Rheumatological therapy in Prehispanic Mesoamerica.

Nahuatl medicine was remarkably advanced in Prehispanic Mesoamerica. Thoughts on health and disease were different to those prevalent in Europe in the sixteenth century because they included magic, religion and different kinds of animal, mineral and, notably, herbal medicine. These resources were used in a supplementary, not isolated, way by Nahua physicians (ticitl) according to patients' needs and beliefs. Most Nahua physicians had similar knowledge but there were some differences between rural and urban areas, and those who were also doctor-priests of a particular deity. After the European colonization of Mesoamerica, great efforts were made by Spaniards and Indians to recover the immense amount of ancient knowledge in Mesoamerica related to medicine. Some of this work, not all, is included in the Cruz-Badiano Codex, the Florentine Codex or Historia general de las cosas de la Nueva España, and the Francisco Hernández Codex. A review of these codices and the recent literature on the practice of Nahua Medicine was performed with particular interest in herbal medicine in rheumatic diseases, or symptoms probably related to rheumatic diseases, during the sixteenth century in the land currently known as Mexico.

Rheumatological Therapy in Prehispanic Mesoamerica. / Terapéutica reumatológica en la mesoamérica prehispánica.

Nahuatl medicine was remarkably advanced in Prehispanic Mesoamerica. Thoughts on health and disease were different to those prevalent in Europe in the sixteenth century because they included magic, religion and different kinds of animal, mineral and, notably, herbal medicine. These resources were used in a supplementary, not isolated, way by Nahua physicians (ticitl) according to patients' needs and beliefs. Most Nahua physicians had similar knowledge but there were some differences between rural and urban areas, and those who were also doctor-priests of a particular deity. After the European colonization of Mesoamerica, great efforts were made by Spaniards and Indians to recover the immense amount of ancient knowledge in Mesoamerica related to medicine. Some of this work, not all, is included in the Cruz-Badiano Codex, the Florentine Codex or Historia general de las cosas de la Nueva España, and the Francisco Hernández Codex. A review of these codices and the recent literature on the practice of Nahua Medicine was performed with particular interest in herbal medicine in rheumatic diseases, or symptoms probably related to rheumatic diseases, during the sixteenth century in the land currently known as Mexico.

Bioactive Components in Human Milk Along the First Month of Life: Effects of Iodine Supplementation during Pregnancy.

BACKGROUND/AIMS: Human milk is considered the most suitable food for infants. The potential benefits of breastfeeding can be explained by the presence of different growth and neurotrophic factors in human milk. This study was designed to detect some biomarkers in human milk, which could be involved in the infant neurodevelopment and in the regulation of the maturation of neonatal intestine (brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), glial fibrillary acidic protein (GFAP), fibroblast growth factor 21 (FGF21), lysophosphatidic acid (LPA) and autotaxin (ATX)), and compare them on the basis of the consumption of iodine supplements or multivitamins. METHODS: A prospective study included 37 healthy breastfeeding mothers, divided into 3 different groups: (1) 10 mothers who did not take supplements, (2) 17 mothers who took potassium iodine (KI) 200 µg/day and (3) 10 mothers who took a multivitamin supplement. RESULTS: The concentrations of BDNF, GDNF, GFAP, FGF21, LPA and ATX in human milk were not significantly different in women who took a multivitamin or KI supplement compared with those who did not take any supplement. CONCLUSIONS: The presence of neurotrophic factors in human milk is neither modified by the consumption of supplements nor by their type.

Desempeño del examen clínico objetivo estructurado como instrumento de evaluación en la certificación nacional como reumatólogo / Performance of an objective structured clinical examination in a national certification process of trainees in rheumatology

Objetivo. Determinar la validez de constructo y la confiabilidad de un examen clínico objetivo estructurado (ECOE) en la evaluación de una certificación nacional como reumatólogo. Método. En 2013 y 2014, se aplicaron sendos ECOE y evaluación teórica (ET) a 32 y 38 residentes aspirantes a la certificación de reumatólogo, respectivamente. Se incluyeron 12 y 15 estaciones calificadas mediante lista de cotejo validada. Previamente, 3 reumatólogos certificados realizaron sendas pruebas piloto. Se calculó la puntuación global del ECOE y se evaluó su desempeño. Resultados. En 2013, la media ± DE del ECOE fue de 7,1 ± 0,6) y ningún aspirante tuvo calificación reprobatoria (CR); la media de la ET fue de 6,5 ± 0,6 y 7 aspirantes (21,9%) tuvieron CR (< 6). En 2014, la media del ECOE fue de 6,7 ± 0,6) y 3 aspirantes (7,9%) tuvieron CR, de los cuales 2 reprobaron la ET; la media de la ET fue de 6,4 ± 0,5) y 7 aspirantes (18,5%) tuvieron CR, 2 de los cuales reprobaron el ECOE. En 2013, la correlación entre el ECOE y la ET fue de r = 0,44, p = 0,006. En ambos años, los reumatólogos certificados obtuvieron mejores calificaciones en el ECOE que los residentes. El porcentaje de aprobados en la ET fue mayor entre quienes aprobaron el ECOE que entre quienes lo reprobaron: 86% vs. 67%, p = 0,02. Se aplicaron 9 estaciones en ambos años y sus puntuaciones mostraron correlación de 0,81 a 0,95, p ≤ 0,01. Conclusión. El ECOE es una herramienta adecuada para evaluar las competencias clínicas de los aspirantes a la certificación (AU)

Objective. To assess reliability and validity of the objectively-structured clinical examination (OSCE) applied in postgraduate certification processes by the Mexican Board of Rheumatology. Method. Thirty-two (2013) and 38 (2014) Rheumatology trainees (RTs) underwent an OSCE consisting of 12 and 15 stations respectively, scored according to a validated check-list, as well as 300-multiple-choice 300 question examination (MCQ). Previously, 3 certified rheumatologists underwent a pilot-OSCE. A composite OSCE score was obtained for each participant and its performance examined. Results. In 2013, OSCE mean score was 7.1 ± 0.6 with none RT receiving a failing score while the MCQ score was 6.5 ± 0.6 and 7 (21.9%) RTs receiving a failing (< 6) score. In 2014, the OSCE score was 6.7 ± 0.6, with 3 (7.9%) RTs receiving a failing score (2 of them also failed MCQ) while the MCQ score was 6.4 ± 0.5 and 7 (18.5%) RTs were disqualified (2 of them also failed OSCE). A significant correlation between the MCQ and the OSCE scores was observed in the 2013 (r=0.44; P=0.006). Certified rheumatologists performed better than RTs at both OSCE. Overall, 86% of RTs obtaining an OSCE passing score also obtained a MCQ passing score, while this was only 67% (P=.02) among those who obtained an OSCE failing score. Nine stations were applied at both consecutive years. Their performance was similar in both certification processes, with correlation coefficients ranging from 0.81 to 0.95 (P≤0.01). Conclusion. The OSCE is a valid and reliable tool to assess the Rheumatology clinical skills in RTs (AU)