Adenosine Increases the Immunosuppressive Capacity of Cervical Cancer Cells by Increasing PD-L1 Expression and TGF-ß Production through Its Interaction with A2AR/A2BR.

The present study provides evidence showing that adenosine (Ado) increases the expression of programmed death ligand 1 (PD-L1) in cervical cancer (CeCa) cells by interacting with A2AR/A2BR and that TGF-ß1 acts in an autocrine manner to induce PD-L1 expression, enhancing the immunosuppressive effects of CeCa cells on activated T lymphocytes (ATLs) and CD8+ cytotoxic T lymphocytes (CTLs) specific for antigenic peptides derived from E6 and E7 proteins of HPV-16. Interestingly, the addition of the antagonists ZM241385 and MRS1754, which are specific for A2AR and A2BR, respectively, or SB-505124, which is a selective TGF-ß1 receptor inhibitor, to CeCa cell cultures significantly inhibited PD-L1 expression. In addition, supernatants from CeCa cells that were treated with Ado (CeCa-Ado Sup) increased the expression of PD-1, TGF-ß1, and IL-10 and decreased the expression of IFN-γ in ATLs. Interestingly, the addition of an anti-TGF-ß neutralizing antibody strongly reversed the effect of CeCa-Ado Sup on PD-1 expression in ATLs. These results strongly suggest the presence of a feedback mechanism that involves the adenosinergic pathway, the production of TGF-ß1, and the upregulation of PD-L1 expression in CeCa cells that suppresses the antitumor response of CTLs. The findings of this study suggest that this pathway may be clinically important and may be a therapeutic target.

Asociación del riesgo a desarrollar diabetes mellitus tipo 2 según la calculadora de la asociación americana de diabetes (ADA) y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana / Association of the risk of developing type 2 diabetes mellitus according to the American Diabetes Association (ADA) calculator and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic

Introducción: la diabetes mellitus tipo 2 (DM2) se define como un trastorno metabólico caracterizado por niveles de glucosa en sangre crónicamente elevados. La DM2 representa el paradigma de las enfermedades crónicas en las que existe una estrecha asociación entre factores familiares y ambientales. Por este motivo, este estudio tiene como finalidad determinar la asociación del riesgo a desarrollar DM2 y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana. Tales incluyen: alcohol, café y té. Metodología: Estudio observacional, transversal, analítico y prospectivo. Se aplicó cuestionario, recolectaron datos antropométricos y se determinó glucosa capilar a la muestra (n=304). Resultados: la prevalencia a presentar un alto riesgo a desarrollar DM2 en la población es de 35.5%, mientras que la prevalencia a presentar riesgo bajo es de 64.5%. En cuanto a hábitos tóxicos, no existió correlación positiva entre consumo de té y desarrollo de DM2. Sin embargo, sí entre el consumo de café y alcohol. Conclusiones: los habitantes de salinas presentan un bajo riesgo a desarrollar DM2, pero utilizan factores de riesgos modificables que aumentan la prevalencia a DM2.

Introduction: Type 2 diabetes mellitus (DM2) is defined as a metabolic disorder characterized by chronically elevated blood glucose levels. DM2 represents the paradigm of chronic diseases in which there is a close association between family and environmental factors. Therefore, the purpose of this study is to determine the association of the risk of developing DM2 and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic. Such habits include alcohol, coffee and tea. Methodology: Observational, cross-sectional, analytical and prospective study. A questionnaire was applied, anthropometric data was collected, and capillary glucose was determined in the study sample (n=304). Results: the prevalence of presenting a high risk of developing DM2 in the population is 35.5%, while the prevalence of presenting low risk is 64.5%. Regarding toxic habits, there was no positive correlation between tea consumption and the development of DM2. However, this result differed between consumption of coffee and alcohol. Conclusions: the inhabitants of Salinas have a low risk of developing DM2 but are subject to modifiable risk factors that increase said prevalence.

Infections and risk factors for infection-related mortality after pediatric allogeneic hematopoietic stem cell transplantation in Mexico: A single center retrospective study.

OBJECTIVE: To identify the type of infections and risk factors for infection-related mortality (IRM) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: Retrospective cohort study of patients <16 years of age treated in 2010-2019 was conducted. Unadjusted hazard ratios (HR) and adjusted hazard ratios (aHR) with 95% confidence intervals (95% CIs) were estimated using Cox regression. Cumulative incidence was calculated. RESULTS: Data for 99 pediatric patients were analyzed. The myeloablative conditioning was the most used regimen (78.8%) and the hematopoietic stem cell source was predominantly peripheral blood (80.8%). Primary graft failure occurred in 19.2% of patients. Frequency of acute graft-versus-host disease was 46.5%. Total of 136 infectious events was recorded, the most common of which were bacterial (76.4%) followed by viral infection (15.5%) and then fungal infection (8.1%). The best predictors for infection subtypes where the following: a) for bacterial infection (the age groups of 10.1-15 years: aHR = 3.33; 95% CI: 1.62-6.85 and. >15 years: aHR = 3.34; 95% CI: 1.18-9.45); b) for viral infection (graft versus host disease: aHR = 5.36; 95% CI: 1.62-17.68), however, for fungal infection statistically significant predictors were not identified. Related mortality was 30% (n = 12). Increased risk for infection-related mortality was observed in patients with unrelated donor and umbilical cord stem cells recipients (HR = 3.12; 95% CI: 1.00-9.85). CONCLUSIONS: Frequencies of infections and infection-related mortality appear to be similar to those reported. Unrelated donors and stem cells from umbilical cord recipients were associated with a high risk of mortality.

[Antigenotoxicity of the soy isoflavone genistein in mice exposed to carcinogenic hexavalent chromium compounds]. / Antigenotoxicidad de la isoflavona de soya genisteína en ratones expuestos a compuestos cancerígenos del cromo hexavalente.

Introduction: Introduction: the consumption of antioxidant-rich foods such as soy isoflavones may be an alternative in the protection and modulation against metal-induced genotoxicity with carcinogenic potential associated with oxidative stress. Objective: to evaluate the antigenotoxic effects of soy isoflavone genistein in mice exposed to carcinogenic compounds of hexavalent chromium (Cr[VI]). Material and method: twenty-five male Hsd:ICR mice were divided into five groups treated as follows: a) vehicle 1 (sterile distilled water, intraperitoneally); b) vehicle 2 (corn oil for fat-soluble compounds, orally); c) 15 mg/kg of genistein, orally; d) 20 mg/kg of CrO3, intraperitoneally; and e) 15 mg/kg of genistein four hours before the application of 20 mg/kg of CrO3. Evaluations of micronuclei (MN), apoptosis, ratio of polychromatic/normochromatic erythrocytes (EPC/ENC) and cell viability in peripheral blood obtained at 0, 24, 48 and 72 hours were performed. Results: the treatment with genistein reduced MN when administered prior to treatment with CrO3, the effect being greater at 48 hours (reduction of 84 %). Cell viability was reduced with genistein and CrO3 treatments alone, the effect being greater in the latter. Conclusions: genistein effectively blocked the genotoxic action of CrO3. The fact that MN and apoptosis were reduced in the group treated with genistein and CrO3 suggests that genistein could have inhibited the oxidative damage of Cr(VI) since, as there were no cells with damage, the apoptotic pathways were not activated.

Introducción: Introducción: el consumo de alimentos ricos en antioxidantes como las isoflavonas de la soya puede ser una alternativa en la protección y modulación de la genotoxicidad de metales con potencial cancerígeno asociado al estrés oxidativo. Objetivo: evaluar el efecto antigenotóxico de la isoflavona de soya genisteína en ratones expuestos a compuestos cancerígenos de cromo hexavalente (Cr[VI]). Material y método: veinticinco ratones Hsd:ICR macho fueron divididos en cinco grupos tratados de la siguiente forma: a) vehículo 1 (agua destilada estéril, vía-oral); b) vehículo 2 (aceite de maíz para compuestos liposolubles, vía-intraperitoneal); c) 15 mg/kg de genisteína, vía-oral; d) 20 mg/kg de CrO3 vía-intraperitoneal; y e) 15 mg/kg de genisteína cuatro horas antes de la aplicación de 20 mg/kg de CrO3. Se realizaron evaluaciones de micronúcleos (MN), apoptosis, relación de eritrocitos policromáticos/normocromáticos (EPC/ENC) y viabilidad celular en sangre periférica obtenida a las 0, 24, 48 y 72 horas. Resultados: el tratamiento con genisteína redujo los MN cuando fue administrada previamente al tratamiento con CrO3, siendo mayor el efecto a las 48 horas (reducción del 84 %). La viabilidad celular se redujo con los tratamientos de genisteína y CrO3 solos, siendo mayor el efecto en este último. Conclusiones: la genisteína bloqueó eficazmente la acción genotóxica del CrO3. El hecho de que se redujeran los MN y la apoptosis en el grupo tratado con la genisteína y el CrO3 sugiere que la genisteína pudo haber inhibido el daño oxidativo del Cr(VI) ya que, al no haber células con daño, las vías apoptóticas no se activaron.

Evidence that cervical cancer cells cultured as tumorspheres maintain high CD73 expression and increase their protumor characteristics through TGF-ß production.

Recently, a link between the biological activity of CD73 and tumorigenicity in solid tumors has been proposed. We previously reported that the generation of adenosine (Ado) by the activity of CD73 in cervical cancer (CC) cells induces transforming growth factor-beta 1 (TGF-ß1) production to maintain CD73 expression. In the present study, we analyzed the participation of TGF-ß1 in CD73 expression and the development of protumoral characteristics in CaSki CC cells cultured as tumorspheres (CaSki-T) and in monolayers (CaSki-M). Compared with those in CaSki-M cells, CD73 expression and Ado generation ability were significantly increased in CaSki-T cells. CaSki-T cells exhibited enrichment in the CSC-like phenotype due to increases in the expression levels of stem cell markers (CD49f, CK17, and P63; OCT4 and SOX2), greater sphere formation efficiency (SFE), and an increase in the percentage of side population (SP) cells. Interestingly, compared with CaSki-M cells, CaSki-T cells produced a greater amount of TGF-ß1 and presented a marked protumor phenotype characterized by a significant decrease in the expression of major histocompatibility complex class-I (MHC-I) molecules, an increase in the expression of multidrug resistance protein-I (MRP-I) and vimentin, and an increase in the protein expression levels of Snail-1 and Twist, which was strongly reversed with TGF-ß1 inhibition. These results suggest that the presence of TGF-ß1-CD73-Ado feedback loop can promote protumoral characteristics in the CC tumor microenvironment.

Estrés académico, procrastinación y usos del Internet en universitarios durante la pandemia por covid-19 / Academic Stress, Procrastination, and Internet Uses Among College Students During the covid-19 Pandemic / Estresse acadêmico, procrastinação e uso da Internet em estudantes universitários durante a pandemia de covid-19

La pandemia por covid-19 repercutió en las prácticas educativas y convirtió a las tecnologías de la información y la comunicación ­sobre todo Internet­ en medios indispensables para continuar con las actividades académicas; pero a la par incrementaron el riesgo de que los estudiantes usen mal estas herramientas y con ello aparezcan fenómenos como la procrastinación. Por tanto, el objetivo fue analizar la relación entre el estrés académico, el uso problemático de Internet, la adicción a las redes sociales y la procrastinación académica. Materiales y métodos: estudio cuantitativo, no experimental, de corte transversal. Se utilizó el inventario sisco de estrés académico, el cupo para uso problemático de Internet, la smas-sf de adicción a redes sociales y la Escala de Procrastinación Académica. La muestra la conformaron 448 estudiantes universitarios mexicanos entre los 17 y los 34 años. Resultados: se hallaron diferencias significativas por sexo, en cuanto a las reacciones ante el estrés académico, y en la categoría de la autorregulación, donde los hombres indicaron una baja autorregulación. Por su parte, en la sub-muestra de mujeres se encontró una relación positiva y significativa entre el uso de las redes sociales y la procrastinación académica; mientras que, en los hombres, entre los problemas por el uso de las redes sociales y las reacciones psicológicas ante el estrés. Conclusión: el cambio de modalidad de estudio (de presencial a virtual) ha generado consecuencias en los universitarios, como estrés académico, procras-tinación y usos inadecuados de Internet.

The covid-19 pandemic has affected educational practices, turning the information and communication technologies and the Internet into essential means to continue academic activities while increasing the risk of students misusing these tools, favoring phenomena such as procrastination. This study aimed to analyze the relationship between academic stress, problematic Internet use, social media addiction, and academic procrastination. Materials and methods: In this quantitative, non-experimen-tal, and cross-sectional study, the sisco inventory for academic stress, cupi for problematic Internet use, smas-sf for addiction to social networks, and academic procrastination scale were used. The sample was made up of 448 Mexican university students aged 17­34 years. Results: Significant differences were found by sex in terms of reactions to academic stress and in the category of self-regulation, where men indicated low self-regulation. Moreover, a positive and significant relationship was found between the use of social networks and academic procrastination in women and the problems due to the use of social networks and psychological reactions to stress in men. Conclusion: The change from face-to-face to virtual modality has led to consequences such as academic stress, procrastination, and inappropriate use of the Internet among university students.

a pandemia do covid-19 impactou as práticas educacionais, tornando as Tecnologias da Informação e Comunicação (tic) e principalmente a Internet meios indispensáveis para a continuidade das atividades acadêmicas; mas ao mesmo tempo aumenta o risco de que os alunos façam mau uso dessas ferramentas e com isso apareçam fenômenos como a procrastinação. Portanto, o objetivo do presente estudo foi analisar a relação entre estresse acadêmico, uso problemático da Internet, vício em redes sociais e procrastinação acadêmica. Materiais e métodos: estudo quantitativo, não experimental e transversal. Foram utilizados o Inventário sisco de estresse acadêmico, o cupi para uso problemático da Internet, o smas-sf para vício em redes sociais e a escala de procrastinação acadêmica (epa). A amostra foi composta por 448 estudantes universitários mexicanos com idades entre 17 e 34 anos. Resultados: foram encontradas diferenças significativas em função do sexo nas reações ao estresse acadêmico e na catego-ria de auto-regulamentação, onde os homens indicaram baixa auto-regulamentação. Por outro lado, foi encontrada uma relação positiva e significativa, na subamostra de mulheres, entre o uso de redes sociais e procrastinação acadêmica, enquanto que para os homens houve relação positiva e significativa entre problemas devido ao uso de redes sociais e reações psicológicas ao estresse. Conclusão: a mudança da modalidade presencial para a virtual gerou consequências em universitários como estresse acadêmico, procrastinação e uso inadequado da Internet.

Influence of invertor and evertor muscle fatigue on functional jump tests and postural control: A prospective cross-sectional study

ABSTRACT Objective: Fatigue of the ankle's stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre- and post-fatigue conditions of the ankle invertor and evertor muscles. Methods: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120°/s. Results: Participants had an average age of 24.3 years (SD ± 2.08), the height of 1.73 m (SD ± 0.08), and a weight of 68.63 kg (SD ± 10.29). The average Body Mass Index (BMI) was 22.88 (SD ± 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. Conclusions: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.

Comunicación en el consultorio de medicina familiar: trabajo multicéntrico, cualitativo cuantitativo, en los meses de abril a julio de 2014, en Buenos Aires, Rosario y Tucumán / Communication in Family Medicine practice: multicenter research trial, qualitative and quantitative, from April to June 2014. in the City of Buenos Aires, Rosario and Tucumán

Introducción: la comunicación es trascendental para la vida en sociedad. El éxito de cualquier entrevista clínica depende de la calidad de la comunicación entre el médico y el paciente. Distintos factores pueden interferir en esta, como el ambiente, el tiempo y las interrupciones. Objetivo: Evaluar el grado de comprensión del mensaje transmitido por el médico hacia el paciente. Material y método: Trabajo multicéntrico, cualitativo cuantitativo. Componente cuantitativo: descriptivo de corte transversal de abril a julio de 2014. Se incluyeron 1200 adultos de ambos sexos, que asistieron a los Ce.M.A.P y 40 médicos de familia. Componente cualitativo: Muestreo no probabilístico, intencional, hasta saturación de datos. Triangulación y convergencia de datos. Resultados y discusión: Respecto al componente cuantitativo, se encontró que nuestras hipótesis acerca de la falta de comprensión del mensaje (indicaciones y problema de salud) no pudieron comprobarse. Ya que las indicaciones realizadas por el médico tuvieron una adecuación total del 60% y comprendieron el problema de salud un 77% de los pacientes entrevistados. Para el componente cualitativo luego del análisis temático se obtuvieron barreras (tiempo, paciente polidemandante, ideas previas, omisión de indicaciones no farmacológicas) y facilitadores (conocimiento previo del problema de salud, longitudinalidad, paciente acompañado) para la comprensión del mensaje. Conclusiones: Los pacientes entienden el mensaje de sus médicos de familia, ya que contamos con herramientas concretas como la escucha empática, el proceso clínico centrado en la persona y la longitudinalidad en la atención (AU)

Introduction: communication is important for life in a society. Success in any clinical interview depends on the quality of patient-doctor communication. Different factors may interfere, like the environment, time and interruptions. Objective: Asses the level of understanding of the message given to the patient by the doctor. Material and method: Multicenter research trial, qualitative and quantitative. Quantitative component: cross sectional descriptive from April to June 2014. 1200 adults of both sexes who assisted to the primary health care center: "Ce.M.A.P." in the City of Buenos Aires, Rosario and Tucumán and 40 family practitioners. Qualitative component: nonprobability, intentional sampling upon data saturation. Data triangulation and convergence. Results and discussion: as regards the quantitative component, we found out that our hypothesis in relation to the lack of understanding in the message (indications and health problem) could not be proven. Since 60% of the practitioner's indications were followed and 77% of the interviewed patients understood the health problem. Considering the qualitative component after the thematic analysis, barriers (time, highly demanding patient, previous knowledge, omission of non-pharmacological indications) and facilitators were obtained (previous knowledge of health problem, longitudinality, accompanied patient) to understand the message. Conclusion: patients understand their family practitioner's message since we have specific tools like empathic listening, patient centered healthcare and longitudinality in attention (AU)

Detection of CD39 and a Highly Glycosylated Isoform of Soluble CD73 in the Plasma of Patients with Cervical Cancer: Correlation with Disease Progression.

Persistent infection with high-risk human papillomavirus (HR-HPV) is the main factor in the development of cervical cancer (CC). The presence of immunosuppressive factors plays an important role in the development of this type of cancer. To determine whether CD39 and CD73, which participate in the production of immunosuppressive adenosine (Ado), are involved in the progression of CC, we compared the concentrations and hydrolytic activity of these ectonucleotidases in platelet-free plasma (PFP) samples between patients with low-grade squamous intraepithelial lesions (LSILs) (n = 18), high-grade squamous intraepithelial lesions (HSILs) (n = 12), and CC (n = 19) and normal donors (NDs) (n = 15). The concentrations of CD39 and CD73 in PFP increased with disease progression (r = 0.5929, p < 0.001). The PFP of patients with HSILs or CC showed the highest concentrations of CD39 (2.3 and 2.2 times that of the NDs, respectively) and CD73 (1.7 and 2.68 times that of the NDs, respectively), which were associated with a high capacity to generate Ado from the hydrolysis of adenosine diphosphate (ADP) and adenosine monophosphate (AMP). The addition of POM-1 and APCP, specific inhibitors of CD39 and CD73, respectively, inhibited the ADPase and AMPase activity of PFP by more than 90%. A high level of the 90 kD isoform of CD73 was detected in the PFP of patients with HSILs or CC. Digestion with endoglycosidase H and N-glycanase generated CD73 with weights of approximately 90 kD, 85 kD, 80 kD, and 70 kD. In addition, the levels of transforming grow factor-ß (TGF-ß) in the PFPs of patients with LSIL, HSIL and CC positively correlated with those of CD39 (r = 0.4432, p < 0.001) and CD73 (r = 0.5786, p < 0.001). These results suggest that persistent infection by HR-HPV and the concomitant production of TGF-ß promote the expression of CD39 and CD73 to favor CC progression through Ado generation.

[Leading causes of death during the induction therapy in pediatric patients with acute lymphoblastic leukemia]. / Principales causas de mortalidad durante la fase de inducción a la remisión en los pacientes pediátricos con leucemia linfoblástica aguda.

BACKGROUND: Leukemias are the leading cause of childhood cancer. In most developed countries 1-2% of patients die during remission induction; however, in developing countries, this figure is higher and the causes of death apparently vary among the populations studied. The aim was to determine the cause of death during remission induction in pediatric patients with acute lymphoblastic leukemia (ALL) in the hospital "Dr. Gaudencio González Garza" of Centro Médico Nacional La Raza from January 1, 2009, to December 31, 2014. METHODS: A retrospective cohort study was carried out and a descriptive statistical analysis was performed. RESULTS: During the study period, a total of 463 patients with ALL were diagnosed, out of which 5.4% died (n = 25). Among the patients who died, 64% (n = 16) were female and 60% had high-risk clinical features at diagnosis. The main causes of death were septic shock and bleeding. CONCLUSIONS: Early mortality was five times higher than the one reported for developed countries, while the causes of death did not differ. Close monitoring is necessary to detect and promptly treat complications secondary to chemotherapy toxicity in Mexican pediatric patients with ALL.

Introducción: las leucemias son la principal causa de cáncer en la infancia. En la mayoría de países desarrollados fallecen entre 1 y 2% de los pacientes durante la inducción a la remisión; sin embargo, en países en vías de desarrollo, esta cifra al parecer es superior y las causas de muerte varían entre las poblaciones estudiadas. El objetivo fue determinar la causa de mortalidad durante la fase de inducción a la remisión en los pacientes pediátricos con diagnóstico de leucemia linfoblástica aguda (LLA) en el Hospital General "Dr. Gaudencio González Garza" del Centro Médico Nacional La Raza del 1 de enero de 2009 al 31 de diciembre de 2014. Métodos: se realizó un estudio de cohorte retrospectivo y se utilizó estadística descriptiva. Resultados: se diagnosticaron un total de 463 pacientes con LLA durante el periodo de estudio, de los cuales falleció el 5.4% (n = 25). Entre los pacientes que fallecieron, el 64% (n = 16) eran del sexo femenino y el 60% tenía características clínicas de alto riesgo al momento del diagnóstico. Entre las principales causas de muerte estuvieron el choque séptico y las hemorragias. Conclusiones: la frecuencia de mortalidad temprana en los pacientes con LLA fue cinco veces más elevada que la reportada para países desarrollados, mientras que las causas de muerte no difieren. Se requiere de una vigilancia estrecha para detectar y tratar oportunamente las complicaciones secundarias a toxicidad por quimioterapia en pacientes pediátricos mexicanos con LLA.

El peso de un diagnóstico / The weight of a diagnosis

Introducción: el estado nutricional (EN) infantil requiere adecuada evaluación. Objetivos: Describir el EN de niños de 1-5 años que asistieron a tres centros de atención primaria de una obra social en 2014 y su método de evaluación. Conocer el impacto del diagnóstico en sus familias. Materiales y métodos: Estudio multicéntrico cuali-cuantitativo, n=891. Se revisaron historias clínicas y se entrevistó a padres de niños con diagnóstico de obesidad o bajo peso. Resultados: El 52% de los niños fueron evaluados con percentilos Peso/Edad, hallándose 71% eutrófico, 6% con obesidad, y 4% bajo peso. Utilizando percentilos IMC/Edad, 60% resulto eutrófico, 14 % con obesidad y 1% con bajo peso. En el análisis cualitativo se observaron: naturalización diagnóstico, dificultad de los padres para poner límites, sentimientos de culpa y frustración y déficit en la comunicación médico-familia. Conclusión: El 60% de los niños de 1-5 años que consultaron en tres centros de atención primaria de un obra social en el 2014 resultaron eutróficos, 14% con obesidad y 1% bajo peso. La mayoría de los niños fueron evaluados utilizando percentilos incorrectos. La subestimación del diagnóstico por parte de los padres fue favorecida por el uso de eufemismos y lenguaje diminutivo por parte de los médicos.

Introduction: childhood nutritional status (NS) requires adequate assessment. Objectives: To describe NS of children aged 1-5 that attended three primary care centers of a social security organisation during 2014 and its method of assessment. To know the impact the diagnosis had on their families. Materials and methods: Quali-quantitative multicenter study, n=891. Charts were reviewed and parents of children diagnosed with obesity or low weight were interviewed. Results: 52% of children were assessed using Weight/Age percentiles, being 71% eutrophic, 6% with obesity, and 4% low weight. Using BMI/Age percentiles, 60% were eutrophic, 14% with obesity and 1% with low weight. In the qualitative analysis were observed: naturalization of the diagnosis, parental difficulties in setting limits, feelings of the quilt and frustration, anddeficits in physician-family communication. Conclusion: Using the BMI/Age curve, 60% of the 1-5 year olds who were attended at three primary care centers of a social security organisation in 2014 were eutrophic, 14% were obese and 1% had low weight. Most children were assessed using wrong percentiles. Underestimation of the diagnosis by parents was favored by the use of euphemisms and diminutive language by physicians.

Caracterización de la microbiota nativa del queso Oaxaca tradicional en tres fases de elaboración / Characterization of the native microflora of traditional Oaxaca cheese in three phases of production

El queso Oaxaca tradicional goza de gran reconocimiento y consumo a nivel nacional, al ser elaborado con leche cruda de vaca es considerado como factor de riesgo para la salud, sin embargo, contiene flora natural no patógena como las bacterias lácticas (BAL), que le proporciona características extraordinarias y su reconocida tipicidad siendo importante su caracterización. Se realizó el conteo, aislamiento y caracterización fenotípica (pruebas morfológicas, bioquímicas, factores de crecimiento y fermentación) de coliformes totales, BAL, levaduras y Staphylococcus spp.en las etapas de leche, cuajada y queso. Todos los recuentos se encontraron fuera de la normativa mexicana (NOM-243-SSA1-2010); se observó diferencia (p<0,05) entre la etapa de leche y queso para coliformes totales, BAL y levaduras. Se aislaron 43 cepas de BAL, 38 de coliformes, 24 de levaduras y 16 de Staphylococcus spp. El 72,1% de las BAL correspondió al género Lactococcus y el 27,9% a Lactobacillus, se detectó la presencia de E. coli, Staphylococcus aureus y Rhodotorula spp. Los resultados muestran deficientes prácticas de higiene en la elaboración de queso Oaxaca, siendo importante la identificación de la microbiota autóctona y monitoreo en toda la cadena productiva a fin de obtener un producto artesanal inocuo y de mejor calidad.

The traditional Oaxaca cheese is highly regarded nationally and its consumption, being made from raw cow’s milk is considered as a risk factor to health, however is nonpathogenic natural flora and lactic acid bacteria (LAB), which provides unique characteristics and typicality recognized to be important characterization. Count was performed, isolation and phenotypic characterization (morphological and biochemical tests, growth factors and fermentation) of total coliforms, LAB, yeasts and Staphylococcus in the stages of milk, curd and cheese. All counts were found outside Mexican standards (NOM-243-SSA1-2010), was difference (p<0.05) between the stage of milk and cheese for total coliforms, LAB and yeasts. 43 strains were isolated from BAL, coliform 38, 24 yeasts, and 16 Staphylococcus. The 72.1% of the BAL corresponded to the genus Lactococcus and 27.9% for Lactobacillus, we detected the presence of E. coli, Staphylococcus aureus, and Rhodotorula spp. The results show poor hygiene practices in Oaxaca cheese making and it is important to identify the indigenous microbiota and monitoring throughout the production chain in order to get a handmade product safe and of better quality.

Análogos de incretina e inhibidores de la DDP-4: ¿qué papel desempeñan en la prevención primaria de las enfermedades cardiovasculares? / Incretin analogs and inhibitors of DPP-4: which is their role in the primary prevention of cardiovascular diseases?

La diabetes mellitus tipo 2 (DM2) es una enfermedad altamente prevalente, la cual ha mostrado un incremento acelerado en las últimas décadas, pues se ha duplicado el número de personas con esta enfermedad. Diversos estudios epidemiológicos revelan que el 70% de las muertes por diabetes son causadas por eventos cardiovasculares (enfermedad coronaria y accidente cerebrovascular). Recientemente se ha observado una expansión en el descubrimiento de medicamentos para el manejo de la DM2, los mismos que, para su introducción en el mercado, deben mostrar beneficios adicionales para el sistema cardiovascular. Este artículo tiene como propósito determinar el papel de los nuevos medicamentos hipoglicemiantes que actúan en el sistema de las incretinas y sus efectos en la prevención primaria de eventos cardiovasculares.

Type 2 diabetes mellitus (T2DM) is a highly prevalent disease, which has shown a rapid increase in recent decades, doubling the number of people with this disease. Several epidemiological studies show that 70% of diabetes deaths are caused by cardiovascular events (coronary heart disease and stroke). Recently there has been an expansion in the discovery of drugs for the management of type 2 diabetes. These drugs must demonstrate additional cardiovascular system benefits before its introduction in the market. This paper aims to determine the role of new antidiabetic drugs that act on the incretin system and its effects on the primary prevention of cardiovascular events.

La filosofía MEAW y el rol de los terceros molares en el desarrollo y tratamientos de las mordidas abiertas / MEAW philosophy and the riole of third molars in the development and treatment of openbites

Multiloop Edgewise Archwire Technique es una técnica desarrollada en los años 60 por Young H. Kim, la cual ha tenido un fuerte desarrollo en los países de Asia, especialmente Japón y Corea, por el Prof. Sadao Sato de la Universidad de Kanagawa, Japón. En la experiencia de la filosofía MEAW se ha dado particular importancia al tratamiento no quirúrgico de clases III y mordidas abiertas esqueletales. La discrepancia posterior (CP), concepto nuevo para la ortodoncia occidental, es considerada para determinar la remoción temprana de los terceros molares debido a su importancia como factor coadyuvante en la recidiva de los tratamientos de ortodoncia, especialmente el apiñamiento incisivo y en particular en la orientación del Dr. Sato, debido a su importancia en el desarrollo de la DP, que como se ha mencionado, es un factor etiopatogénico en el desarrollo de las maloclusiones esqueletales y mordidas abiertas antes, durante y postratamiento de ortodoncia.

The age incidence of childhood B-cell precursor acute lymphoblastic leukemia in Mexico City.

The objective of this population-based survey was to assess the peak age of incidence of B-cell precursor acute lymphoblastic leukemia (ALL) in children in Mexico City (MC). All patients were classified according to their immunophenotype, and only B-cell precursor and T-lineage were analyzed. Rates of incidence were calculated x10 children. Of the 364 children from MC who were included in this study, immunophenotyping had been performed for 81.6%. The frequency of B-cell precursor ALL was 76.1%, whereas T lineage ALL showed a frequency of 23.6%. Peak age for ALL was 2 to 3 years of age. B-cell precursor ALL was the major contributor to peak age; T lineage ALL showed a peak among 1 and 3 years of age. We conclude that the age peak for children with ALL in MC is within the ranges reported for developed countries and that B-cell precursor ALL is the main contributor to these peak.

Frequency of transferable multiple antibiotic resistance amongst coliform bacteria isolated from a treated sewage effluent in Antofagasta, Chile

Antibiotic-resistant coliform bacteria from raw and treated water from activated sludge of a sewage treatment plant were isolated on eosin methylene blue agar (EMB) plates in the separate presence of ampicillin, tetracycline, chloramphenicol and streptomycin. Antibiotic resistant coliforms obtained from inflow and effluent waters were studied to determine influences of treatment on the species composition, resistance patterns and transferable resistance in these bacteria. The bacterial counts obtained showed a high proportion of antibiotic resistant coliforms in the treated effluent. The resistant coliform species were eliminated at different rates by the treatment. Escherichia coli decreased, whereas the proportion of Klebsiella sp increased. The percentage of multiple-resistant isolates increased at the end of the treatment process. The high frequency of resistance was to ampicillin, followed by tetracycline and sulpha-trimethoprim. Moderate incidence of resistance was to streptomycin, chloramphenicol and cephradine. The lowest rate of resistance was to kanamicin and nalidixic acid. Mating experiments of multiple-resistant coliforms with an E. coli K-12 donor confirmed the capability of transferring its resistance. The results of this study suggested that wastewater treatment could reduce the total number of enteric bacteria in sewage, but may increase the proportion of antibiotic resistant coliforms in effluent water. Environmental release and agricultural use of treated sewage effluent containing bacteria having elevated antibiotic resistance levels presents a potential public health risk, as well as the risk of transferring the antibiotic resistance to bacterial populations in the environment.

Estudio retrospectivo de los primeros 100 casos de ecocardiografía trasesofágica en el Hospital Max Peralta, durante el período 2003-2005 / Retrospective study of the first 100 cases of transesophageal heart ultrasound in the Hospital Max Peralta, during perid 2003-2005

Introducción: La ecocardiografía transesofágica ha permitido superar las limitaciones del acceso transtoráccico lo que permite entregar con claridad y resolución, imágenes de la estructura y función cardíacas y de los grandes vasos. El objetivo de este estudio fue evaluar las indicaciones, complicaciones y diagnósticos de los primeros cien ecocardiogramas transesofágicos realizados en nuestro centro. Material y métodos: Es un estudio retrospectivo realizado en base a los expedientes clínicos desde el periodo en que se adquirió el equipo (2003) hasta completar los primeros cien ecocardiogramas tranesofágicos (setiembre 2005) en el Servicio de Cardiología del Hospital Max Peralta, Cartago, Costa Rica, con un equipo multiplanar. Resultados: Los primeros cien procedicientos se realizaron en 89 pacientes (edad promedio de 44,5 años). 49 por ciento fueron hombres. Las indicaciónes más frecuentes para la realización del ecocardiograma transesofágico fueron cardiopatía congénita (36 por ciento), tumores y/o masas (13 por ciento) y endocarditis (11 por ciento). Los diagnósticos definitivos fueron principalmente valvulopatías nativas, dilatación y/o hipertrofia de cámaras derechas, comunicación interauricular e hipertensión pulmonar. Sólo hubo complicaciones leves como hipotensión arterial y las relacionadas a la sedación. Conclusión: Este estudio demuestra la utilidad diagnóstica y seguridad del ecocardiogrma transesofágico en nuestro centro, con resultados comparables a otras series. Palabras claves: ecocardiografía transesofágica, masas, endocarditis, valvulopatías.

Utilización de coliformes fecales y colifagos en el control de la calidad bacteriológica de aguas servidas tratadas por lodos activados / Use of fecal coliforms and coliphage to determine the bacteriological quality of activated sludge sewage treatment

Evidence from the scientific literature suggests that coliform bacteria are not adequate indicators for fecal contamination, and the need has been expressed for development of rapid, accurate, and cost-effective techniques for determining the bacteriological quality of water. One alternative has been the use of coliphage methods. The objetive of the present study was to evaluate bacteriological water quality of sewage treated with fecal coliforms and coliphage. Water samples were collected from three stations: 1) influent, 2) middle, and 3) effluent at the Antofagasta activated sludge treatment plant. Coliform bacteria were determined using the MPN technique, and coliphage enumeration as described by Isbister et al., (1983). Escherichia coli ATCC 13706 was used as the host strain. The counts of both organisms decreased in a similar way through the different treatment steps with little variation over a one-year period. Coliphage numbers were lower than the bacteria by about one log. After the sewage treatment chlorination step the coliphage number was higher than the fecal coliforms. These differences showed that the coliphage was more resistent to chlorine than the fecal coliforms. The results suggested than the coliphage could be used as an alternate indicator in evaluation of bacteriological quality of treated sewage effluent.

Fuertes evidencias sugieren que las bacterias coliformes no son indicadores adecuados de contaminación fecal. Hay una gran necesidad por el desarrollo de una técnica más rápida, acuciosa y de bajo costo para determinar la calidad bacteriológica del agua. Los colifagos parecen ser una excelente alternativa. El objetivo de este estudio fue evaluar la calidad bacteriológica de aguas servidas tratadas por medio de los coliformes fecales y colifagos. Muestras de aguas fueron recolectadas de tres estaciones: afluente, en el medio y efluente en la planta de tratamientos de Antofagasta por lodos activados. Las bacterias coliformes fueron determinadas por la técnica del NMP y la enumeración de colifagos, como describe Isbister y col (1983). Escherichia coli ATCC 13706 fue usada como cepa huésped. Los recuentos de ambos microorganismos disminuyeron en forma similar a lo largo de las diferentes etapas del tratamiento con variaciones pequeñas durante un año, siendo el número de colifagos más bajos que los coliformes fecales en un log. Al final del tratamiento de las aguas servidas, etapa de cloración, los números de los colifagos fueron más altos que los coliformes fecales. Estos resultados sugieren que los colifagos pueden ser usados como un indicador alternativo para la evaluación de la calidad bacteriológica de las aguas tratadas.