Analysis of SIRT1 genetic variants in young Mexican individuals: relationships with overweight and obesity.

The high prevalence of obesity in Mexico starting from the early stages of life is concerning and represents a major public health problem. Genetic association studies have reported that single nucleotide variants (SNVs) in SIRT1, an NAD+-dependent deacetylase that plays an important role in the regulation of metabolic cellular functions, are associated with multiple metabolic disorders and the risk of obesity. In the present study, we analyzed the effect that the SNVs rs1467568 and rs7895833 of the SIRT1 gene may have on cardiometabolic risk factors in a young adult population from Mexico. A cross-sectional study was carried out with young adults between the ages of 18 and 25 who had a body mass index (BMI) greater than 18.5 kg/m2. This study included 1122 young adults who were classified into the normal weight (n = 731), overweight group (n = 277), and obesity group (n = 114) according to BMI of whom 405 and 404 volunteers were genotyped for rs1467568 and rs7895833 respectively using TaqMan probes through allelic discrimination assays. We found that the male sex carrying the G allele of rs7895833 had slightly lower BMI levels (p = 0.009). Furthermore, subjects carrying rs1467568 (G allele) showed a 34% lower probability of presenting with hyperbetalipoproteinemia where female carrying rs1467568 had lower levels of total cholesterol (p = 0.030), triglycerides (p = 0.026) and LDL cholesterol (p = 0.013). In conclusion, these findings suggest that the presence of both SNVs could have a non-risk effect against dyslipidemia in the Mexican population.

Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren.

PURPOSE: Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. METHODS: A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. RESULTS: A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). CONCLUSIONS: The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. IMPLICATIONS: Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9, and with low SES.

Glycemia and associated factors in a pediatric population in Mexico.

Aims: In this study, we evaluated the association of sociodemographic, lifestyle and cardiometabolic factors with blood glucose levels in children and adolescents in Mexico. Methods: An analytical cross-sectional study of 642 children and adolescents aged 6 to 19 years from different educational centers located in municipalities of the state of San Luis Potosí, Mexico, was carried out. Pearson χ2 and Spearman correlation tests and multiple linear regression models were used to evaluate the associations of the variables with glycemia. Results: The prevalence of prediabetes was 8.0% in both sexes. Male participants were more likely to develop hyperglycemia than female participants (OR 2.7, 95% CI: 1.5-5.0). The variables associated with glucose levels were male sex, high socioeconomic status, inadequate diet, high blood pressure, and increased total cholesterol, LDL cholesterol, and triglycerides, which also explained up to 15.6% (p < 0.05) of the variability in glucose concentrations. Conclusion: The detection of sociodemographic, lifestyle and cardiometabolic factors in children and adolescents will contribute to the implementation of prevention strategies for cardiometabolic diseases, among which prediabetes is common.

Evaluation of polycyclic aromatic hydrocarbons in sediments of Balsas River Mouth, Pacific Coast, Mexico: Sources, risks, and genotoxicity.

Polycyclic aromatic hydrocarbons (PAHs) were assessed in sediments (n = 7) collected from the mouth of the Balsas River, Pacific Coast, Mexico. The total PAH levels ranged between 142.1 and 3944.07 µg kg-1 in the summer and 137.65-3967.38 µg kg-1 in the winter, probably reflecting the anthropogenic activities of the region. Calculation of the four analytical ratios of [Anthracene/(Anthracene + Phenanthrene)]: [Fluoranthene/(Fluoranthene + Pyrene)], [Fluoranthene/Pyrene: Fluoranthene/(Fluoranthene + Pyrene)], [Indeno [123-cd]Pyrene/(Indeno [123-cd]Pyrene + Benzo [ghi]Perylene)]: [Benzo [a]anthracene/(Benzo [a]Anthracene + Chrysene)], and [Anthracene/Phenanthrene]: [Fluoranthene/(Fluoranthene + Pyrene)] revealed a mixed PAH source, from petroleum and biomass combustion. Significant statistical correlations (r2 = 0.90) between the 4 and 5 ringed PAHs denote that adsorption is the principal mechanism for accumulation in sedimentary archives. Ecotoxicological indices (Mean Effect Range Medium Quotient and Mean Probable Effect Level Quotient) indicated moderate pollution with adverse biological impacts on ambient benthonic organisms. The calculations of Toxicity Equivalent Quotient and Mutagen Equivalent Quotient values proposed that the region is highly polluted by mutagenic and carcinogenic PAH compounds. The genotoxic evaluation of Lutjanus guttatus (Spotted rose snapper) presented significant DNA damage and discrepancies in Ethoxyresorufin-O-Deethylase activity. Based on the toxicological and genotoxicological evaluation of PAHs in sediments, the region was observed to be largely impacted from biological damage.

Un caso de neumonía organizada tras la ruptura intracapsular de implantes mamarios de silicona / A case of organized pneumonia after intracapsular rupture of silicone breast implants

La neumonía organizada es una entidad poco frecuente, caracterizada por la formación de conglomerados fibroblásticos intraalveolares conocidos como cuerpos de Masson, que puede ser criptogénica o secundaria a una respuesta inmunitaria a diversos estímulos, tales como enfermedades hematológicas, autoinmunitarias, exposición a sustancias químicas, fármacos, tóxicos, etc. Detectada y tratada de forma precoz, suele tener una buena respuesta a la corticoterapia, aunque si se diagnostica de forma tardía, la afectación pulmonar puede ser extensa, y, además, si el estímulo antigénico persiste, la respuesta al tratamiento será incompleta. Presentamos el caso clínico de una paciente de 65 años de edad quien hace 18 meses aproximadamente presentó la rotura intracapsular de sus implantes mamarios, 27 años después de su colocación. Con el mismo tiempo de evolución ha desarrollado progresivamente disnea, tos seca y dolor inframamario, habiendo llegado al diagnóstico de neumonía organizada bilateral difusa, asociada a dicha rotura de implantes.

Organizing pneumonia is a rare entity, characterized by the formation of intraalveolar fibroblastic conglomerates known as Masson bodies, which may be cryptogenic or secondary to an immune response to various stimuli, such as hematological, autoimmune diseases, exposure to chemical substances, drugs, toxics, etc. If it is detected and treated early, it usually has a good response to corticosteroid therapy, although if it is diagnosed late, the lung involvement can be extensive, and furthermore, if the antigenic stimulus persists, the response to treatment will be incomplete. We present the clinical case of a 65-year-old patient who had intracapsular rupture of her breast implants approximately 18 months ago, 27 years after their placement. With the same evolution time, she progressively developed dyspnea, dry cough and under mammary pain, having reached the diagnosis of diffuse bilateral organizing pneumonia, associated with implant rupture.

Uricaemia and associated health determinants in a paediatric population in Mexico.

BACKGROUND AND AIM: Uric acid (UA) is a product of the catabolism of purines, and its increase in blood may be related to the development of cardiometabolic diseases. Whether UA is the result or causal determinant of the appearance of risk factors for cardiometabolic disease is not yet known. UA levels among the young student population in San Luis Potosi have increased in recent years, which may be indicative of a serious future public health concern. Therefore, the objective of this study was to evaluate the association of sociodemographic, lifestyle and cardiometabolic determinants with UA levels in children and adolescents in San Luis Potosí. METHODS AND RESULTS: A total of 730 students (54.1% female and 45.9% male, 6-19 years old) participated in the study. The subjects attended one of five public schools located in San Luis Potosí. Venous blood samples were collected, blood serum was separated by centrifugation, and UA concentrations were measured with an automated analytical platform. UA was associated with most of the independent variables studied. It presented a positive correlation with body mass index (r = 0.363, p < 0.01). Male sex, socioeconomic status, total screen time, exercise, adequate sleep, systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol explained 23%-39% (p < 0.001) of the variability of plasma concentrations of UA in children and adolescents. CONCLUSION: Early detection of these determinants will prevent future diseases. Moreover, it will help with the implementation of preventive strategies that could improve the health of this population.

A ten-year monitoring of essential and non-essential elements in the dolphinfish Coryphaena hippurus from the southern Gulf of California.

The concentrations of As, Cd, Cu, Pb and Zn were measured in muscle tissue of Coryphaena hippurus captured in the southern Gulf of California to determine inter-annual variations and their relation with environmental parameters for the period 2006-2015; additionally, health risk to consumers was assessed according to levels of studied elements and rate of fish consumption in northwest Mexico. During 2014 and 2015 the levels of As, Cd, Cu, and Zn were significantly lower than the rest of the years; in the case of As, it was also significantly lower in 2010. Oceanic Niño Index was negatively correlated with Zn concentrations in fish, while sea surface temperature was negatively correlated with Zn, Pb and Cd concentrations in dolphinfish. The simultaneous occurrence of the analyzed elements in muscle of dolphinfish indicated that health effects on consumers are not likely to occur; nevertheless, fishermen with elevated fish consumption might be at risk.

Modelo campo de salud para el estudio de la hipertensión arterial en estudiantes universitarios / Health field model for the study of arterial hypertension in university students

Introducción: el modelo campo de salud se agrupa en cuatro segmentos; biología humana [BH], medio ambiente [MA], Estilos de vida [EV] y servicios de salud [SS] descrito por primera vez por Mack Lalonde, es un instrumento para un análisis integral de la hipertensión arterial [HTA]. Objetivo: analizar las divisiones del campo de salud y su asociación con la HTA en estudiantes universitarios. Material y métodos: se trata de un estudio no experimental, descriptivo, transversal y prospectivo; muestra por conveniencia de 200 estudiantes universitarios. Se utilizó cuestionario Simão (2005) y medidas antropométricas y medición de la presión arterial [PA]. Estadística descriptiva y no paramétrica x2 y U de Mann Whitney. Resultados: la división del campo de salud con mayor prevalencia fueron los SS (62%). Hubo asociación estadísticamente significativa en presión arterial sistólica [PAS] con la BH (x2=9.53, gl=2, p=.009) y MA (x2=6.79, gl=2, p=.034) y en presión arterial diastólica [PAD] con BH (x2=6.13, gl=2, p=.047) y MA (x2=6.79, gl=2, p=.05). Conclusiones: el modelo de Lalonde permite valorar los factores causales y la prevalencia de la HTA en estudiantes universitarios.

Introduction: the health field model is grouped into four segments: human biology [HB], environment [E], lifestyles [LS] and health services [HS]. First described by Mack Lalonde, is an instrument for a comprehensive analysis of arterial hypertension [HBP]. Objective: analyze the divisions of the health field and its association with the HBP in university students. Material and methods: this is a non experimental, descriptive, cross-sectional and prospective study; convenience sample of 200 college students. A Simão questionnaire (2005), anthropometric measurements and measurement of blood pressure [BP] were used. Descriptive and non-parametric statistics x2 and Mann Whitney's U. Results: the division of the health field with the highest prevalence was the HS (62%). There was a statistically significant association in systolic blood pressure [SBP] with HB (x2=9.53, gl=2, p=.009) and E (x2=6.79, gl=2, p=.034) and in diastolic blood pressure [DBP] with HB (x2=6.13, gl=2, p=.047) and E (x2=6.79, gl=2).05. Conclusion: Lalonde model allows us to assess the causal factors and the prevalence of hypertension in university students.

Conocimientos y prácticas sobre foto protección en bañistas de ocho playas de Lima / Knowledge and practices of photoprotection in bathers of eight beaches of Lima

Resumen INTRODUCCIÓN : La radiación ultravioleta solar puede resultar perjudicial para la salud y provocar desde quemaduras hasta enfermedades como el cáncer, por ello, el cuidado frente a la alta radiación solar es importante. OBJETIVOS : El objetivo general del presente estudio fue determinar si existe asociación entre los conocimientos y las prácticas sobre foto protecciónen los bañistas peruanos. MATERIALES Y MÉTODOS : Se realizó un estudio trasversal analítico con 380 bañistas peruanos en ocho playas de Lima. Los participantes respondieron un cuestionario donde se recopiló información de los conocimientos y las prácticas de foto protección. Los conocimientos se categorizaron en altos y bajos, y las prácticas en adecuadas e inadecuadas. Para el análisis se empleó la prueba de Chi cuadrado de Pearson y el modelo de regresión de Poisson ajustado por la edad, sexo, nivel educativo y estado civil. RESULTADOS : Se encontró que la práctica de protección adecuada más frecuente fue el uso de foto protector(63%) y la menos frecuente fue el uso adecuado de manga larga y pantalón largo (9,7%). También se evidenció una relación entre los conocimientos altos y tres prácticas fundamentales: uso de foto protector, sombrilla y lentes de sol. CONCLUSIONES : En la muestra de bañistas peruanos, los participantes reportaronde manera general prácticas de foto proteccióndeficientes; además, el poseer conocimientos acerca de la protección solar no aseguró una práctica adecuada de todas las medidas de foto protección.

Abstract INTRODUCTION : Ultraviolet rays can have damaging health effects and cause from sunburn all the way up to diseases such as cancer. Thus, precautionary measures against intense solar radiation are important. OBJECTIVES: The overall objective of this study was to determine whether there is an association between photoprotection knowledge and practices in Peruvianbeach-goers. MATERIALS AND METHODS : An analytical cross-sectional study comparing survey and observational data obtained from 380 Peruvians at eight beaches in Lima was conducted. The participants answered a questionnaire where knowledge was categorized into high and low, and reported practices were dichotomized as appropriate and inappropriate. For variable analysis, Chi square test of Pearson and Poisson regression model adjusted for age, sex, education level and marital status were used. RESULTS : It was found that the most common reported appropriate practice of photoprotection was the use of sunscreen (63%) and the least frequent was the appropriate use of a long sleeve t-shirt and long pants (9.7%). It was also evident that there is a significant relationship between high knowledge and three core practices, including use of sunscreen, beach umbrellas and sunglasses. CONCLUSIONS : In this sample of Peruvian beach-goers, participants generally reported poor photoprotection practices; furthermore, knowledge about sun protection did not assure the practice of all photoprotection measures.

Uso de Tai Chi para la salud del adulto mayor: revisión bibliográfica / Use of Tai Chi for the health of the elderly: A bibliographic review / Uso do Tai Chi para a saúde de idosos: uma revisão bibliográfica

RESUMEN Introducción: La población de adultos mayores está incrementando y se observa la necesidad emergente de implementar estrategias dirigidas a recuperar o conservar su salud para que puedan gozar de una vejez plena. Técnicas como el Tai Chi podrían contribuir, ya que han mostrado tener múltiples beneficios para quien la práctica, tales como mejoras en la concentración, memoria, marcha, equilibrio, reducción del riesgo de caídas, fortalecimiento del sistema cardiovascular, reducción del estrés y la depresión, entre otros beneficios. Objetivo: Analizar la evidencia científica del uso del Tai Chi para conservar la salud del adulto mayor. Desarrollo: Revisión bibliográfica realizada durante el periodo 2013-2019 en distintas bases de datos como: Pubmed, Dialnet, SciELO, LILACS, ScienceDirect y Google Académico. Se utilizaron las palabras Tai Chi Chuan, Tai Ji Quan, Tai Chi. Aplicando los criterios de elegibilidad se seleccionaron 29 artículos. Resultados: Gran porcentaje de los artículos revisados estudian la atención de síntomas físicos que deterioran la movilidad del adulto mayor, sin embargo, también se encontraron investigaciones dirigidas a la parte psicológica, como el estrés, la ansiedad, el insomnio, la depresión y el enfado-tensión, en las cuales la práctica del Tai Chi demostró mejoría. Conclusiones: El Tai Chi es una terapia alternativa para prevenir y conservar la salud del adulto mayor, fácil de aprender y de bajo costo. En la revisión bibliográfica realizada no se reportan reacciones adversas durante ni después de la práctica de la técnica; el profesional de enfermería puede recomendarla ampliamente para ser implementada como un cuidado dirigido al adulto mayor.

ABSTRACT Introduction: The population of older adults is increasing and an emergent need to implement strategies aimed at recovering or maintaining their health is observed. In this sense, techniques such as Tai Chi could contribute because they have demonstrated bringing diverse benefits for those who practice them, including improvements in the concentration, memory, gait, and equilibrium, a reduction in the risk of falls, a strengthening of the cardiovascular system, and a reduction of stress and depression, among other benefits. Objective: To analyze the scientific evidence on the use of Tai Chi as a health promoter and preserver among older adults. Development: This bibliographic review was conducted during 2013-2019 on the Pubmed, Dialnet, SciELO, LILACS, ScienceDirect and Academic Google databases. The keywords used were Tai Chi Chuan, Tai Ji Quan, and Tai Chi. After filtering through the eligibility criteria, 29 articles were selected for the review. Results: An important percentage of the articles were focused on the attention to physical symptoms which impair the mobility of older adults; nevertheless, some studies addressed psychological issues such as stress, anxiety, sleep disorders, depression, and anger-tension, as well. In these studies, the practice of Tai Chi was associated with health improvements among older adults. Conclusions: Tai Chi is an alternative therapy to promote and maintain health among older adults. This technique is easy to learn, and its practice is not expensive. No adverse reactions during or after the practice of this technique were reported in the studies of this literature review. Therefore, the nursing professional can recommend Tai Chi practice to be implemented as a complementary healthcare measure for older adults.

RESUMO Introdução: A população de idosos está aumentando e observa-se a necessidade emergente de implementação de estratégias que visem a recuperação ou preservação da saúde para que possam desfrutar de uma velhice plena. Técnicas como o Tai Chi podem contribuir, dado que têm se mostrado múltiplos benefícios para quem o pratica, tais como melhora na concentração, memória, marcha, equilíbrio, redução do risco de quedas, fortalecimento do sistema cardiovascular, redução de estresse e depressão, entre outros benefícios. Objetivo: Analisar a evidência científica do uso do Tai Chi na preservação da saúde de idosos. Desenvolvimento: Revisão bibliográfica realizada no período 2013-2019 em diferentes bases de dados como: Pubmed, Dialnet, SciELO, LILACS, ScienceDirect e Google Academic. Foram utilizadas as palavras Tai Chi Chuan, Tai Ji Quan, Tai Chi. Aplicando os critérios de elegibilidade, foram selecionados 29 artigos. Resultados: Grande porcentagem dos artigos revisados estuda a atenção aos sintomas físicos que prejudicam a mobilidade do idoso, porém, as pesquisas também foram direcionadas à parte psicológica, como estresse, ansiedade, insônia, depressão e raiva-tensão, em que a prática do Tai Chi demonstrou melhora. Conclusões: O Tai Chi é uma terapia alternativa para prevenir e preservar a saúde do idoso, de fácil aprendizado e de baixo custo. Na revisão bibliográfica realizada, não foram relatadas reações adversas durante ou após a prática da técnica; o profissional de enfermagem pode recomendar veementemente que seja implementada como cuidado ao idoso.

Metástasis ganglionar como presentación de un carcinoma papilar de tiroides oculto, variedad folicular: reporte de caso / Lymph node metastasis as a presentation of an occult papillary thyroid carcinoma, follicular variety: case report

El carcinoma oculto de tiroides está poco reportado. Se presenta el caso de una mujer de 59 años. Durante un control por hipotiroidismo se solicitó ecografía cervical, la que mostró áreas hipoecogénicas en lóbulo derecho, una formación nodular hiperecogénica circunscrita no sospechosa de 8 mm y una adenopatía cervical periglandular derecha de 20 x 12 x 8 mm con áreas quísticas y microcalcificaciones, asociadas a hipervascularización. Se solicitó punción aspirativa por aguja fina del ganglio linfático, con resultado de citología negativa para células neoplásicas. El examen microscópico es compatible con tiroiditis, por lo que no es posible descartar metástasis. Se realizó biopsia del ganglio linfático, el que se informa como metástasis ganglionar linfática de 1.3 cm, histología de carcinoma papilar variedad folicular, sin invasión extracapsular. Se realizó tiroidectomía total y disección cervical derecha. El estudio anatomopatológico reportó una tiroiditis crónica de Hashimoto con un nódulo fibroso hialinizado de 0,4 cm negativo para tumor maligno y metástasis en 4 de 28 ganglios linfáticos, sin invasión extracapsular. El tamaño de la metástasis fue de 0,3 a 0,9 cm. Posteriormente se administró 100 mci de radioyodo. Actualmente, la paciente está en buenas condiciones y mantiene controles con ecografía y tiroglobulina periódicos.

Occult thyroid carcinoma is under-reported. The case of a 59-year-old woman is presented. During a check-up for hypothyroidism, a cervical ultrasound was requested, which showed hypoechogenic areas in the right lobe, an 8 mm nonsuspicious circumscribed hyperechogenic nodular formation and a 20 x 12 x 8 mm right cervical periglandular lymphadenopathy with cystic areas and microcalcifications, associated with hypervascularisation. Fine needle aspiration of the lymph node was requested, with negative cytology results for neoplastic cells. Microscopic examination was compatible with thyroiditis, so metastasis could not be ruled out. A biopsy of the lymph node was performed, which was reported as a 1.3 cm lymph node metastasis, histology of papillary carcinoma of the follicular variety, without extracapsular invasion. Total thyroidectomy and right cervical dissection were performed. The anatomopathological study reported chronic Hashimoto's thyroiditis with a 0.4 cm hyalinised fibrous nodule negative for malignant tumour and metastases in 4 of 28 lymph nodes, without extracapsular invasion. The size of the metastasis was 0.3 to 0.9 cm. Subsequently, 100 mci of radioiodine was administered. The patient is currently in good condition and maintains regular ultrasound and thyroglobulin monitoring.

Tirotoxicosis por enfermedad trofoblástica gestacional: revisión a partir de 3 casos / Thyrotoxicosis due to gestational trophoblastic disease: clinical cases

La enfermedad trofoblástica gestacional (ETG) es una complicación del embarazo poco común. Corresponde a un espectro de lesiones proliferativas del tejido trofoblástico: Mola Hidatiforme (MH) en sus formas parcial y completa, Coriocarcinoma, Tumor Trofoblástico y Tumor Trofoblástico Epiteloide. Los distintos tipos de ETG presentan en común la hipersecreción de gonadotrofina coriónica humana (hCG). La hCG es una hormona glicoproteica con una estructura muy similar a la TSH, por lo cual puede estimular la función tiroidea en condiciones fisiológicas y en algunas condiciones patológicas. La ETG puede cursar con hipertiroidismo, el cual puede variar en intensidad, desde una presentación asintomática con alteración leve de hormonas tiroideas a un cuadro de hipertiroidismo manifiesto. Se presentan 3 casos clínicos de pacientes con ETG, específicamente MH que evolucionaron con tirotoxicosis transitoria. Los casos presentaron un cuadro leve de hipertiroidismo con pocos síntomas asociados. La taquicardia fue el único síntoma en la mayoría de los casos. En todas las pacientes las hormonas tiroideas se normalizaron después del tratamiento de la ETG. Conclusión: Se debe tener presente la posibilidad de hipertiroidismo en toda paciente con ETG. Un alto nivel de sospecha permitirá identificar a aquellas pacientes que cursen con hipertiroidismo, permitiendo así un diagnóstico y tratamiento oportuno.

Gestational trophoblastic disease (GTD) is a rare complication of pregnancy. GTD includes a group of proliferative lesions of trophoblastic tissue: partial and complete hydatidiform mole, choriocarcinoma, epithelioid trophoblastic tumor, and placental site trophoblastic tumor. The different types of GTD have in common the hypersecretion of human chorionic gonadotropin (hCG). HCG is a glycoprotein hormone with a similar structure to TSH. In physiological and pathological conditions hCG can stimulate thyroid function. GTD can present with hyperthyroidism, which can vary in intensity, from an asymptomatic presentation with mild alteration of thyroid hormones to a manifest hyperthyroidism. We present 3 clinical cases of patients with GTD thyrotoxicosis. All cases presented mild hyperthyroidism. Tachycardia was the only symptom in most cases. In all patients thyroid hormones return to normal after treatment of GTD. Conclusion: In patients with GTD the possibility of hyperthyroidism should be kept in mind. A high level of suspicion will allow to identifying patients with hyperthyroidism.

Clostridium ramosum rapidly identified by MALDI-TOF MS. A rare gram-variable agent of bacteraemia.

Clostridium ramosum is an enteric anaerobic, endospore-forming, gram-positive rod with a low GC content that is rarely associated with disease in humans. We present a case of C. ramosum bacteraemia. To the best of our knowledge, this is the second case of C. ramosum bacteraemia in an elderly patient presenting with fever, abdominal pain and bilious emesis. We highlight the Gram stain variability, the lack of visualization of spores and the atypical morphology of the colonies that showed C. ramosum in a polymicrobial presentation that initially appeared to show monomicrobial bacteraemia. The microorganism was rapidly identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We present a comprehensive literature review of 32 cases of clinical infections by C. ramosum in which we describe, if available, sex, age, clinical symptoms, predisposing conditions, other organisms present in the blood culture, other samples with C. ramosum , identification methodology, treatment and outcome.

Variation of δ18O in otoliths of Stellifer lanceolatus and Eucinostomus gula environmental change indicator in Terminos Lagoon, Mexico.

Environmental changes have been associated with natural climatic variability or human activity. Water resources management is, perhaps, the most drastic change observed in the coastal environment. However, external forcings such as the El Niño event have important implications in the global and regional hydrological balance. These environmental changes have an impact on the density and biomass of the ichthyofauna in the Terminos Lagoon (TL) for the past 30 years, presumably, associated with variations in the temperature and surface salinity of the sea. Therefore, in the present study, δ18O was quantified in otoliths of two important species due to their dominance: Stellifer lanceolatus and Eucinostomus gula, and to understand the environmental changes reflected in both species. The δ18O was analyzed in otoliths of these two species captured in 1998/1997, 2006/2007 and 2016/2017 and were compared with in situ temperature and salinity data. Sea surface temperature and salinity increased by 2 °C and 9, respectively, between 1997 and 2017. Stellifer lanceolatus δ18O values was in isotopic equilibrium with seawater calcite; while, E. gula is not in isotopic equilibrium. The δ18O of S. lanceolatus and E. gula varied significantly with the increase in salinity (R2 = 0.8987 and R2 = -0.2964) and not with the sea surface temperature. S. lanceolatus is an excellent bioindicator of changes in sea surface salinity in this region of the Gulf of Mexico.

[Frequency of malignancy in thyroid incidentalomas detected by whole body 18F-FDG PET/CT]. / Frecuencia de malignidad en incidentalomas tiroideos detectados con tomografía por emisión de positrones/tomografía computada (PET/CT) con F18-FDG de cuerpo entero.

BACKGROUND: Thyroid incidentalomas detected by 18F-Fludeoxyglucose (FDG) PET/CT are defined as an incidental and unexpected thyroid focus present in a patient studied for a non-thyroid disease. AIM: To assess the frequency of malignancy of nodular thyroid incidentalomas, and their association with 18F-FDG avidity (standard uptake value (SUV) max). MATERIAL AND METHODS: Whole body PET/CT performed from December 2008 to December 2017 were reviewed selecting those that showed nodular thyroid foci. Glands with diffuse increased uptake were excluded. Thyroid ultrasonography and fine-needle aspiration cytology (FNAC) performed after PET/CT were reviewed. Bethesda score and SUVmax were correlated. RESULTS: Of 5,100 whole body 18F-FDG PET/CT, 119 showed a thyroid nodular uptake (2.3%). Forty eight percent of these patients were studied with FNAC or surgery, 50% of which (29/58) were confirmed as malignant. Benign nodules showed significantly lower 18F-FDG uptake (n = 20, SUVmax: 3.5 ± 1.7) than Bethesda V-VI (n=24, SUVmax: 8.2 ± 5.2) and thyroid metastases (n=5, SUVmax: 6.3 ± 2.1). The best cut-off value to distinguish between benign and malignant nodules was a SUVmax of 5.0, with a sensitivity of 76% (95% confidence intervals (CI) 56-90%), a specificity of 85% (95% CI 62 - 97%), and positive likelihood ratio of 5 (95% CI 1.8 - 14.6). The size of the thyroid nodule was not predictive of malignancy. CONCLUSIONS: Half of nodular thyroid incidentalomas detected by 18F-FDG PETC/CT are malignant. A nodule with a SUVmax ≥ 5,0 is highly suggestive of malignancy, regardless of its size.

Critical-sized mandibular defect reconstruction using human dental pulp stem cells in a xenograft model-clinical, radiological, and histological evaluation.

PURPOSE: This research evaluated clinical, histological, and radiological osseous regeneration in a critical-sized bilateral cortico-medullary osseous defect in model rabbits from New Zealand after receiving a hydroxyapatite matrix and polylactic polyglycolic acid (HA/PLGA) implanted with human dental pulp stem cells (DPSCs). METHODS: Eight New Zealand rabbits with bilateral mandibular critical-sized defects were performed where one side was treated with an HA/PLGA/DPSC matrix and the other side only with an HA/PLGA matrix for 4 weeks. RESULTS: An osseointegration was clinically observed as well as a reduction of 70% of the surgical lumen on one side and a 35% on the other. Histologically, there was neo-bone formation in HA/PLGA/DPSC scaffold and angiogenesis. A bone radiodensity (RD) of 80% was radiologically observed achieving density levels similar to mandibular bone, while the treatment with HA/PLGA matrix achieves RD levels of 40% on its highest peaks. CONCLUSIONS: HA/PLGA/DPSC scaffold was an effective in vivo method for mandibular bone regeneration in critical-sized defects induced on rabbit models.

Frecuencia de malignidad en incidentalomas tiroideos detectados con tomografía por emisión de positrones/tomografía computada (PET/CT) con F18-FDG de cuerpo entero / Frequency of malignancy in thyroid incidentalomas detected by whole body 18F-FDG PET/CT

Background: Thyroid incidentalomas detected by 18F-Fludeoxyglucose (FDG) PET/CT are defined as an incidental and unexpected thyroid focus present in a patient studied for a non-thyroid disease. Aim: To assess the frequency of malignancy of nodular thyroid incidentalomas, and their association with 18F-FDG avidity (standard uptake value (SUV) max). Material and Methods: Whole body PET/CT performed from December 2008 to December 2017 were reviewed selecting those that showed nodular thyroid foci. Glands with diffuse increased uptake were excluded. Thyroid ultrasonography and fine-needle aspiration cytology (FNAC) performed after PET/CT were reviewed. Bethesda score and SUVmax were correlated. Results: Of 5,100 whole body 18F-FDG PET/CT, 119 showed a thyroid nodular uptake (2.3%). Forty eight percent of these patients were studied with FNAC or surgery, 50% of which (29/58) were confirmed as malignant. Benign nodules showed significantly lower 18F-FDG uptake (n = 20, SUVmax: 3.5 ± 1.7) than Bethesda V-VI (n=24, SUVmax: 8.2 ± 5.2) and thyroid metastases (n=5, SUVmax: 6.3 ± 2.1). The best cut-off value to distinguish between benign and malignant nodules was a SUVmax of 5.0, with a sensitivity of 76% (95% confidence intervals (CI) 56-90%), a specificity of 85% (95% CI 62 - 97%), and positive likelihood ratio of 5 (95% CI 1.8 - 14.6). The size of the thyroid nodule was not predictive of malignancy. Conclusions: Half of nodular thyroid incidentalomas detected by 18F-FDG PETC/CT are malignant. A nodule with a SUVmax ≥ 5,0 is highly suggestive of malignancy, regardless of its size.

Association of missense variants in GDF9 with litter size in Entlebucher Mountain dogs.

In the past two decades, average litter size (ALS) in Entlebucher Mountain dogs decreased by approximately 0.8 puppies. We conducted a GWAS for ALS using the single-step methodology to take advantage of 1632 pedigree records, 892 phenotypes and 372 genotypes (173 662 markers) for which only 12% of the dogs had both phenotypes and genotypes available. Our analysis revealed associations towards the growth differentiation factor 9 gene (GDF9), which is known to regulate oocyte maturation. The trait heritability was estimated at 43.1%, from which approximately 15% was accountable by the GDF9 locus alone. Therefore, markers flanking GDF9 explained approximately 6.5% of the variance in ALS. Analysis of WGSs revealed two missense substitutions in GDF9, one of which (g.11:21147009G>A) affected a highly conserved nucleotide in vertebrates. The derived allele A was validated in 111 dogs and shown to be associated with decreased ALS (-0.75 ± 0.22 puppies per litter). The variant was further predicted to cause a proline to serine substitution. The affected residue was immediately followed by a six-residue deletion that is fixed in the canine species but absent in non-canids. We further confirmed that the deletion is prevalent in the Canidae family by sequencing three species of wild canids. Since canids uniquely ovulate oocytes at the prophase stage of the first meiotic division, requiring maturation in the oviduct, we conjecture that the amino acid substitution and the six-residue deletion of GDF9 may serve as a model for insights into the dynamics of oocyte maturation in canids.

Hipertiroidismo en personas mayores de 65 años: serie de casos de un hospital universitario / Thyrotoxicosis in the elderly: case series report from a university hospital

Introducción: En Chile en las últimas décadas ha aumentado la población de personas mayores de 65 años. La tirotoxicosis en este grupo está asociada a complicaciones como fibrilación auricular (FA), insuficiencia cardiaca (ICC), osteoporosis y aumento de la mortalidad. En algunos casos puede presentarse con síntomas no específicos, cuadro conocido como hipertiroidismo apático. Objetivos: Evaluar las características clínicas de la tirotoxicosis en personas mayores. Método: Serie de casos retrospectiva. Se analizaron fichas clínicas de pacientes mayores de 65 años con el diagnóstico de tirotoxicosis controlados en nuestro centro entre enero de 2012 y mayo de 2018. Resultados: En el periodo estudiado 54 pacientes fueron diagnosticados de tirotoxicosis. Se excluyen 4 por datos incompletos. El 80% corresponden a mujeres. La mediana de edad fue 71 años (rango 65-94), sin diferencias por género (p=0,61). La etiología más frecuente fue enfermedad de Graves (EG) en 64%, seguido por bocio multinodular hiperfuncionante en 20%, adenoma tóxico en 10% y asociada a fármacos en 6%. De los pacientes con EG, 28% presentó orbitopatía distiroidea (OD) clínicamente evidente. Un 30% se diagnosticó en contexto de baja de peso, deterioro cognitivo o patología cardiovascular, sin presentar síntomas clásicos de hipertiroidismo. Un 16% presentó FA, 14% ICC y 6% fractura osteoporótica. El 28% fue diagnosticado durante una hospitalización o requirió ser hospitalizado durante los meses siguientes. Los mayores de 75 años presentan una mayor probabilidad de hipertiroidismo apático (OR 5,1, IC95% 1,15-22,7 p=0,01). Además, las complicaciones aumentan en mayores de 75 años, encontrándose en este grupo todos los casos de FA. Conclusiones: La etiología más común de tirotoxicosis fue la EG, a diferencia de lo reportado en otras poblaciones. Un número importante de pacientes debutó sin síntomas clásicos de hipertiroidismo, principalmente mayores de 75 años, por lo que se debe tener una alta sospecha en este grupo etario.

Introduction: Hyperthyroidism in the elderly can produce severe complications such as atrial fibrillation (AF), heart failure (CHF) and osteoporosis. In the elderly, thyrotoxicosis may have only nonspecific symptoms, known as apathetic hyperthyroidism. Objective: To evaluate the clinical characteristics of thyrotoxicosis in the elderly. Methods: Retrospective case series. We reviewed clinical records of patients with thyrotoxicosis older than 65 years, between January 2012 and March 2019. Results: During this period, 54 patients were diagnosed with thyrotoxicosis. Four patients were excluded due to incomplete data. 80% were women. The average age was 73 years (range 65-94), without age difference between gender (p=0,61). The most frequent etiology was Graves' disease in 64%. Hyperfunctioning multinodular goiter was confirmed in 20%, toxic adenoma in 10% and drug-associated in 6%. Twenty eight percent of Graves' disease patients had dysthyroid orbitopathy. Thirty percent presented as apathetic hyperthyroidism. Sixteen percent of the patients presented AF, 14% CHF, and 6% osteoporotic fracture. Twenty-eight percent were diagnosed during hospitalization or required hospitalization in the following months. Those older than 75 years had a greater probability of presenting apathetic hyperthyroidism (OR 5.1, 95% CI 1.15- 22.7 p=0.01). Complications increase in this age group, with all cases of AF. Conclusions: The most common etiology of thyrotoxicosis in this group was GD. This differs from other populations. A significant number of patients presented without classic symptoms of hyperthyroidism, especially in people older than 75 years. Special attention should be paid to atypical symptoms of hyperthyroidism in this group.