Evaluación geriátrica integral del adulto mayor / Cross sectional geriatric assessment of Mexican older people

Background: Due to the progressive aging of our population, it is imperative to evaluate the life conditions and health limitations of older people. Aim: To report the results of an integral geriatric evaluation of Mexican older people. Material and Methods: A cross-sectional assessment of 324 older subjects of a median age of 70 years (57 percent females) beneficiaries of the Mexican Institute of Social Security of the city of Querétaro. Social, demographic, medical, functional and cognitive variables were evaluated. Results: Of the studied subjects, 37 percent were illiterate, 61 percent lived with a partner and 47 percent were dedicated to household activities. Thirty three percent had visual impairment, 54 percent had hearing impairment, 39 percent had urinary incontinence, 26 percent reported falls in the last six months, 34 percent had nutritional problems, 38 percent were functionally dependent, 49 percent had sleeping problems, 25 percent had cognitive impairment and 25 percent had depression. Conclusions: The general health outlook of this population is encouraging, considering that more than half are not functionally impaired.

Prevención primaria de las malformaciones congénitas / Primary prevention of congenital malformations

Las malformaciones congénitas han adquirido durante los últimos años una importancia creciente como causa de morbimortalidad, especialmente durante el primer año de vida. Dado que la modificación génica es una realidad en el tratamiento de muy pocas enfermedades genéticas, el énfasis está destinado a la prevención. Por otro lado, la gran mayoría de las malformaciones congénitas se producen por la interacción de factores genéticos y ambientales. De tal manera que la prevención primaria se ha basado principalmente en la modificación de estos factores ambientales. En el presente artículo se discuten pautas básicas de prevención de malformaciones congénitas, aplicables a cualquier población y se enfatiza el uso de ácido fólico en la prevención de los defectos de cierre del tubo neural, utilizando por primera vez intervenciones nutricionales de salud pública.

Combinatorial chemistry in cancer research.

Among the different strategies to treat cancer, chemotherapy approaches are the subject of intense research efforts. There is still a high demand for new anticancer drugs exhibiting improved efficiency and selectivity for their use in combined therapy strategies. The high development of molecular and cellular biology tools has made possible the set up of simple in vitro assays, susceptible to automation, thus bringing about the possibility of rapid screening of hundreds of compounds. Chemistry has reacted to this challenge by developing a new technology: combinatorial chemistry. By this procedure large collections of compounds, known as chemical libraries, can be prepared in a rapid and efficient manner. In recent years, combinatorial chemistry has had a great impact on drug discovery programmes addressed to tackling cancer pharmaceutical targets. In this review, the contribution of this technology to the discovery of anticancer drugs that are currently in clinical trials or already in the market is discussed.

Arousal and differential Fos expression in histaminergic neurons of the ascending arousal system during a feeding-related motivated behaviour.

Arousal depends on the concerted activity of the ascending arousal system (AAS) but specific stimuli may primarily activate some nuclei of this system. Motivated behaviours are characterized by behavioural arousal, although it is not known which AAS nuclei are active during a motivated behaviour. To address this issue, rats were rendered motivated for food by fasting them for 1 day and then were enticed with food that they could not obtain for varying periods of time. We studied the level of arousal by polysomnography or radiotelemetry, and Fos-ir in the AAS, during food enticing. We found a strong arousal and an early increase in Fos-ir in the histaminergic neurons from the tuberomammillary nucleus, after 30 min of enticing, followed by increased Fos-ir in the whole AAS if food enticing was prolonged to 1 or 2 hours. In contrast, food presentation to non-motivated rats did not increase arousal or Fos-ir in the tuberomammillary nucleus. As opposed to the active arousal of the motivated rats, passive arousal induced by sensory stimulation was associated with increased Fos-ir in the locus coeruleus and the orexin neurons, but not with increased Fos-ir in the tuberomammillary nucleus or in the other nuclei of the AAS. We conclude that the arousal during feeding-related motivated behaviour is associated primarily with the activation of the tuberomammillary nucleus, while the other arousal-related nuclei become active later on.

[Rotational atherectomy (Rotablator) for percutaneous transluminal coronary angioplasty]. / Aterectomía rotacional (Rotablator) en la angioplastía coronaria percutánea transluminal.

BACKGROUND: The use of Rotablator in percutaneous transluminal coronary angioplasty attempts to reduce the atheromatous plaque abrading it and fragmenting the parietal calcium of the artery. AIM: To report our experience with the use of Rotablator. PATIENTS AND METHODS: Rotational atherectomy was performed in 189 patients aged 60.8 +/- 11 years (154 men). The clinical indication for the procedure was chronic angina in 22%, unstable angina in 44%, myocardial infarction in 21%, silent angina in 7% and re-stenosis in 6%. One hundred seventy seven patients were followed for a mean of 15.9 +/- 6.3 months. RESULTS: Two hundred thirty six stenoses in 215 coronary arteries were treated with a 98.7% angiographic success rate. One patient had a Q infarction and no patient died or required emergency surgery. Fourteen patients had rises in CK MB enzymes (non Q infarction). Three patients had a pseudoaneurism and three had bleedings that required transfusion. Of the followed patients, 33 had a clinically suspected re-stenosis, that was angiographically confirmed in 23. Cardiac mortality was 2.3%. Seventy nine percent of patients had an evolution without angina or coronary events. CONCLUSIONS: Percutaneous transluminal coronary angioplasty with the use of Rotablator had a high immediate success rate and a low incidence of complications. The clinical evolution of patients has been favorable with a low incidence of mortality and ischemic events.

Morphogenesis of the epithelial cell transporting phenotype: synthesis and distribution of ion channels.

The exchange of substances between higher organisms and the environment takes place across epithelia consisting of one or more cell layers. To perform this function, epithelial cells have two basic differentiated properties: 1) they form tight junctions (TJs) that seal the extracellular space, and 2) they are polarized into an apical and a basolateral domain, with entirely different structural, biochemical and physiological properties. Our understanding of the mechanisms involved in the expression of these properties has been greatly enhanced by the availability of epithelial cell lines that form TJs and polarize in vitro under conditions suitable for experimental control. In this article we summarize our studies on the synthesis and polarized expression of ion channels in epithelial cells. MDCK cells have four types of K+ channels in the apical domain, and a fifth one in the basolateral domain. The basolateral side also has a population of CI- channels. Each type of channel is absolutely polarized. Harvesting with trypsin-EDTA reduces the area of the plasma membrane by 50% and the channel population by 90%. Upon plating, these channels are recovered within a few hours. We describe here the main extracellular and intracellular mechanisms involved in these phenomena.

Morphogenesis of the epithelial cell transporting phenotype: systhesis and distribution of ion channels

The exchange of substance between higher organisms and the environment takes place across epithelia consisting of one or more cell layers. To perform this function, epithelial cells have two basic differentiated properties: 1) they form tight junctions (Tjs) that seal the extracellular space, and 2) they are polarized into an apical and a basolateral domain, with entirely different structural, biochemical and physiological properties. Our understanding of the mechanisms involved in the expression of these properties has been greatly enchanced by the availability of epithelial cell lines that form Tjs and polarize in vitro under conditions suitable for experimental control. In this article we summarize our studies on the synthesis and polarized expression of ion channels in epithelial cells. MDCK cells have four types of K+ channels in the apical domain, and a fifth one in the basolateral domain. The basolateral side also has a population of Cl- channels. Each type of channel is absolutely polarized. Harvesting with trypsin-EDTA reduces the area of the plasma membrane by 50 per cent and the channel population by 90 per cent. Upon plating, these channels are recovered within a few hours. We describe here the main extracellular and intracellular mechanisms involved in these phenomena.

[Radiofrequency fulguration of accessory pathways]. / Fulguración por radiofrecuencia de haces paraespecíficos.

Between August 1991 and August 1993, 75 patients (42 male) with Wolff Parkinson White syndrome (43 concealed) were subjected to radiofrequency ablation of accessory pathways at our institution. 55 had left, 8 postero septal, 2 anteroseptal and 10 right accessory pathways. A retrograde aortic technique with placement of the ablation catheter in close proximity to the mitral annulus was used for most of the patients with left accessory pathways and for some with posteroseptal pathways. The right, anteroseptal and some posteroseptal pathways were ablated using a right heart approach placing the ablation catheter in the tricuspid annulus. Ablation was successful in 61 patients (81%). One subject developed a fatal cardiac tamponade after a transeptal catheterization and was unrelated to the ablation per se. It is concluded that radiofrequency ablation of accessory pathways is a curative procedure for a great majority of patients with Wolf Parkinson White syndrome.