The utility of genomic public databases to mitochondrial haplotyping in contemporary Mestizo population of Mexican origin.

There are different public databases and open access information that can be exploited to be reused in different research projects. With this concept in mind, we carried out a study to answer the question about the prevalence of haplogroups in human populations of modern Mexico. Since the publication of genomic and mitochondrial data in Latin American populations are very scarce and with very small samples, our work proposes to consider the availability of genomic and genetic data collections that can be reused for other purposes, different from those initially proposed in the investigations where the sequences were obtained. The objective of the present study was to explore the population structure of Mexico using available information in the public database. Through the search of information in the nucleotide database of National Center of Biotechnology Information (NCBI) of complete sequences of mitochondrial genome (16 Kb) of indigenous people, Mexican Mestizo population and Mexican-Americans living in the United States, they were classified according to the polymorphisms associated with haplogroups A, B, C and D reported in the literature as the most frequent. We obtained 283 sequences, of which 255 were selected with the criteria mentioned. The haplotyping results showed 113 different clades and subclades distributed in a general way in eight haplogroups. The most frequent groups that dominate the population were the haplogroup A with 90 individuals representing 36%, followed by haplogroup B in 65 individuals representing 26% of the sample.

Mamoplastía de reducción: resultados desde la perspectiva del paciente: validación lingüística y psicométrica del Breast Q Reduction and Mastopexy Module Instrument / Validation of the Spanish version of the breast Q reduction and mastopexy module

Background: The Breast Q Reduction and Mastopexy Module evaluate breast related quality of life from the perspective of the patients. Body self-image, social performance, sexuality and physical symptoms are assessed. Aim: To translate the Breast Q Reduction and Mastopexy Module to Spanish and validate the translated version to be used in Chile. Material and Methods: The linguistic validation guidelines of the MAPI/TRUST Research institute were used and the survey was applied to six patients aged 29 +/- 6 years with 14 +/- 2 years of studies. The internal stability of the test was assessed using Cronbach alpha. Results: The mean body mass index of the patients was 25 +/- 1 kg/m². The internal stability of the scale was 97 percent. The scores of the test in the preoperative period ranged from 74 to 125 points. Conclusions: The Breast Q Reduction and Mastopexy Module is a valid instrument to assess the results of reductive mammoplasty among Spanish speaking patients.

Objetivo: El Breast Q Reduction and Mastopexy Module es un instrumento específico para la evaluación de calidad de vida asociado a mamas desde la perspectiva del paciente, publicado originalmente en inglés, el cual cuenta con una evaluación pre y otra postoperatoria. El objetivo del presente estudio es traducir y validar este instrumento al español para su uso en Chile. Material y Método: Se utilizaron las guías de validación lingüística del MAPI/TRUST Research institute. El proceso de validación requirió la traducción ingles-español, contra traducción español-inglés, conciliación inglés-inglés y aplicación piloto de la escala en al menos 5 sujetos. La estabilidad interna se evaluó con el alfa de Cronbach, se utilizó estadística descriptiva y analítica para analizar los resultados. Resultados: Las 6 pacientes evaluadas tuvieron una edad promedio de 29 +/- 16 (SD) años, IMC 25 +/- 1 kg/m² y 14 +/- 2 años de estudio. La estabilidad interna de la escala fue de 97 por ciento. Los resultados obtenidos entre el preoperatorio de las pacientes, variaron de 74 a 125 puntos, con una mediana de 98 puntos. Conclusiones: El instrumento Breast Q Reduction and Mastopexy Module es un instrumento válido, confiable y reproducible para la evaluación de los resultados de la mamoplastía de reducción, desde la perspectiva de los pacientes chilenos hispanoparlantes.

Rinoplastía: resultados desde la perspectiva del paciente. Validación lingüística y psicométrica del Rhinoplasty Outcome Evaluation Instrument / Validation of the spanish version of the Rhinoplasty Outcome Evaluation

Background: The Rhinoplasty Outcome Evaluation is a questionnaire that assesses, form the point of view of the patient, the functional and cosmetic outcome of rhinoplasty. It has six items for esthetic and functional domains, using Likert type questions with five alternatives. The scale ranges from 6 that is the worst outcome to 30, the best. Aim: To translate and validate the Rhinoplasty Outcome Evaluation, to be used in Chile. Material and Methods: The linguistic validation guidelines of the MAPI/TRUST Research Institute were used. The instrument was translated from English to Spanish, counter translated and applied to a pilot sample of five patients. The internal stability was assessed using Cronbach alpha. Results: The five female patients in whom the questionnaire was applied were aged 22 +/- 4 years, had 15 +/- 2 years of studies and their body mass index was 23 +/- 4 kg/m². Cronbach alpha was 84 percent. The scale changed from 10 points in the preoperative period to 17 points in the postoperative period. Conclusions: The Rhinoplasty Outcome Evaluation is a valid and reliable questionnaire to evaluate the results of rhinoplasty.

Introducción: El Rhinoplasty Outcome Evaluation es un instrumento específico para la evaluación cosmética y funcional de la nariz desde la perspectiva del paciente; publicado originalmente en inglés, cuenta con 6 ítems pertenecientes a dominios estéticos y funcionales administrados en preguntas tipo Likert de 5 puntos. El puntaje de la escala puede tomar un valor que va de 6 a 30 puntos, donde el puntaje de 6 es la peor satisfacción con la nariz y 30 la mejor imaginable. El objetivo del presente estudio es traducir y validar este instrumento al español para su uso en Chile. Materiales y Métodos: Se utilizaron las guías de validación lingüística del MAPI/TRUST Research Institute. El proceso de validación requirió la traducción inglés-español, contra traducción español-inglés, conciliación inglés-inglés y aplicación de la escala en 5 pacientes. La estabilidad interna se evaluó con el alfa de Cronbach, se utilizó estadística descriptiva y analítica para analizar los resultados. Resultados: Las 5 pacientes evaluadas tuvieron una edad promedio de 22 +/- 4 años, IMC 23 +/- 4 kg/m² y 15 +/- 2 años de estudio, todas de sexo femenino. La estabilidad interna de la escala fue de 84 por ciento (alfa de Cronbach). Se logró evidenciar que los resultados obtenidos entre el preoperatorio y el postoperatorio de las pacientes, variaron de 10 a 17 puntos, con una mediana de 14 puntos. Conclusiones: El instrumento Rhinoplasty Outcomes Evaluation es un instrumento válido, confiable y reproducible para la evaluación de los resultados de la rinoplastía, desde la perspectiva de los pacientes chilenos hispanoparlantes.

Cumplimiento en el manejo de hemoderivados por personal de enfermería en un hospital de México / Compliance of blood components management by nursing in a hospital of Mexico

Resumen:

Introducción: hace 20 años en México se inició la regulación para la disposición de sangre humana y sus componentes, sin que a la fecha se logre su cumplimiento.

Objetivo: evaluar el nivel de conocimiento y cumplimiento en el registro y manejo de hemoderivados por el personal de enfermería de una unidad del Instituto Mexicano del Seguro Social. Metodología: estudio exploratorio, transversal y descriptivo tipo sombra. Mediante un muestreo simple aleatorio, se evaluaron 48 enfermeras. Para recolectar la información, se utilizaron dos instrumentos: uno validado para identificar el cumplimiento en el manejo de hemoderivados y otro para determinar el nivel de conocimientos con base en los criterios de la NOM-003-SSA2-1993. Se realizó un análisis de frecuencias y X2 para comparar proporciones de cumplimiento y conocimiento con base en el grado académico de la población estudiada. Se consideraron significativas las diferencias con un valor de p < 0.05. Resultados: la aplicación del instrumento demostró que sólo 35.4 % conoce acerca del manejo de sangre y sus componentes, 18.7 % no sabe acerca de ello; con predominio del conocimiento regular en 45.8 %. Con relación al cumplimiento, 75 % de enfermeras cumplen el manejo de hemoderivados con un nivel de mínimo a excelente, predominando el cumplimiento parcial con 37.5 %. La comparación entre el nivel de conocimiento y el grado académico evidenció diferencias estadísticamente significativas solo entre el personal que tiene licenciatura respecto del que tiene alguna especialidad (p = 0.014).

Conclusiones: el personal de enfermería evaluado (n = 48) omite las acciones establecidas en el procedimiento de la transfusión de hemoderivados, con lo que pone en riesgo la integridad física y la salud del paciente.

Abstract:

Introduction: 20 years ago in Mexico began regulation for the disposal of human blood and its components, to date not archieved fulfill.

Objective: To assess the level of knowledge and compliance in the registration and management of blood products by the nursing staff of a unit of the Institute¼ Mexicano del Seguro Social, in accordance with official regulations.

Methodology: An exploratory, cross-sectional study in which subjects were observed —without knowing—was carried out. From a simple random sample, 48 nurses were evaluated. Two validated instruments were used to collect information: one for identifying performance in blood derivative management and the other one for determining the level of knowledge based on NOM-003-SSA2-1993 criteria. Frequency analysis and X2 test were carried out to compare performance and knowledge proportions based on academic level of the study population. Difference was considered significant when p < 0.05.

Results: The application of the instrument showed that only 35.4% of the nurses had an acceptable level of knowledge regarding the handling of blood components, and 18.7 % lacked all knowledge, with an average level of knowledge of 45.8 % predominating. Related to compliance with the handling of blood components, 75 % of the nurses had a level ranging from minimal to excellent with partial compliance predominating at 37.5%. The comparison between level of knowledge and academic level showed statistically significant differences only between personnel with a bachelor's degree and those with a speciality (p = 0.014).

Conclusions: Principally, the nursing personnel evaluated (n = 48) omitted established actions in blood derivative transfusion procedure, a situation that can put at risk the health and life of the patient.

Short-term combination therapy and long-term relapse prevention in the treatment of severe acne vulgaris.

Few long-term treatment regimens for severe acne vulgaris have been investigated in clinical trials. Data were combined from two consecutive, randomized, double-blind, controlled studies to evaluate the efficacy, safety and subject satisfaction of four nine-month regimens in severe acne vulgaris treatment. Subjects were first randomized to receive doxycycline (DCN) and adapalene 0.1% - benzoyl peroxide 2.5% (A/BPO) or vehicle once daily for 12 weeks. Subjects who had at least 50% global improvement were subsequently randomized to receive A/BPO or its vehicle once daily for 24 weeks. Over nine months, there were four regimens: A/BPO and DCN followed by A/BPO, vehicle and DCN followed by A/BPO, A/BPO and DCN followed by vehicle, and vehicle and DCN followed by vehicle. Among the four regimens, A/BPO and DCN followed by A/BPO led to the highest percentage of subjects rated "clear" or "almost clear" (50.0% vs. 40.4%, 26.2% and 25.0%, respectively), biggest reduction in total lesion counts (76% vs. 70%, 51% and 47%, respectively) and greatest subject satisfaction (85.0% vs. 75.5%, 63.3% and 52.4%, respectively) at week 36. It provided a faster onset of action compared to groups started with vehicle and DCN (P<.05 at week 2). Subjects receiving A/BPO and DCN followed by vehicle experienced deterioration once the active treatment was discontinued. All regimens were safe and well-tolerated. In conclusion, efficacious initial therapy and long-term treatment are both important. An initial combination therapy with adapalene-BPO and DCN followed by longer-term adapalene-BPO treatment is an efficacious and satisfactory new regimen for severe acne subjects.

Active core rewarming avoids bioelectrical impedance changes in postanesthetic patients.

BACKGROUND: Postoperative hypothermia is a common cause of complications in patients who underwent laparoscopic cholecystectomy. Hypothermia is known to elicit electrophysiological, biochemical, and cellular alterations thus leading to changes in the active and passive membrane properties. These changes might influence the bioelectrical impedance (BI). Our aim was to determine whether the BI depends on the core temperature. METHODS: We studied 60 patients (52 female and 8 male) age 40 to 80 years with an ASA I-II classification that had undergone laparoscopic cholecystectomy under balanced inhalation anesthesia. The experimental group (n = 30) received active core rewarming during the transanesthetic and postanesthesic periods. The control group (n = 30) received passive external rewarming. The BI was recorded by using a 4-contact electrode system to collect dual sets of measurements in the deltoid muscle. The body temperature, hemodynamic variables, respiratory rate, blood-gas levels, biochemical parameters, and shivering were also measured. The Mann-Whitney unpaired t-test was used to determine the differences in shivering between each group at each measurement period. Measurements of body temperature, hemodynamics variables, respiratory rate, and BI were analyzed using the two-way repeated-measures ANOVA. RESULTS: The gradual decrease in the body temperature was followed by the BI increase over time. The highest BI values (95 ± 11 Ω) appeared when the lowest values of the temperature (35.5 ± 0.5°C) were reached. The active core rewarming kept the body temperature within the physiological range (over 36.5°C). This effect was accompanied by low stable values (68 ± 3 Ω) of BI. A significant decrease over time in the hemodynamic values, respiratory rate, and shivering was seen in the active core-rewarming group when compared with the controls. The temporal course of shivering was different from those of body temperatue and BI. The control patients showed a significant increase in the serum-potassium levels, which were not seen in the active-core rewarming group. CONCLUSIONS: The BI analysis changed as a function of the changes of core temperature and independently of the shivering. In addition, our results support the beneficial use of active core rewarming to prevent accidental hypothermia.

Effective and safe combination therapy for severe acne vulgaris: a randomized, vehicle-controlled, double-blind study of adapalene 0.1%-benzoyl peroxide 2.5% fixed-dose combination gel with doxycycline hyclate 100 mg.

There is a paucity of treatment options for severe acne vulgaris aside from oral isotretinoin. This randomized, vehicle-controlled, multicenter, double-blind study evaluated the efficacy and safety of combination therapy using adapalene 0.1%-benzoyl peroxide 2.5% (A/BPO) fixed-dose combination gel with doxycycline hyclate 100 mg in the treatment of severe acne vulgaris. A total of 459 participants were randomized in a 1:1 ratio to receive oral doxycycline hyclate 100 mg once daily and either A/BPO or vehicle once daily for 12 weeks. Efficacy in the A/BPO with doxycycline group was demonstrated as early as week 2 compared with the vehicle arm for total, inflammatory, and noninflammatory lesions (all P < .005). At week 12, this combination was superior to vehicle with doxycycline in reducing total, inflammatory, and noninflammatory lesion counts (an added incremental benefit of 23%, 24%, and 21%, respectively), as well as for global success and overall participant satisfaction (all P < .001). Digital UV fluorescence photography demonstrated a rapid reduction in Propionibacterium acnes in the A/BPO with doxycycline group, particularly within the first 4 weeks. These findings provide evidence on the efficacy of combining A/BPO and the oral antibiotic doxycycline in the treatment of severe acne vulgaris.

Immunogenicity of Helicobacter pylori urease B protein and DNA vaccines in a mouse model.

A vaccine could alleviate major morbidity and mortality associated with Helicobacter pylori infection. We immunized BALB/c mice with 3 doses of a protein or DNA vaccine based on H pylori urease B. Protein alone was immunogenic even after the first dose, whereas DNA did not elicit antibodies after 3 doses. DNA preceding protein (D-P-P) appeared to blunt the response to protein, whereas DNA following protein (P-D-D) shifted from a predominantly T helper 2 (Th2) profile to a balanced Th1:Th2 profile. These preliminary findings may have important implications for the development of an H pylori vaccine.

Acral PUVA: induced pigmented macules

This report describes four patients with chronic psoriasiform dermatitis of the palms and soles who developed pigmented macular lesions after localized photochemotherapy (PUVA) to these areas. These lesions had varied histopathologic presentations including lentigines, atypical melanocytic proliferation and a junction nevus suggesting a wide clinico pathologic spectrum in the PUVA-induced pigmented macules