Hyperpigmented lesions with acquired atrophy following Blaschko lines in a patient with diagnosed with localized scleroderma.

BACKGROUND: Linear atrophoderma of Moulin (LAM) is a dermatosis that affects children and adolescents characterized by hyperpigmented and atrophic linear lesions following Blaschko lines. So far, less than 50 cases have been published. Therefore, it is a rare entity with unknown etiology and a chronic and self-limited course. Histologically, it is described as hyperpigmentation of the basal layer without the involvement of the dermis and subcutaneous tissue. No specific treatment exists currently. Localized scleroderma is a chronic and progressive autoimmune connective tissue disorder that affects the skin and adjacent tissues, characterized by abnormal collagen deposition and alteration in elastic fibers, blood vessels, and annexes. No reports have been published on the coexistence of localized scleroderma and LAM. CASE REPORT: We describe the case of an 11-year-old male with a clinical diagnosis of linear scleroderma since 5 years of age. Four years later, the patient developed atrophic and hyperpigmented lesions following Blaschko lines in the posterior trunk. A biopsy of both dermatoses was performed: the trunk showed epidermis with hyperpigmentation of the basal layer, and within the dermis, no alteration in the collagen bundles; the forearm biopsy corroborated scleroderma. Based on the clinical-pathological correlation, LAM coinciding with localized linear scleroderma was diagnosed. CONCLUSIONS: LAM is an infrequent entity by itself. Moreover, its coexistence with sclerodermiform syndrome has not been reported in the indexed literature.

Management experience of pediatric meningioma in a Mexican reference center.

OBJECTIVE: Determine the histopathological and clinical characteristics of patients diagnosed with meningiomas and to establish the frequency of these tumors in the pediatric population Mexican. Determine the NF1/2 frequency in meningioma pediatric. METHODS: Samples from the histopathology file were reviewed, and from the complete clinical file the following patient data was reviewed: age, gender, diagnosis, diagnosis year, surgical resection, location, tumor size, symptoms, and family background. The frequency of NF1/2 in pediatric meningioma was reviewed in literature. RESULTS: Forty-four de novo cases were collected from pediatric patients; 19 were female patients and 25 males. The most frequent histological subtype was transitional meningioma. Of all the cases, 75% had a supratentorial localization and 20% had an extramedullary intrarachidian localization. Some clinical manifestations included seizures, paresis, headache, and visual disturbances. CONCLUSION: There is a low incidence of meningiomas in the pediatric population, more than 70% are Grade I, and they have supratentorial localization.

Benefits and Challenges in the Incorporation of Insects in Food Products.

Edible insects are being accepted by a growing number of consumers in recent years not only as a snack but also as a side dish or an ingredient to produce other foods. Most of the edible insects belong to one of these groups of insects such as caterpillars, butterflies, moths, wasps, beetles, crickets, grasshoppers, bees, and ants. Insect properties are analyzed and reported in the articles reviewed here, and one common feature is nutrimental content, which is one of the most important characteristics mentioned, especially proteins, lipids, fiber, and minerals. On the other hand, insects can be used as a substitute for flour of cereals for the enrichment of snacks because of their high content of proteins, lipids, and fiber. Technological properties are not altered when these insects-derived ingredients are added and sensorial analysis is satisfactory, and only in some cases, change in color takes place. Insects can be used as substitute ingredients in meat products; the products obtained have higher mineral content than traditional ones, and some texture properties (like elasticity) can be improved. In extruded products, insects are an alternative source of proteins to feed livestock, showing desirable characteristics. Isolates of proteins of insects have demonstrated bioactive activity, and these can be used to improve food formulations. Bioactive compounds, as antioxidant agents, insulin regulators, and anti-inflammatory peptides, are high-value products that can be obtained from insects. Fatty acids that play a significant role in human health and lipids from insects have showed positive impacts on coronary disease, inflammation, and cancer. Insects can be a vector for foodborne microbial contamination, but the application of good manufacturing practices and effective preservation techniques jointly with the development of appropriate safety regulations will decrease the appearance of such risks. However, allergens presented in some insects are a hazard that must be analyzed and taken into account. Despite all the favorable health-promoting characteristics present in insects and insects-derived ingredients, willingness to consume them has yet to be generalized.

Triggered micropore-forming bioprinting of porous viscoelastic hydrogels.

Cell-laden scaffolds of architecture and mechanics that mimic those of the host tissues are important for a wide range of biomedical applications but remain challenging to bioprint. To address these challenges, we report a new method called triggered micropore-forming bioprinting. The approach can yield cell-laden scaffolds of defined architecture and interconnected pores over a range of sizes, encompassing that of many cell types. The viscoelasticity of the bioprinted scaffold can match that of biological tissues and be tuned independently of porosity and stiffness. The bioprinted scaffold also exhibits superior mechanical robustness despite high porosity. The bioprinting method and the resulting scaffolds support cell spreading, migration, and proliferation. The potential of the 3D bioprinting system is demonstrated for vocal fold tissue engineering and as an in vitro cancer model. Other possible applications are foreseen for tissue repair, regenerative medicine, organ-on-chip, drug screening, organ transplantation, and disease modeling.

Pediatric ependymoma: GNAO1, ASAH1, IMMT and IPO7 protein expression and 5-year prognosis correlation.

OBJECTIVE: The aim of this work was to evaluate a pediatric ependymoma protein expression that may be useful as a molecular biomarker candidate for prognosis, correlated with clinical features such as age, gender, histopathological grade, ependymal tumor recurrence and patient survival. PATIENTS AND METHODS: Immunohistochemistry assays were performed for GNAO1, ASAH1, IMMT, IPO7, Cyclin D1, P53 and Ki-67 proteins. Kaplan-Meier and Cox analysis were performed for age, gender, histopathological grade, relapse and survival correlation. RESULTS: We found that three proteins correlate with histopathological grade and relapse; two proteins correlate with survival; one protein does not correlate with any clinical feature. CONCLUSION: Our results suggest that, out of the proteins analyzed, five may be considered suitable prognostic biomarkers and one may be considered a predictive biomarker for response to treatment of pediatric ependymoma.

Lipoma en región maxilofacial en pacientes pediátricos. Presentación de un caso / Lipoma of the maxillofacial region in pediatric patients. A case study

RESUMEN Se denominan lipomas aquellas lesiones benignas, perte necientes al grupo de neoplasias mesenquimatosas compuestas por tejido adiposo con o sin cápsula fibrosa u otros elementos histológicos que determinarán sus características físicas. Dentro de las neoplasias benignas se presentan del 13-20% en cabeza y cuello, reportándose 0.5-5% en cavidad bucal, por lo que se considera poco común en la región maxilofacial, siendo más frecuente después de la quinta década de vida, es raro que se presente en pacientes jóvenes o niños. Es por ello que presentamos el reporte de un caso de lipoma en paciente pediátrico, el cual tratamos en el Servicio de Cirugía Maxilofacial Pediátrica del Hospital de Pediatría «Dr. Silvestre Frenk Freud¼, Centro Médico Siglo XXI.

ABSTRACT Lipomas are benign lesions that belong to the group of mesenchymal neoplasms. Lipomas are composed of fat tissue with or without fibrous capsule or other histological elements that determine the physical characteristics of the lipoma. Within the group of benign neoplasms 13 to 20% occur in the head and neck, and 0.5 to 5% in the oral cavity. The appearance of these neoplasms in the maxillofacial region is uncommon, and seldom occurs in children or young patients, being more frequent over 50 years of age. In this report we present a case of lipoma in a pediatric patient that was treated in the Service of Pediatric Maxillofacial Surgery at the «Dr. Silvestre Frenk Freund¼ Hospital, in the IMSS XXI Century National Medical Center.

In vivo anti-arthritic and antioxidant effects from the standardized ethanolic extract of Moussonia deppeana

ABSTRACT Moussonia deppeana (Schltdl. & Cham.) Klotzsch ex Hanst., Gesneriaceae, known as tlachichinole, is a Mexican medicinal plant used for treatment of chronic inflammation-related diseases such as arthritis. In this paper, the main metabolite verbascoside was quantified in ethanolic extract; anti-arthritic and antioxidant activities were also evaluated in Complete Freund's Adjuvant induced arthritis in mice, with complete hematological evaluation, and oxidative stress measure in edema and ganglionic tissues on day 28. In popliteal ganglion, CD4+ lymphocytes and tumor necrosis factor alpha concentration were measured in addition to histological analysis. Ethanolic extract contained 79.2 mg of verbascoside/g extract, and this extract at 450 mg/kg generated an inhibition of 24% over paw edema development and increased body weight gain on final day. For hematological parameters, same dose decreased total leukocytes and lymphocytes, as well as decreased oxidation rate over biomolecules in edema and ganglionic tissues, and increased antioxidant enzyme activity. In ganglionic tissue, CD4+ lymphocytes and tumor necrosis factor alpha level showed no differences at any tested dose compared to complete Freund's adjuvant untreated group. Histological analysis of popliteal ganglion revealed moderate reduction of follicular hyperplasia, leukocyte infiltration and lipid inclusions at 450 mg/kg dose. Ethanolic extract of M. deppeana possesses anti-edematous activity associated to a moderate reduction in follicular hyperplasia, with immune-modulatory and antioxidant effects during experimental arthritis in mice.

Clinical and Radiographic Evaluation of Rehabilitated Implants with Overdenture with Two Ball Abutments in the Mandible and Submitted to Immediate Load: One Year of Observation / Evaluación Clínica y Radiográfica de Implantes Rehabilitados con Sobredentadura con dos Pilares de Bola en la Mandíbula y Sometidos a Carga Inmediata: Un Año de Observación

ABSTRACT: The purpose of this prospective clinical study was to evaluate the clinical and radiographic survival of two non-splinted implants immediately loaded with ball abutments for supporting mandibular overdentures. Thirty edentulous patients using full dentures (22 women and 8 men) with a mean age of 64 years were included in this study. Each patient received two inter-foraminal implants in the mandible, near the canine, with an insertion torque greater than 45 Ncm. Nonsplinted ball abutments were connected to the implants, and the overdenture was immediately loaded. The success of the implants was clinically and radiographically evaluated; along with the satisfaction level of the patients, after the first year of having placed the implants. One patient withdrew from the study. After 12 months the implants were loaded, the survival rate was of 98.27 %, one implant failed. The average bone loss was of 0.34 mm. No surgical complications were observed, minor prosthetic maintenance appointments were required. The satisfaction of the patients was of 89.3 %. The immediate loading of two non-splinted implants in the inter-foraminal area of the mandible retaining an overdenture by means of ball abutments is a predictable treatment, with a high success rate of survival and a favorable response of the peri-implant tissues. The patients showed good satisfaction with this treatment modality.

RESUMEN: El propósito de este estudio clínico prospectivo fue evaluar la supervivencia de manera clínica y radiográfica de dos implantes no ferulizados cargados inmediatamente con pilares tipo bola para soportar sobredentaduras mandibulares.Treinta pacientes desdentados totales usuarios de prótesis total (22 mujeres y 8 hombres) con una edad promedio de 64 años se incluyeron en este estudio. Cada paciente recibió dos implantes interforaminales en la mandíbula aproximadamente en posición de canino con un torque mayor a los 45 Ncm. Pilares no ferulizados tipo bola se conectaron a los implantes y se cargó inmediatamente la sobredentadura. El éxito de los implantes se evaluó clínica y radiográficamente; así como el nivel de satisfacción de los pacientes al año de haber sido colocados los implantes. Una paciente se retiró del estudio. Después de 12 meses de cargados los implantes la tasa de supervivencia fue del 98,27 %, un implante fracasó. El promedio de pérdida ósea fue de 0.34 mm. No se observaron complicaciones quirúrgicas, se requirieron citas de mantenimiento protésicas menores. La satisfacción de los pacientes fue del 89,3 %. La carga inmediata de dos implantes no ferulizados en el área interforaminal de la mandíbula reteniendo una sobredentadura a través de pilares en bola es un tratamiento predecible, con un alta tasa de éxito de supervivencia, y respuesta favorable de los tejidos periimplantares. Los pacientes muestran una buena satisfacción ante ésta modalidad de tratamiento.

Pediatric pineal germinomas: Epigenetic and genomic approach.

OBJECTIVE: We identify and correlate chromosomal alterations, methylation patterns and gene expression in pediatric pineal germinomas. METHODS: CGH microarray, methylation and gene expression were performed through the Agilent platform. The results were analyzed with MatLab software, MapViewer, DAVID, GeneCards and Hippie. RESULTS: Amplifications were found in 1q24.2, 1q31.3, 2p11.2, 3p22.2, 7p13, 7p15.2, 8p22, 12p13.2, 14q24.3 y 22q12; and deletions were found in 1q21.2, 9p24.1, 10q11.22, 11q11, 15q11.2 and 17q21.31. In the methylation analysis, we observed 10,428 CpG Islands with a modified methylation status that may affect 11,726 genes. We identified 1260 overexpressed genes and 470 underexpressed genes. The genes RUNDC3A, CDC247, CDCA7L, ASAH1, TRA2A, LPL and NPC2 were altered among the three levels. CONCLUSIONS: We identified the 1q24.2 and 1q31.3 amplified regions and the 1q21.3 and 11q11 deleted regions as the most important aims. The genes NPC2 and ASAH1 may play an important role in the development, progression and tumor maintenance. The ASAH1 gene is an ideal candidate to identify drug responses. These genomic and epigenetic studies may help to characterize the formation of pineal germ cell tumors to determine prognostic markers and also to identify shared characteristics in gonadal and extragonadal tumors.

Conocimientos y prácticas de los Pediatras con respecto a la atención perinatal en niños con malformaciones con pronóstico reservado de vida

Introducción: El comfort care neonatal es el cuidado paliativo y de apoyo que se brinda a los bebes que nacen con bajísimas posibilidades de vida y fallecen a las horas o a los pocos días, para suavizar o mitigar el dolor y poner calidad de vida en estos pacientes. Objetivo: Identificar los conocimientos y prácticas de los pedíatras con respecto a la atención perinatal en niños con malformaciones con pronóstico reservado de vida. Material y Método: Estudio observacional, descriptivo, de corte transversal. Se aplicó una encuesta anónima con preguntas cerradas a Pediatras del Centro Materno Infantil del Hospital de Clínicas, Facultad de Ciencias Médicas de San Lorenzo y del Hospital General Barrio Obrero del Ministerio de Salud Pública y Bienestar Social. Resultados: Se analizaron 106 encuestas, 89 (84%) de los pediatras no recomiendan el aborto a una mujer embarazada cuyo hijo nacerá con malformaciones incompatibles con la vida. El 16% (17) recomiendan el aborto en aquellos casos, para evitar el sufrimiento de los padres y por la calidad de vida que estos bebes llevarían. En el caso de los recién nacidos que no respiran al nacer, 93 (88%) de los pediatras deciden no reanimarlo, 85 (80%) de los pediatras no tienen conocimiento de un protocolo en el manejo de estos recién nacidos, y sólo el 21 (20%) conoce el comfort care neonatal. Conclusión: La mayoría de los pediatras no conoce un protocolo para el manejo de estos bebes, y utilizan su propio criterio. La conducta tomada ante el nacimiento de estos niños, que no respiran al nacer fue de no reanimar. La mayoría de los pediatras no recomendarían el aborto a una mujer embarazada cuyo hijo nacerá con malformación incompatible con la vida.

Introduction: Neonatal comfort care is the palliative and supportive care provided to infants who are born with very low chances of life and who die within hours or a few days of birth, to soften or mitigate pain and to improve the quality of life in these patients. Objective: To identify the knowledge and practices of pediatricians regarding perinatal care in children with malformations with a poor prognosis. Materials and Methods: This was an observational, descriptive and cross-sectional study. An anonymous survey with close-ended questions was given to Pediatricians at the Maternal and Child Health Center of the School of Medicine's Clínicas Hospital in San Lorenzo and the Barrio Obrero General Hospital, which belongs to the Ministry of Public Health and Social Welfare. Results: 106 surveys were analyzed; 89 (84%) pediatricians do not recommend abortions to a pregnant woman whose child will be born with malformations incompatible with life. 16% (17) recommend abortions in those cases to avoid the suffering of the parents and because of the quality of life that these babies would have. In the case of newborns who do not breathe at birth, 93 (88%) pediatricians decide not to provide resuscitation, 85 (80%) pediatricians are not aware of the existence of a protocol to manage these newborns, and only 21 (20%) know about neonatal comfort care. Conclusions: Most pediatricians are not aware of the existence of a protocol to manage these newborns, and use their own criteria. The usual decision when faced with a newborn that did not attempt to breathe at birth was to not resuscitate. Most pediatricians would not recommend an abortion to a pregnant woman whose child will be born with malformations incompatible with life.

Frecuencia y características epidemiológicas de golpes en la cabeza en niños menores de 5 años / Frequency and epidemiological characteristics of head injuries in children under 5 years of age

Objetivos: el objetivo de este estudio fue describir la frecuencia, características epidemiológicas y posibles mecanismos patogénicos de golpes en la cabeza sufridos por niños de cinco o menos años de edad. Material ymétodos: Estudio observacional de tipo descriptivo, utilizando un cuestionario dirigido a madres de familia queacuden a consulta externa de Pediatría del Hospital Nacional Cayetano Heredia (HNCH). El cuestionario se aplicómediante un muestreo aleatorio simple sistematizado...

Objectives: to describe the frequency, epidemiologic characteristics and possible pathogenic mechanisms of thehead injuries in children of five years of age or younger. Methods: Observational descriptive study based on asurvey/questionnaire administered through a systematic random sampling procedure to mothers selected from thepediatric Outpatient Service of a general hospital in Lima...

Genomics and epigenetics: A study of ependymomas in pediatric patients.

OBJECTIVE: We identify chromosomal alterations, the methylation pattern and gene expression changes in pediatric ependymomas. METHODS: CGH microarray, methylation and gene expression were performed through the Agilent platform. The results were analyzed with the software MatLab, MapViewer, DAVID, GeneCards and Hippie. RESULTS: Amplification was found in 14q32.33, 2p22.3 and 8p22, and deletion was found in 8p11.23-p11.22 and 1q21.3. We observed 42.387 CpG islands with changes in their methylation pattern, in which we found 272 genes involved in signaling pathways related to carcinogenesis. We found 481 genes with altered expression. The genes IMMT, JHDMD1D, ASAH1, ZWINT, IPO7, GNAO1 and CISD3 were found to be altered among the three levels. CONCLUSION: The 2p22.3, 8p11.23-p11.22 and 14q32.33 regions were identified as the most important; the changes in the methylation pattern related to cell cycle and cancer genes occurred in MIB2, FGF18 and ITIH5. The IPO7, GNAO1 and ASAH1 genes may play a major role in ependymoma development.

Identification of proteins associated with amyloidosis by polarity index method.

There is a natural protein form, insoluble and resistant to proteolysis, adopted by many proteins independently of their amino acid sequences via specific misfolding-aggregation process. This dynamic process occurs in parallel with or as an alternative to physiologic folding, generating toxic protein aggregates that are deposited and accumulated in various organs and tissues. These proteinaceous deposits typically represent bundles of ß-sheet-enriched fibrillar species known as the amyloid fibrils that are responsible for serious pathological conditions, including but not limited to neurodegenerative diseases, grouped under the term amyloidoses. The proteins that might adopt this fibrillar conformation are some globular proteins and natively unfolded (or intrinsically disordered) proteins. Our work shows that intrinsically disordered and intrinsically ordered proteins can be reliably identified, discriminated, and differentiated by analyzing their polarity profiles generated using a computational tool known as the polarity index method (Polanco & Samaniego, 2009; Polanco et al., 2012; 2013; 2013a; 2014; 2014a; 2014b; 2014c; 2014d). We also show that proteins expressed in neurons can be differentiated from proteins in these two groups based on their polarity profiles, and also that this computational tool can be used to identify proteins associated with amyloidoses. The efficiency of the proposed method is high (i.e. 70%) as evidenced by the analysis of peptides and proteins in the APD2 database (2012), AVPpred database (2013), and CPPsite database (2013), the set of selective antibacterial peptides from del Rio et al. (2001), the sets of natively unfolded and natively folded proteins from Oldfield et al. (2005), the set of human revised proteins expressed in neurons, and non-human revised proteins expressed in neurons, from the Uniprot database (2014), and also the set of amyloidogenic proteins from the AmyPDB database (2014).

Aplicación de un método analítico revalidado por cromatografía líquida para la cuantificación de permetrina 1 por ciento / High performance liquid chromatography-validated analytical method for 1 percent permethrin quantification

INTRODUCCIÓN: en Cuba, al igual que en otros países, la infestación por Pediculus capitis se ha incrementado notablemente a partir de la década de los setenta, por lo que se desarrolla un intenso programa dirigido a su control y prevención, en el cual se incluyen estudios sobre la calidad de la permetrina, que es un piretroide sintético, activo frente a una amplia gama de parásitos, con actividad pediculicida a 1 por ciento y escabicida a 5 por ciento. Dada su baja toxicidad y por responder favorablemente a la relación riesgo/beneficio, constituye uno de los pediculicidas de elección para disminuir la infestación por piojos. OBJETIVO: revalidación de una metódica analítica por cromatografía líquida de alta resolución y su aplicación en la cuantificación de 12 muestras de 2 lotes de loción de permetrina 1 por ciento, de producción nacional. MÉTODOS: los parámetros evaluados fueron linealidad, precisión y exactitud. Se prepararon 7 estándares de calibración y soluciones de trabajo con concentraciones que se encontraban entre 100 y 15 000 µg/mL. Estos parámetros de validación fueron verificados a través del coeficiente de correlación, el coeficiente de variación y el error relativo porcentual. RESULTADOS: la especificidad del método fue corroborada a través de los cromatogramas realizados, en los cuales los tiempos de retención fueron entre 8,8 y 9,2 min para el isómero trans y entre 10,7 y 11,2 min para el isómero cis. El coeficiente de correlación determinado para ambos isómeros fue mayor que 0,99; el coeficiente de variación fue menor que 3 por ciento y el error relativo porcentual estuvo entre -3 y 1 por ciento, tanto para los estudios interdía como intradía. Se determinó que la media de la concentración de permetrina en lotes de solución tópica 1 por ciento resultó de 6 780,14 µg/mL. CONCLUSIONES: el método revalidado fue lineal, preciso y exacto dentro del rango de concentraciones estudiadas. La concentración de permetrina calculada estuvo por debajo de lo esperado según la información de la composición de la solución de permetrina 1 por ciento (9 100-10 900 µg/mL). Este método resulta útil para la cuantificación de solución de permetrina 1 por ciento en los estudios de calidad del producto farmacológico que se distribuye a la población.

INTRODUCTION: in Cuba, as well as in other countries, Pediculus capitis infestation has increased since the 70´s; this is the reason why a program aimed at controlling and preventing this infestation was designed. This program includes quality control studies of the active synthetic pyrethroid Permethrin and its activity at 1 percent on lice and 5 percent on scabies. Due to its low toxicity and positive risk/benefit ratio, Permethrin is a pediculicide of choice to decrease Pediculus capitis infestation. OBJECTIVE: to validate an analytical method using high performance liquid chromatography and its application in the quantification of 12 samples from 2 batches of Cuban-made 1 percent permethrin pediculicidal preparation. METHODS: linearity, precision and accuracy parameters were determined. Seven calibration standards and working solutions with concentrations ranging from 100 to 15 000 µg/mL were prepared. These validation parameters were verified through the correlation coefficient, the variation coefficient and the percentage relative error. RESULTS: the specificity of this method was proved in the chromatograms that showed retention times of 8.8 to 9.2 min for the isomer trans and 10.7 to 11.2 min for the isomer cis. The correlation coefficient for both isomers was higher than 0.99; the variation coefficient was under 3 percent and the percentage relative error was -3 and 1 percent for the inter-day and intraday studies, respectively. The mean permethrin concentration in 1 percent solution batches was estimated at 6 780.14 µg/mL. CONCLUSIONS: the validated method was linear, precise and exact within the range of the studied concentrations. The estimated concentration of permethrin was below the expected rate according to the composition of 1 percent permethrin solution (9 100-10 900 µg/mL). This method may be useful for the quantification of 1 percent permethrin solutions in the quality studies of the product sold to the population.

[Incidence and trends of neuroblastoma in Mexican children attending at Instituto Mexicano del Seguro Social]. / Incidencia y tendencia del neuroblastoma en niños derechohabientes del IMSS.

BACKGROUND: Neuroblastoma (NB) is the principal tumor of the sympathetic nervous system in children. OBJECTIVE: to describe the epidemiological and clinical characteristics of Mexican children with NB. METHODS: A population-based, prolective study, with data obtained from the Childhood Cancer Registry of the Instituto Mexicano del Seguro Social. The frequencies and incidence of the variables of the study were obtained by age and sex. The trend was calculated with the annual percentage of change. RESULTS: Of a total of 2758 children with cancer, 72 (2.6%) were identified in the Group IV, according to the International Classification of Childhood Cancer. The average incidence for NB was 3.8, the highest incidence was found in Guerrero. NB was highest in the group under one year of age (18.5). The male/female ratio was 1.1 and there was no trend toward an increase. Stages III and IV were presented in 88% of the cases. There was no association between the stages, the age at the TD, or the histological pattern. CONCLUSIONS: It is possible that the low incidence of NB in Mexican children is due to the difficulty in early diagnosis due the majority of the cases was diagnosed in the advanced stages.

Epidemiological and some clinical characteristics of neuroblastoma in Mexican children (1996-2005).

BACKGROUND: Neuroblastoma (NB) is the principal tumor of the sympathetic nervous system in children under one year of age. The incidence in developed countries is greater than that in developing countries. The aim of this article is to present the epidemiological and some clinical characteristics of Mexican children with NB. METHODS: A population-based, prolective study, with data obtained from the Childhood Cancer Registry of the Instituto Mexicano de Seguro Social. STATISTICAL ANALYSIS: The simple frequencies of the variables of the study and the annual average incidence (per 1,000,000 children/years) by age and sex were obtained. The trend was evaluated by calculating the annual percentage of change. The curves of Kaplan-Meyer were employed for the survival rate and the log-rank test was used to compare the curves. RESULTS: Of a total of 2,758 children with cancer registered during the period from 1996-2005, 72 (2.6%) were identified as having Group IV, defined according to the International Classification of Childhood Cancer. The incidence for NB was 3.8 per 1,000,000 children/year; NB was highest in the group of children under one year of age, followed by the group of children between the ages 1-4 years (18.5 and 5.4 per 1,000,000 children/years, respectively). The male/female ratio was 1.1 and there was no trend toward an increase. The time of diagnosis was 26 days (median), but varied according to the stage at diagnosis. Stages III and IV were presented in 88% of the cases. There was no association between the stage, the age at time of diagnosis, or the histological pattern. The overall five-year survival rate was 64%; the patients with stage I, II, III, or IVs did not die; and the five-year survival rate of cases in Stage IV was 40%. CONCLUSION: It is possible that the low incidence of neuroblastoma in Mexican children is due to the difficulty in diagnosing the cases with the best prognosis, some of which could have had spontaneous regression. There was no trend to an increase; the majority of the cases were diagnosed in the advanced stages; and the overall five-years survival rate was similar to that for developed countries.

Estudio de bioequivalencia: formulaciones genéricas y comerciales de estaduvine, lamiduvine, zidovudine e indinavir en pacientes cubanos infectados con VIH / Bioequivalence study: generic and trade formulations of stavudine, lamivudine, zidovudine and indinavir in Cuban HIV-infected subjects

Objetivo: El presente estudio describe los estudios de bioequivalencia de los genéricos cubanos antirretrovirales estavudina, lamivudina, zidovudina e indinavir con respecto a sus productos innovadores. Diseño: Los estudios de bioequivalencia de cada antirretroviral estudiado (formulación de prueba, P y referencia, R), se realizaron en 13 ó 14 sujetos, según el caso con la utilización de las medias en un estudio aleatorio, cruzado y a dosis única con un período de lavado de 10 días. Métodos: Las concentración de los antirretrovirales en plasma se monitorearon durante un período de 12 h después de la administración de estos, mediante el uso de métodos validados de cromatografía líquida de alta resolución (HPLC). Los parámetros farmacocinéticos se determinaron con el uso el software profesional WinNolin, versión 2.1. La comparación de los parámetros farmacocinéticos se realizó con un intervalo de confianza del 95 por ciento con la utilización del software NCSS 2000 PASS 2000 (hipótesis nula). Para el estudio de bioequivalencia se usó el software Equiv Test de soluciones estadísticas, empleando ANOVA con el 90 por ciento de intervalo de confianza. Resultados: El presente estudio mostró que no se observaron diferencias significativas en las medias de AUC0-12, AUC0-¥, Cmax y Tmax de ambas formulaciones de estavudina, lamivudina, zidovudina e indinavir. Se concluye que los parámetros farmacocinéticos estudiados se encuentran dentro de los rangos establecidos siendo 80-125 por ciento para Cmax, AUC0-12, y AUC0-¥. En el caso de Cmax de la zidovudina el rango fue 70-143 por ciento. Conclusión: Estos resultados avalan que los genéricos antirretrovirales cubanos son bioequivalentes con sus respectivos productos innovadores en términos de velocidad y magnitud de la absorción

Análisis de programas educativos a pacientes hipertensos / Analysis of educational programs to hypertensive patients

Estudio descriptivo, transversal y prospectivos, que tiene como objetivo evaluar la educación a pacientes hipertensos (HT), entregada por profesionales de salud, en consultorios del área pública y privada de Santiago entre enero y octubre de 1999. Se estudiaron aleatoriamente 122 pacientes HT, cuyo criterio de inclusión fue al menos estar un año en tratamiento y control en consultorios o centros privados. La recolección de la información fue a través de una encuesta aplicada por enfermeras, que incluye tres aspectos básicos: quién entrega la información, el conocimiento de factores de riesgo y síntomas de consulta urgente, y reconocimiento de la patología como crónica. Los resultados fueron: el 83,6 por ciento de los pacientes tiene un conocimiento deficiente de los factores de riesgo, y esto es directamente proporcional a la escolaridad, aun cuando el 93,4 por ciento la reconoce como una enfermedad crónica. En relación a los síntomas de consulta urgente, el 40 por ciento tiene conocimiento deficiente. El 90 por ciento de los pacientes tiene un control periódico, entre 1 y 10 años de duración de la enfermedad. El 61,5 por ciento reconoce el rol educativo de la enfermera. Conclusiones. El paciente HT controlado por profesional de salud tiene un no cumplimiento de su manejo, tratamiento y complicaciones. La mayoría de los pacientes no tiene conocimiento, o es deficiente, de los factores de riesgo y éste es proporcional a la educación de los pacientes. Entre 0 y 10 años de la enfermedad los controles son periódicos, pero en el sector público es más notorio el desconocimiento de los factores de riesgo. Hay un mayor conocimiento de los síntomas de Urgencia en nivel de escolaridad superior con aquellos en el área privada. Recomendaciones. La no adhesividad es una conducta normal para el HT, se deben implementar estrategias educativas que ayuden al paciente a decidir acciones que favorezcan el autocuidado y tengan un impacto en cambiar el estilo de vida, que prevengan complicaciones y eleven los costos en salud, con la creación de un indicador que permita conocer el grado de adhesividad con las nuevas estrategias diseñadas