Interaction Effects of FTO and MC4R Polymorphisms on Total Body Weight Loss, Post-Surgery Weight, and Post-Body Mass Index after Bariatric Surgery.

Bariatric surgery (BS) is considered the most effective intervention for patients with severe obesity and is used to maintain long-term weight loss and glycemic control. The aim of this study was to analyze the effects of genotypes and haplotypes of the fat mass and obesity-associated (FTO) and melanocortin 4 receptor (MC4R) genes on total body weight loss (TBWL), post-surgery weight, and post-BMI after bariatric surgery. We retrospectively selected 101 patients from Bajio High Specialty Regional Hospital, León Guanajuato, México, who underwent Roux-en-Y gastric bypass (RYGB) to determine their body mass index (BMI), blood pressure, biochemical characteristics, and comorbidities. Post-surgery, patients were referred for registered anthropometry and blood pressure. Glucose, lipid and hepatic profiles, and insulin, leptin, and ghrelin levels were measured, and rs9939609, rs9930506, and rs1421085 FTO and rs17782313 MC4R polymorphisms were genotyped. Six (4-8) years after BS, post-surgery weight was greater in carriers of the rs9939609 and rs1421085 risk genotypes. TBWL was lower for the rs9930506 and rs1421085 risk genotypes. Insulin and HOMA-IR were greater in patients with the three FTO polymorphisms. There were significant interaction effects of the rs9930506 and rs1421085 FTO risk genotypes on weight and BMI in response to BS. No association was found with the MC4R polymorphism. The genotypes and haplotypes of the FTO gene influence post-surgery weight, TBWL, insulin levels, and HOMA-IR.

Giant paratubal cyst: report of a case in second level public hospital.

BACKGROUND: Giant paratubal cysts are mostly benign tumors, with an incidence of 10%. The incidence rate of neoplasms is 2% to 3%, including papillary carcinoma and serous papillary neoplasms. CASE REPORT: A 35-year-old woman who began her current condition 3 years after her pregnancy, with urgency when urinating, abdominal pain and sensation of abdominal mass, who was diagnosed and protocolized in a second public level hospital of the State of Mexico, treated with open surgery, and good postoperative evolution.

ANTECEDENTES: Los quistes paratubáricos gigantes son en su mayoría tumores benignos, con una incidencia del 10%. La tasa de incidencia de neoplasias es del 2 al 3%, incluyendo carcinoma papilar y neoplasias papilares serosas. CASO CLÍNICO: Mujer de 35 años que comenzó su condición actual 3 años después de un embarazo, con urgencia al orinar, dolor abdominal y sensación de masa abdominal, que fue diagnosticada y protocolizada en un hospital público de segundo nivel del Estado de México, tratada con cirugía abierta y con buena evolución posoperatoria.

The use of readily available laboratory tests for the identification of the emerging yeast Candida auris in Mexico.

Identification of the emerging multidrug-resistant yeast Candida auris is challenging. Here, we describe the role of the Mexico national reference laboratory Instituto de Diagnóstico y Referencia Epidemiológicos Dr. Manuel Martínez Báez (InDRE) and the Mexican national laboratory network in the identification of C. auris. Reference identification of six suspected isolates was done based on phenotypic and molecular laboratory methods, including growth in special media, evaluation of isolate micromorphology, and species-specific PCR and pan-fungal PCR and sequencing. The four C. auris isolates identified were able to grow on modified Sabouraud agar with 10% NaCl incubated at 42 °C. With one exception, isolates of C. auris were spherical to ovoid yeast-like cells and blastoconidia, with no hyphae or pseudohyphae on cornmeal agar. C. auris isolates were resistant to fluconazole. Species-specific and pan-fungal PCR confirmed isolates as C. auris. Sequence analysis revealed the presence of two different C. auris clades in Mexico, clade I (South Asia) and clade IV (South America).

Terahertz imaging demonstrates its diagnostic potential and reveals a relationship between cutaneous dehydration and neuropathy for diabetic foot syndrome patients.

Diabetic foot syndrome, a long term consequence of Diabetes Mellitus, is the most common cause of non-traumatic amputations. Around 8% of the world population suffers from diabetes, 15% of diabetic patients present a diabetic foot ulcer which leads to amputation in 2.5% of the cases. There is no objective method for the early diagnosis and prevention of the syndrome and its consequences. We test terahertz imaging, which is capable of mapping the cutaneous hydration, for the evaluation of the diabetic foot deterioration as an early diagnostic test as well as ulcers prevention and tracking tool. Furthermore, the analysis of our terahertz measurements combined with neurological and vascular assessment of the patients indicates that the dehydration is mainly related to the peripheral neuropathy without a significant vascular cause.

Origen anómalo de una de las ramas de la arteria pulmonar (OAAP): tratamiento quirúrgico y resultados / Anomalous origin of one of the branches of the pulmonary artery (AOPA): Surgical treatment and outcome

Resumen Introducción: El origen anómalo de una de las ramas de la arteria pulmonar procedente de la aorta ascendente es poco frecuente. Objetivo: Identificar las características clínicas y quirúrgicas de los pacientes sometidos a reimplante de la rama afectada. Método: Se realizó un estudio observacional, transversal, descriptivo, retrospectivo y retrolectivo, en el que se incluyeron los pacientes diagnosticados de origen anómalo de alguna de las ramas de la arteria pulmonar y que fueron tratados mediante cirugía correctiva en el Instituto Nacional de Cardiología Ignacio Chávez, en el periodo del 1 de enero de 2003 al 31 de enero de 2019. De los expedientes se extrajeron las características demográficas, los antecedentes quirúrgicos, los diagnósticos, los reportes ecocardiográficos y tomográficos, la técnica quirúrgica y el estado posquirúrgico. Resultados: Se encontraron nueve pacientes sometidos a cirugía de corrección, con un promedio de edad de 2 ± 2 años, un peso de 11.4 ± 1.5 kg y una talla de 82 ± 15 cm. El 67% fueron de sexo masculino. La rama afectada con más frecuencia fue la derecha; el 68% se originaban directamente de la aorta y el 42% de un conducto arterioso persistente. La corrección con circulación extracorpórea tuvo un tiempo promedio de pinzamiento aórtico de 35 minutos y de soporte circulatorio de 45 minutos. Se utilizó el implante directo o con material sintético. Las complicaciones fueron falla ventricular, sangrado, arritmias y neumonía nosocomial. La mortalidad fue del 11%. Conclusiones: El tratamiento quirúrgico para el reimplante de la rama anómala de la arteria pulmonar es el procedimiento de elección, y con cuidados quirúrgicos y posteriores tiene un buen pronóstico a mediano y largo plazo.

Abstract Introduction: The anomalous origin of one of the branches of the pulmonary artery from the ascending aorta is rare. Objective: To identify the clinical and surgical characteristics of the patients undergoing reimplantation of the affected branch. Method: An observational, cross-sectional, descriptive, retrospective and retrolective study was performed; patients diagnosed with anomalous origin of one of the branches of the pulmonary artery and treated by corrective surgery at the Instituto Nacional de Cardiología Ignacio Chavez, in the period from January 1, 2003 to January 31, 2019, were included. It was extracted from the files: demographic characteristics, surgical antecedents, diagnoses, echocardiographic and tomographic reports, surgical technique and post-surgical status. Results: Nine patients underwent correction surgery, with an average age of 2 ± 2 years, 11.4 ± 1.5 kg and height 82 ± 15 cm; 67% were male. The most frequent affected branch was the right, 68% originated directly from the aorta and 42% from a patent ductus arteriosus. The correction with extracorporeal circulation had an average aortic cross-clamp of 35 minutes and circulatory support of 45 minutes, the direct or synthetic implant was used. The complications were ventricular failure, bleeding, arrhythmias and nosocomial pneumonia. Mortality was 11%. Conclusions: Surgical treatment for reimplantation of the anomalous branch of the pulmonary artery is the procedure of choice, which with surgical and subsequent care has a good prognosis in the medium and long term.

A novel NIR-image segmentation method for the precise estimation of above-ground biomass in rice crops.

Traditional methods to measure spatio-temporal variations in biomass rely on a labor-intensive destructive sampling of the crop. In this paper, we present a high-throughput phenotyping approach for the estimation of Above-Ground Biomass Dynamics (AGBD) using an unmanned aerial system. Multispectral imagery was acquired and processed by using the proposed segmentation method called GFKuts, that optimally labels the plot canopy based on a Gaussian mixture model, a Montecarlo based K-means, and a guided image filtering. Accurate plot segmentation results enabled the extraction of several canopy features associated with biomass yield. Machine learning algorithms were trained to estimate the AGBD according to the growth stages of the crop and the physiological response of two rice genotypes under lowland and upland production systems. Results report AGBD estimation correlations with an average of r = 0.95 and R2 = 0.91 according to the experimental data. We compared our segmentation method against a traditional technique based on clustering. A comprehensive improvement of 13% in the biomass correlation was obtained thanks to the segmentation method proposed herein.

Escherichia fergusonii in a patient with a traumatic amputation of the right pelvic limb.

El nombre de Escherichia fergusonii es en honor del microbiólogo William H. Ferguson. Es un bacilo gramnegativo, móvil, oxidasa negativo, catalasa positivo, reductor de nitrato y fermentador, oportunista que se asocia a infecciones de sitio quirúrgico. Una niña de 12 años fue remitida a un servicio de urgencias ortopédicas en la Ciudad de México con amputación traumática de la extremidad pélvica derecha. Tenía exposición ósea y requirió varios desbridamientos quirúrgicos. En el hueso y el tejido muscular se aisló E. fergusonii solo resistente a trimetoprima-sulfametoxazol y ampicilina, más otros gérmenes. Recibió un mes de ertapenem más ampicilina, con marcada mejoría.The name of Escherichia fergusonii was in honor of the microbiologist William H. Ferguson. It is a gram-negative rod, motile, oxidase negative,catalase positive, nitrate reducing and fermenter. Opportunistic that is associated with surgical site infections. A 12-year-old girl was referred to an orthopedic emergency department in Mexico City with a traumatic amputation of the right leg, she had bone exposure and required several surgical debridements. From bone and soft tissue samples we isolated E. fergusonii only resistant to trimethoprim sulfamethoxazole and ampicillin, and other germs. She received a month of ertapenem plus ampicillin with marked improvement.

Revisión sistemática entre la obesidad y enfermedad periodontal / Systematic review between obesity and periodontal disease

Objetivos: Evaluar la relación entre periodontitis y obesidad, para brindar información actual sobre el posible rol que desempeña la obesidad en la enfermedad periodontal. : Se realizó una búsqueda Material y métodos exhaustiva y de manera manual en las 4 revistas más importantes en periodoncia según el factor de impacto del ISI Web of science. : La obesidad se asocia con la periodontitis. El area de grasa visceral fue el Resultados indicador más adecuado de la obesidad en relación con la periodontitis. : La obesidad es una condición Conclusiones sistémica y multifactorial y su relación con la enfermedad periodontal es respalda por la literatura. (AU)

Objectives: To evaluate the relationship between periodontitis and obesity, to provide current information on the possible role of obesity in periodontal disease and thus, the dentist can educate, prevent patients suffering from these diseases and thus contribute to the improvement of their oral health. Material and methods: A comprehensive and manual search was carried out in the 4 most important journals in periodontics according to the ISI Web of Science impact factor. Results: Obesity is associated with periodontitis. The area of visceral fat was the most adequate indicator of obesity in relation to periodontitis. Conclusions: Obesity is a systemic and multifactorial condition and its relation with periodontal disease is supported by the literature. (AU)

Traumatic L5-S1 spondylolisthesis in a 15-year-old: a case report.

Traumatic spondylolisthesis is a rare injury resulting from complex trauma and high-energy mechanisms. We present a case report of traumatic spondylolisthesis at the L5-S1 disc space of a patient who was buried after a wall fell on his back. In the physical examination, bilaterally decreased muscle strength was observed. Examination images indicated a 90% slip at L5-S1. Surgical treatment was provided with a posterior and anterior approach using pedicle fixation and an anterior cage. After 4 months, there was significant recovery of muscle strength in the lower limbs.

Pain and quality of life in patients undergoing radiotherapy for spinal metastatic disease treatment.

BACKGROUND: Radiotherapy is an important tool in the control of pain in patients with spinal metastatic disease. We aimed to evaluate pain and of quality of life of patients with spinal metastatic disease undergoing radiotherapy with supportive treatment. METHODS: The study enrolled 30 patients. From January 2008 to January 2010, patients selection included those treated with a 20 Gy tumour dose in five fractions. Patients completed the visual analogue scale for pain assessment and the SF-36 questionnaire for quality of life assessment. RESULTS: The most frequent primary sites were breast, multiple myeloma, prostate and lymphoma. It was found that 14 spinal metastatic disease patients (46.66%) had restricted involvement of three or fewer vertebrae, while 16 patients (53.33%) had cases involving more than three vertebrae. The data from the visual analogue scale evaluation of pain showed that the average initial score was 5.7 points, the value 30 days after the end of radiotherapy was 4.60 points and the average value 6 months after treatment was 4.25 points. Notably, this final value was 25.43% lower than the value from the initial analysis. With regard to the quality of life evaluation, only the values for the functional capability and social aspects categories of the questionnaire showed significant improvement. CONCLUSION: Radiotherapy with supportive treatment appears to be an important tool for the treatment of pain in patients with spinal metastatic disease.

Interacción proliferación-inflamación en granulomas dentarios periapicales epitelizados y quistes radiculares mediante técnicas inmunohistoquímicas / Proliferation-inflammation interaction in epithelized periapical granulomas and radicular cysts by means of immunohistochemical techniques

El objetivo del presente estudio fue determinar la interacción molecular y celular existente en los granulomas periapicales epitelizados, cuyos protagonistas son las células epiteliales de Malassez y las células inflamatorias adyacentes. Las muestras diagnosticadas como procesos periapicales crónicos epitelizados fueron estudiadas bajo la técnica de inmunohistoquímica, los marcadores utilizados para evaluar el factor inflamatorio para linfocitos el CD4+ (linfocitos T colaboradores) y el CD8+ (linfocitos T citotóxicos). Para la proliferación epitelial se seleccionó el factor de crecimiento Ki-67 de manera tal de poder establecer el compromiso de las células de Malassez. De las 22 muestras analizadas inmunohistoquímicamente se detectó un gran compromiso inflamatorio grado II en el total de las muestras, con respecto a la proliferación epitelial se identificó el grado I en un 49 por ciento, grado II 31, 8 por ciento, grado III en un 9,09 por ciento y grado IV 13,63 por ciento. De lo investigado se destaca que el factor irritativo local CD4, CD8 constituye la base del desarrollo de la proliferación epitelial, pero sin la presencia de los restos epiteliales de Malassez no tendría mayor significancia. Esta mutua interacción determinó la evolución de estas lesiones y como consecuencia se desarrollan a partir de lesiones periapicales epitelizadas diferentes grado de proliferación, culminando con la formación de quistes dentarios radiculares.

[Transanesthetic anaphylactic shock induced by propofol and fentanyl: case report]. / Choque anafiláctico transanestésico por propofol y fentanil: comunicación de un caso.

We report an anaphylactic shock case secondary to propofol and fentanyl exposition, demonstrated by skin tests. A male patient, 19 years old, was admitted in the operating room for resection of residual juvenile nasal angyofibroma. The anesthetic induction was done with atropin 800 microg, midazolam 2 mg, fentanyl 200 microg, propofol 150 mg, and neuromuscular block with rocuronium 30 mg. One minute after the application of drugs, hypotension of 60/30 mmHg and tachycardia of 130 was observed. By the second minute the blood pressure dropped to 40/20 mmHg, tachycardia got 135, facial edema and generalized wheals occurred and the plestimography and oxymetry record were absent. Once resolved the event and the patient recovered, skin tests were performed with positive results to propofol and fentanyl, so that they were excluded in the next surgical intervention that concluded without incidents and with success.

Procedimiento del levantamiento legal del cadaver por muerte violenta en La Paz: participación del médico forense / Procedure of the legal survey of the carcass by violent death in La Paz: participation of the medical examiner

La crónica roja anuncia a diario de origen violento, estos hechos exigen su investigación criminal a instancias del Ministerio Público, debiendo realizarse el procedimiento del levantamiento legal del cadáver, sin pérdida de tiempo, en el lugar del hecho, donde la labor del médico forense es determinante ya que 50 a 65 por ciento de la verdad de lo que ocurrió se obtiene en esta fase de la autopsia, debido a que conoce de cerca el fenómeno cadavérico, traduciendo a la justicia datos como: la causa, posible hora de la muerte, mediante el examen del interfecto, la vestimenta y la escena; además colabora en la colecta de evidencias sospechosas. En nuestro medio, los hechos demuestran que este procedimiento judicial es realizado por una diligencia conformada por agentes policiales y el fiscal, sin la participación del Forense; este problema he motivado la presente investigación, dado que en otros paises el levantamiento no procede presencia del Forence...