Technical position on milk and its derivatives in adult health and disease from the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría. / Posición técnica sobre la leche y derivados lácteos en la salud y en la enfermedad del adulto de la Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Gerontología y Geriatría.

Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed.

[Mexican consensus on portal hypertension]. / Consenso Mexicano de Hipertensión Portal.

The aim of the Mexican Consensus on Portal Hypertension was to develop documented guidelines to facilitate clinical practice when dealing with key events of the patient presenting with portal hypertension and variceal bleeding. The panel of experts was made up of Mexican gastroenterologists, hepatologists, and endoscopists, all distinguished professionals. The document analyzes themes of interest in the following modules: preprimary and primary prophylaxis, acute variceal hemorrhage, and secondary prophylaxis. The management of variceal bleeding has improved considerably in recent years. Current information indicates that the general management of the cirrhotic patient presenting with variceal bleeding should be carried out by a multidisciplinary team, with such an approach playing a major role in the final outcome. The combination of drug and endoscopic therapies is recommended for initial management; vasoactive drugs should be started as soon as variceal bleeding is suspected and maintained for 5 days. After the patient is stabilized, urgent diagnostic endoscopy should be carried out by a qualified endoscopist, who then performs the corresponding endoscopic variceal treatment. Antibiotic prophylaxis should be regarded as an integral part of treatment, started upon hospital admittance and continued for 5 days. If there is treatment failure, rescue therapies should be carried out immediately, taking into account that interventional radiology therapies are very effective in controlling refractory variceal bleeding. These guidelines have been developed for the purpose of achieving greater clinical efficacy and are based on the best evidence of portal hypertension that is presently available.

[Cardiovascular effects immediate to the inhalation of tobacco smoke with different concentrations of nicotine]. / Efectos cardiovasculares inmediatos a la inhalación de humo de tabaco con diferente concentración de nicotina.

Fifteen healthy and non smoking men, age range 20 to 27 years (23.6 +/- 2.5 (SD) were subject of a double blind study designed to compare the immediate cardiovascular effects of smoking "regular" and "light" cigarettes (nicotine content: 1.1 mg and 0.6 mg, respectively). The measured cardiovascular parameters were: heart rate, blood pressure, echographic calculations of the left ventricle fractional shortening, amplitude of the posterior wall systolic movement and posterior wall contraction velocity, as well as QTc interval and T wave amplitude. All those measurements were obtained before and after smoking one or two other kind of cigarette. When the changes evoked by the regular cigarette were compared to the changes evoked by the light cigarette, no significant difference was detected. When analyzing the modifications that each kind of cigarette produced to its respective basal-control measurement the following observations were detected: heart rate increased after smoking both types of cigarette (p less than 0.001), blood pressure was raised only with regular cigarette (systolic, p less than 0.002; diastolic, p less than 0.005). QTc interval was prolonged (p less than 0.05) and T wave amplitude decreased (p less than 0.02) after regular and light cigarette. It is concluded that tobacco of regular and light cigarettes significantly and immediately affects diverse cardiovascular parameters, but there is no a clear or definite difference when the changes produced by the two types of cigarette are compared to each other, at least at the level of nicotine here utilized.