Wearables for Stress Management: A Scoping Review.

In recent years, wearable devices have been increasingly used to monitor people's health. This has helped healthcare professionals provide timely interventions to support their patients. In this study, we investigated how wearables help people manage stress. We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) standard to address this question. We searched studies in Scopus, IEEE Explore, and Pubmed databases. We included studies reporting user evaluations of wearable-based strategies, reporting their impact on health or usability outcomes. A total of 6259 studies were identified, of which 40 met the inclusion criteria. Based on our findings, we identified that 21 studies report using commercial wearable devices; the most common are smartwatches and smart bands. Thirty-one studies report significant stress reduction using different interventions and interaction modalities. Finally, we identified that the interventions are designed with the following aims: (1) to self-regulate during stress episodes, (2) to support self-regulation therapies for long-term goals, and (3) to provide stress awareness for prevention, consisting of people's ability to recall, recognize and understand their stress.

ECG Standards and Formats for Interoperability between mHealth and Healthcare Information Systems: A Scoping Review.

Interoperability is defined as the ability of a system or device to communicate between different technologies and software applications. This allows the exchange and use of data in an efficient, precise, and robust way. The present article gives researchers and healthcare information systems developers a qualitative and quantitative synthesis of the state of knowledge related to data formats and data standards proposed for mHealth devices interoperability in healthcare information systems that retrieve and store ECG data. We carry out a scoping review to answer to following questions: (1) What digital data formats or data standards have been proposed for the interoperability of electrocardiograph data between traditional healthcare information systems and mobile healthcare information systems? (2) What are the advantages and disadvantages of these data formats or data standards? The scoping review was conducted in four databases in accordance with the JBI methodology for scoping reviews, and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A total of 4018 studies were identified of which 30 studies met the inclusion criteria. Based on our findings, we identify four standards and nine formats for capturing and storing streaming ECG data in mobile health applications. The standards used were HL7, SCP-ECG, x73-PHD, and PDF/A. Formats include CSV, PDF-ECG, and seven XML-based formats. These are ECG-XML, HL7-XML, mPCG-XML, mECGML, JSON, SaECG, and CDA R2.

Cytotoxic Evaluation of (2S)-5,7-Dihydroxy-6-prenylflavanone Derivatives Loaded PLGA Nanoparticles against MiaPaCa-2 Cells.

The search for new alternatives for the prevention and treatment of cancer is extremely important to minimize human mortality. Natural products are an alternative to chemical drugs, since they are a source of many potential compounds with anticancer properties. In the present study, the (2S)-5,7-dihydroxy-6-prenylflavanone (semi-systematic name), also called (2S)-5,7-dihydroxy-6-(3-methyl-2-buten-1-yl)-2-phenyl-2,3-dihydro-4H-1-Benzopyran-4-one (CAS Name registered) (1) was isolated from Eysenhardtia platycarpa leaves. This flavanone 1 was considered as the lead compound to generate new cytotoxic derivatives 1a, 1b, 1c and 1d. These compounds 1, 1a, 1b, 1c, and 1d were then loaded in nanosized drug delivery systems such as polymeric nanoparticles (NPs). Small homogeneous spherical shaped NPs were obtained. Cytotoxic activity of free compounds 1, 1a, 1b, 1c, and 1d and encapsulated in polymeric NPs (NPs1, NPs1a, NPs1b, NPs1c and NPs1d) were evaluated against the pancreatic cancer cell line MiaPaCa-2. The obtained results demonstrated that NPs1a and NPs1b exhibited optimal cytotoxicity, and an even higher improvement of the cytotoxic efficacy was exhibited with the encapsulation of 1a. Based on these results, NPs1a were proposed as promising anticancer agent candidates.

Estigma, discriminación y adherencia al tratamiento en niños con VIH y SIDA: una perspectiva bioética / Stigma, discrimination and adherence to treatment of children with HIV and AIDS: a bioethical perspective / Estigma, discriminação e aderência ao tratamento em crianças com HIV e AIDS: uma perspectiva bioética

Investigación sobre el proceso de estigma y discriminación en niños con VIH y SIDA, y sus consecuencias en la adherencia al tratamiento desde una perspectiva bioética. Estudio deliberativo-hermenéutico con el uso de la narrativa en cuidadores primarios y en niños. Se aplicó cuestionarios para determinar la presencia de dichas variables y se realizó la interpretación de la información según la teoría de Paul Ricoeur, en tres momentos: respeto y estima de sí, relaciones interpersonales plenas y ética e instituciones justas. Se estudiaron once casos: seis niños y cinco niñas de los cuales solo tres fueron adherentes: dos y una respectivamente, comprobando la hipótesis de la influencia que el estigma y la discriminación ejercen sobre la adherencia al tratamiento; los casos detectados coincidieron con los de no adherencia al tratamiento. Se deliberó acerca de la problemática sugiriendo cursos de acción prudente en los tres niveles mencionados. Se mostró la importancia en el cuidado y la estima de los cuidadores primarios; ya que interviene en el desarrollo y percepción del síndrome en los niños.

This article discloses the results of an research into the process of stigma and discrimination in children with HIV and aids, and the impact they have on adherence from a bioethics perspective. It is a deliberative hermeneutical study using narrative in primary caregivers and children, questionnaires were applied to determine them the presence of these variables. The interpretation of the data was performed according to the theory of Paul Ricoeur, on three occasions: respect and esteem; fulfilling relationships; and ethical and fair institutions. Eleven cases were studied: 6 boys and 5 girls of which only three were adherents: 2 and 1 respectively. Hypothesis was tested for the influence that stigma and discrimination have on adherence to treatment; detected cases coincided with those of non-adherence to treatment. Discussion of the problem was performed suggesting courses prudent action in all three levels. The importance in caring and esteem showed primary caregivers; as it influences the development and perception of the syndrome in children.

Investigação sobre o processo de estigma e discriminação em crianças com HIV e AIDS, e suas consequências na aderência ao tratamento a partir de uma perspectiva bioética. Estudo deliberativo-hermenêutico com a utilização da narrativa em cuidadores primários e em crianças. Foram aplicados questionários para determinar a presença das referidas variáveis e se realizou a interpretação da informação segundo a teoria de Paul Ricoeur, em três momentos: respeito e autoestima, relações interpessoais plenas e ética e instituições justas. Se estudaram onze casos: seis meninos e cinco meninas, dos quais só três foram aderentes: dois e uma respectivamente, comprovando a hipótese da influência que o estigma e a discriminação exercem sobre a aderência ao tratamento; os casos detectados coincidiram com os de não aderência ao tratamento. Se deliberou acerca da problemática sugerindo cursos de ação prudente nos três níveis mencionados. Se mostrou a importância no cuidado e na estima dos cuidadores primários, já que intervém no desenvolvimento e percepção da síndrome em crianças.

Anti-inflammatory and antioxidative effects of six pentacyclic triterpenes isolated from the Mexican copal resin of Bursera copallifera.

BACKGROUND: Bursera copallifera (Burseraceae) releases a resin known as "copal ancho" which has been used, since pre-Colombian times, as ceremonially burned incense and to treat tooth ache, tumors, arthritis, cold, cough, and various inflammatory conditions; however, its anti-inflammatory potential is poorly studied. The aim of the present study was to isolate, quantify, and to investigate the anti-inflammatory activity of triterpene compounds isolated from the copal resin of B. copallifera. METHODS: The constituents present in the total resin of B. copallifera were obtained by successive chromatographic procedures, and quantitative analysis was performed by High Performance Liquid Chromatography (HPLC). Anti-inflammatory effects of the isolated triterpenes were investigated to determine their inhibitory effects on phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced edema in mice, viability and nitric oxide (NO) production inhibition on lipopolysaccharide (LPS)-activated RAW 264.7 macrophages, and inhibition of cyclooxygenase (COX)-1, COX-2 and secretory Phospholipase A2 (sPLA2) activities in vitro. RESULTS: Quantitative phytochemical analysis of the copal resin showed the presence of six pentacyclic triterpenes of which, 3-epilupeol (59.75 % yield) and α-amyrin (21.1 % yield) are the most abundant. Among the isolated triterpenes, 3-epilupeol formiate (Inhibitory Concentration 50 % (IC50) = 0.96 µmol), α.amyrin acetate (IC50 = 1.17 µmol), lupenone (IC50 = 1.05 µmol), and 3-epilupeol (IC50 = 0.83 µmol) showed marked inhibition of the edema induced by TPA in mice. α-amyrin acetate and 3-epilupeol acetate, at 70 µM, also inhibited the activity of COX-2 by 62.85 and 73.28 % respectively, while α-amyrin and 3-epilupeol were the best inhibitors of the production of NO in LPS-activated RAW 264.7 cells with IC50 values of 15.5 and 8.98 µM respectively, and did not affected its viability. All compounds moderately inhibited the activity of PLA2. CONCLUSIONS: This work supports the folk use of B. copallifera and provides the basis for future investigations about the therapeutic use of this resin in treating inflammation.

Actitud hacia la muerte y su relación con la empatía médica en estudiantes de Medicina / Attitude towards death and their relationship with medical empathy in medical students

Introducción: la actitud hacia la muerte y la empatía corresponden a aptitudes personales y sociales, de dichas aptitudes se desprende la creación de buenas relaciones humanas, por lo tanto deberían ser consideradas como un aspecto esencial de profesionalismo en la medicina y, por ende, debería ser incorporado al proceso de enseñanza­aprendizaje. Objetivo: asociar las actitudes hacia la muerte y empatía en estudiantes de Medicina. Métodos: se realizó un estudio no experimental, correlacional de corte longitudinal. La muestra fue no probabilística a conveniencia y se conformó con 307 voluntarios de primer año de la Facultad de Medicina UAEMéx; se aplicó la escala de Empatía Médica de Jefferson y Perfil Revisado de actitud hacia la muerte. Se realizó la comparación de medias mediante ANOVA y Prueba T de Student, la relación de variables se hizo por el coefiente de correlación de Pearson. Resultados: en la Empatía Médica de Jefferson el promedio obtenido por los hombres fue mayor con respecto a las mujeres en el pre y pos test; solo se encontró una diferencia estadísticamente significativa en el pretest. El 54,59 por ciento de estudiantes obtuvieron un puntaje superior al promedio en ambas mediciones. Conclusiones: las actitudes hacia la muerte y la Escala de Empatía Médica de Jefferson se relacionan positiva y negativamente, los valores de las correlaciones son débiles, pero significativos(CU)

Introduction: The attitude toward death and empathy correspond to personal and social skills, such skills creating good human relations is clear, therefore they should be regard as an essential aspect of professionalism in medicine and, therefore, It should be incorporated into the teaching-learning process. Objective: The objective of this research was to associate the attitudes toward death and empathy in medical students. Methods: Anon-experimental study, correlational slitting was performed. The sample was non-probabilistic convenience and settled for 307 volunteers first year of the Faculty of Medicine at the Autonomous University of the State of Mexico; Scale of Physician Empathy Jefferson and revised profile attitude toward death was given. Comparison of means was performed using ANOVA and Student t test, the ratio of variables was made by the Pearson correlation coefiente. Results: Jefferson Medical Empathy average earned by men was higher compared to women in the pre and post test; only statistically significant difference was found in the pre test. 54.59 percent of the students scored above average on both measures score. Conclusions: Attitudes toward death and the Scale of Physician Empathy Jefferson relate positively and negatively, the values ​​of the correlations are weak, but significant(AU)

(1) H and (13) C NMR data on natural and synthetic capsaicinoids.

Capsaicinoids are the compounds responsible for the pungency of chili peppers. These substances have attracted the attention of many research groups in recent decades because of their antinociceptive, analgesic, anti-inflammatory, and anti-obesity properties, among others. There are nearly 160 capsaicinoids reported in the literature. Approximately 25 of them are natural products, while the rest are synthetic or semi-synthetic products. A large amount of NMR data for the capsaicinoids is dispersed throughout literature. Therefore, there is a need to organize all this NMR data in a systematic and orderly way. This review summarizes the (1) H and (13) C NMR data on 159 natural and synthetic capsaicinoids, with a brief discussion of some typical and relevant aspects of these NMR data. Copyright © 2015 John Wiley & Sons, Ltd.

Production of the anti-inflammatory compound 6-O-palmitoyl-3-O-ß-D-glucopyranosylcampesterol by Callus cultures of Lopezia racemosa Cav. (Onagraceae).

Lopezia racemosa Cav. is a plant used in Mexican traditional medicine to heal inflammatory diseases. From this plant we isolated the novel compound 6-O-palmitoyl- 3-O-ß-D-glucopyranosylcampesterol (1) and 6-O-palmitoyl-3-O-ß-D-glucopyranosyl-ß-sitosterol (2), previously reported to have cytotoxic activity on several cancer cell lines. We evaluated the anti-inflammatory activity of 1 in vivo by mouse ear edema induced with 12-O-tetradecanoylphorbol-13-acetate (TPA) and 57.14% inhibition was observed. The aim of our study was to obtain callus cultures derived from this plant species with the ability to produce the compounds of interest. Callus cultures were initiated on MS basal medium amended with variable amounts of naphthaleneacetic acid (NAA), or 2,4-dichlorophenoxyacetic acid (2,4-D), combined or not with 6-benzylaminopurine (BAP). Ten treatments with these growth regulators were carried out, using in vitro germinated seedlings as source of three different explants: hypocotyl, stem node, and leaf. Highest yield of 1 was observed on callus derived from leaf explants growing in medium containing 1.0 mg/L 2,4-D and 0.5 mg/L BAP. Selected callus lines produced less 1 than wild plants but the in vitro cultured seedlings showed higher production. So we conclude that it could be attractive to further investigate their metabolic potential.

Development and characterization of two nano-structured systems for topical application of flavanones isolated from Eysenhardtia platycarpa.

Many of the inflammatory diseases are becoming common in ageing society throughout the world. The clinically used anti-inflammatory drugs suffer from the disadvantage of side effects. Alternative to these drugs are natural products, since ancient times traditional medicines are being used for the treatment of inflammation. In the present study, four flavanones isolated from Eysenhardtia platycarpa leaves with a potent pharmacological activity were formulated in effective drug delivery systems: nanoemulsion and polymeric nanoparticles for topical use as novel anti-inflammatory topical formulations. Nanoemulsion system exhibited droplet sizes less than 70 nm and polymeric nanoparticles with a size of 156-202 nm possessed zeta potential values less than -25 mV that provided good stability and obtained high entrapment efficiency (78-90%). In vitro release and ex vivo permeation studies were performed on Franz-type diffusion cells and quantified by high performance liquid chromatography (HPLC), all formulations showed steady state release profiles over time and steady increase of flavanones in the skin permeation test. The anti-inflammatory activity, tested by TPA (12-O-tetradecanoylphorbol-13-acetate), induced oedema in mice ear suggesting that prenylated flavanones improve significantly their anti-inflammatory activity when are vehiculized in nanosized systems. Our results suggested that 5-hydroxy-7-methoxy-6-prenyl flavanone loaded nanoemulsion and polymeric nanoparticle could be proposed as potential topical anti-inflammatory formulations with the best properties for the treatment of inflammatory disorders.

First Colombian multicentric newborn screening for congenital toxoplasmosis.

AIMS: To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern). MATERIALS AND METHODS: We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain) to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life. RESULTS: 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality). A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city. CONCLUSIONS: Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.

Validación de pruebas ELISA IgM anti-Toxoplasma para uso en programas de tamización en recién nacidos / Validation of anti-Toxoplasma IgM ELISA tests in newborn screening programs

Objetivos. Evaluar y determinar el punto de corte para la detección de IgM anti-Toxoplasma por el método ELISA, en muestras de sangre de cordónumbilical, mediante dos ensayos comerciales diferentes, y correlacionar los resultados obtenidos con el diagnóstico de toxoplasmosis congénitarealizado por seguimiento serológico y los datos clínicos. Métodos. Se evaluó la prueba IgM anti-Toxoplasma ELISA de Vircell®, frente a los resultados por Western blot e IgM ELISA de Labsystems®. Seestudiaron 105 muestras de cordón umbilical de niños colombianos, obtenidas de seis ciudades diferentes por Western blot y seguimiento clínico yserológico en aquellos positivos. Se obtuvo una curva receptor-operador (ROC) para la prueba ELISA IgM anti-Toxoplasma de Vircell® y de Labsystems®. Se analizó la concordancia entre pruebas en 105 sueros obtenidos de cordón umbilical. Resultados. El mejor desempeño para la prueba Vircell® fue con un punto de corte de índice 8 y la prueba de Labsystems® con un punto de cortede 16 inmunounidades enzimáticas. Frente al Western blot, la prueba Vircell® tuvo una sensibilidad de 100 % (IC 95%; 71,8-100) y una especificidadde 78 % (IC 95%; 69-85,7), la prueba Labsystems® tuvo una sensibilidad de 100 % (IC95%; 71,8-100) y una especificidad de 100 % (IC95%; 96-100). Laconcordancia entre ambas pruebas (Labsystems® y Vircell®) fue de 80 %, con un índice kappa de 0,45. Conclusiones. Un punto de corte de un índice 8 para la prueba ELISA IgM anti-Toxoplasma de Vircell® y un punto de corte de 16 inmunounidadesenzimáticas por Labsystems®, permiten identificar infecciones congénitas en sangre de cordón umbilical en niños colombianos.

Objectives: To evaluate and validate the detection of anti-Toxoplasma IgM ELISA in umbilical cord blood by means of two different commercialassays and to correlate the results with the diagnosis of congenital infection in children by serological follow up and clinical data. Materials and methods: We evaluated the commercial anti-Toxoplasma IgM ELISA kitÔ from Vircell (Granada, Spain) compared to the results of Toxoplasma IgM Western blotÔ (LDbio, Lyon, France) and IgM ELISA testÔ from Labsystems (Finland). We obtained the receptor-operator curve (ROC) for the IgMELISA assay form Vircell and Labsystems. We studied 105 umbilical cord blood serum samples from Colombian children from six different cities by Westernblot, and clinical and serological follow up for positive cases. The kappa agreement index was determined for the 105 sera obtained from umbilical cords. Results: The Vircell assay showed a better performance with a cut-off index of 8 against a 16 for Labsystems for enzyme immunounits (EUI). Whenthe results were evaluated against the Western blot assay, the Vircell IgM assay had a sensitivity of 100% (IC95%: 71.8-100) and a specificity of 78%(IC95%: 69-85.7), the IgM assay from Labsystems had a sensitivity of 100% (IC95%; 71.8-100) and a specificity of 100% (IC95%; 96-100). Agreement between both tests (Labsystems and Vircell) was 80% and had a kappa index of 0.45. Conclusions: A cut-off point of 8 for the anti-Toxoplasma IgM ELISA assay from Vircell and 16 EIU for the Labsystems assay allow the identificationof congenital infections in umbilical cord blood samples from Colombian children.

Análisis Probabilista de Seguridad de tratamientos de radioterapia con un acelerador lineal de uso médico / Probabilistic safety assessment of the radiotherapy treatment with a linear accelerator for medical use

RESUMEN El trabajo presenta los resultados del Análisis Probabilista de Seguridad al proceso de tratamiento de radioterapia con un acelerador lineal de uso médico desarrollado por el Foro Iberoamericano de Organismos Reguladores Radiológicos y Nucleares. Se evaluaron las exposiciones accidentales potenciales durante el proceso de tratamiento del paciente, los trabajadores y miembros del público, aunque el énfasis del estudio se orientó hacia los pacientes. El método de análisis de modos de fallos y efectos se utilizó para definir los sucesos iniciadores de accidentes y los métodos de árboles de sucesos y árboles de fallo para determinar las secuencias accidentales que se pueden producir. Una vez cuantificada la frecuencia de ocurrencia de las secuencias accidentales se realizaron análisis de importancia para determinar los sucesos más significativos desde el punto de vista de la seguridad y se identificaron los principales contribuyentes al riesgo, así como las recomendaciones de seguridad más apropiadas para reducirlo.

ABSTRACT This paper presents the results of the Probabilistic Safety Assessment to the radiotherapy treatment with an Electron Linear Accelerator for Medical Use, which was conducted in the framework of the Iberian-American Forum of Radiological and Nuclear Regulatory Agencies. Potential accidental exposures during the treatment of patients, workers and members of the public were assessed, although the study was mainly focused on patients. The methodology of failure modes and effects analysis was used to define accident initiating events and methods of event tree and fault tree analysis to determine the accident sequences that may occur. After quantifying the frequency of occurrence of the accident sequences, an important analysis was carried out in order to determine the most significant events from the point of view of safety. The major contributors to risk were identified as well as the most appropriate safety recommendations to reduce it.

Honokiol and magnolol production by in vitro micropropagated plants of Magnolia dealbata, an endangered endemic Mexican species.

An efficient protocol for the in vitro propagation of Magnolia dealbata Zucc., an important medicinal plant that is the source of the anxiolytic and anticancer compounds honokiol and magnolol, was established. This plant is wild-crafted, and conservationists have expressed concerns with regard to the sustainability of production. In the present work, two factors were found to be of importance for the regeneration of M. dealbata and the production of honokiol and magnolol. These factors were the type of explants and the combination and concentration of plant-growth regulators. Green, compact, nodular organogenic callus was obtained from leaf explants in a medium fortified with Murashige and Skoog salts and supplemented with 1.5 mg/L 2,4-dicholorophenoxyacetic acid and 1.5 mg/L kinetin. Shoots multiplication from callus cultures was achieved in the Murashige and Skoog (MS) medium with 1.5 mg/L thidiazuron (TDZ). Phenol secretion was controlled by the addition of 250 mg/L of activated charcoal. For rooting, shoots were transferred to MS medium supplemented with several auxins. After root induction, the plants were hardened in earthen pots containing sand, soil, and vermiculite. The contents of honokiol (HK) and magnolol (MG) were determined in different plant materials by high-performance liquid chromatography-diode-array detection techniques. This analysis revealed that the honokiol and magnolol content in aerial and underground parts of micropropagated M. dealbata were higher than that observed in wild plants (both 6 months old). Our results suggest that conservation of M. dealbata is possible by means of in vitro multiplication of leaf-derived callus. The usefulness of M. dealbata regeneration and production of HK and MG may be attributed to the proper selection of explant sourcing and identification of the correct growth medium to support adequate growth. This careful selection of explants and growth medium leads to a very useful source of plant material for pharmacological and phytomedicinal screening applications and, above all, would safeguard this plant species from the threat of extinction.

Production of honokiol and magnolol in suspension cultures of Magnolia dealbata Zucc.

Honokiol and magnolol, important anxiolytic and anti-cancer agents, have been produced in cell-suspension cultures of the endangered Mexican plant Magnolia dealbata Zucc. In vitro cultures of the plant were established, and the accumulation of honokiol and magnolol in callus and cell-suspension cultures was measured. Leaf samples were the best explants for callus establishment and metabolite production, and Murashige and Skoog medium supplemented with 1 mg/L 2, 4-dichlorophenoxyacetic acid and 1 mg/L kinetin yielded 2.3 mg/g of honokiol and 5.9 mg/g of magnolol. Bacterial and fungal contamination was inhibited with a multiple-step tissue sterilization procedure. Oxidation was inhibited with 1 g/L activated charcoal. Cell-suspension batch cultures derived from friable callus obtained from leaves of this species were grown for 30 days in shaker flasks containing Murashige and Skoog medium. Throughout the growth cycle, honokiol and magnolol levels, fresh and dry weight, and sucrose uptake were determined. The effects of carbon source concentration on biomass accumulation and the synthesis of bioactive compounds were studied. By using 3 mL of inocula supplemented with 3% (w/v) sucrose, maximum yields of honokiol (8.1 mg/g) and magnolol (13.4 mg/g) were obtained after 25 days. These yields were 300% and 382%, respectively, of the yields of honokiol and magnolol obtained from field-grown plants.

Botox, tratamiento fútil en pacientes menores de doce años de edad con espasticidad / Botox: A futile treatment for patients under twelve years of age suffering from muscle spasticity

El artículo sostiene la futilidad del Botox cuando éste se aplica en pacientes menores de doce años de edad con espasticidad, basándose principalmente en estudios realizados por diversos investigadores que plantean el actuar del fármaco sobre el cuerpo. Al tiempo que propone ampliar la visión en la atención de la discapacidad, partiendo de la persona como un ser integral, ubicándolo en su historia personal, en sus capacidades y etapa de la vida en que se encuentra, sin que se restrinja solo a la corporeidad del paciente. Plantea que los pacientes menores de doce años con espasticidad son personas que se encuentran en proceso de desarrollar sus capacidades y potencializarlas, la espasticidad se manifiesta por una triada: hipertonía, hiperrreflexia y reflejos patológicos, lo que limita la movilidad pero no la obstruye. Es resultado de la secuela de una lesión en las vías córtico espinales, por lo que el tratamiento debe de ir más allá de las expresiones corporales que el paciente hace evidente durante la realización de movimientos voluntarios.

The following article presents the research of multiple investigators about the futility of Botox when this drug is applied on patients younger than twelve years old and the effects of the body of the subjects. At the same time invites to amply the vision on the attention of disability, taking the person as a complete being, placing his or hers personal history, his or hers capacities and the life phase he or she is living actually. Also shows that the patients with spasticity younger than twelve years old are people who is on process of developing his or hers capabilities and potencialize them, the spasticity is a sequel of injury on cortical spinal routes that manifest hypertonic, hiperreflex and pathologic reflexes that limit the mobility but do not impede it, so the treatment must be beyond corporal expressions that the patient made evident during the voluntary movement realization.

Antihyperglycemic activity and chemical constituents of Eysenhardtia platycarpa.

The methanolic extracts from branches (BEP) and leaves (LEP) of Eysenhardtia platycarpa significantly decreased the blood glucose levels in normal and streptozotocin (STZ)-induced diabetic rats. One new flavone, (1"R)-5,4',1"-trihydroxy-6,7-(3",3"-dimethylchroman)flavone (1), together with the known compounds 5,7-dihydroxy-6-methyl-8-prenylflavanone (3), 5,7-dihydroxy-8-methyl-6-prenylflavanone (4), 5,7-dihydroxy-6-prenylflavanone (5), 5,7-dihydroxy-8-prenylflavanone (6), 3-O-acetyloleanolic acid (7), oleanolic acid, 3beta-acetoxy-11alpha,12alpha-epoxy-oleanan-28,13beta-olide, lupeol, betulinic acid, beta-sitosterol, beta-sitosteryl beta-D-glucopyranoside, beta-sitosteryl palmitate, and 3-O-methyl-myo-inositol were isolated from BEP. Additionally, one new flavanone, (2S)-4'-O-methyl-6-methyl-8-prenylnaringenin (2), as well as the known compounds 3, 4, 6, 4'-O-methyl-8-prenylnaringenin (8), and 5-hydroxy-7-methoxy-8-prenylflavanone (9) were isolated from LEP. 3-O-Acetyloleanolic acid (7), identified as the major constituent of BEP, showed a significant decrease (31 mg/kg of body weight, P < 0.05) in the glucose level of STZ-induced diabetic rats. The obtained results correlate with the traditional use of this species.

Symptoms at pre- and postmenopause in rural and urban women from three States of Mexico.

OBJECTIVES: We studied the possible influence of modern cultural conditions on symptoms at menopause in three distant populations, comparing urban vs. rural women from three different States of Mexico: Guanajuato, Coahuila and Yucatán. In these groups we compared the age at menopause and symptoms at pre- and postmenopause. METHODS: A total of 7632 volunteers were selected from Guanajuato, Coahuila and Yucatán. In house visits, an oral questionnaire was applied to women 45-60 years old, non-pregnant or lactating, without hysterectomy, chronic illness, or hormone treatment. We collected general and personal data, clinical, somatometric variables, and symptoms: hot flashes, vaginal dryness, dispareunia, and diminished sexual interest. Depressive mood and anxiety were evaluated with the Hamilton-Bech-Rafaelsen Scale. RESULTS: The mean age at menopause was 48.0 years. A logistic regression identified the association of age at menopause with urban or rural residence, and the State of origin. Scores for depression and anxiety were lower in Yucatán, and they were higher in rural women. Hot flashes, vaginal dryness and the diminished sexual interest were increased at postmenopause. Hot flashes varied from 73 to 32%, and were associated with menopause, low schooling, rural residence, body mass index (BMI), and State of residence. Similar factors were associated with vaginal dryness, dispareunia, and loss of sexual interest. Depressive mood was associated with rural residence, State of residence, menopause, high BMI, smoking habit, age, and schooling. Anxiety was associated with menopause, rural residence, low schooling, high BMI, and age. The loss of sexual interest was associated with age, BMI, menopause and number of pregnancies. CONCLUSIONS: The frequencies of symptoms at menopause have similar ranges to other countries. Ethic and socio-cultural and environmental factors are involved in the appearance or symptoms.

Gangrena de fournier: experiencia con 5 pacientes / Fournier's grangrene: report of five patients

La gangrena de Fournier es una infección poco frecuente de las regiones genitales, perineal y perianal. Presentamos cinco casos de gangrena de Fournier, estudiados en siete años, cuatro hombres y una mujer con un promedio de edad de 60 años (52-68). Los cinco casos presentaron diabetes mellitus, 2 eran alcohólicos crónicos, todos los casos se manejaron con resucitación con líquidos parenterales, desbridación quirúrgica amplia con limpieza exhaustiva y triple esquema de antibioticoterapia. En 3 casos se realizó colostomía por tener un origen anorrectal, en un caso se realizó cistoscopía por presentar estrechez uretral, en un caso se realizó orquidectomía bilateral. Nuestra mortalidad fue del 60 por ciento (3 pacientes). La muerte fue por sepsis no controlada y acidosis metabólica severa, con un rango de hospitalización de 16 días.

Filtro de Greenfield de titanio para la interrupción de la vena cava inferior: informe de un caso / Titaniu, Greendield filter for interruption of the inferior cava vein: case report

Presentamos el primer reporte de la interrupción de la vena cava inferior mediante un filtro de Greenfield de titanio, por vía percutánea endovascular en el Hospital Militar Regional de Puebla. Este procedimiento se realizó en una mujer de 42 años de edad con trombosis venosa profunda de miembros inferiores de la vena cava inferior, presentando además sangrado profuso uterino como complicación médica de la anticoagulación con heparina. Se procedió a colocar un filtro de Greenfield de titanio a nivel suprarrenal siendo bien tolerado el procedimiento; se realizó a las 48 horas cirugía abdominal con histerectomía total y salpingooforectomía bilateral sin complicaciones siendo egresada la paciente del Hospital a los 10 días. Se hace una revisión de la literatura mundial desde 1970 de los filtros de Greenfield para la vena cava

Leiomiosarcoma primario de la vena cava inferior. Informe de un caso / Primary leiomiosarcoma of the inferior cava vein. Case report

Los tumores venosos son raros, difíciles de diagnosticar y usualmente malignos, los leiomiosarcomas de las grandes venas predominantemente de la vena cava inferior constituyen más del 50 por ciento de esta patología. Los síntomas y signos son sujetos a la localización del tumor y a la estenosis u obstrucción del sistema venoso, la flebografía es extremadamente importante para diagnosticarlos, sin embargo la tomografía axial computarizada con medio de contraste ayuda a determinar la naturaleza neoplásica de esta condición, siendo la resección quirúrgica el tratamiento de elección aunque el estado benignidad y malignidad no puede ser determinado transoperatoriamente. Este reporte describe el caso de una paciente con leiomiosarcoma de la vena cava inferior con resección quirúrgica y reconstrucción de la vena cava inferior con un injerto de politetrafluoroetileno con buenos resultados a corto plazo