[Mortalidad por enfermedad de Alzheimer en México de 1980 a 2014].

BACKGROUND: Dementias are rarely considered to be a main cause of death; therefore there are only few studies on Alzheimer's mortality covering long periods. OBJECTIVE: To describe mortality from Alzheimer's disease in México for the period from 1980 to 2014. METHOD: Cross-sectional study where, with official mortality data in Mexico according to codes 331.0 and G30, respectively, of the 9th and 10th revisions of the International Statistical Classification of Diseases and Related Health Problems, crude and standardized Alzheimer's disease mortality rates were obtained, both nationally and by states. RESULTS: From almost being inexistent, deaths from Alzheimer's disease went to a rate of 65.12 per 1000 females and 43.66 per 1000 males in the 2010-2014 five-year period. Throughout the study period, the age group with highest mortality rates for this cause were those older than 80 years, with 0.29 per 100,000 population in 1980-1984 and 55.02 in 100,000 in the 2010-2014 period. The region with the highest mortality was the northwest, with rates higher than 2.28 per 100,000 population. CONCLUSIONS: Mortality from Alzheimer's disease is a public health problem in Mexico with a growing trend, especially among women and older adults. Early diagnostic measures and opportune treatment are required in primary care in order to reduce this problem.

INTRODUCCIÓN: Raramente se considera a las demencias como causa principal de muerte, por consiguiente existen pocos estudios sobre la mortalidad por Alzheimer a través de largos periodos. OBJETIVO: Describir la mortalidad por enfermedad de Alzheimer en México durante el periodo 1980-2014. MÉTODO: Estudio transversal en el que, con datos oficiales de mortalidad en México según los códigos 331.0 y G30 de la novena y décima revisiones de la Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud, se obtuvieron tasas crudas y estandarizadas de mortalidad por enfermedad de Alzheimer, nacional y por entidad federativa. RESULTADOS: De ser casi inexistentes, en el quinquenio 2010-2014 se registraron tasas de 65.12 y 43.66 muertes por enfermedad de Alzheimer por cada 1000 mujeres y 1000 hombres, respectivamente. En todo el periodo estudiado, el grupo etario con las mayores tasas de mortalidad por esta causa fue el de mayores de 80 años, con 0.29 en 100 000 habitantes durante 1980-1984 y 55.02 durante 2010-2014. La región con mayor mortalidad fue la noroeste, con tasas mayores a 2.28 en 100 000 habitantes. CONCLUSIONES: La mortalidad por enfermedad de Alzheimer es un problema de salud pública en México con tendencia creciente, especialmente entre mujeres y adultos mayores. Se requieren medidas diagnósticas precoces y tratamiento oportuno en primer nivel para aminorar este problema.

[Pathogenic mechanisms of neuronal damage in multiple sclerosis]. / Mecanismos patogénicos en el desarrollo de la esclerosis múltiple: ambiente, genes, sistema inmune y estrés oxidativo.

Multiple sclerosis is the most common cause of progressive neurological disability in young adults. This disease involves damage to the myelin sheath that normally insulates the electrical activity of nerve fibers. This leads to a wide range of symptoms as specific nerves become injured and lose their function. Epidemiological and experimental studies show that genetic alterations, antioxidant enzyme abnormalities and autoimmunity are risk factors for developing the disease. Recent evidence suggests that inflammation and oxidative stress within the central nervous system are major causes of ongoing tissue damage. Resident central nervous system cells and invading inflammatory cells release several reactive oxygen and nitrogen species which cause the histopathological features of multiple sclerosis: demyelization and axonal damage. The interplay between inflammatory and neurodegenerative processes results in an intermittent neurological disturbance followed by progressive accumulation of disability. Reductions in inflammation and oxidative stress status are important therapeutic strategies to slow or halt the disease processes. Therefore, several drugs are currently in trial in clinical practice to target this mechanism; particularly the use of supplements such as antioxidants and omega-3 polyunsaturated fatty acids, in order to improve the survival and quality of patients' lives.

Dietary fat and antioxidant vitamin intake in patients of neurodegenerative disease in a rural region of Jalisco, Mexico.

OBJECTIVE: To evaluate and compare the intake of lipids and (A, E, and C) vitamins in patients with and without possible neurodegenerative diseases. METHODS: Twenty adults with possible Alzheimer's disease or Parkinson's disease and 41 control subjects (50-89 years old) from a rural region were studied. Dietary intake was evaluated with the analysis of macronutrients and micronutrients conducted by a food frequency questionnaire and 24 hours dietary record. Analyses were adjusted for age, sex, body mass index, and energy intake. Through interrogation and use of medical record form of health secretary we obtained information about the sociodemographic characteristics. Multivariate analysis of variance to allow for covariated adjustment was used. RESULTS: Patients had a lower energy intake, vitamin C (P = 0.016), fruits (P < 0.001), vegetables (P = 0.037), and oils and fat (P = 0.002), than the controls. Interestingly, the C vitamin intake in patients was still higher than the recommended. Patients had a higher consumption of cereals (P = 0.017), high-animal fat diet (P = 0.024), and whole milk (P < 0.001); 2.4% of the controls smoke and 5% are alcohol consumers. Eighty-five percent of patients and 78% of the controls do not have physical activity. Family history of subjects in this study indicated chronic diseases. CONCLUSION: The subjects included in this study had a high intake of C vitamin, this is due to the consumption of fruits and vegetables. However, patients with possible Alzheimer's or Parkinson's disease had a lower intake of fruits and vegetables, which could be due to type of food to which they have access.

Renal dysfunction as a consequence of acute liver damage by bile duct ligation in cirrhotic rats.

UNLABELLED: Renal failure is a common complication in patients with alcohol-induced cirrhosis who undergo a superimposed severe alcoholic hepatitis. AIM: Our aim was to evaluate renal dysfunction established as a consequence of acute liver damage (ALD) induced by bile duct ligation (BDL) in cirrhotic rats. Hepatic and renal functional assays were performed. RESULTS: Hyperbilirubinemia and increased alanine aminotransferase and aspartate aminotransferase (p<0.05) in rats with BDL were observed since the first day of bile obstruction in cirrhotic rats. Urinary volume and urinary sodium concentration showed a significant reduction (p<0.05) on days 3 and 5 after BDL. Plasma renin activity, plasma renin concentration, serum creatinine, and BUN values increased (p<0.05) from day 1 to day 7 after BDL. Glomerular filtration rate was substantially decreased from day 1 to day 7. Histological changes became apparent since day 3 after BDL in which glomeruli with mesangial hypercellularity took place in the absence of tubular necrosis; with portal inflammation and proliferation of biliar conduits. Results of the present work demonstrate that ALD induced by BDL in cirrhotic rats produces changes in renal function. In conclusion, this experimental model demonstrates that an ALD of variable etiology, either surgical or induced by CCl(4), can cause important damage that eventually results in renal function deterioration. This experimental model may be suitable, to study the physiopathology of this syndrome, as well as for the evaluation of different pharmacological therapies.

Omega 3 Fatty Acids Supplementation and Oxidative Stress in HIV-Seropositive Patients. A Clinical Trial.

HIV-seropositive patients show high incidence of coronary heart disease and oxidative stress has been described as relevant key in atherosclerosis development. The aim of this study was to assess the effect of omega 3 fatty acids on different markers of oxidative stress in HIV-seropositive patients. We performed a randomized parallel controlled clinical trial in The Instituto Mexicano del Seguro Social, a public health hospital. 70 HIV-seropositive patients aged 20 to 55 on clinical score A1, A2, B1 or B2 receiving highly active antiretroviral therapy (HAART) were studied. They were randomly assigned to receive omega 3 fatty acids 2.4 g (Zonelabs, Marblehead MA) or placebo for 6 months. At baseline and at the end of the study, anthropometric measurements, lipid profile, glucose and stress oxidative levels [nitric oxide catabolites, lipoperoxides (malondialdehyde plus 4-hydroxialkenals), and glutathione] were evaluated. Principal HAART therapy was EFV/TDF/FTC (55%) and AZT/3TC/EFV (15%) without difference between groups. Treatment with omega 3 fatty acids as compared with placebo decreased triglycerides (-0.32 vs. 0.54 mmol/L; p = 0.04), but oxidative stress markers were not different between groups.

Mecanismos patogénicos en el desarrollo de la esclerosis múltiple: ambiente, genes, sistema inmune y estrés oxidativo / Pathogenic mechanisms of neuronal damage in multiple sclerosis

La esclerosis múltiple (EM) es la principal causa de discapacidad neurológica de origen no traumático en adultos jóvenes. EM es una enfermedad crónica inflamatoria que se caracteriza por daño a las fibras nerviosas y la cubierta de mielina. Esto produce una gran variedad de síntomas una vez que nervios específicos muestran inflamación y pérdida de su función. Estudios epidemiológicos y experimentales han identificado alteraciones genéticas, anormalidades en enzimas antioxidantes y autoinmunidad como algunos de los factores de riesgo para el desarrollo de la enfermedad. Evidencia reciente sugiere que la inflamación y el estrés oxidativo en el sistema nervioso central contribuyen al daño del tejido cerebral. Las células residentes en el sistema nervioso central así como las células inflamatorias invasivas liberan una gran cantidad de especies reactivas de oxígeno y nitrógeno, las cuales causan desmielinización y destrucción de los axones: los hallazgos histopatológicos de la esclerosis múltiple. La interacción entre los procesos inflamatorios y neurodegenerativos producen perturbaciones neurológicas intermitentes seguidas por la acumulación progresiva de la discapacidad. Para tratar de limitar o disminuir la progresión de la enfermedad es necesario reducir la inflamación y el estrés oxidativo como estrategia terapéutica importante. Con la finalidad de mejorar la sobrevivencia y la calidad de vida de los pacientes, se están desarrollando ensayos clínicos con suplementos alimenticios tales como los antioxidantes y los ácidos grasos poliinsaturados omega-3.

Multiple sclerosis is the most common cause of progressive neurological disability in young adults. This disease involves damage to the myelin sheath that normally insulates the electrical activity of nerve fibers. This leads to a wide range of symptoms as specific nerves become injured and lose their function. Epidemiological and experimental studies show that genetic alterations, antioxidant enzyme abnormalities and autoimmunity are risk factors for developing the disease. Recent evidence suggests that inflammation and oxidative stress within the central nervous system are major causes of ongoing tissue damage. Resident central nervous system cells and invading inflammatory cells release several reactive oxygen and nitrogen species which cause the histopathological features of multiple sclerosis: demyelization and axonal damage. The interplay between inflammatory and neurodegenerative processes results in an intermittent neurological disturbance followed by progressive accumulation of disability. Reductions in inflammation and oxidative stress status are important therapeutic strategies to slow or halt the disease processes. Therefore, several drugs are currently in trial in clinical practice to target this mechanism; particularly the use of supplements such as antioxidants and omega-3 polyunsaturated fatty acids, in order to improve the survival and quality of patients’ lives.

Breve introducción a la neuroinmunología / Brief introduction to the neuroimmunology

A partir de la década de los setentas se ha demostrado una importante dependencia direccional entre los sistemas inmune (SI) y el sistema nervioso central (SNC), con la intervención de mensajeros comunes. Las citocinas del SI son capaces de modular respuestas y procesos a nivel del SNC, mientras que los neurotransmisores y neuropéptidos pueden a su vez ejercer su efecto sobre grupos celulares especificos del SNC. Un grupo importante de estos péptidos es el de los opioides endógenos, como las endorfinas y las encefalinas. Las endorfinas alfa y beta tienen la capacidad de activar la quimiotaxis e influenciar la diferenciación y proliferación de linfocitos T y B. La ß-endorfina incrementa la actividad de las células natural killer (NK). La met-encefalina y la leu-encefalina desarrollan funciones de tipo inmunomodulador con respecto a la producción de anticuerpos (Acs) por las células plasmáticas. Incrementan la producción de Acs., pueden aumentar el número de leucocitos circulantes y la producción de interleucina-2 (IL-2). Una vía en el sistema neuroinmunológico es controlada por el eje-HPA (hipotálamo-pituitaria-adrenales, principal coordinador y regulador de las interacciones entre el sistema inmune, el SNC y el endocrino