 especies y 42 familias. Para el listado final se incluyeron registros de un promedio de 45 cámaras trampa, operativas desde agosto 2014 hasta abril 2015, más registros concluyentes de evaluaciones ornitológicas previas. Este trabajo reporta 82 nuevos registros de aves para el Santuario, 7 de los cuales provienen de cámaras trampa. En este sentido, la diversidad total de aves del Santuario es 290 especies y 46 familias. Aparte de las 45 especies entre endémicos, amenazados y casi amenazados de extinción, se destaca el nuevo registro para la región Cajamarca la Perdiz Gris Tinamus tao. Los resultados encontrados sugieren que aún falta mucho por conocer sobre la diversidad de aves del Santuario; sin embargo, resalta el rol clave del área protegida para la conservación de aves de esta región

The Tabaconas Namballe National Sanctuary (TNNS) is located at the limit of distribution of many endemic species from the Northern Andes, in an area threatened by deforestation and with many gaps in ornithological information. We report an updated list of species of the Sanctuary, and identify those species of conservation concern. We sampled three representative sites: Páramos, Chichilapa and El Sauce, during the dry season (September-October in 2014) and rainy season (March-April in 2015). We employed several complementary methods: counting points, mist-nets, nocturnal transects and non-systematic records. We recorded 197 (40 families) and 153 (39 families) species in the dry and rainy seasons respectively, with a total of 226 species and 42 families. In order to get an updated checklist, we include records of an average of 45 trap cameras, operative from August 2014 to April 2015, and we compile conclusive records from previous ornithological assessments. This work reports 82 new records of birds of the Sanctuary, 7 of which come from camera traps. In this way, the bird diversity of the Sanctuary is 290 species and 46 families. In addition to the 45 species between endemic, threatened and near threatened with extinction, we highlight a new record from the region Cajamarca, the Gray Tinamou Tinamus tao. Our results suggest that there is still much to know about the diversity of birds in the Sanctuary, however, it highlights the key role of this protected area in terms of bird conservation in this region

[Heterotopic gastric mucosa in duodenum: endoscopic and histological features]. / Mucosa gástrica heterotópica en duodeno: características clínicas endoscópicas e histológicas.

OBJECTIVE: The aim of this study was characterized sin duodenum the heterotopic gastric mucosa. MATERIALS AND METHODS: The slides with the diagnosis of heterotopic gastric mucosa during 2014-2015, were reviewed, and clinical, histological and endoscopic data was to collected for every case. RESULTS: 45 cases of heterotopic gastric mucosa in duodenum were found, 91.1% were located in duodenum bulb and 73.2%, presenting as polyps in 73.2% of cases. In all cases, parietal cell was identified as main criteria for the diagnosis. Neither Helicobacter pylori nor dysplasia were identified. CONCLUSIONS: Our data confirm its non neoplastic nature. Heterotopic gastric mucosa should be taken into account in diagnosis of duodenal polyps. Parietal cells identification in duodenal mucosa is essential in differential diagnosis with peptic duodenitis.

Mucosa gástrica heterotópica en duodeno: características clínicas endoscópicas e histológicas / Heterotopic gastric mucosa in duodenum: endoscopic and histological features

Objetivo: Caracterizar la mucosa gástrica heterotópica en duodeno en nuestro medio. Materiales y métodos: Se seleccionaron dos instituciones, los casos de mucosa gástrica heterotópica que cumplieran los criterios histológicos establecidos para el diagnóstico durante los años 2014-2015. Las láminas con el diagnóstico de mucosa gástrica heterotópica en duodeno fueron revisadas por 3 patólogos, se recolectó información clínica, endoscópica e histológica en cada caso. Resultados: Se encontraron 45 casos de mucosa gástrica heterotópica en duodeno, 91,1% se localizaron en bulbo duodenal y 73,2% se presentaron endoscópicamente como pólipos. En todos los casos se identificó células parietales como criterio para hacer el diagnóstico histopatológico, en ningún caso se identificó Helicobacter pylori ni displasia en la biopsia duodenal. Conclusiones: Nuestros datos confirman su naturaleza benigna. El diagnóstico de mucosa gástrica heterotópica, aunque infrecuente, debe tenerse en cuenta en el estudio de pólipos duodenales, siendo la identificación de células parietales en mucosa duodenal fundamental para el diagnóstico diferencial histológico especialmente con la metaplasia gástrica de duodenitis péptica

Objective: The aim of this study was characterized sin duodenum the heterotopic gastric mucosa. Materials and methods: The slides with the diagnosis of heterotopic gastric mucosa during 2014-2015, were reviewed, and clinical, histological and endoscopic data was to collected for every case. Results: 45 cases of heterotopic gastric mucosa in duodenum were found, 91.1% were located in duodenum bulb and 73.2%, presenting as polyps in 73.2% of cases. In all cases, parietal cell was identified as main criteria for the diagnosis. Neither Helicobacter pylori nor dysplasia were identified. Conclusions: Our data confirm its non neoplastic nature. Heterotopic gastric mucosa should be taken into account in diagnosis of duodenal polyps. Parietal cells identification in duodenal mucosa is essential in differential diagnosis with peptic duodenitis

Decidualization Mediated by Steroid Hormones Modulates the Innate Immunity in Response to Group B Streptococcal Infection in vitro.

BACKGROUND: Decidual cells play a role in the modulation of the innate immune response to protect pregnancy against infection. Steroid hormones regulate the innate immune response in different tissues, and they are involved in several biological processes like decidualization. The aim of this study was to assess if steroid hormones modulate the innate immunity in endometrial stromal cells (ESCs) and decidual stromal cells (DSCs) in response to group B streptococcus (GBS) infection in vitro. METHODS: Primary cultures of ESC were differentiated into DSC using 36 nM estradiol + 300 nM progesterone, and both were infected with GBS overnight. Concentrations of pro- and anti-inflammatory mediators (interleukin [IL]-1ß, IL-6, tumor necrosis factor [TNF]-α, IL-10, and TGF-ß), chemokines (IL-8 and GCP-2), and human ß-defensins (HBD-1, HBD-2, and HBD-3) were measured in the culture supernatants. RESULTS: DSCs showed a significant increase in IL-6 (p < 0.05), TNF-α (p < 0.05), IL-10 (p < 0.01), and TGF-ß (p < 0.05) secretion after GBS infection, while these changes were not observed in infected ESCs. IL-8 and GCP-2 increased after GBS infection, regardless of decidualization. ß-Defensins 1-3 decreased (p < 0.05) in ESCs after GBS infection, and hormone decidualization preserved the secretion of these antimicrobial peptides. CONCLUSIONS: Decidualization mediated by steroid hormones balance the pro- and anti-inflammatory response at the maternal-fetal interface under infection conditions.

Maternal and Fetal Lipid and Adipokine Profiles and Their Association with Obesity.

Background. Maternal metabolic changes impact fetal metabolism resulting in a higher risk for developing chronic diseases later in life. The aim of this study was to assess the association between maternal and fetal adipokine and lipid profiles, as well as the influence of maternal weight on this association. Methods. Healthy pregnant women at term who delivered by C-section were enrolled. Maternal and fetal glucose, lipid profile, adiponectin, leptin, and resistin levels were analyzed by obesity and maternal weight gain. Statistics included descriptives, correlations, and mean differences (SPSS v20.0). Results. Adiponectin and resistin concentrations were higher in fetal blood, while leptin was lower (p < 0.05). A significant inverse association between maternal resistin and fetal LDL-cholesterol (LDL-C) (r = -0.327; p = 0.022) was observed. A positive correlation was found between maternal and fetal resistin (r = 0.358; p = 0.013). Women with excessive weight gain had higher leptin levels and their fetuses showed higher LDL-C levels (p < 0.05). Conclusions. Maternal resistin showed an inverse association with fetal LDL-C, suggesting that maternal adiposity status may play an active role in the regulation of fetal lipid profile and consequently, in fetal programming. Excessive maternal weight gain during pregnancy may exert an effect over metabolic mediators in both mother and newborn.

Matrix Metalloproteinase-3 (MMP-3) Is an Endogenous Activator of the MMP-9 Secreted by Placental Leukocytes: Implication in Human Labor.

BACKGROUND: The activity of matrix degrading enzymes plays a leading role in the rupture of the fetal membranes under normal and pathological human labor, and matrix metalloproteinase-9 (MMP-9) it is considered a biomarker of this event. To gain further insight into local MMP-9 origin and activation, in this study we analyzed the contribution of human placental leukocytes to MMP-9 secretion and explored the local mechanisms of the pro-enzyme activation. METHODS: Placental blood leukocytes were obtained from women at term gestation without labor and maintained in culture up to 72 h. MMP-9 activity in the culture supernatants was determined by zymography and using a specific substrate. The presence of a potential pro-MMP-9 activator in the culture supernatants was monitored using a recombinant biotin-labeled human pro-MMP-9. To characterize the endogenous pro-MMP-9 activator, MMP-1, -3, -7 and -9 were measured by multiplex assay in the supernatants, and an inhibition assay of MMP-9 activation was performed using an anti-human MMP-3 and a specific MMP-3 inhibitor. Finally, production of MMP-9 and MMP-3 in placental leukocytes obtained from term pregnancies with and without labor was assessed by immunofluorescence. RESULTS: Placental leukocytes spontaneously secreted pro-MMP-9 after 24 h of culture, increasing significantly at 48 h (P≤0.05), when the active form of MMP-9 was detected. Culture supernatants activated the recombinant pro-MMP-9 showing that placental leukocytes secrete the activator. A significant increase in MMP-3 secretion by placental leukocytes was observed since 48 h in culture (P≤0.05) and up to 72 h (P≤0.001), when concentration reached its maximum value. Specific activity of MMP-9 decreased significantly (P≤0.005) when an anti-MMP-3 antibody or a specific MMP-3 inhibitor were added to the culture media. Placental leukocytes from term labor produced more MMP-9 and MMP-3 compared to term non-labor cells. CONCLUSIONS: In this work we confirm that placental leukocytes from human term pregnancies are able to secrete large amounts of MMP-9, and that the production of the enzyme it is enhanced by labor. We also demonstrate for the first time that endogenous MMP-3 plays a major role in MMP-9 activation process. These findings support the contribution of placental leukocytes to create the collagenolytic microenvironment that induces the rupture of the fetal membranes during human labor.

Estrategia educativa para el cuidado domiciliario de los bebes prematuros: Madres usuarias del programa madre canguro de Tunja, Colombia / Educational strategy por home care of premature babies: mothers users of kangaroo mother program from Tunja, Colombia

Introducción: El objetivo de este estudio fue diseñar y aplicar una estrategia educativa sobre cuidados del RN en el hogar, con los componentes: contacto piel a piel, posición canguro, lactancia materna exclusiva, temperatura ideal y oxigenación ideal. Permitiendo identificar conocimientos y capacidades para cuidar a sus hijos. Se evidenció la necesidad de empoderar a las madres para que ofrecieran el cuidado a sus hijos en el hogar por medio de la Teoría de Mediano Rango de Kristen Swanson. Materiales y Métodos: Se diseñó y aplicó un formato de evaluación sobre conocimientos de componentes del PMC, a diez madres. Se realizó la intervención educativa, en varios etapas con demostraciones prácticas en talleres; detección de vacíos conceptuales y acompañamiento con intervenciones personalizadas. Resultados: Se encontró falta de conocimiento sobre los ítems básicos de posición del niño, contacto piel a piel, alimentación, manejo del oxígeno, evaluación de la temperatura y respiración, signos de alarma y beneficios del PMC. Se detectaron factores culturales y del sistema de salud como obstáculos para que las mamás asumieran compromisos para con el cuidado de los bebés. Discusión: El correcto desarrollo del PMC ambulatorio debe iniciar partiendo del diagnóstico de necesidades educativas relacionadas con el cuidado materno perinatal. El apoyo del profesional de enfermería, es fundamental para que las madres tengan seguridad y autonomía dentro del domicilio. Conclusión: El diseño de la estrategia educativa debe ser flexible, disponer de recursos humanos dedicados a capacitación individualizada, visitas de monitoreo y evaluación familiar, ya que contribuyen a afianzar el apoyo, disipar dudas, temores y en la correcta aplicación de las actividades prácticas del PMC.

Introduction: The Objective of this study was to make and to apply an educational strategy aimed at users of PMC mothers at the Hospital San Rafael in Tunja, about RN-care at home, according to the components: skin-to-skin, kangaroo position, exclusive breastfeeding, perfect temperature and perfect oxygenation. The mothers degree of compliance was taken into account, allowing to identify with a semi structured interview, the level of knowledge and skills that they had to care their preterm infants. Finally, we evaluated the level of knowledge and skills acquired by the mothers after receiving the training. Also we evidenced the need to empower mothers to care their children at home watching the Kangaroo Mother Program components through the Medium-Range Theory Kristen Swanson. Materials and Methods: We anticipated an experience that included the design and application of an evaluation form about knowledge of Kangaroo Mother Program components, PMC, to ten mothers, through semi structured interview; evaluation and observation in PMC techniques to determine the level of ability to children care at home. Educational intervention was performed in several stages: Training Group Activities about theoretical concepts, practical demonstrations in participatory workshops, semi-structured interviews, and conceptual gap detection was performed with accompaniment personalized interventions focused on motivation, reinforcement and retraining in the theoretical and practical PMC components. Results: The lack of structured knowledge on basic items child's position, skin to skin contact, food, oxygen management, evaluation of temperature and respiration, warning signs and benefits of PMC. All mothers met the PMC and its importance for child care but seven continued to feel fear to take the baby to home especially with oxygen. Cultural factors were detected and the health system was constituted obstacles for moms to make commitments for the care of babies. Discussion: The Kangaroo Mother Program in Hospital San Rafael in Tunja is considered viable because it is a strategy that meets the needs of population, and involves aspects of management commitment Breastfeeding Program, Programs Strategies to reduce infant mortality, and the accreditation of the Neonatology Service. Also reaffirms its viability to transcend in decreased readmissions, and long term, the decrease in neonatal mortality. The proper development of outpatient PMC should start based on the actual diagnosis related educational needs perinatal maternal care. The support of nurses to the mother in making decisions, it is essential for them to have security to develop the autonomy that can occur within the home. Conclusion: The design of the educational strategy for training purposes in PMC hospital should be flexible, allowing adjustments according to socioeconomic and cultural conditions, particularly levels of education, mother's age and parity; it was found that these factors influence the security, compliance and continuity of the PMC. The training group activities are effective mothers, but it is necessary to have resources dedicated to individualized training, to monitoring and evaluation visits in the family for feedback, as it helps develop family support, to dispel the doubts, fears, and in the correct application of the practical activities of the PMC.

Clinical impact of RehaCom software for cognitive rehabilitation of patients with acquired brain injury.

We describe the clinical impact of the RehaCom computerized cognitive training program instituted in the International Neurological Restoration Center for rehabilitation of brain injury patients. Fifty patients admitted from 2008 through 2010 were trained over 60 sessions. Attention and memory functions were assessed with a pre- and post-treatment design, using the Mini-Mental State Examination, Wechsler Memory Scale and Trail Making Test (Parts A and B). Negative effects were assessed, including mental fatigue, headache and eye irritation. The program's clinical usefulness was confirmed, with 100% of patients showing improved performance in trained functions.