[Related factors to lack of implementation of antenatal corticosteroids]. / Factores relacionados con la falta de aplicación de glucocorticoides antenatales.

BACKGROUND: Despite the known benefits of antenatal corticosteroids therapy its use in clinical practice is not generalized. OBJECTIVE: To identify factors related to antenatal corticosteroids non administration. METHODS: Cross-sectional and descriptive study that included patients admitted to Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", who had indication for antenatal corticosteroids therapy but did not receive it. Variables: antenatal corticosteroids therapy prescription, factors related to antenatal corticosteroids therapy non administration and lapsed time between diagnosis and birth. RESULTS: Antenatal corticosteroids therapy were not prescribed in 79 (94%) of 84 patients. Main related factors were imminent birth and severe maternal complication. The longer amount of time from diagnosis to birth was before hospitalization (91 vs. 9%, p <0.0005). CONCLUSION: The biggest and best opportunity for the administration of inducers of fetal lung maturity is during prenatal care, when cases with increased risk of preterm birth are detected.

[Effects of the use of 17 ß-estradiol and genistein in Alzheimer's disease in women with menopause]. / Efectos del uso del 17 ß-estradiol y la genisteína en la enfermedad de Alzheimer en mujeres con menopausia.

The use of 17 ß-estradiol and genistein in women with menopause helps in the reduction of vasomotor symptoms and cognitive improvement. There is evidence on the use of certain flavonoids such as genistein, which has a potentially neuroprotective role in neurodegenerative diseases such as Alzheimer's. Scientific evidence on the effects of phytoestrogens and genistein during menopause and their effect on cognition are scarce, however, in the present review it was found that the intervention with 17 ß-estradiol has positive effects on cognition in women with Alzheimer's disease. In addition, the use of genistein, daidzein or any supplement based on isoflavones may influence vasomotor symptoms. 17 ß-estradiol supplements in women in early menopause and with some degree of cognitive impairment may have beneficial effects.

Sequence logic at enhancers governs a dual mechanism of endodermal organ fate induction by FOXA pioneer factors.

FOXA pioneer transcription factors (TFs) associate with primed enhancers in endodermal organ precursors. Using a human stem cell model of pancreas differentiation, we here discover that only a subset of pancreatic enhancers is FOXA-primed, whereas the majority is unprimed and engages FOXA upon lineage induction. Primed enhancers are enriched for signal-dependent TF motifs and harbor abundant and strong FOXA motifs. Unprimed enhancers harbor fewer, more degenerate FOXA motifs, and FOXA recruitment to unprimed but not primed enhancers requires pancreatic TFs. Strengthening FOXA motifs at an unprimed enhancer near NKX6.1 renders FOXA recruitment pancreatic TF-independent, induces priming, and broadens the NKX6.1 expression domain. We make analogous observations about FOXA binding during hepatic and lung development. Our findings suggest a dual role for FOXA in endodermal organ development: first, FOXA facilitates signal-dependent lineage initiation via enhancer priming, and second, FOXA enforces organ cell type-specific gene expression via indirect recruitment by lineage-specific TFs.

Oral glutamine reduces myocardial damage after coronary revascularization under cardiopulmonary bypass. A randomized clinical trial.

BACKGROUND: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers. METHODS: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation. Patients were randomly assigned to receive oral glutamine (0.5 g/kg/day) or maltodextrin 3 days before surgery. Cardiac injury markers as troponin-I, creatine phosphokinase, and creatine phosphokinase-Mb were measured at 1, 12, and 24 hours postoperatively. RESULTS: At 12 and 24 hours serum markers levels were significantly lower in the glutamine group compared with controls (p = 0.01 and p = 0.001, respectively) (p = 0.004 and p < 0.001, respectively). Overall, complications were significantly lower in the glutamine group (p = 0.01, RR = 0.54, 95% CI 0.31-0.93). Mortality was observed with 2 cases of multiple organ failure in control group and 1 case of pulmonary embolism in glutamine group (p = 0.50). CONCLUSION: Preoperative oral glutamine standardized at a dose of 0.5 g/kg/day in our study group showed a significant reduction in postoperative myocardial damage. Lower cardiac injury markers levels, morbidity and mortality were observed in patients receiving glutamine.

Options for the Development of Noninvasive Glucose Monitoring: Is Nanotechnology an Option to Break the Boundaries?

Nowadays nanotechnology has many applications in products used in various areas of daily life; however, this technology has also an option in modern medicine and pharmacy. Therefore, this technology is also an attractive option for the field of diagnosis and treatment of diabetes. Many people with diabetes measure their blood glucose levels regularly to determine the insulin dose. Ideally glucose values would be measured noninvasively (NI). However, none of all the NI approaches studied in the past decades enabled reliable NI measurements under all daily life conditions. Particularly an unfavorable signal-to-noise ratio turned out to be problematic. Based on the known physical possibilities for NI glucose monitoring the focus of this review is on nanotechnology approaches. Functional prototypes exist for some of these that showed promising results under defined laboratory conditions, indicating a good sensitivity and selectivity for glucose. On the second hand is to optimize the technological process of manufacturing. In view of the rapid progress in micro- and nanoelectronics hopefully NI glucose monitoring systems can be developed in the near future.

Influencia del tipo de escuela (especial o regular) sobre el aprovechamiento académico del alumnado con necesidades educativas especiales / Influence of Type of School (Special or General) on the Achievement of Students with Special Educational Needs

Resumen En México, los niños con necesidades educativas especiales pueden educarse en escuelas regulares integradoras o en escuelas de educación especial (Centros de Atención Múltiple). En general, estos servicios promueven y apoyan el proceso de integración educativa. Sin embargo, existe poca evidencia sobre la posible influencia que ejercen sobre el aprovechamiento académico de los alumnos. En el presente estudio, se evaluó la influencia del tipo de escuela en 23 niños con necesidades educativas especiales, 12 de escuela regular y 11 de Centros de Atención Múltiple. Se aplicaron cinco pruebas de aprovechamiento académico de la Batería III Woodcock-Muñoz. Los resultados indican un mejor desempeño general y equivalentes de grado más acordes con la edad en alumnos de las escuelas regulares integradoras que los de Centros de Atención Múltiple, particularmente en alumnos que no presentan discapacidad. Sin embargo, de acuerdo con las normas de calificación, el rendimiento académico de los alumnos es en general muy bajo.

Abstract In Mexico, children with special educational needs may be educated in integrative general schools or special education schools (Multiple Care Centers). In general, these services promote and support the process of educational integration. However, there is little evidence of the potential influence they have on student achievement. The present study evaluated the influence of the type of school in 23 children with special educational needs, 12 from regular school and 11 from Multiple Care Centers. Five academic achievement tests of Battery III Woodcock-Muñoz were applied. Results indicate a better overall performance and grade equivalents, more consistent with age, of integrating regular school students than of those in Multiple Care Centers, this was particularly the case for students who do not have a disability. However, according to grading standards, students' academic performance is generally very low.

Promoción de la adherencia terapéutica de mujeres con obesidad mediante psicoeducación / Promotion of therapeutic adherence in obese women through a psychoeducative intervention

Resumen El sobrepeso y la obesidad de la población mexicana constituyen un serio problema de salud. Para su control, se requiere del paciente una adherencia terapéutica muy alta, que implica el seguimiento de las instrucciones médicas, cambios en estilos de alimentación y ejercicio, además de cambios en cogniciones, conductas y actitudes relacionadas con la obesidad. El logro de la adherencia resulta difícil, especialmente para las mujeres. En la presente investigación se implementó una intervención psicoeducativa para promover una mayor adherencia terapéutica en un grupo de ocho mujeres con sobrepeso u obesidad que recibían servicios públicos de salud para bajar de peso, los cuales comprendían apoyo médico, de trabajo social, de nutrición y de ejercicio físico. La intervención se realizó semanalmente, consistió en doce sesiones de 90 minutos cada una. Se utilizó un diseño cuasi experimental con grupo control. Se evaluó mediante valores antropométricos, indicadores biológicos y la escala OQL-2007 de O'Donnell y Warren. Los resultados mostraron cambios significativos en los indicadores biológicos y en cogniciones, conductas y actitudes hacia el sobrepeso y obesidad, por lo que se concluye que la psicoeducación, combinada con los otros apoyos mencionados, es efectiva para aumentar la adherencia terapéutica.

Abstract The overweight and obesity in the Mexican population have become a severe health issue that requires high levels of therapeutic adherence in order to control it, including changes in life style, diet and exercise, and modifications in cognitions, behaviors and attitudes towards obesity. The achievement of adherence is a complex process especially for women. This research implemented a psychoeducative intervention to increase the therapeutic adherence in an experimental group of eight obese or overweight women who receive support in the public health system to reduce weight, including medical and social work support and also nutritionist and physical activation. A quasi-experimental study with a control group of eight women was designed. Results show significant changes in biological and anthropometric indicators and in cognitions, behaviors and attitudes toward overweight and obesity. It is concluded that psychoeducation combined with other support actions is effective to improve the therapeutic adherence.