Update of variants identified in the pancreatic ß-cell KATP channel genes KCNJ11 and ABCC8 in individuals with congenital hyperinsulinism and diabetes.

The most common genetic cause of neonatal diabetes and hyperinsulinism is pathogenic variants in ABCC8 and KCNJ11. These genes encode the subunits of the ß-cell ATP-sensitive potassium channel, a key component of the glucose-stimulated insulin secretion pathway. Mutations in the two genes cause dysregulated insulin secretion; inactivating mutations cause an oversecretion of insulin, leading to congenital hyperinsulinism, whereas activating mutations cause the opposing phenotype, diabetes. This review focuses on variants identified in ABCC8 and KCNJ11, the phenotypic spectrum and the treatment implications for individuals with pathogenic variants.

Functional Expression and One-Step Protein Purification of Manganese Peroxidase 1 (rMnP1) from Phanerochaete chrysosporium Using the E. coli-Expression System.

Manganese peroxidases (MnP) from the white-rot fungi Phanerochaete chrysosporium catalyse the oxidation of Mn2+ to Mn3+, a strong oxidizer able to oxidize a wide variety of organic compounds. Different approaches have been used to unravel the enzymatic properties and potential applications of MnP. However, these efforts have been hampered by the limited production of native MnP by fungi. Heterologous expression of MnP has been achieved in both eukaryotic and prokaryotic expression systems, although with limited production and many disadvantages in the process. Here we described a novel molecular approach for the expression and purification of manganese peroxidase isoform 1 (MnP1) from P. chrysosporium using an E. coli-expression system. The proposed strategy involved the codon optimization and chemical synthesis of the MnP1 gene for optimised expression in the E. coli T7 shuffle host. Recombinant MnP1 (rMnP1) was expressed as a fusion protein, which was recovered from solubilised inclusion bodies. rMnP1 was purified from the fusion protein using intein-based protein purification techniques and a one-step affinity chromatography. The designated strategy allowed production of an active enzyme able to oxidize guaiacol or Mn2+.

Low bone mineral density and renal malformation in Mexican patients with Turner syndrome are associated with single nucleotide variants in vitamin D-metabolism genes.

Turner syndrome (TS) is a common genetic disorder. TS-phenotype includes short stature, gonadal dysgenesis, cardiac and kidney malformations, low bone mineral density (low-BMD) and thyroiditis. TS-phenotype varies from patient to patient and the cause is not clear, the genomic background may be an important contributor for this variability. Our aim was to identify the association of specific single nucleotide variants in the PTPN22, VDR, KL, and CYP27B1 genes and vitamin D-metabolism, heart malformation, renal malformation, thyroiditis, and low-BMD in 61 Mexican TS-patients. DNA samples were genotyped for SNVs: rs7975232 (VDR), rs9536282 (KL), rs4646536 (CYP27B1), and rs1599971 (PTPN22) using the KASP assay. Chi-square test under a recessive model and multifactorial dimensionality reduction method were used for analysis. We found a significant association between renal malformation and the rs9536282 (KL) variant and between rs4646536 (CYP27B1) and low-BMD, these variants may have modest effects on these characteristics but contribute to the variability of the TS phenotype. In addition, we identified gene-gene interactions between variants in genes KL, CYP27B1 and VDR related to vitamin D-metabolism and low-BMD in TS-patients. Our results support the idea that the genetic background of TS-patients contributes to the clinical variability seen in them.

Duplication of SOX9 associated with 46,XX ovotesticular disorder of sex development.

RESEARCH QUESTION: The purpose of the present study was to investigate whether ten unrelated SRY-negative individuals with this sex differentiation disorder presented a double dose of SOX9 as the cause of their disease. DESIGN: Ten unrelated SRY-negative 46,XX ovotesticular disorder of sexual development (DSD) subjects were molecularly studied. Multiplex-ligation dependent probe amplification (MLPA) and quantitative real-time PCR analysis (qRT-PCR) for SOX9 were performed. RESULTS: The MLPA analysis demonstrated that one patient presented a heterozygous duplication of the entire SOX9 coding region (above 1.3 value of peak ratio), as well as at least a ~ 483 kb upstream duplication. Moreover, no duplication of other SOX9 probes was observed corresponding to the region between -1007 and -1500 kb upstream. A qRT-PCR analysis showed a duplication of at least -581 kb upstream and ~1.63 kb of the coding region that encompasses exon 3. The limits of the duplication were mapped approximately from ~71539762 to 72122741 of Chr17. No molecular abnormalities were found in the remaining nine patients. CONCLUSION: This study is thought to be the first report regarding a duplication of SOX9 that is associated with the presence of 46,XX ovotesticular DSD, encompassing at least -581 kb upstream, and the almost entire coding region of the gene.

Aspartame Administration and Insulin Treatment Altered Brain Levels of CYP2E1 and CYP3A2 in Streptozotocin-Induced Diabetic Rats.

This study demonstrates that aspartame consumption and insulin treatment in a juvenile diabetic rat model leads to increase in cytochrome P450 (CYP) 2E1 and CYP3A2 isozymes in brain. Diabetes mellitus was induced in postweaned 21-day-old Wistar male rat by streptozotocin. Animals were randomly assigned to one of the following groups: untreated control, diabetic (D), D-insulin, D-aspartame, or the D-insulin + aspartame-treated group. Brain and liver tissue samples were used to analyze the activity of CYP2E1 and CYP3A2 and protein levels. Our results indicate that combined treatment with insulin and aspartame in juvenile diabetic rats significantly induced CYP2E1 in the cerebrum and cerebellum without modifying it in the liver, while CYP3A2 protein activity increased both in the brain and in the liver. The induction of CYP2E1 in the brain could have important in situ toxicological effects, given that this CYP isoform is capable of bioactivating various toxic substances. Additionally, CYP3A2 induction in the liver and brain could be considered a decisive factor in the variation of drug response and toxicity.

Exploring the effect of the axial ligands on the anticancer activity of [C,N,N'] Pt(IV) cyclometallated compounds.

The synthesis of three novel [C,N,N'] Pt(IV) cyclometallated compounds containing hydroxo, dichloroacetato or trifluoroacetato axial ligands is reported. Compound [PtCl(OH)2{(CH3)2N(CH2)2NCH(4-FC6H3)}] (3) was prepared by the oxidative addition of hydrogen peroxide to [C,N,N'] Pt(II) cyclometallated compound [PtCl{(CH3)2N(CH2)2NCH(4-FC6H3)}] (1) and further the reaction of compound 3 with dichloroacetate or trifluoroacetate anhydrides led to the formation of the corresponding compounds [PtCl(CHCl2COO)2{(CH3)2N(CH2)2NCH(4-FC6H3)}] (4) and [PtCl(CF3COO)2{(CH3)2N(CH2)2NCH(4-FC6H3)}] (5). The properties of the new compounds along with those of the compound [PtCl3{(CH3)2N(CH2)2NCH(4-FC6H3)}] (2), including stability in aqueous media, reduction potential using cyclic voltammetry, cytotoxic activity against the HCT116 CRC cell line, DNA interaction, topoisomerase I and cathepsin inhibition, and computational studies involving reduction of the Pt(IV) compounds and molecular docking studies, are presented. Interestingly, the antiproliferative activity of these compounds against the HCT116 CRC cell line, which is in all cases higher than that of cisplatin, follows the same trend as the reduction potentials so that the most easily reduced compound 2 is the most potent. In contrast, according to the electrophoretic mobility and molecular docking studies, the efficacy of these compounds in binding to DNA is not related to their cytotoxicity. The most active compound 2 does not modify the DNA electrophoretic mobility while the less potent compound 3 is the most efficient in binding to DNA. Although compounds 2 and 3 have only a slight effect on cell cycle distribution and apoptosis induction, generation of ROS to a higher extent for the most easily reduced compound 2 was observed.

Mexican Clinical Practice Guidelines for Adult Overweight and Obesity Management.

PURPOSE: To develop Mexico's first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers. RECENT FINDINGS: A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.

Optimizing Nutritional Status of Patients Prior to Major Surgical Intervention.

In patients undergoing elective cardiovascular and thoracic surgery, malnutrition and the deterioration of nutritional status are associated with negative outcomes. Recognition of the contributory factors and the complications stemming from surgical stress is important for the prevention and management of these patients. We have reviewed the literature available and focused on the nutritional and metabolic aspects affecting surgical patients, with emphasis on the recommendations of enhanced recovery protocols. The implementation of enhanced recovery protocols and nutritional support guidelines focusing on the surgical patient as part of a multidisciplinary approach would improve the nutritional status of surgical patients at risk for negative outcomes.

Feasibility of aquaculture cultivation of elkhorn sea moss (Kappaphycus alvarezii) in a horizontal long line in the Tropical Eastern Pacific.

Seaweed aquaculture has become a profitable and an attractive alternative of cultivation thanks to its quick biomass production for food, feed, and other non-food applications. In addition, the ecosystem services generated by seaweed cultivation towards carbon fixation represents a more sustainable solution to the ocean's acidification. The growth of elkhorn sea moss (Kappaphycus alvarezii) was evaluated in three plots with 200 propagules during a period of 70 days in a floating raft system covered by a fishing net underneath. Initial weight of propagules was 159.3 ± 12.74 g in wet biomass and 15.3 ± 1.43 g in dry biomass and were sampled up to 19 days (in the lag growth phase; period I), up to 33 days (in the exponential growth phase; period II) and up to 70 days (in the stationarity growth phase; period III). The variations of sea surface water temperature, salinity, turbidity (Secchi depth), total ammonium, nitrites, nitrates, and phosphate were determined. The growth increase was more evident in the exponential phase II when a dry biomass of 28.0 ± 2.48 (1153.3 ± 6.25 g in wet mass) was reached, more than 7 times the biomass of propagules with an average daily growth rate of 15.2% g.day-1. The carrying capacity of the zone was estimated at 86.2% in the area where 53 cultivation units would be projected. The economic analysis presented a financial feasibility with a net profit of 19% over the projected income and an IRR of 16.5%, recovering the investment in an estimated period of 4.3 years. We recommend to continue with larger-scale studies to optimize the cultivation of K. alvarezii in the study area.

Ultrasonographic description of brain cortex and cingulate sulcus development in Mexican neonates and infants with congenital hypothyroidism.

BACKGROUND: Ultrasonography of cortical and cingulum maturity patterns, were studied in newborns and infants with congenital hypothyroidism (CH). METHOD: Transversal study of 29 newborns and infants with CH, detected by neonatal screening and confirmed with thyroid function test, thyroid ultrasonography, and thyroid scintigraphy. During the first 2 months of life, transfontanelar brain ultrasonography was performed. Brain cortex maturity was assessed by normality referents provided by Slagle and Timor methods. RESULTS: Cortical immaturity signs were observed in 69% of infants (20 patients with Slage's method brain cortex development delay (Pearson's p=0.05). Logistic nominal analysis for normality prediction demonstrated a correlation between brain cortex development and age, bone age, treatment duration, and type of CH. The most sensitive detecting technique was sagittal sight by Slagle's method. CONCLUSIONS: Brain cortex delayed development is frequent in children with CH. Bone age, postnatal age at treatment start, and time since treatment start, correlates with neurological development, but not athyreosis or sublingual nodule.

Maternal Anxiety Associated with Nocturnal Childhood Enuresis.

Introduction: Nocturnal enuresis is a common problem affecting 20% of 5-year-old children; its prevalence decreases with age. Nocturnal bedwetting in children younger than 5 is generally accepted by parents and society, but the expectation of parents is that children will achieve a higher degree of responsibility and increased control with age. Some studies have identified maternal distress as a factor associated with childhood urinary incontinence; specifically, maternal stress, maternal depression, and maternal anxiety. The aim of this study was to compare the degree of anxiety (trait and state) among mothers of children with nocturnal enuresis and mothers of healthy children. Methods: This was a prospective, cross-sectional, comparative study including two groups: a control group of 25 mothers of healthy children from open population, and an enuresis group of 25 mothers of children with nocturnal enuresis of the pediatric urology clinic of a third-level Mexican Hospital. STAI-T and STAI-S tests were performed and assessed blindly. Quantitative variables were compared using the Mann−Whitney U test, and qualitative determinations using a chi-square test or Fischer's exact test. Results: The STAI-S and STAI-T tests results identified 14 (56%) mothers of enuretic children with moderate-to-severe trait anxiety versus 4 (16%) mothers from the control group and moderate-to-severe state anxiety in 23 (92%) of the mothers of enuretic children compared to 7 (28%) control-group mothers. The anxiety scores were significantly higher for the enuresis group for both tests: STAI-T: 53.00 ± 8.39 versus 41.52 ± 9.61 (p < 0.001) and STAI-S: 56.48 ± 6.83 versus 43.84 ± 10.57 (p < 0.001). Conclusion: Mothers of children with nocturnal enuresis present state anxiety ranging from moderate to severe. In clinical practice, our results indicate that the transitory emotion experienced by mothers of enuretic children cannot be neglected in an enuresis treatment program, state anxiety needs to be evaluated, and psychological interventions need to be implemented.

Latin American consensus: children born small for gestational age.

BACKGROUND: Children born small for gestational age (SGA) experience higher rates of morbidity and mortality than those born appropriate for gestational age. In Latin America, identification and optimal management of children born SGA is a critical issue. Leading experts in pediatric endocrinology throughout Latin America established working groups in order to discuss key challenges regarding the evaluation and management of children born SGA and ultimately develop a consensus statement. DISCUSSION: SGA is defined as a birth weight and/or birth length greater than 2 standard deviations (SD) below the population reference mean for gestational age. SGA refers to body size and implies length-weight reference data in a geographical population whose ethnicity is known and specific to this group. Ideally, each country/region within Latin America should establish its own standards and make relevant updates. SGA children should be evaluated with standardized measures by trained personnel every 3 months during year 1 and every 6 months during year 2. Those without catch-up growth within the first 6 months of life need further evaluation, as do children whose weight is ≤ -2 SD at age 2 years. Growth hormone treatment can begin in SGA children > 2 years with short stature (< -2.0 SD) and a growth velocity < 25th percentile for their age, and should continue until final height (a growth velocity below 2 cm/year or a bone age of > 14 years for girls and > 16 years for boys) is reached. Blood glucose, thyroid function, HbA1c, and insulin-like growth factor-1 (IGF-1) should be monitored once a year. Monitoring insulin changes from baseline and surrogates of insulin sensitivity is essential. Reduced fetal growth followed by excessive postnatal catch-up in height, and particularly in weight, should be closely monitored. In both sexes, gonadal function should be monitored especially during puberty. SUMMARY: Children born SGA should be carefully followed by a multidisciplinary group that includes perinatologists, pediatricians, nutritionists, and pediatric endocrinologists since 10% to 15% will continue to have weight and height deficiency through development and may benefit from growth hormone treatment. Standards/guidelines should be developed on a country/region basis throughout Latin America.

First reports of envenoming by South American water snakes Helicops angulatus and Hydrops triangularis from Bolivian Amazon: A one-year prospective study of non-front-fanged colubroid snakebites.

Although snakebite incidence is underestimated in Bolivia, the Amazon region presents the highest incidence of these accidents. The local effects of bites by some non-front-fanged colubroid (NFFC) snakes are usually confused with that of viperids, resulting in the improper use of antivenoms and medications. Since there is scarce information on clinical treatment and management of NFFC bites from Bolivian Amazon, we conducted a prospective study of NFFC snakebites by reviewing the records of patients admitted with a snakebite diagnosis at Hospital Central Ivirgarzama, Bolivia. Snakebites were recorded for 12 months (December 2019-November 2020), including information about the sex and age of the patient, snakebite date, and treatment. Eight (5.7 %) of 152 patients were bitten by NFFC Helicops angulatus, Hydrops triangularis, and Erythrolamprus sp. Our results showed that 5/7 patients had prolonged clotting time and INR, as well as local edema and mild pain, suggesting systemic envenoming. Previously non-documented mild coagulopathy was observed for H. angulatus and H. triangularis bites. In some cases, incorrect first-aid measures, and inappropriate use of bothropic/lachesic antivenom were administrated. All the patients received supportive therapy and antihistamine drugs. Unsupported use of non-evidence-based treatments for snakebites such as corticoids, non-steroidal anti-inflammatory drugs (NSAIDs), and prophylactic antibiotic prescription were recorded. In conclusion, we describe the first formally documented snakebite cases produced by NFFC from Bolivia, highlighting the urgent need for training of the medical team in the snake identification, clinical management of snakebite, and the existence of a human-snake conflict involving NFFC species.

Anthocyanins and Functional Compounds Change in a Third-Generation Snacks Prepared Using Extruded Blue Maize, Black Bean, and Chard: An Optimization.

The effect of extrusion cooking on bioactive compounds in third-generation snacks (TGSE) and microwave-expanded snacks (MWSE) prepared using black bean, blue maize, and chard (FBCS) was evaluated. FBCS was extruded at different moisture contents (MC; 22.2-35.7%), extrusion temperatures (ET; 102-142 °C), and screw speeds (SP; 96-171 rpm). Total anthocyanin content (TAC), contents of individual anthocyanins, viz., cyanidin-3-glucoside, malvidin-3-glucoside, pelargonidin-3-glucoside, pelargonidin-3-5-diglucoside, and delphinidin-3-glucoside chloride, total phenolic content (TPC), antioxidant activity (AA), and color parameters were determined. TAC and individual anthocyanin levels increased with the reduction in ET. ET and MC affected the chemical and color properties; increase in ET caused a significant reduction in TPC and AA. Microwave expansion reduced anthocyanin content and AA, and increased TPC. Extrusion under optimal conditions (29% MC, 111 rpm, and 120 °C) generated products with a high retention of functional compounds, with high TAC (41.81%) and TPC (28.23%). Experimental validation of optimized process parameters yielded an average error of 13.73% from the predicted contents of individual anthocyanins. Results suggest that the TGSE of FBCS obtained by combining extrusion and microwave expansion achieved significant retention of bioactive compounds having potential physiological benefits for humans.

Volume-Based Feeding Enhances Enteral Delivery by Maximizing the Optimal Rate of Enteral Feeding (FEED MORE).

BACKGROUND: The importance of enteral nutrition (EN) in critically ill patients is well documented. However, actual administration of EN frequently does not amount to prescribed nutrition goals. Persistent underfeeding may lead to impaired immune response, increased mortality, and higher costs. Traditionally, EN uses a rate-based approach, utilizing slow titration to goal and a final fixed hourly rate, regardless of interruptions in feeding. Volume-based feeding (VBF) establishes a 24-hour EN goal volume, and the rate varies to achieve this daily goal when interruptions occur. MATERIALS AND METHODS: This was a retrospective, single-center, quasi-experimental study comparing traditional rate-based feeding (RBF) to VBF in adult patients admitted to the medical and neurosurgical intensive care units (ICUs). The primary outcome was mean percentage of total goal energy received after EN initiation until 7 days, transfer from ICU, removal of feeding tube, or oral diet order placed. Secondary outcomes included mean percentage of total goal protein received, percentage of patients meeting 80% of nutrition goals, incidence of gastric residual volumes >400 mL, and incidence of moderate hyperglycemia (>250 mg/dL). RESULTS: The study enrolled 189 patients. Mean percentage of goal energy delivered (75% RBF, 102% VBF; P < .001) and goal protein delivered (68% RBF, 87% VBF; P < .001) was significantly higher with VBF compared with RBF. CONCLUSION: VBF demonstrated a significant increase in energy and protein delivery with no major safety or tolerability issues. VBF should be considered for use in ICU patients to optimize nutrition delivery.

An electrochemical biosensor for the detection of Mycobacterium tuberculosis DNA from sputum and urine samples.

Tuberculosis (TB) is a major global public health problem with high mortality and morbidity. In low-middle income countries (LMIC) a large number of respiratory symptomatic cases that require TB screening per year demands more accurate, fast and affordable testing for TB diagnostics. Sputum smear is the initial screening test in LMICs, however, its sensitivity is limited in patients with low sputum bacilli load. The same limitation is observed in the currently available molecular tests. We designed, standardized and evaluated an electrochemical biosensor that detects the highly specific DNA insertion element 6110 (IS6110). A PCR amplified DNA product is hybridized on the surface of the working electrode built on FTO-Glass with immobilized specific DNA probes, after which cyclic voltammetry is performed with an Ag/AgCl reference electrode and a platinum counter electrode. The response of the sensor was measured by the ratio (cathodic peak current of the hybridized sensor) / (cathodic peak current of the non-hybridized sensor). We tested the biosensor, using positive hybridization control sequences, genomic DNA extracted from M. tuberculosis strains and sputum of TB patients, and extracted DNA from the urine of healthy controls spiked with M. tuberculosis DNA. This biosensor was effective for the detection of M. tuberculosis DNA with a detection limit of 16 fM in sputum sample and 1 fM in spiked urine samples. The low cost and the relatively brief duration of the assay make this an important TB screening tool in the fight against tuberculosis.

In Vitro Antibacterial Activity of Hibiscus sabdariffa L. Phenolic Extract and Its In Situ Application on Shelf-Life of Beef Meat.

Compounds from spices and herbs extracts are being explored as natural antibacterial additives. A plant extract used in traditional folk medicine is Hibiscus sabdariffa L., also known as Roselle. Therefore, the potential use of a phenolic hibiscus extract as antibacterial or natural food preservative was analyzed in vitro and in situ. A phenolic extract was obtained from hibiscus calyces and fractionated, and then the fractions were tested against foodborne pathogen bacteria. Liquid-liquid extraction and solid-phase extraction were used to fractionate the hibiscus extract, and HPLC was employed to analyze the fractions' phenolic composition. Minimum bactericidal concentration (MBC) and minimal inhibitory concentration (MIC) were calculated for brute hibiscus phenolic extract, each of the fractions and pure commercial phenolic compounds. Bacteria tested were Escherichia coli, Salmonella enterica serovar Typhimurium, Staphylococcus aureus, Listeria monocytogenes and Bacillus cereus. The fraction obtained after liquid-liquid extraction presented the best performance of MBC and MIC against the bacteria tested. Furthermore, a hibiscus ethanolic extract was employed as a natural preservative to extend the shelf-life of beef. Microbiological, color and sensory analyses were performed to the meat during the shelf-life test. The application of the phenolic hibiscus extract also showed an increase of the duration of the meat`s shelf life.

Protein-conformational diseases in childhood: Naturally-occurring hIAPP amyloid-oligomers and early ß-cell damage in obesity and diabetes.

BACKGROUND AND AIMS: This is the first time that obesity and diabetes mellitus (DM) as protein conformational diseases (PCD) are reported in children and they are typically diagnosed too late, when ß-cell damage is evident. Here we wanted to investigate the level of naturally-ocurring or real (not synthetic) oligomeric aggregates of the human islet amyloid polypeptide (hIAPP) that we called RIAO in sera of pediatric patients with obesity and diabetes. We aimed to reduce the gap between basic biomedical research, clinical practice-health decision making and to explore whether RIAO work as a potential biomarker of early ß-cell damage. MATERIALS AND METHODS: We performed a multicentric collaborative, cross-sectional, analytical, ambispective and blinded study; the RIAO from pretreated samples (PTS) of sera of 146 pediatric patients with obesity or DM and 16 healthy children, were isolated, measured by sound indirect ELISA with novel anti-hIAPP cytotoxic oligomers polyclonal antibody (MEX1). We carried out morphological and functional studied and cluster-clinical data driven analysis. RESULTS: We demonstrated by western blot, Transmission Electron Microscopy and cell viability experiments that RIAO circulate in the blood and can be measured by ELISA; are elevated in serum of childhood obesity and diabetes; are neurotoxics and works as biomarkers of early ß-cell failure. We explored the range of evidence-based medicine clusters that included the RIAO level, which allowed us to classify and stratify the obesity patients with high cardiometabolic risk. CONCLUSIONS: RIAO level increases as the number of complications rises; RIAOs > 3.35 µg/ml is a predictor of changes in the current indicators of ß-cell damage. We proposed a novel physio-pathological pathway and shows that PCD affect not only elderly patients but also children. Here we reduced the gap between basic biomedical research, clinical practice and health decision making.

Puberty blockade: Clinical guideline for the diagnosis and treatment of precocious puberty.

The Mexican Society of Pediatric Endocrinology developed a clinical practice guide for the diagnosis and treatment of precocious puberty. This document presents recommendations related to the interventions for the inhibition of central precocious puberty. The detailed description of the methodology for the development of this guide and the grading system, as well as the synthesis of the evidence on which it is based can be consulted in this same supplement.

La Sociedad Mexicana de Endocrinología Pediátrica elaboró una guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz. Este documento presenta recomendaciones relacionadas con las intervenciones para inhibir la pubertad precoz central. La descripción detallada de la metodología para el desarrollo de esta guía y del sistema de gradación, así como la síntesis de la evidencia en la que se basa, pueden consultarse en este mismo suplemento.

Diagnosis of precocious puberty: clinical guideline for the diagnosis and treatment of precocious puberty.

The Mexican Society of Pediatric Endocrinology developed a clinical practice guide for the diagnosis and treatment of precocious puberty. This document presents recommendations related to the diagnosis of precocious puberty. The detailed description of the methodology for the development of this guide and the grading system, as well as the synthesis of the evidence on which it is based can be accessed in this same supplement.

La Sociedad Mexicana de Endocrinología Pediátrica elaboró una guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz. Este documento presenta recomendaciones relacionadas con el diagnóstico de pubertad precoz. La descripción detallada de la metodología para el desarrollo de esta guía y del sistema de gradación, así como la síntesis de la evidencia en la que se basa, pueden consultarse en este suplemento.