Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin.

Background: End-stage renal failure of unknown origin (ESRD-UO) is a public health problem in Mexico and many regions of the world. The prevalence of ESRD-UO in Aguascalientes, Mexico, is one of the highest worldwide, particularly in adults between 20 and 40 years of age. Our aim was to screen adolescents for chronic kidney disease (CKD) to identify risk factors and histologically characterize adolescents with persistent albuminuria. Methods: This was a cross-sectional, observational and comparative study of adolescents in whom serum creatinine and the albumin:creatinine ratio (ACR) were determined when screening for CKD. A clinical evaluation and risk factor survey were conducted. Patients with an abnormal ACR (≥30 mg/g) or a low glomerular filtration rate (GFR) (≤75 mL/min/1.73 m2) were re-evaluated and a renal ultrasound (US) was obtained. A kidney biopsy was performed in patients with persistent albuminuria. Results: A total of 513 students were included; 19 had persistent albuminuria and 494 were controls. The prevalence of persistent albuminuria was 3.7% [95% confidence interval (CI) 2.1-5.3]. Only one patient had a decreased GFR. None of the patients with persistent albuminuria had anatomical abnormalities of the urinary tract by renal US. Patients with persistent albuminuria had a decreased total renal volume compared with the control group (150 versus 195 mL/m2; P < 0.01). Eighteen kidney biopsies were performed; 72% had glomerulomegaly and only one patient had mild fibrosis. Podocyte abnormalities were evident on electron microscopy, including partial fusion (100%), microvillous degeneration (80%) and increased organelles (60%). Risk factors for persistent albuminuria were: homestead proximity to maize crops, the use of pesticides at the father's workplace, a family history of CKD and blood pressure abnormalities. The body mass index and breastfeeding were protective factors. Conclusions: The prevalence of persistent albuminuria in adolescents in Aguascalientes is high and histologic compromise is characterized by podocyte injury in the absence of fibrosis. The renal volume of persistent albuminuria patients was decreased, suggesting oligonephronia. Exposure to environmental toxins such as pesticides, even prenatally, may be responsible for this pathological entity. Screening programs in adolescents by determining ACR are necessary in this setting.

Association Analysis Between the Functional Single Nucleotide Variants in miR-146a, miR-196a-2, miR-499a, and miR-612 With Acute Lymphoblastic Leukemia.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is characterized by an abnormal proliferation of immature lymphocytes, in whose development involves both environmental and genetic factors. It is well known that single nucleotide polymorphisms (SNPs) in coding and noncoding genes contribute to the susceptibility to ALL. This study aims to determine whether SNPs in miR-146a, miR-196a-2, miR-499a, and miR-612 genes are associated with the risk to ALL in pediatric Mexican population. METHODS: A multicenter case-control study was carried out including patients with de novo diagnosis of ALL and healthy subjects as control group. The DNA samples were obtained from saliva and peripheral blood, and the genotyping of rs2910164, rs12803915, rs11614913, and rs3746444 was performed using the 5'exonuclease technique. Gene-gene interaction was evaluated by the multifactor dimensionality reduction (MDR) software. RESULTS: miR-499a rs3746444 showed significant differences among cases and controls. The rs3746444G allele was found as a risk factor to ALL (OR, 1.6 [95% CI, 1.05-2.5]; p = 0.028). The homozygous GG genotype of rs3746444 confers higher risk to ALL than the AA genotype (OR, 5.3 [95% CI, 1.23-23.4]; p = 0.01). Moreover, GG genotype highly increases the risk to ALL in male group (OR, 17.6 [95% CI, 1.04-298.9]; p = 0.00393). In addition, an association in a gender-dependent manner among SNPs located in miR-146a and miR-196a-2 genes and ALL susceptibility was found. CONCLUSION: Our findings suggest that SNP located in miR-499a, miR-146a, and miR-196a-2 genes confer risk to ALL in Mexican children. Experimental analysis to decipher the role of these SNPs in human hematopoiesis could improve our understanding of the molecular mechanism underlying the development of ALL.

Clinical Case: Patient with Mixed Graft Rejection Four Days after Kidney Transplantation Developed Specific Antibodies against Donor Bw4 Specificities.

Kidney transplantation, like other transplants, has the risk of producing graft rejection due to genetic differences between donor and recipient. The three known types of renal rejection are listed in the Banff classification: T-cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), and mixed rejection. The human leukocyte antigens (HLA) are highly polymorphic and may be the targets of donor-specific antibodies, resulting in ABMR. Therefore, prior to transplantation, it is necessary to analyze the HLA genotype of the donor and recipient, as well as the presence of DSA, in order to avoid hyperacute rejection. However, due to the shortage of kidneys, it is very difficult to find a donor and a recipient with completely matched HLA genotypes. This can trigger a future rejection of the kidney, as is reported in this work. We describe a patient who received a kidney transplant after a negative DSA test, who developed graft rejection with antibodies against the donor's HLA-Bw4 public epitope and lymphocytic infiltrate four days after transplantation, whose differential diagnosis was mixed rejection.

Discovery of Benzopyrrolizidines as Promising Antigiardiasic Agents.

Current treatments for giardiasis include drugs with undesirable side effects, which increase the levels of therapeutic desertion and promote drug resistance in the parasites. Herein, we describe the antigiardiasic evaluation on Giardia lamblia trophozoites of a structurally diverse collection of 74 molecules. Among these scaffolds, we discovered a benzopyrrolizidine derivative with higher antigiardiasic activity (IC50 = 11 µM) and lower cytotoxicity in human cell cultures (IC50 = 130 µM) than those displayed by the current gold-standard drugs (metronidazole and tinidazole). Furthermore, this compound produced morphologic modifications of trophozoites, with occasional loss of one of the nuclei, among other changes not observed with standard giardicidal drugs, suggesting that it might act through a novel mechanism of action.

Assessment of littoral algal diversity from the northern Gulf of Mexico using environmental DNA metabarcoding.

Traditional methods for algal biodiversity monitoring are costly and time inefficient because they rely on high-level taxonomic expertise to address species identity problems involving phenotypic plasticity and morphological convergence. These problems are exacerbated in regions such as the Gulf of Mexico, that has a limited history of phycological exploration, but that are economically important or threatened by numerous anthropogenic stressors. Given the high pace of disturbance to natural systems, there is a critical need for expedient and cost-effective tools for the study of benthic algal communities. Here we document the use of environmental DNA metabarcoding, using the partial LSU rDNA and 23S rDNA plastid molecular markers, to elucidate littoral algal diversity in the Northern Gulf of Mexico. We assigned 73.7% of algal OTUs to genus and 59.6% to species ranks. Our current study detected molecular signals for 35 algal/protist species with no previous reports in the Gulf of Mexico, thus providing an important, molecular-validated, baseline of species richness for this region. We also make several bioinformatic recommendations for the efficient use of high-throughput sequence data to assess biological communities.

Genotype-Environment Interaction Analysis of NQO1, CYP2E1, and NAT2 Polymorphisms and the Risk of Childhood Acute Lymphoblastic Leukemia: A Report From the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia.

Background: Acute lymphoblastic leukemia (ALL) is the main type of cancer in children. In Mexico and other Hispanic populations, the incidence of this neoplasm is one of the highest reported worldwide. Functional polymorphisms of various enzymes involved in the metabolism of xenobiotics have been associated with an increased risk of developing ALL, and the risk is different by ethnicity. The aims of the present study were to identify whether NQO1, CYP2E1, and NAT2 polymorphisms or some genotype-environmental interactions were associated with ALL risk in Mexican children. Methods: We conducted a case-control study including 478 pediatric patients diagnosed with ALL and 284 controls (children without leukemia). Ancestry composition of a subset of cases and controls was assessed using 32 ancestry informative markers. Genetic-environmental interactions for the exposure to hydrocarbons were assessed by logistic regression analysis. Results: The polymorphisms rs1801280 (OR 1.54, 95% CI 1.21-1.93), rs1799929 (OR 1.96, 95% CI 1.55-2.49), and rs1208 (OR 1.44, 95% CI 1.14-1.81) were found to increase the risk of ALL; being the risks higher under a recessive model (OR 2.20, 95% CI 1.30-1.71, OR 3.87, 95% CI 2.20-6.80, and OR 2.26, 95% CI 1.32-3.87, respectively). Gene-environment interaction analysis showed that NAT2 rs1799929 TT genotype confers high risk to ALL under exposure to fertilizers, insecticides, hydrocarbon derivatives, and parental tobacco smoking. No associations among NQO1, CYP2E1, and ALL were observed. Conclusion: Our study provides evidence for the association between NAT2 polymorphisms/gene-environment interactions, and the risk of childhood ALL in Mexican children.

Natural Extracts Abolished Lipid Accumulation in Cells Harbouring non-favourable PNPLA3 genotype.

Background & aims. G-allele of PNPLA3 (rs738409) favours triglycerides accumulation and steatosis. In this study, we examined the effect of quercetin and natural extracts from mushroom and artichoke on reducing lipid accumulation in hepatic cells. MATERIAL AND METHODS: Huh7.5 cells were exposed to oleic acid (OA) and treated with quercetin and extracts to observe the lipid accumulation, the intracellular-TG concentration and the LD size. Sterol regulatory element binding proteins-1 (SREBP-1), peroxisome proliferator-activated receptor (PPARα-γ) and cholesterol acyltransferase (ACAT) gene expression levels were analysed. RESULTS: Quercetin decreased the intracellular lipids, LD size and the levels of intracellular-TG through the down-regulation of SREBP-1c, PPARγ and ACAT1 increasing PPARα. The natural-extracts suppressed OA-induced lipid accumulation and the intracellular-TG. They down-regulate the hepatic lipogenesis through SREBP-1c, besides the activation of lipolysis through the increasing of PPARα expression. CONCLUSIONS: Quercetin and the aqueous extracts decrease intracellular lipid accumulation by down-regulation of lipogenesis and up-regulation of lipolysis.

In vitro antiparasitic activity of new thiosemicarbazones in strains of Trypanosoma cruzi.

In this study thiosemicarbazones derivatives of 5-[(trifluoromethyl)phenylthio]-2-furaldehyde were synthesized and evaluated in terms of their efficiency in challenging the growth of epimastigote forms of Trypanosoma cruzi, the etiological agent of Chagas' disease. A number of compounds were synthesized from 5-bromo-2-furfuraldehyde using nucleophilic aromatic substitution, with a series of trifluoromethyl thiolates, followed by condensation reactions with thiosemicarbazide. Their molecular structures were determined by (1)H, (13)C and (19)F NMR, MS and IR spectroscopy. When tested with T. cruzi, they showed a stronger reaction, similar to nifurtimox and benznidazole, with the 5-[nitro-4-(trifluoromethyl)phenyltio]-2-furaldehyde thiosemicarbazone (compound 4) showing the highest antiparasitic activity. This improved activity may be explained due to the nitro group present in the molecule, which potentiates its activity. The thiosemicarbazone derivatives in this study showed no apoptosis in platelets or monocytes, nor did they induce platelet activation. The trypanocidal activity of these substances represents a good starting point for a medicinal chemistry program aimed at therapy for Chagas' disease.

Synthesis and structural characterization of fluorinated thiosemicarbazones.

Six new fluorinated thiosemicarbazones R­C(R')=N-NH-C(S)NH(2) (R = 2,4-C(6)H(3)F(2), R' = H (1); R = 2,5-C(6)H(3)F(2), R' = H (2); R = 2,6-C(6)H(3)F(2), R' = H (3); R = 3,4-C(6)H(3)F(2), R' = H (4); R = 3,5-C(6)H(3)F(2), R' = H (5) and R = 4-C(6)H(4)F, R' = C(6)H(5), (6)) have been prepared. The molecular structures of compounds 1 to 6 have been determined.

[Impacts of technological knowledge of small indigenous farmers on food availability in the Mexican southeast]. / Impactos del conocimiento tecnológico sobre la disponibilidad alimentaría de campesinos indígenas en el sureste mexicano.

This study was conducted to evaluate the impact of technological knowledge (acquired in Farmer Field Schools) on the availability of food for poor indigenous farmers, who are mainly dedicated to the production of maize for home consumption in the Cuicateca regi6n, Oaxaca, Mexico. The variables analyzed were 1) Level of technological knowledge, 2) maize yield, and 3) time that the last maize harvest supplied the food needs of the farmers in question (a proxy indicator of food availability). A random sample of 36 participants in the rural training schools and a control group of the same size were given questionnaires at the beginning and end of their study. The statistical analysis was done using the Pearson chi-2 contrast test and the Kolmogorov-Smirnov test. After finding that there was no normal distribution, the Wilcoxon test to contrast paired data was used, and finally, correlations were obtained. It was found that the increase in technological knowledge of 7.29 +/- 1.01 to 46.64 +/- 18.40 did not correlate (P > or = 0.05) with the time that the last maize harvest lasted in providing food. The results show that the increase in technological knowledge does not increase availability of maize as food.

Impactos del conocimiento tecnológico sobre la disponibilidad alimentaría de campesinos indígenas en el sureste mexicano

La investigación tuvo por objetivo evaluar el impacto del conocimiento tecnológico, obtenido mediante Escuelas de campo, sobre la disponibilidad alimentaria de campesinos indígenas pobres dedicados principalmente a la producción de maíz para autoconsumo en la región Cuicateca de Oaxaca, México. Las variables analizadas fueron: 1) Nivel de conocimiento tecnológico; 2) Rendimientos de Maíz y 3) Tiempo en que la última cosecha, de maíz, abastece las necesidades alimenticias de los campesinos referidos (un indicador proxi de disponibilidad alimentaria). A una muestra aleatoria de 36 participantes en Escuelas de campo y un grupo testigo de igual tamaño se aplicaron cuestionarios al inicio y final del estudio. El análisis estadístico se realizó con las pruebas de contraste x2 de Pearson así como la de Kolmogorov-Smirnov y en virtud de no haberse comprobado una distribución normal, se aplicó la prueba de Wilcoxon para contrastar datos pareados, y finalmente se obtuvieron correlaciones. Se encontró que el aumento en el Nivel de conocimiento tecnológico de 7.29±1.01 a 46.64±18.40 no presenta correlación (P>0.05) con el tiempo en que la última cosecha, de maíz, abastece las necesidades alimenticias. Los resultados muestran que el incremento en el nivel de conocimiento tecnológico no aumenta la disponibilidad alimentaria de maíz.

This study was conducted to evaluate the impact of technological knowledge (acquired in Farmer Field Schools) on the availability of food for poor indigenous farmers, who are mainly dedicated to the production of maize for home consumption in the Cuicateca región, Oaxaca, Mexico. The variables analyzed were 1) Level of technological knowledge, 2) maize yield, and 3) time that the last maize harvest supplied the food needs of the farmers in question (a proxy indicator of food availability). A random sample of 36 participants in the rural training schools and a control group of the same size were given questionnaires at the beginning and end of their study. The statistical analysis was done using the Pearson x2 contrast test and the Kolmogorov-Smirnov test. After finding that there was no normal distribution, the Wilcoxon test to contrast paired data was used, and finally, correlations were obtained. It was found that the increase in technological knowledge of 7.29±1.01 to 46.64±18.40 did not correlate (P>0.05) with the time that the last maize harvest lasted in providing food. The results show that the increase in technological knowledge does not increase availability of maize as food.

[Pontine myelinolysis after a hypoglycemic episode]. / Mielinólisis pontina después de un evento de hipoglucemia.

A case of central pontine myelinolysis following hypoglycemia is reported. The case was a 26- year-old female. Diabetes mellitus was found when she was 8 years old and she has hypertension and renal failure. She suffered a severe hypoglycemia at an unknown time. After the episode she developed a vegetative state. A magnetic resonance scan showed features consistent with the presence of central pontine myelinolysis.

Efectividad del cierre en bloque de la línea media del abdomen / Effectiveness of block closure of the medial line of the abdomen

Objetivo. Evaluar la efectividad del cierre en bloque de la pared abdominal sobre la línea media, con sutura continua de monofilamento sintético no absorbible, en presencia de múltiples factores de riesgo. Sede. Hospital General de segundo nivel de atención. Tipo de estudio. Prospectivo, longitudinal, sin grupo control. Pacientes y método. Se incluyeron los pacientes sometidos a laparotomía media durante el periodo comprendido entre el 1 de octubre de 1990 y el 1 de octubre de 1992, el seguimiento postoperatorio fue de 24 meses. En todos los pacientes, el cierre de la incisión se efectuó con monofilamento sintético no absorbible calibre 0 (polipropileno), la técnica incluyó el cierre continuo del peritoneo, aponeurosis posterior y aponeurosis anterior en un solo plano. Resultados. Se estudiaron 42 pacientes, 22 del sexo masculino, 20 del femenino, el promedio de edad fue de 40 años. Siete de los pacientes tenían más de 60 años, cuatro cursaron con hipotensión transoperatoria y tres tenían cáncer, éstos fueron factores que incrementaron el riesgo de falla en la cicatrización; otros factores como la cirugía de urgencia (40 pacientes) y sepsis intraabdominal (23 pacientes) también estuvieron presentes, todos los pacientes tenían al menos un factor de riesgo asociado. Las complicaciones enocntradas fueron: infección de la herida quirúrgica (3), hematoma (1). No se presentaron dehiscencia, hernia postincisional, tampoco se registró mortalidad durante los 24 meses de seguimiento. Conclusión. Se trata de un método confiable que puede prevenir complicaciones asociadas a la cicatrización de la herida quirúrgica, conserva la anatomía y fisiología de la línea media del abdomen

El 99mTc-alendronato como nueva opción en la gammagrafía ósea / 99mTc-Alendronate as an option in bone scanning

Objetivo. Comparar la calidad de las imágenes de gammagrafía ósea obtenidas con un radiofármaco nuevo, el 99mTc-ABP, con aquéllas obtenidas con el 99mTc-MDP. Material y métodos. Fue un estudio comparativo en un mismo sujeto. Se estudiaron 9 voluntarios sanos (5 mujeres y 4 hombres) de 23 a 39 años de edad. A todos se les inyectaron 740 MBq de los radiofármacos Tc-ABP y Tc-MDP con un intervalo de 72 horas entre uno y otro. Dos horas después de cada inyección se les realizó un gammagrama óseo de cuerpo entero con una cámara de centello MultiSpect 2 y se determinaron los parámetros radiofarmacocinéticos. Tres médicos nucleares evaluaron por separado la calidad de las imágenes mediante el trazado de regiones de interés (RDI) sobre vértebras, costillas, esternón, fémur, articulaciones y cráneo. Se obtuvieron relaciones hueso/músculo con RDI sobre diferentes huesos. Los resultados se compararon etadísticamente con las pruebas de kappa y de Wilcoxon. Resultados. La concordancia sobre la calidad de las imágenes de los dos radiofármacos por los tres observadores fue moderada (kappa 0.4). La relación fémur/músculo mostró una distribución normal y no manifestó diferencias significativas entre radiofármacos. Conclusiones. La calidad de las imágenes con ambas preparaciones fue similar. Recomendamos utilizar al 99mTc-ABP en la gammagrafía ósea debido a la menor exposición a radiación del paciente

Quiste de colédoco: valor diagnóstico de la Pancreatocolangiografía retrograda endoscópica / Choledochal cyst: endoscopic retrograde cholangio pancreatography (ERCP) diagnosis value

Presentamos 6 casos de quiste de colédoco diagnosticados por Pancreatocolangiografía Retrograda Endoscópica (PCRE), las edades de los pacientes fueron 12, 13, 17, 20, 29 y 36 años, 5 pacientes fueron de sexo femenino y 1 de sexo masculino, el síntoma principal fue dolor abdominal. La Pancreatocolangiografía Retrógrada Endoscópica demuestra detalles anatómicos de los conductos biliares, pacreático y unión pancreático biliar que permite tomar actitudes de manejo quirúrgico o endoscópico adecuadas.

We presented six cases of choledochal cysts all of which were diagnosed by ERCP. Patients were 12,13, 17,20, 29 and 36 years old. Five were female and one was a male. The main symptom was abdominal pain. The Endoscopic Retrograde Cholangiopancreatograplty showed the anatomic details of the biliary tree and the pancreaticobiliary ductal junction and also allowed us to decide the adecuate management of the patient.

[CHOLEDOCHAL CYST: ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY(ERCP) DIAGNOSIS VALUE] / Quiste de Colédoco: Valor diagnósticode la Pancreatocolangiografía retrograda endoscópica.

We presented six cases of choledochal cysts all of whichwere diagnosed by ERCP. Patients were 12,13,17,20,29 and 36 years old. Five were female and one was a male. The main symptom was abdominal pain.The Endoscopic Retrograde Cholangiopancreatography showed the anatomic details of the biliary tree and the pancreaticobiliary ductal junction and also allowed us to decide the adecuate management of the patient.

nueva evangelización

Contiene: Fundamentos bíblicos-teológicos de la evangelización liberadora - La evangelización durante la colonia, llegada de la religión católica - La nueva evangelización.

SPECT-99mTc-HMPAO en un caso de epilepsia parcial continua y encefalitis focal / Single photon emission computed tomography in a case of epilepsia partialis continua and chronic encephalitis

Describimos el caso de una niña de 8 años de edad con epilepsia parcial continua (EPC) con sacudidas clónicas del hemicuerpo izquierdo y con deterioro neurológico progresivo. Los tratamientos antiepilépticos fracasaron en mejorar el cuadro convulsivo. La paciente fue estudiada con SPECT-99mTc-HMPAO, además de electroencefalograma (EEG), tomografía computada (TCC) y resonancia magnética de cráneo (IRM). Durante el periodo ictal, los estudios de SPECT demostraron un aumento del flujo sanguíneo cerebral en el hemisferio cerebral derecho, y durante el periodo interictal, una disminución del flujo sanguíneo en el mismo hemisferio, particularmente en lóbulo temporal y área rolándica. El EEG mostró descargas epileptógenas continuas caracterizadas por puntas y puntas onda en el hemisferio cerebral. La TCC fue normal y la IRM mostró incremento de la señal en el hemisferio cerebral derecho especialmente en región rolándica y lóbulos temporal y frontal. Se programó para lobectomía temporal y corticectomía frontal derecha. Un estudio histopatológico reveló cambios compatibles con encefalitis viral (síndrome de Rasmussen). La paciente ha continuado sin crisis convulsivasa 10 meses de seguimiento y con programa de rehabilitación intensivo. Regresó a la escuela tres meses después de la cirugía caminando con apoyo de un bastón y su IQ fue normal. Este estudio muestra la utilidad del SPECT en el diagnóstico y manejo de la EPC

Proyecto de factibilidad: desarrollo de la comunidad campesina y su evangelizacion

Contiene: Introducccion - Objetivos - Diagnostico y justificacion - Localizacion y tamaño - Organizacion - Aspectos teologicos - Aspectos economicos-financieros - Evaluacion.