Effects on structure by spectroscopic investigations, valence state and morphology properties of FeCo-containing SnO2 catalysts for glycerol valorization to cyclic acetals.

The effects on the structure, valence state and morphological properties of FeCo-containing SnO2 nanostructured solids were investigated. The physicochemical features were tuned by distinct synthesis routes e.g., sol-gel, coprecipitation and nanocasting, to apply them as catalysts in the glycerol valorization to cyclic acetals. Based on Mössbauer and XPS spectroscopy results, all nanosized FeCoSn solids have Fe-based phases, which contain Co and Sn included in the structure, and well-dispersed Fe3+ and Fe2+ surface active sites. Raman, FTIR and EPR spectroscopies measurements of the spent solids demonstrated structural stability for the sol-gel based solid, which is indeed responsible for the highest catalytic performance, among the nanocasted and coprecipitated counterparts. Morphological and elemental analyses illustrated distinct morphologies and composition on solid surface, depending on the synthesis route. The Fe/Co and Fe/Sn surface ratios are closely related to the catalytic performance. The improved glycerol conversion and selectivities of the solid obtained by sol-gel method was ascribed to the leaching resistance and the Sn action as a structural promoter.

Effect of retrograded starch with different amylose content on the rheological properties of stored yogurt.

Resistant starch (RS) promotes health benefits; however, when added to foods, it could change the rheological properties. The effect of adding different concentrations (2.5, 5, 7.5, and 10%) of retrograded corn starch with 27% (RNS) or 70% (RHS) amylose content on the properties of yogurt was evaluated through measurements of flow behavior and gel structure. Syneresis and resistant starch content were also assessed. Results were analyzed using multiple regression to describe the effect of starch concentration and storage time on the properties of yogurt added with RNS or RHS. Syneresis was reduced, RNS reinforced the structure increasing the water absorption capacity and the consistency index; meanwhile, RHS provided a yogurt containing up to 10 g of RS in 100 g of sample, allowing obtaining a functional dairy product. Creep-recovery test showed that adding RNS or RHS favored the matrix conformation, and the yogurt samples were able to recover. The final product behaved like a solid material with a firmer and more stable gel structure, resulting in a strengthened gel without weakening the yogurt structure, showing a characteristic like Greek-style or stirred yogurt depending on the type and concentration of retrograded starch. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05735-x.

Systemic Steroids for Otolaryngology-Head and Neck Surgery Disorders: An Evidence-Based Primer for Clinicians.

OBJECTIVE: To offer pragmatic, evidence-informed guidance on the use of systemic corticosteroids (SCS) for common otolaryngologic disorders. DATA SOURCES: PubMed, Cochrane Library, and American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guidelines. REVIEW METHODS: A comprehensive search of published literature through November 2021 was conducted on the efficacy of SCS, alone or in combination with other treatments, for managing disorders in otolaryngology and the subdisciplines. Clinical practice guidelines, systematic reviews, and randomized controlled trials, when available, were preferentially retrieved. Interventions and outcomes of SCS use were compiled to generate summary tables and narrative synthesis of findings. CONCLUSIONS: Evidence on the effectiveness of SCS varies widely across otolaryngology disorders. High-level evidence supports SCS use for Bell's palsy, sinonasal polyposis, and lower airway disease. Conversely, evidence is weak or absent for upper respiratory tract infection, eustachian tube dysfunction, benign paroxysmal positional vertigo, adenotonsillar hypertrophy, or nonallergic rhinitis. Evidence is indeterminate for acute laryngitis, acute pharyngitis, acute sinusitis, angioedema, chronic rhinosinusitis without polyps, Ménière's disease, postviral olfactory loss, postoperative nerve paresis/paralysis, facial pain, and sudden sensorineural hearing loss. IMPLICATIONS FOR PRACTICE: Clinicians should bring an evidence-informed lens to SCS prescribing to best counsel patients regarding the risks, anticipated benefits, and limited data on long-term effects. Alternate routes of corticosteroid administration-such as sprays, drops, inhalers, and intralesional injections-may be preferable for many disorders, particularly those that are self-limited or require a prolonged duration of therapy. Prudent use of SCS reduces the risk of medication-related adverse effects. Clinicians who are conversant with high-level evidence can achieve optimal outcomes and stewardship when prescribing SCS.

Microperimetry assessment in foveal hypoplasia: functional results in a series of pediatric patients.

OBJECTIVE: To study the relationships of functional and morphologic retinal parameters in a series of pediatric patients with varying degrees of foveal hypoplasia (FH). DESIGN: Monocentric observational retrospective study. PARTICIPANTS: Among 21 pediatric patients, 16 met inclusion criteria, having FH confirmed with spectral-domain optical coherence tomography (SD-OCT) scan METHODS: Data were analyzed retrospectively. Patients able to undergo macular microperimetry (MP) and SD-OCT examinations were included in the analysis. MP and SD-OCT outcomes were compared with FH grading and best-corrected visual acuity (BCVA) using Pearson's correlation. RESULTS: Thirty-one eyes from 16 patients (mean age 12.4 years) with different degrees of FH were analyzed. Two patients had grade 1, 7 had grade 2, 5 had grade 3, and 2 had grade 4 FH. Clinical nystagmus was present in 8 patients. The correlation between BCVA and SD-OCT data (-0.31) was lower than that found between BCVA and nystagmus (0.64), that for fixation index P1 (-0.60), as well as that for macular sensitivity (-0.63). CONCLUSIONS: Although limited by the small sample, our study confirms the feasibility of automated MP evaluation in pediatric patients with FH. The added value of this work is the provision of data on relationships between anatomic and functional macular measurements acquired with SD-OCT, MP, and BCVA in eyes with various degrees of FH. Larger prospective studies are necessary to confirm these results.

Factors and Practices Associated with Self-Medicating Children among Mexican Parents.

BACKGROUND: Pediatric self-medication is based on the subjective interpretation of symptoms in children by the mother or an adult, the decision to self-medicate is made by a third party. The objective of this work is to provide information on the factors and practices associated with the self-medication of children among parents in Mexico. METHODS: A cross-sectional and descriptive study was conducted between June 2020 and December 2021 on Mexican parents with children under 12 years of age. Online questionnaires were completed with sections on sociodemographic characteristics, use of medicines or medicinal plants and their treated symptoms, sources of collection, and their recommendation. RESULTS: A total of 9905 online surveys were completed with representation from the 32 states of Mexico, and the prevalence of self-medication was 49.6% (n = 4908). Associated factors were age, having two or more children, children with chronic illnesses, medium educational level, unemployment or employment unrelated to health, medium and high socioeconomic level, and lack of medical security. Respondents self-medicated their children on the recommendation of a family member or friend (55.8%), and own initiative (28%). The most used medication was VapoRub (61.3%), followed by paracetamol (56.9%) and chamomile (33.1%), and the most prevalent symptoms were flu/flow (47.7%) followed by cough (34.2%). The main reasons were perceiving symptoms as not serious (69.9%) and reusing medications (51.9%). CONCLUSIONS: There is a high prevalence of self-medication in children in Mexico, mainly associated with children with chronic diseases and families with three or more children.

Guía de práctica clínica para el diagnóstico y el tratamiento de la otitis media aguda en niños.

BACKGROUND: Acute otitis media (AOM) is one of the most prevalent acute conditions in the pediatric population worldwide. This work aimed to elaborate a Clinical Practice Guideline with clinical recommendations systematically developed to assist decision-making of specialists, patients, caregivers, and public policymakers involved in managing patients with AOM in children. METHODS: This document was developed by the College of Pediatric Otorhinolaryngology and Head, and Neck Surgery of Mexico (COPEME) in compliance with international standards. The SIGN quality of evidence classification was used. On behalf of the COPEME, the Guideline Development Group (GDG) was integrated, including otolaryngologists, infectologists, pediatricians, general practitioners, and methodologists with experience in systematic literature reviews and the development of clinical practice guidelines. RESULTS: A consensus was reached on 18 clinical questions, covering what was previously established by the GDG in the scope document of the guidelines. Scientific evidence answering each of these clinical questions was identified and critically evaluated. The GDG agreed on the final wording of the clinical recommendations using the modified Delphi panel technique. Specialists and patient representatives conducted an external validation. CONCLUSIONS: This Clinical Practice Guideline presents clinical recommendations for the prevention, diagnosis, and management of AOM to assist shared decision-making among physicians, patients, and caregivers and improve the quality of clinical care.

INTRODUCCIÓN: La otitis media aguda (OMA) es uno de los padecimientos agudos más prevalentes en la población pediátrica a escala global. El objetivo de este trabajo fue elaborar una guía de práctica clínica con recomendaciones para asistir la toma de decisiones de médicos especialistas, pacientes, cuidadores de pacientes y elaboradores de políticas públicas involucrados en el manejo de la OMA en niños. MÉTODOS: El documento ha sido desarrollado por parte del Colegio de Otorrinolaringología y Cirugía de Cabeza y Cuello Pediátricas de México (COPEME) en cumplimiento con los estándares internacionales. Se empleó la clasificación de calidad de la evidencia de SIGN. En representación del COPEME, se integró el Grupo de Desarrollo de la Guía (GDG), que incluyó otorrinolaringólogos, infectólogos, pediatras, médicos generales y metodólogos con experiencia en revisiones sistemáticas de la literatura y el desarrollo de guías de práctica clínica. RESULTADOS: Se consensuaron 18 preguntas clínicas que abarcaron lo establecido previamente por el GDG en el documento de alcances de la Guía. Se identificó la evidencia científica que responde a cada una de estas preguntas clínicas y se evaluó críticamente. El GDG acordó la redacción final de las recomendaciones clínicas mediante la técnica Delphi de panel. Se llevó a cabo una validación externa por colegas especialistas y representantes de pacientes. CONCLUSIONES: En esta Guía de Práctica Clínica se presentan recomendaciones clínicas para la prevención, el diagnóstico y el manejo de la OMA, con el fin de asistir la toma de decisiones compartidas entre médicos, pacientes y cuidadores con la intención de contribuir a mejorar la calidad de la atención clínica.

Clinical practice guideline for the prevention and management of hypertensive disorders of pregnancy / Guía de práctica clínica para la prevención y el manejo de la enfermedad hipertensiva del embarazo

Objectives: To provide clinical recommendations based on evidence for the the prevention and management of HDP in EsSalud. Methods: A CPG for the the prevention and management of HDP in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and­when it was considered pertinent­primary studies were searched in PubMed y Central during 2021. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice and flowcharts for the prevention, management and follow-up. Finally, the CPG was approved with Resolution 112-IETSI-ESSALUD-2021. Results: This CPG addressed 8 clinical questions, divided into three topics: prevention, management and follow-up of the HDP. Based on these questions, 11 recommendations (6 strong recommendations and 5 weak recommendations), 32 points of good clinical practice, and 3 flowcharts were formulated. Conclusions: The main recommendations in the guideline are the use of magnesium sulfate for the treatment of severe pre-eclampsia and eclampsia. The guideline must be updated in three years' time.

Objetivos: proveer recomendaciones clínicas basadas en evidencia para la prevención y el manejo de la enfermedad hipertensiva del embarazo EHE en EsSalud. Materiales y métodos: se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló ocho preguntas clínicas para ser respondidas por la presente Guía de Práctica Clínica (GPC). Se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando se consideró pertinente, estudios primarios en PubMed y Central durante 2021. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología. En reuniones de trabajo periódicas, el GEG usó la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE) para calificar la evidencia y formular las recomendaciones. Además se resentan los puntos de buenas prácticas clínicas (BPC) y los flujogramas de prevención, manejo y seguimiento. Finalmente, la GPC fue aprobada por Resolución 112-IETSI-ESSALUD-2021. Resultados: en la presente GPC se formularon 11 recomendaciones (6 fuertes y 5 condicionales) que respondieron las preguntas clínicas definidas en el alcance de la GPC, acompañadas de 32 BPC y 3 flujogramas que abordan temas de prevención tratamiento y seguimiento de la EHE Conclusiones: como recomendaciones centrales de la guía se dan el uso de sulfato de magnesio para el tratamiento de la preeclampsia severa y la eclampsia. La guía deberá ser actualizada en tres años.

Novel 2-aryl-4-aryloxyquinoline-based fungistatics for Mucor circinelloides. Biological evaluation of activity, QSAR and docking study.

Zygomycetes are ubiquitous saprophytes in natural environments which transform organic matter. Some zygomycetes of gender Mucor have attracted interest in health sector. Due to its ability as opportunistic microorganisms infecting immuno-compromised people and to the few available pharmacological treatments, the mucormycosis is receiving worldwide attention. Concerning to the pharmacological treatments, some triazole-based compounds such as fluconazole are extensively used. Nevertheless, we focused in the quinolines since they are broadly used models for the design and development of new synthetic antifungal agents. In this study, the fungistatic activity on M. circinelloides of various 2-aryl-4-aryloxyquinoline-based compounds was discovered, and in some cases, it resulted better than reference compound fluconazole. These quinoline derivatives were synthesized via the Csp2-O bond formation using diaryliodonium(III) salts chemistry. A QSAR study was carried out to quantitatively correlate the chemical structure of the tested compounds with their biological activity. Also, a docking study to identify a plausible action target of our more active quinolines was carried out. The results highlighted an increased activity with the fluorine- and nitro-containing derivatives. In light of the few mucormycosis pharmacological treatments, herein we present some non-described molecules with excellent in vitro activities and potential use in the mucormycosis treatment.

Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica.

ANTECEDENTES: Las enfermedades cardiovasculares son la principal causa mundial de mortalidad y México no es la excepción. Los datos epidemiológicos obtenidos en 1990 mostraron que los padecimientos cardiovasculares representaron el 19.8% de todas las causas de muerte en nuestro país; esta cifra se incrementó de manera significativa a un 25.5% para 2015. Diversas encuestas nacionales sugieren que más del 60% de la población adulta tiene al menos un factor de riesgo para padecer enfermedades cardiovasculares (obesidad o sobrepeso, hipertensión, tabaquismo, diabetes, dislipidemias). Por otro lado, datos de la Organización Panamericana de la Salud han relacionado el proceso de aterosclerosis como la primer causa de muerte prematura, reduciendo la expectativa de vida de manera sensible, lo que tiene una enorme repercusión social. OBJETIVO: Este documento constituye la guía de práctica clínica (GPC) elaborada por iniciativa de la Sociedad Mexicana de Cardiología en colaboración con la Sociedad Mexicana de Nutrición y Endocrinología, A.C., Asociación Nacional de Cardiólogos de México, A.C., Asociación Mexicana para la Prevención de la Aterosclerosis y sus Complicaciones, A.C., Comité Normativo Nacional de Medicina General, A.C., Colegio Nacional de Medicina Geriátrica, A.C., Colegio de Medicina Interna de México, A.C., Sociedad Mexicana de Angiología y Cirugía Vascular y Endovenosa, A.C., Instituto Mexicano de Investigaciones Nefrológicas, A.C. y la Academia Mexicana de Neurología, A.C.; con el apoyo metodológico de la Agencia Iberoamericana de Desarrollo y Evaluación de Tecnologías en Salud, con la finalidad de establecer recomendaciones basadas en la mejor evidencia disponible y consensuadas por un grupo interdisciplinario de expertos. El objetivo de este documento es el de brindar recomendaciones basadas en evidencia para ayudar a los tomadores de decisión en el diagnóstico y tratamiento de las dislipidemias en nuestro país. MATERIAL Y MÉTODOS: Este documento cumple con estándares internacionales de calidad, como los descritos por el Instituto de Medicina de EE.UU., el Instituto de Excelencia Clínica de Gran Bretaña, la Red Colegiada para el Desarrollo de Guías de Escocia y la Red Internacional de Guías de Práctica Clínica. Se integró un grupo multidisciplinario de expertos clínicos y metodólogos con experiencia en revisiones sistemáticas de la literatura y el desarrollo de guías de práctica clínica. Se consensuó un documento de alcances, se establecieron las preguntas clínicas relevantes, se identificó de manera exhaustiva la mejor evidencia disponible evaluada críticamente en revisiones sistemáticas de la literatura y se desarrollaron las recomendaciones clínicas. Se utilizó la metodología de Panel Delphi modificado para lograr un nivel de consenso adecuado en cada una de las recomendaciones contenidas en esta GPC. RESULTADOS: Se consensuaron 23 preguntas clínicas que dieron origen a sus respectivas recomendaciones clínicas. CONCLUSIONES: Esperamos que este documento contribuya a la mejor toma de decisiones clínicas y se convierta en un punto de referencia para los clínicos y pacientes en el manejo de las dislipidemias y esto contribuya a disminuir la morbilidad y mortalidad derivada de los eventos cardiovasculares ateroscleróticos en nuestro país. BACKGROUND: Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions. OBJECTIVE: This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country. MATERIAL AND METHODS: This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG. RESULTS: 23 clinical questions were agreed upon which gave rise to their respective clinical recommendations. CONCLUSIONS: We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.

Anatomical-functional concordance of microperimetry and the simplified age-related macular degeneration study classification: A pilot study.

PURPOSE: The principal aim of this pilot study was to investigate the concordance between the different stages of Age-Related Macular Degeneration (AMD), as determined by the simplified classification of the Age Related Eye Disease Study Group (AREDS), and new evaluation criteria using a microperimetry system. METHODS: A complete eye examination and a microperimetry MAIATM (Macular Integrity Assessment, CenterVue, Padova, Italy) examination was performed on 59 eyes with early, intermediate or advanced AMD. We analysed 19 evaluation criteria for every clinical group category. RESULTS: There were 20 female and 12 male participants included with a median age of 74 years (min: 54, max: 87). Thirteen eyes (22%) were classified as category 1, 11 eyes (18.6%) as category 2, 17 eyes (28.8%) as category 3 and 18 eyes (30.6%) as category 4 AMD.All evaluated microperimetry criteria related to retinal sensitivity were found to have a statistically significant difference among the stages (p < 0.05). Fixation stability was unstable in 55.6% of the eyes classified as stage 4 (p = 0.001). The analysis of the distance between the two PRLs - PRL_initial and PRL_final was larger for the stage 4 (p = 0.0258). The mean sensitivity in stages 2 and 3 correlated with the presence or not of reticular pseudodrusen (p = 0.0137). CONCLUSIONS: The mean sensitivity and the categorized sensitivity (set to 25, 15 and 5 dB), the five higher and lower stimuli sensitivity appeared to be the most sensitive criteria to differentiate the four AMD categories. Microperimetry provides a new reproducible method of anatomical-functional macular analysis.

Guía de práctica clínica para el diagnóstico y el tratamiento de la otitis media aguda en niños / Clinical practice guidelines for diagnosis and management of acute otitis media in children

Resumen Introducción: La otitis media aguda (OMA) es uno de los padecimientos agudos más prevalentes en la población pediátrica a escala global. El objetivo de este trabajo fue elaborar una guía de práctica clínica con recomendaciones para asistir la toma de decisiones de médicos especialistas, pacientes, cuidadores de pacientes y elaboradores de políticas públicas involucrados en el manejo de la OMA en niños. Métodos: El documento ha sido desarrollado por parte del Colegio de Otorrinolaringología y Cirugía de Cabeza y Cuello Pediátricas de México (COPEME) en cumplimiento con los estándares internacionales. Se empleó la clasificación de calidad de la evidencia de SIGN. En representación del COPEME, se integró el Grupo de Desarrollo de la Guía (GDG), que incluyó otorrinolaringólogos, infectólogos, pediatras, médicos generales y metodólogos con experiencia en revisiones sistemáticas de la literatura y el desarrollo de guías de práctica clínica. Resultados: Se consensuaron 18 preguntas clínicas que abarcaron lo establecido previamente por el GDG en el documento de alcances de la Guía. Se identificó la evidencia científica que responde a cada una de estas preguntas clínicas y se evaluó críticamente. El GDG acordó la redacción final de las recomendaciones clínicas mediante la técnica Delphi de panel. Se llevó a cabo una validación externa por colegas especialistas y representantes de pacientes. Conclusiones: En esta Guía de Práctica Clínica se presentan recomendaciones clínicas para la prevención, el diagnóstico y el manejo de la OMA, con el fin de asistir la toma de decisiones compartidas entre médicos, pacientes y cuidadores con la intención de contribuir a mejorar la calidad de la atención clínica.

Abstract Background: Acute otitis media (AOM) is one of the most prevalent acute conditions in the pediatric population worldwide. This work aimed to elaborate a Clinical Practice Guideline with clinical recommendations systematically developed to assist decision-making of specialists, patients, caregivers, and public policymakers involved in managing patients with AOM in children. Methods: This document was developed by the College of Pediatric Otorhinolaryngology and Head, and Neck Surgery of Mexico (COPEME) in compliance with international standards. The SIGN quality of evidence classification was used. On behalf of the COPEME, the Guideline Development Group (GDG) was integrated, including otolaryngologists, infectologists, pediatricians, general practitioners, and methodologists with experience in systematic literature reviews and the development of clinical practice guidelines. Results: A consensus was reached on 18 clinical questions, covering what was previously established by the GDG in the scope document of the guidelines. Scientific evidence answering each of these clinical questions was identified and critically evaluated. The GDG agreed on the final wording of the clinical recommendations using the modified Delphi panel technique. Specialists and patient representatives conducted an external validation. Conclusions: This Clinical Practice Guideline presents clinical recommendations for the prevention, diagnosis, and management of AOM to assist shared decision-making among physicians, patients, and caregivers and improve the quality of clinical care.

Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica / Mexican clinical practice guideline for the diagnosis and treatment of dyslipidemias and atherosclerotic cardiovascular disease

resumen está disponible en el texto completo

Abstract Background: Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions. Objective: This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country. Material and methods: This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG. Results: 23 clinical questions were agreed upon which gave rise to their respective clinical recommendations. Conclusions: We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.

[Prevalence of blood eosinophilia in adults with COPD according to the cut-off point]. / Prevalencia de eosinofilia en sangre en adultos con EPOC según el punto de corte.

OBJECTIVE: To determine the prevalence of blood eosinophilia in adults with chronic obstructive pulmonary disease (COPD) according to different cut-off points. METHODS: A cross-sectional study was carried out in patients with COPD. The frequency of blood eosinophilia was determined by absolute (cells/ µL) and relative (%) eosinophil count. Multivariate methods were used in order to identify the associated factors. RESULTS: 81 patients were included; the mean age was 71.9 ± 9.8 years; 46 (57%) of the patients were men. The prevalence of eosinophilia for the cut-off points of ≥ 100, ≥ 150, ≥ 200, ≥ 300, and ≥ 400 cells/µL was of 64.2%, 37.0%, 16.1%, and 9.9% respectively. Out of 81 patients, 34 (42%) had a relative eosinophil concentration of ≥ 2%; 21 (25.9%) ≥ 3%; 14 patients (17.3%) had ≥ 4%; and 10 patients (12.3%) had ≥ 5%. Eosinophilia of ≥ 100 cells/µL was associated with age of ≥ 80 years (OR = 6.04, p = 0.026), and with the exacerbation of COPD (OR = 9.40, p = 0.038); in contrast, eosinophilia of ≥ 2% was associated only with age of ≥ 80 years (OR = 3.73, p = 0.020). In addition, the eosinophil count of ≥ 100 and < 300 cells/µL was associated with the exacerbation of COPD (OR = 11.00, p = 0.026). CONCLUSIONS: Our results suggest that the frequency of eosinophilia in the context of COPD shows substantial variations according to the used definition.

Objetivo: Establecer la prevalencia de eosinofilia en sangre en adultos con enfermedad pulmonar obstructiva crónica (EPOC) según varios puntos de corte. Métodos: Se realizó un estudio transversal en pacientes con EPOC. La frecuencia de eosinofilia en sangre se determinó a partir de la concentración absoluta (células/µL) y relativa (%) de eosinófilos. Fueron realizados modelos multivariados para identificar factores asociados. Resultados: En 81 pacientes incluidos, la edad promedio fue de 71.9 ± 9.8 años; de los cuales, 46 (57 %) fueron hombres. La prevalencia de eosinofilia para los puntos de corte ≥ 100, ≥ 150, ≥ 200, ≥ 300 y ≥ 400 células/µL fue de 64.2, 43.2, 37.0, 16.1 y 9.9 %, respectivamente. De 81 pacientes, 34 (42 %) tuvieron una concentración ≥ 2 %; 21 (25.9 %) ≥ 3 %; 14 (17.3 %) ≥ 4 %; y 10 (12.3 %) ≥ 5 %. La eosinofilia ≥ 100 células/µL se asoció con la edad ≥ 80 años (RM = 6.04, p = 0.026) y con la exacerbación de la EPOC (RM = 9.40, p = 0.038); en cambio, la eosinofilia ≥ 2 %, lo hizo con solamente la edad ≥ 80 años (RM = 3.73, p = 0.020). Complementariamente, la concentración de eosinófilos ≥ 100 y < 300 células/µL se asoció con la exacerbación de la EPOC (RM = 11.00, p = 0.026). Conclusiones: Nuestros resultados sugieren que la frecuencia de eosinofilia en EPOC muestra variaciones sustanciales según la definición adoptada.

Current Practices and Challenges in the Diagnosis and Management of PKU in Latin America: A Multicenter Survey.

This study aimed to describe the current practices in the diagnosis and dietary management of phenylketonuria (PKU) in Latin America, as well as the main barriers to treatment. We developed a 44-item online survey aimed at health professionals. After a pilot test, the final version was sent to 25 practitioners working with inborn errors of metabolism (IEM) in 14 countries. Our results include 22 centers in 13 countries. Most countries (12/13) screened newborns for PKU. Phenylalanine (Phe) targets at different ages were very heterogeneous among centers, with greater consistency at the 0-1 year age group (14/22 sought 120-240 µmol/L) and the lowest at >12 years (10 targets reported). Most countries had only unflavored powdered amino acid substitutes (10/13) and did not have low-protein foods (8/13). Only 3/13 countries had regional databases of the Phe content of foods, and only 4/22 centers had nutrient analysis software. The perceived obstacles to treatment were: low purchasing power (62%), limited/insufficient availability of low-protein foods (60%), poor adherence, and lack of technical resources to manage the diet (50% each). We observed a heterogeneous scenario in the dietary management of PKU, and most countries experienced a lack of dietary resources for both patients and health professionals.

Use of herbal medicine for diabetes mellitus in adults from the central-western region of Mexico.

OBJECTIVE: This study aims to assess the prevalence of herbal medicine (HM) use and factors influencing HM usage including the identification of the main plants consumed by patients with type 2 diabetes mellitus (T2DM) in central-western Mexico. DESIGN: A total of 1862 patients with diabetes were surveyed in public and private hospitals in four states (Guanajuato, Jalisco, Michoacan, and San Luis Potosi) of the central-western region of Mexico. The chi-square test was used to assess associations between HM use and demographic characteristics, such as glucose levels, presence of complications and comorbidities, as well as the selected therapy to treat T2DM. RESULTS: The prevalence of HM use (59.2%) in patients with T2DM was mainly associated with education level (p = 0.001), time of diagnosis of T2DM (p = 0.004), presence of complications (p < 0.001) and comorbidities (p = 0.018) and the use of insulin (p < 0.001). These patients report a higher consumption of herbal medicine compared to those on glycemic control (p < 0.001). The most frequently used medicinal plants to treat T2DM were nopal (54.9%), moringa (26.7%), and aloe (22.1%). CONCLUSION: The prevalence of HM use to treat T2DM in west-central Mexico is high (59.2%) and its consumption is mostly carried out without the recommendation of a health professional (91.9%). The use of HM increases mainly when the patient uses insulin, during complications of the disease or in patients with an inadequate glycemic control.

Evaluation of antiplasmodial activity and cytotoxicity assays of amino acids functionalized magnetite nanoparticles: Hyperthermia and flow cytometry applications.

We report the synthesis of magnetite nanoparticles (MNP) and their functionalization with glycine (MNPGly), ß-alanine (MNPAla), L-phenylalanine (MNPPhAla), D-(-)-α-phenylglycine (MNPPhGly) amino acids. The functionalized nanoparticles were characterized by Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD), electron paramagnetic resonance (EPR), vibrating sample magnetometry (VSM), Mössbauer spectroscopy (MS), magnetic hyperthermia (MH), dynamic light scattering and zeta potential. The functionalized nanoparticles had isoelectric points (IEP) at pH ≃ 4.4, 5.8, 5.9 and 6.8 for samples MNPGly, MNPAla, MNPPhGly and MNPPhAla, respectively, while pure magnetite had an IEP at pH 5.6. In the MH experiments, the samples showed specific absorption rate (SAR) of 64, 71, 74, 81 and 66 W/g for MNP, MNPGly, MNPAla, MNPPhGly, and MNPPhAla, respectively. We used a flow cytometric technique to determine the cellular magnetic nanoparticles plus amino acids content. Magnetic fractionation and characterization of Resovist® magnetic nanoparticles were performed for applications in magnetic particle imaging (MPI). We have also studied the antiproliferative and antiparasitic effects of functionalized MNPs. Overall, the data showed that the functionalized nanoparticles have great potential for using as environmental, antitumor, antiparasitic agents and clinical applications.

Phosphate removal from food industry wastewater by chemical precipitation treatment with biocalcium eggshell.

The physicochemical treatment (PT) of food industry wastewater was investigated. In the first stage, calcium magnesium acetate (CaMgAc4) was synthesized using eggshell (biocalcium), magnesium oxide and acetic acid in a 1:1:1 stoichiometric ratio. In the synthesis process, the thermodynamic parameters (ΔH, ΔS and ΔG) indicated that the reaction was endothermic and spontaneous. The samples were characterized by infrared spectroscopy (IR), scanning electronic microscopy (SEM), X-ray diffraction (XRD) and electron X-ray dispersive spectroscopy (EDS). CaMgAc4 was used to precipitate the phosphate matter. IR analysis revealed that the main functional groups were representative of the acetate compounds and the presence of OH- groups and carbonates. In the physicochemical treatment, a response surface design was used to determine the variables that influence the process (pH, t, and concentration), and the response variable was phosphorus removal. The treatments were carried out in the wastewater industry with an initial concentration of 658 mg/L TP. The optimal conditions of the precipitation treatment were pH 12, time 12 min, and a CaMgAc4 concentration of 13.18 mg/L. These conditions allowed the total elimination (100%) of total phosphorus and phosphates, 81.43% BOD5 and 81.0% COD, 98.9% turbidity, 95.01% color, and 92% nitrogen matter.

Self-treatment and adverse reactions with herbal products for treating symptoms associated with anxiety and depression in adults from the central-western region of Mexico during the Covid-19 pandemic.

ETHNOPHARMACOLOGICAL RELEVANCE: There are plant species used in the Mexican traditional medicine for the empirical treatment of anxiety and depression. AIM OF THE STUDY: This work assessed the prevalence of self-medication with medicinal plants and the prevalence of the concomitant use of prescribed psychiatric drugs and medicinal plants for treating symptoms associated with anxiety and depression during the Covid-19 lockdown in Mexico. MATERIALS AND METHODS: The suspected adverse reactions associated with drug-herb interactions were assessed. The factors associated with self-medication, the concomitant use of herb-drug combinations, and the presence of adverse reactions due their combined use is also reported. The study was descriptive and cross-sectional using an online questionnaire conducted among population with symptoms associated with anxiety and depression (n = 2100) from seven states of central-western Mexico. RESULTS: The prevalence of the use of herbs (61.9%) and the concomitant use of drug-herb combinations (25.3%) were associated with being diagnosed with mental illness [OR:2.195 (1.655-2.912)] and the use of psychiatric medications [OR:307.994 (178.609-531.107)], respectively. The presence of adverse reactions (n = 104) by the concomitant use of drug-herb combinations was associated with being unemployed [p = 0.004, OR: 3.017 (1.404-6.486)]. CONCLUSION: Health professionals should be aware if their patients concomitantly use medicinal plants and psychiatric drugs. Public health campaigns should promote the possible adverse reactions that might produce the concomitant use of drug-herb combinations for mental illnesses.

The efficacy of biofeedback visual rehabilitation therapy in patients with infantile nystagmus syndrome: A retrospective study.

OBJECTIVE: To report fixation stability changes in patients with different forms of infantile nystagmus syndrome (INS), who have undergone a visual rehabilitation through biofeedback fixation training (BFT) with microperimetry (MP). DESIGN: Retrospective study. METHODS: Patients 6 to 12 years-old with INS who performed BFT with MP. Initially 10 once-weekly followed by eight twice-weekly sessions of BFT during a minimum of 6 months period were performed. Visual acuity (VA) and MP fixation stability indices were analyzed, including displacement from fixation point (P1, P2) and percentage of retinal loci used during fixation attempt (BCEA 63% and 95%). Statistical analysis was conducted at baseline (BL), 10 weeks (W10) and 6 months (M6). RESULTS: Twelve patients (mean age 8.9 years.) with INS completed the whole training session. All patients showed significant improvement in the mean BCEA fixation area (deg2): For BCEA@95% BL was 78.0, 46.1 at W10, and 27.4 at M6 (p-value = 0.004). For BCEA@63% BL was 27.3, 15.4 in W10, and 9.17 at M6 (p = 0.01). The ANOVA test for the FS indices of P1 and P2, as well as for BCVA showed no significant difference when compared at the same intervals. CONCLUSION: Fixation stability (FS) indices of BCEAs (63% and 95%) improved at W10 and M6, while P1 and P2 showed significant improvement at W10 but not at M6, probably because BCEA involves a much larger area than P1 and P2. VA did not show significant improvement at any time point.

Cashew gum as a sol-gel precursor for green synthesis of nanostructured Ni and Co ferrites.

The aim of this work consists in the use of cashew gum (Anacardium occidentale), a naturally occurring tropical specie from the Brazilian northeastern coast, for the synthesis of CoFe2O4 (CF) and NiFe2O4 (NF) nanoparticles. The structural, morphological and vibrational properties of nanoparticles were characterized by analytical and spectroscopic techniques such as X-ray diffraction (XRD), FTIR, Raman spectroscopy, TEM, SAED and TG. Magnetic properties were investigated through Mössbauer spectroscopy and DC magnetometry. The XRD results showed single phase nanoparticles with space group Fd-3m and crystallite size of 7.4 and 6.0 for CF and NF, respectively. TEM images showed agglomerated particles with mode sizes of 5.0 and 6.5 nm for CF and NF. SAED confirmed the crystalline spinel structure. The TGA and FTIR showed the presence of a carbonaceous material in the samples. FTIR and Raman spectroscopy demonstrated vibrational modes characteristic of metal­oxygen bonds in the tetrahedral and octahedral sites. Magnetization measurements showed that both samples are superparamagnetic at 300 K. The Mössbauer spectra at 90 K showed the presence of single-phase CF and NF.