Qualitative evaluation of ferritin in serum samples by Raman spectroscopy and principal component analysis.

Iron molecule is of great importance in the synthesis of hemoglobin which is essential for oxygen transport. Iron levels are quantified by accurately high sensitivity tests, such as serum ferritin (SF). However, common studies to quantify SF are long and strenuous (~ 5 h), for example enzyme-linked immunosorbent assay (ELISA). In this paper, blood serum samples were analyzed by Raman spectroscopy (RS), and a computational analysis of spectra is proposed to detect differences in SF as an alternative procedure. Serum samples were obtained from 22 patients, 9 who were clinically diagnosed with anemia and 13 controls. Patients with anemia had low levels of SF (< 30 ng/ml), and a control group had levels between 30 and 500 ng/ml. The spectra obtained were conditioned with a baseline correction and smoothing, then evaluated by principal component analysis (PCA), and a predictive model was estimated by lineal discrimination analysis (LDA). The results showed a clear differentiation of the study groups by PCA, also 99.69% sensitivity and 100% specificity by LDA. This study suggest that Raman spectroscopy is a fast (~ 5 min) and a powerful tool capable to qualitative differentiate ferritin concentrations.

Strawberry polyphenols decrease oxidative stress in chronic diseases / Los polifenoles de la fresa disminuyen el estrés oxidativo en enfermedades crónicas.

Consumption of hypercaloric diets leads to increase of free fatty acids (FFA), pro-inflammatory cytokines and production of oxygen and nitrogen reactive species. These alterations induce oxidative and nitrosative stress causing dysfunction of tissues and consequently the development of chronic diseases. Therefore, it is important to decrease oxidative stress and thus preventing the development of these diseases. Strawberry has a lot of Vitamin C and polyphenols, compounds with excellent antioxidant properties, which may be an option for reducing oxidative stress and therefore to prevent the development of some diseases. Studies conducted in vitro in animal models and clinical studies support that this fruit can be a good alternative to reduce oxidative stress and thus reducing and/or preventing the development of diseases in humans.

El consumo de dietas hipercalóricas conlleva al aumento de ácidos grasos libres (AGL), citocinas proinflamatorias y producción de especies reactivas de oxígeno y de nitrógeno. Estas alteraciones inducen estrés oxidativo y nitrosativo que daña a los tejidos causando disfunción de los mismos y en consecuencia se pueden desarrollar enfermedades crónicas. Por lo tanto, es importante disminuir el estrés oxidativo y con ello prevenir el desarrollo de estas enfermedades. La fresa es un fruto rico en vitamina C y polifenoles, compuestos con excelentes propiedades antioxidantes, por lo que puede ser una opción para la disminución del estrés oxidativo y por lo tanto, para prevenir el desarrollo de algunas enfermedades. Los estudios realizados in vitro, en modelos animales y estudios clínicos sustentan que la fresa puede ser una buena alternativa para disminuir el estrés oxidativo y así atenuar y/o prevenir el desarrollo de enfermedades en el humano.

[Assessment of knowledge in Transfusional Medicine in residents in Bajío]. / Evaluación de conocimientos en Medicina Transfusional en médicos residentes del Bajío.

Background: Despite the existence of national and international guidelines, multiple studies show that the clinical use of blood components is not based on scientific evidence; this situation replicates, therefore it was necessary to apply an assessment tool in our medical unit. Objective: Assessment the knowledge in transfusion medicine in medical residents who have high requirements of blood hemocomponentes in Unidad Médica de Alta Especialidad Hospital de Especialidades No.1 Centro Médico Nacional Bajío. Material and methods: A descriptive cross-sectional study was designed, and through a validated test the knowledge in transfusional medicine of residents of the unit was evaluated. Results: 100 residents participated in the research, most of them from the anesthesiology department; as a result, the evaluation tool showed a "Fair" performance in 75% of the participants. No specialty achieved a "Satisfactory" result. Conclusions: The application of this tool is the first step to develop and implement strategies to reduce unjustified transfusions of blood components and thus continue to provide excellent care to beneficiaries, minimizing risks and optimizing institutional resources.

Introducción: a pesar de la existencia de guías tanto nacionales como internacionales, múltiples estudios han puesto de manifiesto que el uso clínico de hemocomponentes no está basado en la evidencia científica; esta situación se replica y es necesario modificarla. Por ello, se planteó aplicar una herramienta de evaluación de conocimientos en medicina transfusional para tal fin en nuestra unidad. Objetivo: evaluar el conocimiento sobre medicina transfusional en médicos residentes de las especialidades con más demandas de hemocomponentes del Hospital de Especialidades No.1 del Centro Médico Nacional Bajío. Material y métodos: se diseñó un estudio transversal descriptivo y, por medio de un examen validado, se evaluó el conocimiento en medicina transfusional de médicos residentes de las especialidades que indican el mayor número de transfusiones en la unidad. Resultados: se contó con la participación de 100 residentes; la mayor participación fue de la especialidad de Anestesiología. El 75% de los participantes obtuvieron un desempeño "Regular" en la herramienta de evaluación. Ninguna especialidad alcanzó un resultado "Satisfactorio". Conclusiones: la aplicación de esta herramienta es el primer paso para desarrollar e implementar estrategias que permitan disminuir las transfusiones de hemocomponentes injustificadas y de esta manera seguir brindando una atención de excelencia a los derechohabientes, minimizando riesgos y optimizando recursos institucionales.

[Aggressive multifocal extensive cutaneous epithelioid haemagioendothelioma. A case report]. / Hemangioendotelioma epitelioide cutáneo extenso multifocal agresivo. Informe de un caso.

Epithelioid haemangioendothelioma is a rare vascular tumor, first described in 1975 by Dail and Liebow as a bronchioloalveolar carcinoma. Although it usually behaves like a low-grade neoplasm, cases have been reported in which the tumor shows a high grade of malignancy, spreading rapidly throughout the body. We present the case of a 41-year-old man with dermatosis in the left thigh with rapid extension to the abdomen; the initial differential diagnoses were metastatic carcinoma versus lymphoma. When the histopathology was re-examined, a diagnosis of skin epithelioid hemangioendothelioma was confirmed and treatment with radiotherapy was initiated. This tumour rarely affects the skin; there are only a few previously reported cases.

Recovery Of Bone And Muscle Mass In Patients With Chronic Kidney Disease And Iron Overload On Hemodialysis And Taking Combined Supplementation With Curcumin And Resveratrol.

INTRODUCTION: Malnutrition is common in haemodialysis patients and closely related to morbidity and mortality. We evaluated the effect of twelve weeks of supplementation with resveratrol and curcumin on recovery of bone and muscle mass and protein oxidation, lipid peroxidation on patients with chronic kidney disease and iron overload undergoing hemodialysis, we performed a randomized, double-blind, placebo-controlled trial. METHODS: We included a total of 40 patients, were randomly assigned to two groups, 20 to the group with antioxidant supplementation (Resveratrol + Curcumin) (Group A), treated with a daily oral dose of 500 mg of Resveratrol and 500 mg of Curcumin, and 20 to the control group treated with placebo (Group B). RESULTS: Significant differences were found in the body composition of the patients between both groups. There was a significant difference in Body Mass Index (BMI) values (p = 0.002), fat percentage (p = 0.007), muscle mass (p = 0.01) bone mass (p = 0.01), as well as in the score of the subjective global evaluation (p = 0.03). Also differences were found between the basal and final serum levels of Triglycerides (TG) (p = 0.01), VLDL (p = 0.003). A significant decrease in the levels of serum ferritin (2003.69 ± 518.73 vs 1795.65 ± 519.00 ng/mL; p = 0.04). Nor were significant differences observed between the baseline and the final Thiobarbituric Acid Reactive Substances (TBARS) values (70.45 ± 69.21 vs 50.19 ± 32.62, p = 0.24). The same results was obtained for carbonyl values (2.67 ± 0.75 vs 2.50 ± 0.85; p = 0.50). DISCUSSION: The present study is the first assay on patients with chronic kidney disease and iron overload that demonstrates the beneficial effects of combined supplementation with Curcumin and Resveratrol on muscle and bone mass. There was a significant decrease in circulating levels of ferritin, to finding that remarkably novel.

Improvement of diastolic function after regression of left ventricular hypertrophy.

OBJECTIVE: To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic. METHODS: Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure < or =90 and systolic blood pressure < or =140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months. RESULTS: Sixty-three patients were women and 35 were men, mean age was 53.4 +/- 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 +/- 13 to 137 +/- 12.9 mm Hg (p<0.05) and diastolic pressure from 99 +/- 8.6 to 86 +/- 6.37 mm Hg (p<0.05). LV mass index decreased from 155.4 +/- 32.9 to 121.7 +/- 29.14 g/m2 (p<0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p<0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment. CONCLUSIONS: Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.

Improvement of diastolic function after regression of left ventricular hypertrophy / Mejora de la función diastólica tras regresión de la hipertrofia ventricular izquierda

OBJECTIVE: To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic. METHODS: Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure < or =90 and systolic blood pressure < or =140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months. RESULTS: Sixty-three patients were women and 35 were men, mean age was 53.4 +/- 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 +/- 13 to 137 +/- 12.9 mm Hg (p<0.05) and diastolic pressure from 99 +/- 8.6 to 86 +/- 6.37 mm Hg (p<0.05). LV mass index decreased from 155.4 +/- 32.9 to 121.7 +/- 29.14 g/m2 (p<0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p<0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment. CONCLUSIONS: Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.

Pentalogía de Cantrell: actualización y nuevas perspectivas / Pentalogy of Cantrell: update and new perspectives

La pentalogía de Cantrell es una enfermedad rara, con características clínicas, anatómicas y embriológicas peculiares. Esta entidad es una variedad toracoabdominal de la ectopia cordis en la que se asocian cinco anomalías: defecto epigástrico de la línea media abdominal supraumbilical, defecto del tercio inferior del esternón, deficiencia del segmento anterior del diafragma, defectos pericárdicos y malformaciones cardíacas congénitas. La comunicación interventricular e interauricular se encuentra en la mitad de los casos y puede asociarse a otras anomalías extracardíacas como espina bífida, diversas malformaciones del sistema nervioso central, divertículo de Meckel, poliesplenia, entre otros. El diagnóstico se hace mediante ultrasonografía fetal en el primer trimestre de la gestación; en casos incompletos la tomografía helicoidal y la resonancia magnética complementan el diagnóstico. El tratamiento es quirúrgico y en varias etapas, lo primordial es proteger las vísceras expuestas y corregir la cardiopatía congénita. Los resultados aún son controversiales. El pronóstico de la enfermedad depende de la extensión del defecto, el diagnóstico temprano y el manejo perioperatorio. Nosotros consideramos que la pentalogía de Cantrell es una enfermedad compleja en la que es necesaria la intervención multidisciplinaria del equipo de salud para llegar al diagnóstico preciso y decidir el mejor tratamiento.

The pentalogy of Cantrell is a rare disease, with uniqueclinical, anatomical and embryological characteristics. This disease is a thoraco-abdominal variety of ectopia cordis. Five anomalies are associated: epigastric defect of theover umbilical abdominal mean line, defect of inferiorbreastbone third, defect of the anterior segment of the diaphragm, pericardial defects and congenital cardiac malformations. Ventricular septal defect and atrial septal defects are in half of the cases and it could be associatedto other extra cardiac anomalies as bifid spine, several malformations of central nervous system, meckeldiverticulum and polispleenia, among others. The diagnosis is made by fetal ultrasonography in the first trimesterof pregnancy. In incomplete cases, helical tomography and magnetic resonance imaging complete the diagnosis.The treatment is surgical and is carried out in severalstages. It is fundamental to protect the exposed viscera and to correct the congenital heart disease. The results still are controversial. The prognosis of the disease depends on the defect extension, time of diagnosis and peri-operative handling. We considered that the pentalogyof Cantrell is a complex pathology. A multidisciplinary health team intervention is necessary to reacha precise diagnosis and to decide the best treatment.