[Publication in indexed journals is imperative for communication in contemporary medicine]. / La publicación en revistas indexadas es imperativa para la comunicación en la medicina contemporánea.

No Abstract available.

Dyslipidemia and hypercalciuria in a patient with pantothenate kinase 2 deficiency: A novel variant and case report.

Pantothenate kinase-associated neurodegeneration (PKAN, OMIM: 234200) results from biallelic pathogenic variants in PANK2 which encodes pantothenate kinase 2, a crucial mitochondrial enzyme involved in coenzyme A biosynthesis. Pantothenate kinase-associated neurodegeneration patients typically exhibit the distinctive "eye of the tiger" sign on brain magnetic resonance imaging in the globus pallidus, along with psychiatric symptoms, extrapyramidal movements such as parkinsonism and dystonia, eventual speech and gait impairments, and the presence of dysphagia. An 11-year-old girl, with fifth-degree consanguinity, demonstrated typical psychomotor development and growth until the age of 5, when she began experiencing psychiatric symptoms. At the age of 9, she developed hand tremors, progressing to generalized muscular dystonia. By age 10, she exhibited gait and speech impairment. Physical examination revealed extensive generalized dystonia, hand tremors, speech impairment, dysphagia, inability to walk, and heightened osteotendinous reflexes. Metabolic analysis identified dyslipidemia with partial response to statin treatment and normocalcemic hypercalciuria. Exome sequencing revealed a novel likely pathogenic variant in PANK2 (NM_001386393.1:c.526C > G) in a homozygotic state. Pantothenate kinase-associated neurodegeneration typically manifests with generalized dystonia and psychiatric symptoms. Here, we present a Pantothenate kinase-associated neurodegeneration patient with dyslipidemia and hypercalciuria as potentially previously undescribed metabolic phenotype.

Computer-Supported Collaborative Design of Standardized Clinical Cases: Algorithm Development and Validation.

Background: The creation of computer-supported collaborative clinical cases is an area of educational research that has been widely studied. However, the reuse of cases and their sharing with other platforms is a problem, as it encapsulates knowledge in isolated platforms without interoperability. This paper proposed a workflow ecosystem for the collaborative design and distribution of clinical cases through web-based computing platforms that (1) allow medical students to create clinical cases collaboratively in a dedicated environment; (2) make it possible to export these clinical cases in terms of the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) interoperability standard; (3) provide support to transform imported cases into learning object repositories; and (4) use e-learning standards (eg, Instructional Management Systems Content Packaging [IMS-CP] or Sharable Content Object Reference Model [SCORM]) to incorporate this content into widely-used learning management systems (LMSs), letting medical students democratize a valuable knowledge that would otherwise be confined within proprietary platforms. Objective: This study aimed to demonstrate the feasibility of developing a workflow ecosystem based on IT platforms to enable the collaborative creation, export, and deployment of clinical cases. Methods: The ecosystem infrastructure for computer-supported collaborative design of standardized clinical cases consists of three platforms: (1) Mosaico, a platform used in the design of clinical cases; (2) Clavy, a tool for the flexible management of learning object repositories, which is used to orchestrate the transformation and processing of these clinical cases; and (3) Moodle, an LMS that is geared toward publishing the processed clinical cases and delivering their course deployment stages in IMS-CP or SCORM format. The generation of cases in Mosaico is exported in the HL7 FHIR interoperability standard to Clavy, which is then responsible for creating and deploying a learning object in Moodle. Results: The main result was an interoperable ecosystem that demonstrates the feasibility of automating the stages of collaborative clinical case creation, export through HL7 FHIR standards, and deployment in an LMS. This ecosystem enables the generation of IMS-CPs associated with the original Mosaico clinical cases that can be deployed in conventional third-party LMSs, thus allowing the democratization and sharing of clinical cases to different platforms in standard and interoperable formats. Conclusions: In this paper, we proposed, implemented, and demonstrated the feasibility of developing a standards-based workflow that interoperates multiple platforms with heterogeneous technologies to create, transform, and deploy clinical cases on the web. This achieves the objective of transforming the created cases into a platform for web-based deployment in an LMS.

Life cycle environmental impacts of using food waste liquid fodder as an alternative for pig feeding in a conventional Cuban farm.

This work aimed to compare cleaner production alternatives for pig production in the Cuban context through the Life Cycle Assessment (LCA) approach emphasizing the utilization of food waste (FW) as a substitute for traditional grain-based pig feeding. A conventional waste management method (lagooning) was assessed, including more environmentally friendly approaches (use of anaerobic digestion (AD) process); including the substitution of a fraction of solid fodder with food waste liquid fodder (LF), obtained from food waste. The analysis was based on one porcine equivalent livestock unit. The environmental impact categories assessed were global warming, terrestrial ecotoxicity, human carcinogenic toxicity, freshwater ecotoxicity, terrestrial acidification, and freshwater eutrophication. The major environmental benefits for pig production were observed when the maximum capacity of pigs was considered. In addition, favorable environmental performance was achieved by considering the substitution of solid fodder by LF, the AD as a waste management process, and the valorization of the solid and liquid effluents. The avoided products-related activities were the main contributor to freshwater ecotoxicity, human carcinogenic toxicity, and terrestrial ecotoxicity impact categories (up to 71 %). The sensitivity analysis showed that the variation in LF composition (protein concentration) could have a remarkable impact in all impact categories. Climate change performed as the more sensible impact category, suggesting that greenhouse gas (GHG) emissions, such as CO2 and N2O, are important drivers to change the environmental impact and need more attention. This research demonstrates that the environmental profile of the process can be improved by applying a cleaner production approach (AD as a waste management alternative and LF substituting solid fodder).

Hibernoma, tumor benigno infrecuente / Hibernoma, rare benign tumor

El hibernoma es un tumor limítrofe, benigno de comportamiento agresivo, de tejidos blandos, raro en frecuencia, que se origina a partir de los adipocitos pardos residuales, afectando principalmente a mujeres entre 10 a 20 años. Clínicamente se presenta como tumoración, más frecuente en los muslos, de crecimiento lento, móvil, firme e indolora. En los estudios de imagen, puede resultar difícil realizar un diagnóstico diferencial por su similitud con neoplasias malignas. El tratamiento ideal es la resección quirúrgica con márgenes amplios para evitar cualquier tipo de recurrencia local. Se presenta el caso de un hibernoma típico, manejo y tratamiento quirúrgico realizado.

Hibernoma is a borderline tumor, benign with aggressive behavior, of soft tissues, rare in frequency, which originates from residual brown adipocytes, mainly affecting women between 10 and 20 years of age. Clinically it presents as a slow-growing, mobile, firm and painless tumor, more frequent on the thighs. In imaging studies, it can be difficult to make a differential diagnosis due to its similarity to malignant neoplasms. The ideal treatment is surgical resection with wide margins to avoid any type of local recurrence. The case of a typical hibernoma, management and surgical treatment performed is presented.

Primer reporte en Cuba de Anisakis spp. en muestras de pescado en conserva / First report in Cuba of Anisakis spp. in samples of canned fish

Introducción: Las especies de Anisakis representan uno de los grupos parasitarios patógenos transmitidos por alimentos más importantes en relación con sus capacidades zoonóticas y pueden producir una enfermedad emergente llamada anisakiosis. En Cuba, no existen reportes de la enfermedad como tampoco publicaciones sobre la detección del parásito en muestras de productos pesqueros. Objetivo: Identificar larvas de Anisakis spp. en muestras de productos pesqueros. Métodos: Se realizó un estudio para la búsqueda de larvas de Anisakis spp. en muestras de productos pesqueros en conserva recibidos en el Laboratorio de Parasitología de los alimentos del Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba. Se recibieron 96 muestras de dos marcas diferentes. A cada marca se le asignó las letras A o B para proteger la identidad del fabricante. Las larvas recuperadas fueron previamente aclaradas con lactofenol e identificadas morfológicamente por microscopía. Se utilizaron las claves de identificación para larvas de Anisakis spp. descritas en la literatura. Resultados: El 38,5 por ciento del total de muestras de pescado en conserva analizadas estuvieron parasitadas con larvas de Anisakis spp., con una frecuencia media de 1,2 larvas por cada submuestra. Las larvas fueron clasificadas de tercer estadio y de tipo I. Conclusiones: Por primera vez se identificó en Cuba larvas de Anisakis spp. en muestras de pescado en conserva y se proporcionó datos de interés a las autoridades sanitarias para el fortalecimiento de políticas públicas relacionadas con la calidad e inocuidad de los alimentos(AU)

Introduction: Anisakis species represent one of the most important foodborne pathogenic parasitic groups in relation to their zoonotic capabilities, and can produce an emerging disease called anisakiosis. In Cuba, there are no reports of the disease and there are no publications on the detection of the parasite in samples of fishery products. Objective: To identify Anisakis spp. larvae in samples of fishery products. Methods: A study was conducted to search for Anisakis spp. larvae in samples of canned fish products received at the Laboratory of Food Parasitology of the National Institute of Hygiene, Epidemiology and Microbiology of Cuba. Ninety-six samples of two different brands were received. Each brand was assigned letter A or B to protect the identity of the manufacturer. The larvae recovered were previously rinsed with lactophenol and identified morphologically by microscopy. The identification keys for Anisakis spp. larvae described in the literature were used. Results: 38.5 percent of the total canned fish samples analyzed were parasitized with Anisakis spp. larvae, with a mean frequency of 1.2 larvae per subsample. The larvae were classified as third instar and type I. Conclusions: For the first time in Cuba, Anisakis spp. larvae were identified in canned fish samples and provided data of interest to health authorities to strengthen public policies related to food quality and safety(AU)

Efficacy and Safety of Sodium Hyaluronate/chondroitin Sulfate Preservative-free Ophthalmic Solution in the Treatment of Dry Eye: A Clinical Trial.

Purpose: To evaluate the efficacy of a preservative free sodium hyaluronate/chondroitin sulfate ophthalmic solution (SH/CS-PF) in patients with dry eye disease (DED).Methods: This was a randomized phase IV, multicentric, prospective, double-blind clinical trial. Intent-to-treat (ITT) and per-protocol (PP) analyses were performed. Patients were assigned to receive either SH/CS-PF, Systane® Ultra (PEG/PG) or Systane® Ultra PF (PEG/PG-PF) for 90 days. A total of 326 patients were included in the ITT, and 217 in the PP analysis. Efficacy endpoints were goblet cell density, Nelson's grades (conjunctival impression cytology), tear break-up time (TBUT), Ocular Surface Disease Index (OSDI), and Schirmer's test. Other parameters included were tolerability, measured by the ocular symptomatology; and safety, measured through corneal staining, intraocular pressure, visual acuity and adverse events.Results: In the ITT, there was a significant increase in mean goblet cell density in all treatments compared with their baseline (28.4% vs 21.4% and 30.8%), without difference between arms (p = .159). Eyes exposed to SH/CS-PF, PEG/PG and PEG/PG-PF showed Grade 0-I squamous metaplasia (85.5%, 87.9% and 93.2%, respectively). Similar improvements were observed for TBUT (1.24 ± 2.3s vs 1.27 ± 2.4s and 1.39 ± 2.3s) and OSDI scores at day 90 (-8.81 ± 8.6 vs -7.95 ± 9.2 and -8.78 ± 9.8), although no significant intergroup difference was found. Schirmer's test also presented improvement compared to baseline (1.38 ± 4.9 vs 1.50 ± 4.7 and 2.63 ± 5.9), with a significantly higher variation for PEG/PG-PF. There were no significant differences between treatments for any tolerability and safety parameter, nor between ITT and PP analyses for any outcome.Conclusions: The topical application of SH/CS-PF is as effective, safe and well tolerated as that of PEG/PG or PEG/PG-PF. The results suggest that SH/CS-PF may lead to normalization of clinical parameters and symptom alleviation in patients treated for DED.

Characterization of novel GCDH pathogenic variants causing glutaric aciduria type 1 in the southeast of Mexico.

Biallelic mutations of the GCDH gene result in Glutaric Aciduria type 1 (GA1; OMIM #231670), an uncommon autosomal recessive inborn error caused by the deficiency of glutaryl-CoA dehydrogenase (CCDH), a mitochondrial matrix protein involved in the degradation of l-lysine, L-hydroxylysine, and L-tryptophan. The enzymatic deficiency leads to the accumulation of neurotoxins causing macrocephaly at birth, hypotonia and dystonia due to bilateral striatal injury, that evolves with aging, if untreated, to fixed dystonia and akinetic-rigid parkinsonism. In this article, we describe the results of molecular studies of 5 unrelated patients with GA1 in Southern Mexico. Mutational analysis identified 2 novel likely pathogenic GCDH variants (p.Leu130Pro and p.Gly391Val), 1 pathogenic variant that is predicted to cause a premature stop codon (p.Leu370*), and 2 previously reported pathogenic variants (p.Arg294Trp and p.Arg294Gln). The recurrence of the p.Leu130Pro variant (60% of mutant alleles) suggested a possible founder mutation effect. Our results expand the mutational spectrum in GA1 patients and support the importance of early diagnosis through newborn screening that promotes early nutritional treatment and prevents metabolic crisis. TAKE HOME MESSAGE: Glutaric Aciduria type 1 has a wide mutational spectrum; the p.Leu130Pro variant may be a founder mutation in Southeast Mexico.

Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte / Installed Capacity Perception Survey for the Training of Resident's Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico

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Abstract: Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. Material and methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients ˂ 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients ˃ 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and ˃ 90% without regular scientific production.

[Installed Capacity Perception Survey for the Training of Residents Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico]. / Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte.

INTRODUCTION: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. MATERIAL AND METHODS: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. RESULTS: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. CONCLUSIONS: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.

INTRODUCCIÓN: Es fundamental que los médicos residentes de ortopedia (traumatología) sean altamente competentes en todos los aspectos, considerando el equilibrio entre la oferta, demanda, necesidad y contexto. Es primordial identificar la capacidad y calidad instalada para su formación en México. MATERIAL Y MÉTODOS: Estudio observacional, transversal, muestreo no probabilístico-conglomerados, en dos fases. El instrumento tiene ocho dominios, 57 variables y 4,867 ítems. Sesenta profesores de postgrado de 20 estados, 50 sedes hospitalarias, 22 programas universitarios. RESULTADOS: 1,038 años de experiencia (inteligencia colectiva), 17 años de experiencia/profesor (01 a 50 años). Se identificó: patología aguda 30 (2 a 90%), patología crónica 30 (5 a 96%), pacientes 15 años, 10 (3 a 30%), pacientes entre 15 y 65 años, 47 (2 a 78%), pacientes 65 años, 20 (2 a 60%), número de camas/sede 20 (2 a 510), número de consultorios 3 (1 a 48), el número de procedimientos quirúrgicos/sede al año a nivel nacional fue de 960 (50 a 24,650). La media nacional por médico residente es de 362 cirugías/año con 1,450 momentos quirúrgicos/año. CONCLUSIONES: Las necesidades y recursos para la formación de médicos especialistas en ortopedia/traumatología son en alto grado heterogéneos, por lo cual se debería adaptar a las necesidades epidemiológicas de la región de influencia, en un ámbito de transición epidemiológica. Sesenta y dos punto dos por ciento expresó no tener o tener deficiente infraestructura académica y científica en su sede, más de 50% sin rotación al extranjero y 90% sin producción científica regular.

Polymer films containing chemically anchored diazonium salts with long-term stability as colorimetric sensors.

We have prepared polymeric films as easy-to-handle sensory materials for the colorimetric detection and quantification of phenol derivatives (phenols) in water. Phenols in water resources result from their presence in pesticides and fungicides, among other goods, and are harmful ecotoxins. Colorless polymeric films with pendant diazonium groups attached to the acrylic polymer structure were designed and prepared for use as sensory matrices to detect phenol-derived species in water. Upon dipping the sensory films into aqueous media, the material swells, and if phenols are present, they react with the diazonium groups of the polymer to render a highly colored azo group, giving rise to the recognition phenomenon. The color development can be visually followed for a qualitative determination of phenols. Additionally, quantitative analysis can be performed by two different techniques: a) by using a UV-vis spectrophotometer (limit of detection of 0.12 ppm for 2-phenylphenol) and/or b) by using a smartphone with subsequent RGB analysis (limit of detection of 30 ppb for 2-phenylphenol).

Prevalencia de parasitismo intestinal en vendedores informales de alimentos del sector Universidad de El Salvador y Hospitales de Tercer Nivel, Octubre 2019 / Prevalence of intestinal parasitism in informal food vendors in the Universidad de El Salvador and Third Level Hospitals, October 2019

Propósito: establecer un precedente sobre la frecuencia de parasitismo intestinal en vendedores informales ubicados en el sector de la Universidad de El Salvador y hospitales de tercer nivel, a fin de identificarlos como una fuente de infección, y transmitirlos a través de la manipulación de los alimentos, y así poder desarrollar e implementar estrategias de prevención de enfermedades infecciosas intestinales. Materiales y métodos: estudio de tipo observacional, descriptivo, de prevalencia o corte transversal, con una población de 152 vendedores informales de alimentos y una muestra de 109 personas, a los cuales se les realizó una encuesta con el fin de conocer las prácticas de manipulación de alimentos, así como se recolectaron los resultados de los exámenes de heces. Resultados: en los vendedores informales de los sectores en estudio se encontró que el 23.8% de ellos presentaba alguna forma parasitaria, de los cuales el parasito que más se aisló fue el Blastocystis hominis en un 9%, seguido por la Entamoeba histolytica 7% y Endolimax nana 6%, Conclusiones: el estudio demostró que existe una prevalencia de parásitos, principalmente a predominio de protozoarios, en su mayoría en estadio quística, esto facilita la diseminación de esta patología ya que los vendedores informales se constituyen en una fuente y vehículo de transmisión. Además hay una inadecuada manipulación de los alimentos. Recomendaciones: garantizar un control y ordenamiento por parte de las alcaldías municipales a través de un censo actualizado de los vendedores informales, así como coordinar con el MINSAL para capacitar y dar seguimiento a los vendedores informales sobre las prácticas de manipulación de alimentos, así como garantizar el control periódico de su estado de salud

Clinical markers to predict progression from acute to chronic kidney disease in Mesoamerican nephropathy.

An epidemic of chronic kidney disease (CKD) of unknown etiology, known as Mesoamerican Nephropathy (MeN), has been ongoing in Latin America for at least two decades. MeN primarily affects young adults without traditional CKD risk factors, and agricultural workers are disproportionately afflicted. We previously identified an acute phase of MeN that involves acute kidney injury (AKI) with tubulointerstitial nephritis and systemic inflammation. Because clinical disease progression in MeN is not yet understood, we sought to determine clinical predictors for progression from acute MeN to CKD. Through ongoing surveillance in Nicaragua, local physicians reported cases of acute MeN and CKD among agricultural workers. We analyzed clinical data collected during the acute MeN encounter to identify factors associated with progression to CKD. From February 2015 to May 2017, 586 agricultural workers (median age 27.8 years, 90% male) presented with acute MeN. The majority had a normal baseline creatinine, and leukocyturia (98.8%) and peripheral leukocytosis (80.7%) were common. Ultimately, 49 (8.4%) progressed to CKD, the majority of those within 6 months. CKD was attributed to MeN in all cases, and none had diabetes or hypertension. The strongest predictors of CKD progression were anemia and paresthesias at presentation, while leukocytosis was associated with renal recovery. Clinical markers of acute MeN may help clinicians identify patients at high risk for rapid progression to CKD, which in turn can inform early clinical management. Future studies should seek to determine the underlying etiology of disease and identify optimal interventions to interrupt the pathophysiologic process of MeN.

Factores de riesgo de caries dental en niños de la infancia temprana. Paulo VI. Venezuela. 2012 / Risk factors of dental caries in children of early childhood. Paulo VI. Venezuela. 2012

Introducción: la caries dental es una de la enfermedad crónica prevalente en el niño. Objetivo: determinar la prevalencia e identificar los factores de riesgo de caries dental en niños de dos a cinco años de edad. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal, en los consultorios pertenecientes al Área de Salud Integral "Paulo VI", del Municipio Sucre, Estado Miranda, en la República Bolivariana de Venezuela. La muestra estuvo conformada por los 212 niños, de 2 a 5 años, que asistieron a la Consulta Estomatológica. Se aplicó el examen bucal y una encuesta. Se utilizó el porcentaje como medida de resumen y el índice de dientes cariados-obturados e extracción indicada. Resultados: los niños más afectados p fueron los de 5 años, (49,0 %) y existió un ligero predominio en el sexo masculino. El componente cariado presentó el mayor índice, (343). Se comprobó que el índice más elevado de dientes cariadosobturados e extracción indicada se encontró en los niños de 5 años, (2,5). La dieta cariogénica alcanzó el mayor porcentaje, (92,4 %). El 81,1 % de los padres o representantes poseía un bajo nivel de escolaridad y un 80,2 % conocimientos no adecuados sobre salud bucal. Conclusiones: la prevalencia de caries dental fue alta con un discreto incremento en el sexo masculino. La mayor morbilidad por caries se observó a la edad de 5 años. La dieta cariogénica, el bajo nivel de escolaridad y conocimientos inadecuados fueron los factores de riesgo que predominaron (AU).

Introduction: dental caries is the most prevalent chronic disease in children. Objective: to determine the prevalence and to identify the risk factors of dental caries in children aged 2-5 years. Materials and methods: a cross-sectional, descriptive, observational study was carried out in the medical consultations belonging to the Comprehensive Health Area "Paulo VI", Municipality Sucre, Miranda State, in the Bolivarian Republic of Venezuela. The sample was formed by the 212 children, aged 2-5 years, who attended the Dentist Consultation. The oral examination was performed and a survey was applied. The used summary measure was the percentage and the index of decayed-filled teeth and indicated removal. Results: the children most affected by dental caries were the ones aged 5 years (49.0 %) with a slight predominance of the male sex. The decayed component showed the highest index (343). It was proved that the highest DMFT index was found in children aged 5 years. Cariogenic diet reached the highest percent (92.4 %). 81.1 % of the relatives or representatives had a low level of scholarship, and 80.2 % of them, inadequate knowledge on oral health. Conclusions: the dental caries prevalence was high, with a small increase in the male sex. The highest morbidity by caries was observed at the age of 5 years. The predominating risk factors were cariogenic diet, low level of scholarship and inadequate knowledge (AU).

Early detection of acute tubulointerstitial nephritis in the genesis of Mesoamerican nephropathy.

Mesoamerican nephropathy is a devastating disease of unknown etiology that affects mostly young agricultural workers in Central America. An understanding of the mechanism of injury and the early disease process is urgently needed and will aid in identification of the underlying cause and direct treatment and prevention efforts. We sought to describe the renal pathology in Mesoamerican nephropathy at its earliest clinical appearance in prospectively identified acute case patients in Nicaragua. We considered those with elevated (or increased at least 0.3 mg/dL or 1.5-fold from baseline) serum creatinine, leukocyturia, and either leukocytosis or neutrophilia for inclusion in this biopsy study. Renal tissue was obtained by ultrasound-guided biopsy for examination by light, immunofluorescence, and electron microscopy. All 11 individuals who underwent renal biopsy showed tubulointerstitial nephritis, with varying degrees of inflammation and chronicity. Interstitial cellular infiltrates (predominantly T lymphocytes and monocytes), mostly in the corticomedullary junction; neutrophilic accumulation in the tubular lumens; largely preserved glomeruli; few mild ischemic changes; and no immune deposits were noted. The acute components of tubulointerstitial nephritis were acute tubular cell injury, interstitial edema, and early fibrosis. Chronic tubulointerstitial nephritis included severe tubular atrophy, thickened tubular basement membrane, and interstitial fibrosis. Thus, renal histopathology in Mesoamerican nephropathy reveals primary interstitial disease with intact glomeruli.

Newborn cystic fibrosis screening in southeastern Mexico: Birth prevalence and novel CFTR gene variants.

OBJECTIVE: To use the results of the first five years of a cystic fibrosis newborn screening program to estimate the cystic fibrosis birth prevalence and spectrum of cystic fibrosis transmembrane conductance regulator ( CFTR) gene variants in Yucatan, Mexico. METHODS: Screening was performed from 2010 to 2015, using two-tier immunoreactive trypsinogen testing, followed by a sweat test. When sweat test values were >30 mmol/L, the CFTR gene was analyzed. RESULTS: Of 96,071 newborns screened, a second sample was requested in 119 cases. A sweat test was performed in 30 newborns, and 9 possible cases were detected (seven confirmed cystic fibrosis and two inconclusive). The most frequently detected CFTR pathogenic variant (5/14 cystic fibrosis alleles, 35.7%) was p.(Phe508del); novel p.(Ala559Pro) and p.(Thr1299Hisfs*29) pathogenic variants were found. CONCLUSIONS: Cystic fibrosis birth prevalence in southeastern Mexico is 1:13,724 newborns. Immunoreactive trypsinogen blood concentration is influenced by gestational age and by the time of sampling. The spectrum of CFTR gene variants in Yucatan is heterogeneous.

Clinical Evidence of Acute Mesoamerican Nephropathy.

Mesoamerican nephropathy (MeN), an epidemic of unexplained kidney disease in Central America, affects mostly young, healthy individuals. Its etiology is a mystery that requires urgent investigation. Largely described as a chronic kidney disease (CKD), no acute clinical scenario has been characterized. An understanding of the early disease process could elucidate an etiology and guide treatment and prevention efforts. We sought to document the earliest clinical signs in patients with suspected MeN in a high-risk population in Nicaragua. Physicians at a local hospital identified suspect cases and documented clinical/laboratory data, demographics, and medical histories. Over a 1-year period, physicians identified 255 mostly young (median 29 years), male (89.5%) patients with elevated creatinine or reduced creatinine clearance. Mean serum creatinine (2.0 ± 0.6 mg/dL) revealed a 2-fold increase from baseline, and half had stage 2 or 3 acute kidney injury. Leukocyturia (98.4%), leukocytosis (81.4%), and neutrophilia (86.2%) predominated. Nausea (59.4%), back pain (57.9%), fever (54.6%), vomiting (50.4%), headache (47.3%), and muscle weakness (45.0%) were common. A typical case of acute MeN presented with elevated (or increased ≥ 0.3 mg/dL or ≥ 1.5-fold from baseline) creatinine, no hypertension or diabetes, leukocyturia, and at least two of fever, nausea or vomiting, back pain, muscle weakness, headache, or leukocytosis and/or neutrophilia. Rapid progression (median 90 days) to CKD was recorded in 8.5% of patients. This evidence can serve as the basis of a sensitive and urgently needed case definition for disease surveillance of early-stage, acute MeN.

Water-borne protozoa parasites: The Latin American perspective.

Health systems, sanitation and water access have certain limitations in nations of Latin America (LA): typical matters of developing countries. Water is often contaminated and therefore unhealthy for the consumers and users. Information on prevalence and detection of waterborne parasitic protozoa are limited or not available in LA. Only few reports have documented in this field during the last forty years and Brazil leads the list, including countries in South America and Mexico within Central America region and Caribbean islands. From 1979 to 2015, 16 outbreaks of waterborne-protozoa, were reported in Latin American countries. T. gondii and C. cayetanensis were the protozoa, which caused more outbreaks and Giardia spp. and Cryptosporidium spp. were the most frequently found protozoa in water samples. On the other hand, Latin America countries have not got a coherent methodology for detection of protozoa in water samples despite whole LA is highly vulnerable to extreme weather events related to waterborne-infections; although Brazil and Colombia have some implemented laws in their surveillance systems. It would be important to coordinate all surveillance systems in between all countries for early detection and measures against waterborne-protozoan and to establish effective and suitable diagnosis tools according to the country's economic strength and particular needs.

Seed dormancy of Ochradenus baccatus (Resedaceae), a shrubby species from Arabian desert regions / Dormición de semillas de Ochradenus baccatus (Resedaceae), una especie arbustiva de las regiones desérticas arábicas

Abstract:Ochradenus baccatus is a perennial glycophyte growing in Middle East and it is one of the most important food sources for many animal species in desert regions. The aim of our study was to investigate the effects of seed storage, light, temperature and gibberellic acid (GA3) on germination of O. baccatus seeds. We also investigated the germination characteristics of O. baccatus seeds under different saline concentration and their capability to recover germination once they were transferred to distilled water. Seeds were stored at room temperature (20 ± 2 ºC) and at -18 ºC. Germination tests were conducted at alternating temperatures of 15/25, 20/30 and 25/35 ºC in either continuous darkness or photoperiod of 12-h dark/12-h light. To study the effect of GA3 on germination of O. baccatus seeds, freshly-collected seeds and stored seeds were soaked for 24 h in a GA3 water solution (1 g/L) before sowing. To assess the salinity tolerance during germination, seeds were germinated under different salinity levels (100, 200 and 400 mM NaCl). Stored seeds at room temperature and -18 ºC germinate equally well at different temperature regimes and light conditions. However, freshly matured seeds were not able to germinate even when they were treated with GA3. On the contrary, stored seeds at room temperature and -18 ºC treated with GA3 increase the final germination percentages. These results indicated that O. baccatus seeds have physiological dormancy and they need to be stored in order to break their dormancy. In the present study, one year of storage did not show a significant variation in germination between the two storage conditions assayed. Therefore, further research is needed to know about the maximum storage period for O. baccatus seeds under different storage conditions. Very few O. baccatus seeds (less than 5 %) germinated at the tested lowest concentration of NaCl. However, ungerminated seeds were able to germinate when salinity stress was alleviated. In conclusion, O. baccatus seeds have physiological dormancy, and seed storage (at room temperature and at -18 ºC) for one year is effective for breaking this dormancy. In addition, O. baccatus seeds present ability to remain viable in saline conditions and they will be able to germinate once the salinity level decrease. Rev. Biol. Trop. 64 (3): 965-974. Epub 2016 September 01.

ResumenOchradenus baccatus es un glicófito perenne que crece en oriente Medio y es una de las fuentes de alimentación más importantes para muchas especies animales de regiones desérticas. El objetivo de nuestro estudio fue investigar los efectos del almacenamiento de semillas, luz, temperatura y ácido giberélico (GA3) en la germinación de semillas de O. baccatus. También se ha investigado la germinación de semillas de O. baccatus bajo diferentes concentraciones salinas y su capacidad para recuperar la germinación una vez que fueron transferidas a agua destilada. Las semillas se conservaron a temperatura ambiente (20 ± 2 ºC) y a -18 ºC. Los ensayos de germinación se realizaron a temperaturas alternas de 15/25, 20/30 y 25/35 ºC bajo oscuridad continua o fotoperiodo de 12-h oscuridad/12-h luz. Para estudiar el efecto del GA3 en la germinación de semillas de O. baccatus, semillas recién recolectadas y semillas almacenadas se sumergieron durante 24 h en una solución acuosa de GA3 (1 g/L) antes de la siembra. Para evaluar la tolerancia a la salinidad durante la germinación, la semillas fueron germinadas bajo diferentes niveles de salinidad (100, 200 y 400 mM ClNa). Las semillas conservadas a temperatura ambiente y a -18 ºC germinaron igualmente bien en los diferentes regímenes de temperatura y condiciones de iluminación. Sin embargo, las semillas recién maduradas fueron incapaces de germinar incluso cuando se trataron con GA3. Por el contrario, las semillas almacenadas tratadas con GA3 incrementaron los porcentajes finales de germinación. Estos resultados indican que las semillas de O. baccatus tienen dormición fisiológica y necesitan ser almacenadas para romperla. En este estudio, un año de conservación no supuso una variación significativa en la germinación entre las dos condiciones de conservación ensayadas. Por lo tanto, se precisan investigaciones adicionales para conocer cuáles son los periodos máximos de almacenamiento de semillas de O. baccatus bajo diferentes condiciones de conservación. Muy pocas semillas de O. baccatus (menos del 5 %) germinaron a la concentración más baja de ClNa. Sin embargo, las semillas no germinadas fueron capaces de germinar cuando el estrés salino fue aliviado. En conclusión, las semillas de O. baccatus tienen dormición fisiológica y el almacenamiento de las mismas (a temperatura ambiente y a -18 ºC) durante un año es eficaz para romper dicha dormición. Además, las semillas de O. baccatus presentan capacidad para permanecer viables en condiciones salinas y serán capaces de germinar una vez que el nivel de salinidad disminuya.