Socioeconomic Level and the Relationship in Glycemic Behavior in the Mexican Population. A Nutritional Alternative Focused on Vulnerable Populations.

In this study, numerical approximations were generated to analyze the behavior of glycemic variations in the non-diabetic population of the Mexican republic. The main objective of this work is to obtain an overview of the glycemic variations in the non-diabetic population from different socioeconomic statuses in Mexico (Medium-high, medium, and low). Thus, evaluating the effect on the glucose level under a healthy diet considering the socioeconomic capabilities of the population. Through the national health and nutrition survey of Mexico 2020 and the Mexican food base, 1420 virtual patients were proposed (522 low status, 485 medium status and 413 Medium-High status) focused on simulating the glycemic behavior in each of the survey participants. Considering that the average food expenditure of the Mexican population is $107.00 MXN, and the cost of a healthy diet is $66.50 MXN, the economic sustainability of the Mexican population to adopt a healthy diet is revealed. The particularity of this work is focused on obtaining diverse data that are difficult to access in the development of population analyses. Such is the case of the approach proposed for different socioeconomic statuses. In this way, the proposed methodology provides a framework for complementary research contributions to the subject.

Association of NFκß, TNFα, IL-6, IL-1ß, and LPL Polymorphisms with Type 2 Diabetes Mellitus and Biochemical Parameters in a Mexican Population.

Chronic low-grade inflammation is strongly related to the etiology of diabetes mellitus type 2 (T2DM), and the expression of inflammatory cytokines may be modulated by polymorphisms located in the regulatory regions of the NFκß, IL-1ß, IL-6, TNFα, and LPL genes. We considered it particularly important to investigate the relationship of gene polymorphisms involved in chronic inflammation with the risk of T2DM or uncontrolled biochemical parameters. METHODS: We included 199 individuals with a T2DM diagnosis and 213 individuals without a T2DM diagnosis. Restriction fragment length polymorphism (RFLP) analyses were used to assess polymorphisms. RESULTS: We found a risk association between T2DM and uncontrolled biochemical parameters in a Mexican population for the genotypes del/del of NFκß, -174 and -572 of IL-6, C/C of IL-1ß, -308 and -238 of TNFα, and T/T of LPL. In subjects without diabetes (controls), we found an association between the G/C genotype of the -572 polymorphism and the G/C and C/C genotypes of the -597 polymorphism of IL-6 with the risk of glucose levels > 131 mg/dL. Genotype C/C of polymorphism -174 of the IL-6 gene was associated with high triglyceride levels, and levels > 5.8% of HbA1c were associated with the G/A genotype of TNFα -308. CONCLUSION: Here, we describe for the first time the relationship of T2DM risk and uncontrolled biochemical parameters with polymorphisms in the NFκß, IL-6, TNFα, IL-1ß, and LPL genes in a Mexican population. We also showed that for the population included in this study, there is an additive effect of the polymorphisms of the studied genes that considerably increases the risk of developing T2DM.We also showed that there are interactions between genes related to chronic inflammation that affect the risk of T2DM.

Pathological characteristics, survival, and risk of breast cancer associated with estrogen and xenobiotic metabolism polymorphisms in Mexican women with breast cancer.

Prolonged exposure to estrogens is the main factor associated with the risk and prognosis of breast cancer (BC). The genes involved in the biotransformation of estrogens and xenobiotics have allelic variants with modified enzymatic activities. We investigated the association of nine polymorphisms of some genes from the classical estrogen pathway with the risk of breast cancer and their role in the clinicopathological characteristics of poor clinical prognosis in a sample of Mexican women with BC. METHODS: We included 150 controls and 150 cases matched by age. To analyze the selected polymorphisms, TaqMan assays and high-resolution melting (HRM) analysis were used. RESULTS: The polymorphisms of the genes ERα, CYP1A1, CYP1B1, COMT, MGMT, and XRCC1 were positively associated with the BC risk. We found negative associations between CYP1B1G/G genotype and tumor size, and status of lymph node, estrogen receptor, triple negative, and survival. CONCLUSIONS: The polymorphisms included in this study are associated not only with the risk of BC, but also with some clinicopathological characteristics for poor prognosis of patients with breast cancer, highlighting the important role of CYP1B1 Leu432Val polymorphism.

Colecistostomía percutánea como tratamiento de la colecistitis aguda en pacientes con alto riesgo quirúrgico / Percutaneous cholecystostomy to treat acute cholecystitis in patients with high risk for surgery

Objetivo. Evaluar los resultados de las colecistostomías percutáneas realizadas como tratamiento urgente de colecistitis aguda, en busca de predictores de supervivencia. Valorar la recurrencia de colecistitis tras la retirada del catéter en pacientes descartados para cirugía diferida, y buscar factores predictores de recurrencia. Material y métodos. Se revisan retrospectivamente 40 pacientes sometidos a colecistostomía durante dos años. Se analiza la relación de la supervivencia durante el periodo de hospitalización con la evolución de fiebre, dolor abdominal, leucocitosis y proteína C reactiva después del procedimiento. Se analiza la recurrencia de colecistitis tras la retirada del catéter en pacientes descartados para colecistectomía diferida por alto riesgo quirúrgico, así como la influencia de la colangiografía no permeable, la edad, el sexo y las comorbilidades en el porcentaje de recurrencias. Resultados. Durante la hospitalización fallecieron cuatro pacientes por shock séptico (10%). La colecistostomía mejoró significativamente la fiebre, la leucocitosis y el dolor abdominal en un máximo de 5 días tras el procedimiento, pero estas mejoras no tuvieron un efecto estadísticamente relevante sobre la supervivencia, por lo que no se consideran útiles como factores pronósticos. Entre los 15 pacientes descartados para cirugía hubo seis recurrencias de colecistitis (40%) con un seguimiento medio de 6,7 meses tras la retirada del catéter. Un paciente falleció por recurrencia. No se encontró asociación de recurrencia con los parámetros analizados. Conclusiones. La colecistostomía ofrece resultados similares a los obtenidos en otras series como tratamiento urgente de la colecistitis aguda en pacientes con alto riesgo quirúrgico. La retirada del catéter en pacientes descartados para cirugía con colecistitis litiásica es una opción desaconsejable debido al elevado riesgo de recurrencia de colecistitis en comparación con otras series (AU)

Objective. To evaluate the results of percutaneous cholecystostomy for urgent treatment of acute cholecystitis, with the aim of identifying factors that predict survival. To analyze the recurrence of cholecystitis after catheter withdrawal in patients considered unsuitable candidates for delayed surgery, with the aim of identifying factors that predict recurrence. Material and methods. We reviewed 40 patients who underwent percutaneous cholecystostomy in a two-year period. We analyzed survival during hospitalization in relation with fever, abdominal pain, leukocytosis, and C-reactive protein before and after the procedure. We analyzed the recurrence of cholecystitis after catheter withdrawal in patients considered unsuitable candidates for delayed surgery, as well as the influence of obstruction seen on cholangiography, age, sex, and comorbidities on the recurrence rate. Results. During the hospital stay, 4 (10%) patients died of septic shock. Cholecystostomy improved fever, leukocytosis, and abdominal pain within five days of the procedure, but these improvements did not have a statistically significant effect on survival and were not therefore considered useful prognostic factors. Among the 15 patients considered unsuitable candidates for delayed surgery, 6 (40%) had recurrences of cholecystitis during a mean follow-up period of 6.7 months after catheter withdrawal. We found no association between recurrence and any of the parameters analyzed. Conclusions. Outcomes in our series of patients with high risk for surgery who underwent cholecystostomy for urgent treatment of acute cholecystitis were similar to those reported in other series. Withdrawing the catheter in patients considered unsuitable candidates for delayed surgery is not recommended due to the high risk of recurrence of cholecystitis in comparison with other series (AU)

Percutaneous cholecystostomy to treat acute cholecystitis in patients with high risk for surgery.

OBJECTIVE: To evaluate the results of percutaneous cholecystostomy for urgent treatment of acute cholecystitis, with the aim of identifying factors that predict survival. To analyze the recurrence of cholecystitis after catheter withdrawal in patients considered unsuitable candidates for delayed surgery, with the aim of identifying factors that predict recurrence. MATERIAL AND METHODS: We reviewed 40 patients who underwent percutaneous cholecystostomy in a two-year period. We analyzed survival during hospitalization in relation with fever, abdominal pain, leukocytosis, and C-reactive protein before and after the procedure. We analyzed the recurrence of cholecystitis after catheter withdrawal in patients considered unsuitable candidates for delayed surgery, as well as the influence of obstruction seen on cholangiography, age, sex, and comorbidities on the recurrence rate. RESULTS: During the hospital stay, 4 (10%) patients died of septic shock. Cholecystostomy improved fever, leukocytosis, and abdominal pain within five days of the procedure, but these improvements did not have a statistically significant effect on survival and were not therefore considered useful prognostic factors. Among the 15 patients considered unsuitable candidates for delayed surgery, 6 (40%) had recurrences of cholecystitis during a mean follow-up period of 6.7 months after catheter withdrawal. We found no association between recurrence and any of the parameters analyzed. CONCLUSIONS: Outcomes in our series of patients with high risk for surgery who underwent cholecystostomy for urgent treatment of acute cholecystitis were similar to those reported in other series. Withdrawing the catheter in patients considered unsuitable candidates for delayed surgery is not recommended due to the high risk of recurrence of cholecystitis in comparison with other series.

Promoting research in advanced dementia: early clinical results of the Alzheimer Center Reina Sofía Foundation.

The Alzheimer Center Reina Sofía Foundation (ACRSF) was envisaged to address the complex and multi-disciplinary research and care needs posed by Alzheimer's disease (AD) and other neurodegenerative dementias. Patients may be admitted at ACRSF either as inpatients (i.e., nursing home) or outpatients (i.e., day-care center). The research program includes clinical, social, biochemical, genetic, and magnetic resonance investigations, as well as brain donation. We present the inception of the clinical research protocol for the ACRSF, the early results, and the amendments to the protocol. Foreseen as distinct populations, inpatient and outpatient results are presented separately. Data were collected from 180 patients (153 inpatients, 27 outpatients) (86% AD), with informed consent for participation in the research program of the ACRSF. Most patients (95%) had moderate to severe dementia. Nursing home patients were older, displayed marked gait dysfunction, and were significantly more dependent in the activities of daily living (ADL), compared to the day-care patients (p < 0.05). Some cognitive, ADL, and quality of life (QoL) scales were eliminated from the protocol due to floor effect or lack of specificity of contents for advanced dementia. New measurements were added for evaluation of cognition, apathy, agitation, depression, ADL, motor function, and QoL. The final assessment is expected to be sensitive to change in all the clinical aspects of advanced degenerative dementia, to promote multidisciplinary and, desirably, inter-center collaborative research and, eventually, to contribute to the improvement of treatment and care for these patients.

[A comparative study of the effectiveness and tolerability of a procedure involving slow dose-escalation of rivastigmine in patients with mild or moderate Alzheimer-type dementia: the SCALEX study]. / Estudio comparativo de la efectividad y tolerabilidad de un procedimiento de escalado lento de dosis de rivastigmina en pacientes con demencia tipo Alzheimer leve o moderada: estudio SCALEX.

AIMS: To determine and to compare the tolerability and effectiveness of a slow escalation of the dose of rivastigmine in patients with Alzheimer's disease with respect to using it with a faster escalation. PATIENTS AND METHODS: We conducted a multi-centre, naturalistic, open-label, randomised trial with 429 hospital outpatients diagnosed with Alzheimer-type dementia (according to DSM-IV and NINCDS-ADRA criteria) and in whom treatment with rivastigmine was clinically indicated. Two study groups were established: slow escalation and fast escalation (in accordance with usual clinical practice); effectiveness and tolerability variables were analysed in the two groups, as was the proportion of patients who reached therapeutic doses (> 6 mg/day). The scores obtained on the CGI, MMSE, NPI and Barthel index scales were analysed, together with adverse events and reactions concerning spontaneous communication, and scores on the UKU scale. RESULTS: The slow escalation group displayed slightly higher percentages of sub-therapeutic anticipated interruptions than the fast escalation group (chi-square test; p < 0.05). On comparing the two treatment groups, no statistically significant differences were observed for the evolution of the scores on the different scales of effectiveness; no statistically significant differences were found between the two groups in the safety and tolerability analyses (chi-square test, exact test; p > 0.05) for most of the parameters that were studied (adverse reactions in spontaneous communication and the modified UKU scale). CONCLUSION: Slow escalation of the dose of rivastigmine did not display greater effectiveness or tolerability in comparison to an escalation applied in accordance with usual clinical practice.

Estudio comparativo de la efectividad y tolerabilidad de un procedimiento de escalado lento de dosis de rivastigmina en pacientes con demencia tipo Alzheimer leve o moderada: estudio SCALEX / A comparative study of the effectiveness and tolerability of a procedure involving slow dose-escalation of rivastigmine in patients with mild or moderate Alzheimer-type dementia: the scalex study

Determinar y comparar la tolerabilidad y la efectividad de un escalado lento de dosis de rivastigminaen pacientes con enfermedad de Alzheimer frente a su uso en escalado más rápido. Pacientes y métodos. Estudio multicéntrico, naturalístico, abierto y aleatorizado con 429 pacientes ambulatorios diagnosticados de demencia tipo Alzheimer (según criterios DSM-IV y NINCDS-ADRA) y con indicación clínica de tratamiento con rivastigmina. Se determinaron dos grupos de estudio: escalado lento y escalado rápido (según práctica clínica habitual) y se analizaron variables de efectividad y tolerabilidadentre ambos grupos y la proporción de pacientes que alcanzaron dosis terapéuticas (> 6 mg/día). Se analizaron las puntuaciones en las escalas CGI, MMSE, NPI e índice de Barthel, acontecimientos y reacciones adversas de comunicación espontánea, y puntuaciones en la escala UKU. Resultados. El grupo de escalado lento presentó porcentajes ligeramente mayoresde interrupciones anticipadas subterapéuticas que el grupo de escalado rápido (test chi al cuadrado; p < 0,05). No se observaron diferencias estadísticamente significativas para la evolución en las puntuaciones de las distintas escalas de efectividad entre los dos grupos de tratamiento; en el análisis de tolerabilidad y seguridad tampoco se observaron diferencias estadísticamente significativas entre los grupos (test chi al cuadrado, prueba exacta; p > 0,05) para la mayoría de parámetros estudiados (reacciones adversas de comunicación espontánea y escala UKU modificada). Conclusión. El escalado lento de dosisde rivastigmina no demostró mayor eficacia ni mejor tolerabilidad frente a un escalado según la práctica clínica habitual

To determine and to compare the tolerability and effectiveness of a slow escalation of the dose of rivastigmine in patients with Alzheimer’s disease with respect to using it with a faster escalation. Patients and methods. We conducted a multi-centre, naturalistic, open-label, randomised trial with 429 hospital outpatients diagnosed with Alzheimer-type dementia(according to DSM-IV and NINCDS-ADRA criteria) and in whom treatment with rivastigmine was clinically indicated. Two study groups were established: slow escalation and fast escalation (in accordance with usual clinical practice); effectiveness and tolerability variables were analysed in the two groups, as was the proportion of patients who reached therapeutic doses(> 6 mg/day). The scores obtained on the CGI, MMSE, NPI and Barthel index scales were analysed, together with adverse events and reactions concerning spontaneous communication, and scores on the UKU scale. Results. The slow escalation group displayed slightly higher percentages of sub-therapeutic anticipated interruptions than the fast escalation group (chisquare test; p < 0.05). On comparing the two treatment groups, no statistically significant differences were observed for the evolution of the scores on the different scales of effectiveness; no statistically significant differences were found between the two groups in the safety and tolerability analyses (chi-square test, exact test; p > 0.05) for most of the parameters that werestudied (adverse reactions in spontaneous communication and the modified UKU scale). Conclusion. Slow escalation of the dose of rivastigmine did not display greater effectiveness or tolerability in comparison to an escalation applied in accordancewith usual clinical practice

Empleo de reboxetina en el trastorno por déficit de atención e hiperactividad infantil asociado a retraso mental y epilepsia. A propósito de dos casos / The use of reboxetine in attention deficit and hiperactivity disorder in children, associated to mental retardation and epilepsy. Presenting two cases

El Trastorno por déficit de atención e hiperactividad (TADH) constituye uno de los problemas clínicos y de salud mental más importantes en niños y adolescentes por la incapacidad que asocia. Su etiología es aún desconocida, y aunque tradicionalmente se han implicado sistemas dopaminérgicos, en los últimos años están apareciendo nuevos datos que sugieren un papel relevante de los sistemas noradrenérgicos. Los psicoestimulantes son actualmente el tratamiento de elección del TADH, si bien un importante porcentaje de niños y adolescentes no responden, presentan alguna contraindicación para su uso, o no pueden tolerar los efectos adversos asociados. Es por ello la necesidad de encontrar agentes terapéuticos alternativos. Algunos autores han propuesto la Reboxetina, cuyo mecanismo de acción es predominantemente noradrenérgico, como fármaco efectivo en el tratamiento del TADH. Presentamos dos casos de niñas con Trastorno por déficit de atención e hiperactividad, Retraso Mental y Epilepsia en los que se ha utilizado Reboxetina, con buena tolerancia, y una respuesta positiva tanto a nivel conductual como cognitivo. Sugerimos la utilidad de este fármaco en niños con similar perfil clínico y planteamos la necesidad de realizar futuras líneas de investigación que vayan en esta dirección

The attention deficit/hyperactivity disorder (ADHD) represents one of the most predominant clinical and mental health problems in children and adolescents due to the great incapacity it produces. The etiology is still unknown, and although traditionally it was associated to the dopaminergic system in these last years new information reveals the growing importance of the noradrenergic system. At this moment we use stimulants as the main treatment in attention deficit and hyperactivity disorder, although a big percentage of children and adolescents don't respond or have major side effects. This is why we need to find new treatments in this field .Some authors have suggested the use of Reboxetine, which mainly works trough a noradrenergic mechanism, as an effective treatment. We present the cases of two girls with attention deficit and hyperactivity disorder plus mental retardation and epilepsy in which we used Reboxetine with good tolerance and a positive response in conduct and cognitive areas. We suggest this treatment as a useful option in children with a similar clinical pattern and we express the need to create future lines of investigation in this direction

Estudio de perdidas fetales tempranas para asesoramiento genetico

Se realiza un estudio preliminar de perdidas tempranas para asesoramiento genetico, se realizó el análisis necrópsico de productos con peso inferior a 500 g realizado en un período de 18 meses.(AU)

Modificaciones histológicas de la pulpa blanca del bazo durante el Alotrasplante de piel

Se estudia la estructura normal de la pulpa blanca del bazo de ratas. Se valoran los cambios provocados por el alotrasplante de piel en la pulpa esplénica en diferentes días de evolución del experimento, encontrándose variaciones en los tipos celulares en relación con los parámetros estudiados. Se valoró el comportamiento de las células de la línea linfoide presentándose evidencias de activación de inmunoblastes en los períodos finales del alotrasplante. (AU)