Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico.

BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.

Four glycoproteins are expressed in the cat zona pellucida.

The mammalian oocyte is surrounded by a matrix called the zona pellucida (ZP). This envelope participates in processes such as acrosome reaction induction, sperm binding and may be involved in speciation. In cat (Felis catus), this matrix is composed of at least three glycoproteins called ZP2, ZP3, and ZP4. However, recent studies have pointed to the presence of a fourth protein in several mammals (rat, human, hamster or rabbit), meaning that a reevaluation of cat ZP is needed. For this reason, the objective of this research was to analyze the protein composition of cat ZP by means of proteomic analysis. Using ZP from ovaries and oocytes, several peptides corresponding to four proteins were detected, yielding a coverage of 33.17%, 71.50%, 50.23%, and 49.64% for ZP1, ZP2, ZP3, and ZP4, respectively. Moreover, the expression of four genes was confirmed by molecular analysis. Using total RNA isolated from cat ovaries, the complementary deoxyribonucleic acids encoding cat ZP were partially amplified by reverse-transcribed polymerase chain reaction. Furthermore, ZP1 was totally amplified for the first time in this species. As far as we are aware, this is the first study that confirms the presence of four proteins in cat ZP.

Removal of groundwater arsenic using a household filter with iron spikes and stainless steel.

Arsenic (As) in groundwater for domestic use poses a worldwide threat to public health, most notably in rural areas. The aims of this study were: first, determine groundwater composition in a mining area in central Mexico (Huautla); second, assess As exposure through human groundwater consumption and; third, develop and test a household filter to obtain drinking water for these rural communities. From the 17th century through the 1990s, mines in the area produced Ag-galena and sphalerite from volcanic rock. Groundwater flooded the mines when they were abandoned due to low silver prices. Local households now use the water to meet domestic needs. Water from the mines was found to have high As content (0.04-0.26 mg L(-1)) and Fe, Mn, Pb and Cd were also above Mexican drinking water standards and WHO guidelines. All the population in the Huautla community was exposed to the metalloid through water used in food preparation. The best As removal was obtained with a filter using oxidized commercial fiber (HCl 2N as oxidant). Concentrations in the effluent were below Mexican drinking water standards (0.025 mg As L(-1) water) during the 105-day (2520 h) filter operation, with a maximum As removal efficiency of 95.4%. The household filter was simple, low-cost and may be very attractive for As removal in rural areas in developing countries.

Improving collected rainwater quality in rural communities.

The country of Mexico is facing serious problems with water quality and supply for human use and consumption in rural communities, mainly due to topographic and isolation. In Mexico the average annual precipitation is 1,500 cubic kilometers of water, if 3% of that amount were used, 13 million Mexicans could be supplied with drinking water that they currently do not have access. Considering the limited infrastructure and management in rural communities, which do not receive services from the centralized systems of large cities, a modified pilot multi-stage filtration (MMSF) system was designed, developed, and evaluated for treating collected rainwater in three rural communities, Ajuchitlan and Villa Nicolas Zapata (Morelos State) and Xacxamayo (Puebla State). The efficiencies obtained in the treatment system were: colour and turbidity >93%. It is worth mentioning that the water obtained for human use and consumption complies with the Mexican Standard NOM-127-SSA1-1994.

Asymmetries of vestibular dysfunction in major depression.

Depression is characterized by alterations in the circadian secretion of hormones, sleep and motor activity, all of which are regulated by suprachiasmatic nuclei (SCN). The vestibular system in the inner ear registers the amount of motor activity. To test the integrity of this motion sensitive system in depression, we studied the vestibulo-ocular reflex (VOR) in depressive patients who were not taking medication and healthy control subjects, which allowed us to investigate each ear and its corresponding nerve centers. Ocular reflex movement depends on vestibular nuclei activity, and we found that at 30 degrees C stimulation the right vestibular system in depressive patients has approximately half the activity of the left side. Significant asymmetry was not detected in control subjects. We also found a significant decrease in the slow phase (16.92+/-9.13 degrees/s) of the reflex in the depressed group as compared with the control group (43.77+/-16.04 degrees/s). The vestibular nuclei of the right and left sides are hypoactive. Specifically, the right vestibular nucleus is hypoactive in depressed people and can easily be measured using VOR. These results support the abnormal asymmetries hypothesis of depression and suggest that these asymmetries also exist at the level of the brain stem or neuronal centers that are afferents to right vestibular nuclei, like SCN or raphe nuclei.

Antifungal activities of nine traditional Mexican medicinal plants.

Eighteen plant extracts from nine traditional Mexican medicinal plants were tested for antifungal activity against two dermatophyte fungal species (Trichophyton mentagrophytes and Trichophyton rubrum), one non-dermatophyte (Aspergillus niger), and one yeast (Candida albicans). The strongest effect was manifested by the hexane extracts from Eupatorium aschenbornianum and Sedum oxypetalum, as well as the methanol extracts from Lysiloma acapulcensis and Annona cherimolia.

Hepatitis C virus RNA (HCV-RNA) in blood donors and family members seropositive for anti-HCV antibodies.

BACKGROUND: Non-A, non-B virus is responsible for 75-90% of all cases of blood transfusion-related hepatitis. The aim of this work was to determine hepatitis C virus RNA (HCV-RNA) in a group of blood donors and their household contacts. Serotype and genotype of the isolates were also studied. METHODS: HCV antibodies were investigated in 44,588 blood donors with a commercial immunoassay. Forty-four seropositive donors and 72 household members were further studied. Quantitative analysis of viral RNA was performed with Amplicor HCV 2.0 test, while genotype was determined by INNO-LiPA test and serotype with Murex HCV test. RESULTS: Among the 44,588 donors studied, 333 (0.74%) were positive for anti-HCV. Viral RNA was found in 35 (80%) of the 44 seropositive cases studied. Among the 72 household members, HCV antibodies were detected in six (8.3%) and HCV-RNA in four of these individuals. Serotype 1 and genotype 1 were the most frequent types detected (48 and 64%, respectively). The genotype in the blood donor matched that of his seropositive family member in four of six cases. CONCLUSIONS: Our results suggest that intrafamilial transmission of HCV may occur and we stress the need to study household members of seropositive blood donors, as they have a high risk of infection. In this community, genotype 1 is the most prevalent type in blood donors and family members.

Emisiones otoacústicas en disfunciones auditivas retrococleares / Otoacustic emissions in retrocochlear auditory disfunctions

Se analizan las Emisiones Otoacusticas Espontáneas y de Productos de Distorsion obtenidos en enfermos con hipoacusias progresivas o subitas, acompanadas de tinnitus y algunos de mareos. Y se describe la utilidad clinica práctica de ellas en el diagnostico diferencial entre lesiones cocleares o retrococleares

The health status of the Puerto Rican elderly.

Health is a central theme for all the aged since it affects their situation in all spheres of life. The objective of this study was to identify the health conditions of an islandwide sample of non-institutionalized elderly respondents. This study is part of a 31 page questionnaire concerning the social-demographic status of the Puerto Rican elderly. The questions pertaining to the specific topic of health conditions consist of ten items about background information and ten questions pertaining to health. Structured interviews were carried out from September 1983 to September 1985. The tests of significance were those of Kendall's Tau B and C and Cramer's V. The health conditions of greatest magnitude in this population (arthritis, hypertension) are similar to those found in the elderly elsewhere. The oral illness condition was more frequent in the rural population of the island. Socio-economic considerations were found to be an important influence for the magnitude of health conditions.