Periodontitis exacerbation during pregnancy in mice: Role of macrophage migration inhibitory factor as a key inductor.

OBJECTIVE: The present study was designed to investigate the role of macrophage migration inhibitory factor (MIF) in the exacerbation of pregestational periodontal disease (PGPD). BACKGROUND: Periodontitis (PT) is a severe stage of periodontal disease characterized by inflammation of the supporting tissues of the teeth, which usually worsens during pregnancy. MIF is a proinflammatory cytokine that is significantly elevated in periodontitis, both at the beginning and at the end of pregnancy. Although periodontitis usually presents with greater severity during pregnancy, the participation of MIF in the evolution of periodontitis has not been established. METHODS: To analyze the relevance of MIF in the exacerbation of PGPD, we employed a model of PGPD in WT and Mif-/- mice, both with a BALB/c genetic background. PT was induced with nylon suture ligatures placed supramarginally around the second upper right molar. For PGPD, PT was induced 2 weeks before mating. We evaluated histological changes and performed histometric analysis of the clinical attachment loss, relative expression of MMP-2 and MMP-13 by immunofluorescence, and relative expression of the cytokines mif, tnf-α, ifn-γ, and il-17 by quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: Our data revealed that periodontal tissue from PGPD WT mice produced a twofold increase in MIF compared with PT WT mice. Moreover, the evolution of periodontitis in Mif-/- mice was less severe than in PGDP WT mice. Periodontal tissue from Mif-/- mice with PGPD produced 80% less TNF-α and no IFN-γ, as well as 50% lower expression of matrix metalloproteinase (MMP)-2 and 25% less MMP-13 compared to WT PGDP mice. CONCLUSIONS: Our study suggests that MIF plays an important role in the exacerbation of periodontitis during pregnancy and that MIF is partially responsible for the inflammation associated with the severity of periodontitis during pregnancy.

Cranial anatomy of the "round-headed" Amphisbaenian Zygaspis quadrifrons (Squamata, Amphisbaenia) based on high-resolution x-ray computed tomography.

Amphisbaenians are a poorly understood clade of fossorial lizards. Because of their derived anatomy and relative scarcity, the systematics of the clade and its placement within squamates has long been controversial. Traditional approaches grouped species into four assemblages according to burrowing behavior and cranial morphology, resulting in the recognition of "shovel-headed," "round-headed," "keel-headed," and "spade-headed" morphotypes. Recent phylogenetic analyses do not support the monophyly of the taxa that share those morphotypes. Detailed analyses of cranial osteology were previously accomplished using high-resolution x-ray computed tomography (HRXCT) for the "shovel-headed" Rhineura hatcherii (Rhineruidae) and the "spade-headed" Diplometopon zarudnyi (Trogonophidae). A detailed description of the "round-headed" Amphisbaena alba was previously completed based upon traditional "dry" skeletal specimens. Seven species of the "round-headed" Blanus (Blanidae) were also analyzed using HRXCT. The goal of that project was a comparative analysis of all extant species of Blanus rather than a detailed, bone-by-bone description of one species, but certainly is useful for comparison with another "round-headed" taxon. The "round-headed" morphotype is by far the most common among amphisbaenians and is much in need of further documentation. We use HRXCT imagery to provide additional data about the disparity in cranial morphology among amphisbaenians. Those data allow us to provide another detailed description of a "round-headed" amphisbaenian, the poorly known southern African species Zygaspis quadrifrons. HRXCT is ideal for this relatively rare and diminutive species. We are able to visualize and describe a detailed reconstruction of the entire skull as well as individual cranial elements. Comparisons with other species that were described in similar detail-D. zarudnyi, Spathorhynchus fossorium, R. hatcherii, and A. alba-and to a lesser degree with Blanus, reveal a complex mosaic of morphological features of the skull in Zygaspis. Preliminary data suggest that intraspecific variation is present within Z. quadrifrons, and interspecific variation among other species of Zygaspis may be sufficient for species-level recognition based on cranial osteology. Our description is, therefore, also intended to serve as a baseline for comparative analysis of other specimens of Z. quadrifrons and of other species within the genus.

Variation in the cranial osteology of the amphisbaenian genus Zygaspis based on high-resolution x-ray computed tomography.

Amphisbaenians are a specialized fossorial group of reptiles, having developed head-first burrowing, a specialized skull architecture, and an elongated body. This group is generally small-bodied, with some species possessing skulls only a few millimeters long. In this study, we used high-resolution x-ray computed tomography to compare the skulls of 15 specimens from seven of the eight species in the amphisbaenian genus Zygaspis (Zygaspis dolichomenta, Zygaspis ferox, Zygaspis quadrifrons, Zygaspis kafuensis, Zygaspis nigra, Zygaspis vandami, and Zygaspis violacea). Both interspecific and intraspecific variation, including asymmetry, is observed among the cranial bones of the specimens. There are unique morphological features on some cranial bones, including the premaxilla and ectopterygoid of Z. quadrifrons, the pterygoid and vomer of Z. kafuensis, and the extracolumella of Z. nigra. Sexual dimorphism has been previously reported for the species Z. quadrifrons and is observed here as well.

Mexican Colorectal Cancer Research Consortium (MEX-CCRC): Etiology, Diagnosis/Prognosis, and Innovative Therapies.

In 2013, recognizing that Colorectal Cancer (CRC) is the second leading cause of death by cancer worldwide and that it was a neglected disease increasing rapidly in Mexico, the community of researchers at the Biomedicine Research Unit of the Facultad de Estudios Superiores Iztacala from the Universidad Nacional Autónoma de México (UNAM) established an intramural consortium that involves a multidisciplinary group of researchers, technicians, and postgraduate students to contribute to the understanding of this pathology in Mexico. This article is about the work developed by the Mexican Colorectal Cancer Research Consortium (MEX-CCRC): how the Consortium was created, its members, and its short- and long-term goals. Moreover, it is a narrative of the accomplishments of this project. Finally, we reflect on possible strategies against CRC in Mexico and contrast all the data presented with another international strategy to prevent and treat CRC. We believe that the Consortium's characteristics must be maintained to initiate a national strategy, and the reported data could be useful to establish future collaborations with other countries in Latin America and the world.

Pyridoxamine treatment ameliorates large artery stiffening and cerebral artery endothelial dysfunction in old mice.

Age-related increases in large artery stiffness are associated with cerebrovascular dysfunction and cognitive impairment. Pyridoxamine treatment prevents large artery stiffening with advancing age, but the effects of pyridoxamine treatment on the cerebral vasculature or cognition is unknown. The purpose of this study was to investigate the effects of pyridoxamine on blood pressure, large artery stiffness, cerebral artery function, and cognitive function in old mice. Old male C57BL/6 mice consumed either pyridoxamine (2 g/L) or vehicle control in drinking water for ∼7.5 months and were compared with young male C57BL/6 mice. From pre- to post-treatment, systolic blood pressure increased in old control mice, but was maintained in pyridoxamine treated mice. Large artery stiffness decreased in pyridoxamine-treated mice but was unaffected in control mice. Pyridoxamine-treated mice had greater cerebral artery endothelium-dependent dilation compared with old control mice, and not different from young mice. Old control mice had impaired cognitive function; however, pyridoxamine only partially preserved cognitive function in old mice. In summary, pyridoxamine treatment in old mice prevented age-related increases in blood pressure, reduced large artery stiffness, preserved cerebral artery endothelial function, and partially preserved cognitive function. Taken together, these results suggest that pyridoxamine treatment may limit vascular aging.

Síndrome Congénito del ZIKA y su relación con la pérdida auditiva en infantes: Una revisión de la literatura / Congenital ZIKA syndrome and its relationship to hearing loss in infants: A review of literature

Introducción: Los niños con microcefalia secundario al Virus Zika, se agrupan bajo el síndrome congénito del Zika (SZC), el extremo más grave de un espectro de defectos de nacimiento que incluyen además alteraciones en las funciones sensoriales de visión y audición, ya que el virus Zika está incluido dentro de las infecciones virales causadoras de hasta el 40% de las pérdidas auditivas congénitas y adquiridas. Objetivo: identificar en la literatura científica la relación existente entre el Síndrome Congénito del Zika y la pérdida de audición en infantes. Metodología: Revisión sistemática en las principales bases de datos como Science Direct ­ Elsevier, Online Library, Coronavirus Databases, Embase, Springer, entre otras. Resultados: Se encontraron 18 artículos indexados con descriptores de los cuales se incluyeron 8 al cumplir con los criterios de inclusión y exclusión. Discusiones: se evidencia que la pérdida de audición está presente en las diversas poblaciones de infantes evaluadas por medio de pruebas objetivas, las cuales permiten obtener respuestas importantes de la actividad eléctrica a nivel del nervio y la vía auditiva, presentándose fallas notables en los niños con síndrome congénito del Zika. Conclusiones: De acuerdo a los estudios incluidos en la presente investigación es poca la evidencia científica que pueda aportar una asociación significativa y absoluta entre el síndrome congénito del Zika y la pérdida de audición en infantes.

Introduction: Infants with microcephaly secondary to Zika Virus, are grouped under Congenital Zika Syndrome (CZS), the most severe end of a spectrum of birth defects that also include alterations in the sensory functions of vision and hearing, since Zika virus is included within the viral infections causing up to 40% of congenital and acquired hearing loss. Objective: to identify in the scientific literature the relationship between congenital Zika syndrome and hearing loss in infants. Methodology: Systematic review in the main databases such as Science Direct ­ Elsevier, Online Library, Coronavirus Databases, Embase, Springer, among others. Results: 18 articles were found indexed with descriptors of which 8 were included as they met the inclusion and exclusion criteria. Discussions: it is evident that hearing loss is present in the various populations of infants evaluated by means of objective tests, which allow obtaining important responses of the electrical activity at the level of the auditory nerve and pathway, presenting notable failures in children with congenital Zika syndrome. Conclusions: According to the studies included in the present investigation there is little scientific evidence that can provide a significant and absolute association between congenital Zika syndrome and hearing loss in infants.

Modos de vida de personas autistas del centro medicina integral (Cartagena Colombia / Ways of life of autistic people from the integral medicine center (Cartagena Colombia)

Objetivo: Caracterizar los modos de vida de las personas autistas del centro Medicina Integral en la ciudad de Cartagena-Colombia, a través de la epidemiología crítica en su vertiente de la determinación social de la salud. Metodología: Se realizó utilizando técnicas cuali-cuantitativas como la encuesta, la entrevista, la revisión bibliográfica-documental y la observación natural. La muestra estuvo constituida por 105 familias de personas autistas asistentes al centro Medicina Integral en la ciudad Cartagena Colombia y los resultados fueron procesados mediante el software de procesamiento de datos SPSS STATISTICS 25. Resultados: a nivel de los modos de vida de las familias de las personas autistas, las categorías del dominio general determinan la dinámica de los modos de vida. En las categorías de este dominio como la etnia, la clase social y el género del responsable familiar, predominaron la raza mestiza, la inserción social baja y el género masculino. A nivel educativo-laboral, hubo mayor tendencia a trabajos del nivel medio, bajo subordinación e informalidad. El acceso a salud es bueno, pues más del 90 % goza de este servicio en la cobertura. A nivel de exposiciones, son variados los procesos, se evidencian pocos apoyos, contaminación ambiental socioespacial en las familias, inequidad en el territorio, patologización y mitos acerca de la condición de autismo. Conclusiones: se pudo concluir que el autismo en Cartagena Colombia no es una condición aislada, pues se encuentra subsumido bajo sistemas del orden general, particular y singular, que condicionan al individuo y a sus familias

Goal: This work focused its objective on characterizing the ways of life of autistic people at the Integral Medicine Center in the city of Cartagena-Colombia, through critical epidemiology in its aspect of social determination of health. Methodology: It was carried out using qualitative-quantitative techniques such as the survey, the interview, the bibliographical-documentary review and natural observation. The sample consisted of 105 families of autistic people attending the Integral Medicine Center in the city of Cartagena, Colombia, and the results were processed using the SPSS STATISTICS 25 data processing software. Results: at the level of the lifestyles of the families of the autistic people, it is seen how the categories of the general domain determine the dynamics of lifestyles. In the characterization of categories of a particular order such as ethnicity, social class and the gender of the family leader, the mestizo race, low social insertion and the male gender prevailed. At the educational-labor level, the tendency to work at the middle level under subordination and informality with technical and basic studies predominates in more than 60%. Access to health is good, since more than 90% enjoy this service. At the level of exhibitions, the processes are varied, few supports are evident, socio-spatial environmental contamination in families, inequity in the territory, pathologization and myths about the condition of autism. Conclusions: it was possible to conclude that autism in Cartagena Colombia is not an isolated condition, but is subsumed under systems of the general, particular and singular order, which

[Effectiveness and safety of the surgical closure of permeable arteriosus conduct by the general pediatric surgeon: clinical trial]. / Eficacia y seguridad del cierre quirúrgico del conducto arterioso permeable por el cirujano pediatra general: ensayo clínico.

Antecedentes: El conducto arterioso permeable (CAP) es un defecto cardiaco congénito y se considera un problema de salud pública. Se presenta en un alto porcentaje de recién nacidos y en algunos mayores de 1 mes. El cierre farmacológico es el tratamiento inicial preferido, ya que ha tenido excelentes resultados; sin embargo, en aquellos casos en los que no es posible, está indicado el cierre quirúrgico. Objetivo: Evaluar la eficacia y la seguridad del cierre quirúrgico del CAP por cirujanos pediatras sin especialidad en cirugía cardiovascular. Método: Ensayo clínico realizado en pacientes del Hospital General de Occidente, centro hospitalario público de segundo nivel, con diagnóstico de CAP, que requirieron corrección quirúrgica. Se revisaron en forma retrospectiva los expedientes de enero de 2001 a diciembre de 2018. Resultados: Se incluyeron 224 pacientes divididos en dos grupos: grupo I, con 184 (82%) recién nacidos, y grupo II, con 40 (18%) niños grandes de 2 meses a 8 años de edad. A todos se les realizó cierre quirúrgico: 3 por toracoscopía y 221 por toracotomía posterolateral izquierda. Presentaron complicaciones 36 pacientes, lo que representa el 16% del total; solo el 5.3% fueron complicaciones mayores. Fallecieron 24 pacientes en el posoperatorio, lo que representa una mortalidad del 10.7%; ninguno falleció por complicaciones transquirúrgicas. El CAP es un defecto cardíaco congénito que se presenta en alto porcentaje en pacientes prematuros. El cierre farmacológico es el principal tratamiento por tener excelentes resultados en recién nacidos; sin embargo, en aquellos casos en los que no sea posible está indicado el cierre quirúrgico. Todos los pacientes fueron operados por cirujanos pediatras generales, con una sobrevida global del 92%. Conclusiones: En los hospitales donde no hay cirujano cardiovascular pediátrico ni cardiólogo intervencionista, la corrección quirúrgica del CAP puede ser llevada a cabo por un cirujano pediatra. La técnica es reproducible, fácil de realizar y con mínimas complicaciones. Background: The Patent Ductus Arteriosus (PDA) is congenital heart defect and is considered a public health problem. It occurs in a high percentage of newborns and in some older than 1 month. Pharmacological closure is the preferred initial treatment, as it has had excellent results; however, in those cases where it is not possible, surgical closure is indicated. Objective: The objective is to evaluate the efficacy and safety of the surgical closure of the patent PDA when it is carried out by pediatric surgeons without specialization in cardiovascular surgery. Methods: This study was conducted at the West General Hospital, a 2nd level public hospital, with the diagnosis of patent ductus arteriosus that required surgical correction. For the collection of the information, the files from January 2001 to December 2018 were retrospectively reviewed. Results: 224 patients were included; divided into two groups: Group I: 184 (82%) "newborns" and Group II: 40 (18%) "big children" with ages from 2 months to 8 years. All had a surgical closure; 3 by thoracoscopy and 221 by left posterolateral thoracotomy. 36 patients presented complications representing 16% of the total of patients, only 5.3% were major complications. 24 patients died in the postoperative period, representing a mortality of 10.7%, none died due to trans-surgical complications. PDA is a congenital heart defect that occurs in a high percentage of premature patients. The pharmacological closure is the principal treatment because it has had excellent results in newborns; however, in those cases where it is not possible, surgical closure it´s indicated. All patients were operated by general pediatric surgeons, with a global survival of 92%. Conclusions: We conclude that in hospitals where there is no pediatric cardiovascular surgeon or interventional cardiologist, the surgical correction of the PDA can be carried out by a general pediatric surgeon. The technique is reproducible, easy to perform and with minimal complications.

Eficacia y seguridad del cierre quirúrgico del conducto arterioso permeable por el cirujano pediatra general: ensayo clínico / Effectiveness and safety of the surgical closure of permeable arteriosus conduct by the general pediatric surgeon: clinical trial

Resumen Antecedentes: El conducto arterioso permeable (CAP) es un defecto cardiaco congénito y se considera un problema de salud pública. Se presenta en un alto porcentaje de recién nacidos y en algunos mayores de 1 mes. El cierre farmacológico es el tratamiento inicial preferido, ya que ha tenido excelentes resultados; sin embargo, en aquellos casos en los que no es posible, está indicado el cierre quirúrgico. Objetivo: Evaluar la eficacia y la seguridad del cierre quirúrgico del CAP por cirujanos pediatras sin especialidad en cirugía cardiovascular. Método: Ensayo clínico realizado en pacientes del Hospital General de Occidente, centro hospitalario público de segundo nivel, con diagnóstico de CAP, que requirieron corrección quirúrgica. Se revisaron en forma retrospectiva los expedientes de enero de 2001 a diciembre de 2018. Resultados: Se incluyeron 224 pacientes divididos en dos grupos: grupo I, con 184 (82%) recién nacidos, y grupo II, con 40 (18%) niños grandes de 2 meses a 8 años de edad. A todos se les realizó cierre quirúrgico: 3 por toracoscopía y 221 por toracotomía posterolateral izquierda. Presentaron complicaciones 36 pacientes, lo que representa el 16% del total; solo el 5.3% fueron complicaciones mayores. Fallecieron 24 pacientes en el posoperatorio, lo que representa una mortalidad del 10.7%; ninguno falleció por complicaciones transquirúrgicas. El CAP es un defecto cardíaco congénito que se presenta en alto porcentaje en pacientes prematuros. El cierre farmacológico es el principal tratamiento por tener excelentes resultados en recién nacidos; sin embargo, en aquellos casos en los que no sea posible está indicado el cierre quirúrgico. Todos los pacientes fueron operados por cirujanos pediatras generales, con una sobrevida global del 92%. Conclusiones: En los hospitales donde no hay cirujano cardiovascular pediátrico ni cardiólogo intervencionista, la corrección quirúrgica del CAP puede ser llevada a cabo por un cirujano pediatra. La técnica es reproducible, fácil de realizar y con mínimas complicaciones.

Abstract Background: The Patent Ductus Arteriosus (PDA) is congenital heart defect and is considered a public health problem. It occurs in a high percentage of newborns and in some older than 1 month. Pharmacological closure is the preferred initial treatment, as it has had excellent results; however, in those cases where it is not possible, surgical closure is indicated. Objective: The objective is to evaluate the efficacy and safety of the surgical closure of the patent PDA when it is carried out by pediatric surgeons without specialization in cardiovascular surgery. Methods: This study was conducted at the West General Hospital, a 2nd level public hospital, with the diagnosis of patent ductus arteriosus that required surgical correction. For the collection of the information, the files from January 2001 to December 2018 were retrospectively reviewed. Results: 224 patients were included; divided into two groups: Group I: 184 (82%) "newborns" and Group II: 40 (18%) "big children" with ages from 2 months to 8 years. All had a surgical closure; 3 by thoracoscopy and 221 by left posterolateral thoracotomy. 36 patients presented complications representing 16% of the total of patients, only 5.3% were major complications. 24 patients died in the postoperative period, representing a mortality of 10.7%, none died due to trans-surgical complications. PDA is a congenital heart defect that occurs in a high percentage of premature patients. The pharmacological closure is the principal treatment because it has had excellent results in newborns; however, in those cases where it is not possible, surgical closure it´s indicated. All patients were operated by general pediatric surgeons, with a global survival of 92%. Conclusions: We conclude that in hospitals where there is no pediatric cardiovascular surgeon or interventional cardiologist, the surgical correction of the PDA can be carried out by a general pediatric surgeon. The technique is reproducible, easy to perform and with minimal complications.

Visualization and quantification of mimetic musculature via DiceCT.

The muscles of facial expression are of significant interest to studies of communicative behaviors. However, due to their small size and high integration with other facial tissues, the current literature is largely restricted to descriptions of the presence or absence of specific muscles. Using diffusible iodine-based contrast-enhanced computed tomography (DiceCT) to stain and digitally image the mimetic mask of Eulemur flavifrons (the blue-eyed black lemur), we demonstrate-for the first time-the ability to visualize these muscles in three-dimensional space and to measure their relative volumes. Comparing these data to earlier accounts of mimetic organization with the face of lemuroidea, we demonstrate several novel configurations within this taxon, particularly in the superior auriculolabialis and the posterior auricularis. We conclude that DiceCT facilitates the study these muscles in closer detail than has been previously possible, and offers significant potential for future studies of this anatomy.

Comparison of oximeters for the detection of critical congenital heart diseases.

Introduction and objectives: In some centers, the pulse oximetry is not performed with the justification of lack of the adequate oximeter. We compared the effectiveness of two brands of oximeters to perform it. Methods: In neonates, a term of the joint housing service of the Hospital General de Occidente in Zapopan, Jalisco, Mexico, from May to November 2018, an examination of the characteristics of the American Academy of Pediatrics with both oximeters (ChoiceMMed® and Masimo SET®) was carried out, comparing the detection of critical congenital heart disease, time of intake, and false positives. Results: In each group, 1022 patients were analyzed; with the Masimo SET® oximeter, 83 positive tests were obtained (8.12%), of which 22 cases had some heart disease (26.5%), which represents a sensitivity of 100%, specificity of 93.9%, positive predictive value of 26.5%, and negative predictive value of 100% (odds ratio [OR]: 0.73; 95% confidence interval [CI] 0.6-0.8). With the ChoiceMMed® oximeter, 168 positive tests were obtained (16.4%), of which 22 cases had some heart disease (13.09%), with a sensitivity of 100%, specificity of 85.4%, positive predictive value of 13.09%, and negative predictive value 100% (OR: 0.86; 95%CI: 0.8-0.92). Regarding the time to perform the cardiac sieve, the mean in minutes of the Masimo SET® oximeter was 5.38 and the ChoiceMMed® oximeter was 9.7 min. Conclusions: The ChoiceMMed® oximeter contains a large number of false positives and a greater number of echocardiograms and comparatively longer cardiac screen printing with Masimo SET®, however, both with a negative predictive value of 100% eliminating such excuses.

Introducción y objetivos: En algunos centros el tamiz cardíaco no se realiza con la justificación de no tener el oxímetro adecuado. Comparamos la efectividad de dos marcas de oxímetros para realizarlo. Métodos: En los neonatos a término del Servicio de alojamiento conjunto del Hospital General de Occidente en Zapopan Jalisco México de mayo a noviembre del 2018 se realizó tamiz cardíaco según las guías de la Academia Americana de Pediatría con dos oxímetros, el Masimo SET® (aprobado por la FDA) y el ChoiceMMed®, comparando su efectividad para la detección de cardiopatías congénitas críticas, el tiempo de toma y los falsos positivos. Resultados: En cada grupo se analizaron 1,022 pacientes; con el oxímetro Massimo SET® se obtuvieron 83 pruebas positivas (8.12%) de las cuales 22 casos presentaron alguna cardiopatía (26.5%), lo que representa una sensibilidad del 100%, una especificidad del 93.9%, un valor predictivo positivo del 26.5% y un valor predictivo negativo del 100% (Odd Ratio [OR]: 0.73; IC 95%: 0.6-0.8). Con el oxímetro ChoiceMMed® se obtuvieron 168 pruebas positivas (16.4%), de las cuales 22 casos presentaron alguna cardiopatía (13.09%), con una sensibilidad del 100%, una especificidad del 85.4%, un valor predictivo positivo del 13.09% y un valor predictivo negativo del 100% (OR: 0.86; IC 95%: 0.8-0.92). En cuanto al tiempo para realizar el tamiz cardíaco, la media en minutos del oxímetro Masimo SET® fue 5.38 y del oxímetro ChoiceMMed® fue 9.7 minutos. Conclusiones: El oxímetro ChoiceMMed® presentó mayor cantidad de falsos positivos y mayor tiempo de realización del tamiz cardíaco en comparación al Masimo SET®, sin embargo, ambos presentan un valor predictivo negativo del 100%, siendo igualmente útiles como método de detección de cardiopatías críticas.

Comparación de oxímetros para detección de cardiopatías congénitas críticas.

Introduction and objectives: In some centers the pulse oximetry is not performed with the justification of lack of the adequate oximeter. We compared the effectiveness of two brands of oximeters to perform it. Methods: In neonates a term of the joint housing service of a Hospital General de Occidente in Zapopan Jalisco Mexico from May-November 2018, an examination of the characteristics of the American Academy of Pediatrics with both oximeters (ChoiceMMed® and Masimo SET®) was carried out, comparing the detection of critical congenital heart disease (CCC), time of intake and false positives. Results: In each group 1,022 patients were analyzed; with the Masimo SET® oximeter 83 positive tests were obtained (8.12%), of which 22 cases had some heart disease (26.5%), which represents a sensitivity of 100%, specificity of 93.9%, positive predictive value of 26.5% and negative predictive value of 100% (OR: 0.73; 95% CI: 0.6-0.8). With the ChoiceMMed® oximeter, 168 positive tests were obtained (16.4%), of which 22 cases had some heart disease (13.09%), with a sensitivity of 100%, specificity of 85.4%, positive predictive value of 13.09% and negative predictive value 100% (OR: 0.86; 95% CI: 0.8-0.92). Regarding the time to perform the cardiac sieve, the mean in minutes of the Masimo SET® oximeter was 5.38 and the ChoiceMMed® oximeter was 9.7 minutes. Conclusions: The ChoiceMMed® oximeter contains a large number of false positives and a greater number of echocardiograms and comparatively longer cardiac screen printing with Masimo SET®, however, both with a negative predictive value of 100% eliminating such excuses.

Introducción y objetivos: En algunos centros el tamiz cardíaco no se realiza con la justificación de no tener el oxímetro adecuado. Comparamos la efectividad de dos marcas de oxímetros para realizarlo. Métodos: En los neonatos a término del Servicio de alojamiento conjunto del Hospital General de Occidente en Zapopan Jalisco México de mayo a noviembre del 2018 se realizó tamiz cardíaco según las guías de la Academia Americana de Pediatría con dos oxímetros, el Masimo SET® (aprobado por la FDA) y el ChoiceMMed®, comparando su efectividad para la detección de cardiopatías congénitas críticas, el tiempo de toma y los falsos positivos. Resultados: En cada grupo se analizaron 1,022 pacientes; con el oxímetro Massimo SET® se obtuvieron 83 pruebas positivas (8.12%) de las cuales 22 casos presentaron alguna cardiopatía (26.5%), lo que representa una sensibilidad del 100%, una especificidad del 93.9%, un valor predictivo positivo del 26.5% y un valor predictivo negativo del 100% (Odd Ratio [OR]: 0.73; IC 95%: 0.6-0.8). Con el oxímetro ChoiceMMed® se obtuvieron 168 pruebas positivas (16.4%), de las cuales 22 casos presentaron alguna cardiopatía (13.09%), con una sensibilidad del 100%, una especificidad del 85.4%, un valor predictivo positivo del 13.09% y un valor predictivo negativo del 100% (OR: 0.86; IC 95%: 0.8-0.92). En cuanto al tiempo para realizar el tamiz cardíaco, la media en minutos del oxímetro Masimo SET® fue 5.38 y del oxímetro ChoiceMMed® fue 9.7 minutos. Conclusiones: El oxímetro ChoiceMMed® presentó mayor cantidad de falsos positivos y mayor tiempo de realización del tamiz cardíaco en comparación al Masimo SET®, sin embargo, ambos presentan un valor predictivo negativo del 100%, siendo igualmente útiles como método de detección de cardiopatías críticas.

Comparación de oxómetros para detección de cardiopatías congénitas críticas / Comparison of oximeters for the detection of critical congenital heart diseases

Resumen Introducción y objetivos: En algunos centros el tamiz cardíaco no se realiza con la justificación de no tener el oxímetro adecuado. Comparamos la efectividad de dos marcas de oxímetros para realizarlo. Métodos: En los neonatos a término del Servicio de alojamiento conjunto del Hospital General de Occidente en Zapopan Jalisco México de mayo a noviembre del 2018 se realizó tamiz cardíaco según las guías de la Academia Americana de Pediatría con dos oxímetros, el Masimo SET (aprobado por la FDA) y el ChoiceMMed, comparando su efectividad para la detección de cardiopatías congénitas críticas, el tiempo de toma y los falsos positivos. Resultados: En cada grupo se analizaron 1,022 pacientes; con el oxímetro Massimo SET se obtuvieron 83 pruebas positivas (8.12%) de las cuales 22 casos presentaron alguna cardiopatía (26.5%), lo que representa una sensibilidad del 100%, una especificidad del 93.9%, un valor predictivo positivo del 26.5% y un valor predictivo negativo del 100% (Odd Ratio [OR]: 0.73; IC 95%: 0.6-0.8). Con el oxímetro ChoiceMMed se obtuvieron 168 pruebas positivas (16.4%), de las cuales 22 casos presentaron alguna cardiopatía (13.09%), con una sensibilidad del 100%, una especificidad del 85.4%, un valor predictivo positivo del 13.09% y un valor predictivo negativo del 100% (OR: 0.86; IC 95%: 0.8-0.92). En cuanto al tiempo para realizar el tamiz cardíaco, la media en minutos del oxímetro Masimo SET fue 5.38 y del oxímetro ChoiceMMed fue 9.7 minutos. Conclusiones: El oxímetro ChoiceMMed presentó mayor cantidad de falsos positivos y mayor tiempo de realización del tamiz cardíaco en comparación al Masimo SET, sin embargo, ambos presentan un valor predictivo negativo del 100%, siendo igualmente útiles como método de detección de cardiopatías críticas.

Abstract Introduction and objectives: In some centers the pulse oximetry is not performed with the justification of lack of the adequate oximeter. We compared the effectiveness of two brands of oximeters to perform it. Methods: In neonates a term of the joint housing service of a Hospital General de Occidente in Zapopan Jalisco Mexico from May-November 2018, an examination of the characteristics of the American Academy of Pediatrics with both oximeters (ChoiceMMed and Masimo SET) was carried out, comparing the detection of critical congenital heart disease (CCC), time of intake and false positives. Results: In each group 1,022 patients were analyzed; with the Masimo SET oximeter 83 positive tests were obtained (8.12%), of which 22 cases had some heart disease (26.5%), which represents a sensitivity of 100%, specificity of 93.9%, positive predictive value of 26.5% and negative predictive value of 100% (OR: 0.73; 95% CI: 0.6-0.8). With the ChoiceMMed oximeter, 168 positive tests were obtained (16.4%), of which 22 cases had some heart disease (13.09%), with a sensitivity of 100%, specificity of 85.4%, positive predictive value of 13.09% and negative predictive value 100% (OR: 0.86; 95% CI: 0.8-0.92). Regarding the time to perform the cardiac sieve, the mean in minutes of the Masimo SET oximeter was 5.38 and the ChoiceMMed oximeter was 9.7 minutes. Conclusions: The ChoiceMMed oximeter contains a large number of false positives and a greater number of echocardiograms and comparatively longer cardiac screen printing with Masimo SET, however, both with a negative predictive value of 100% eliminating such excuses.

The pro-atherogenic response to disturbed blood flow is increased by a western diet, but not by old age.

Atherogenic remodeling often occurs at arterial locations with disturbed blood flow (i.e., low or oscillatory) and both aging and western diet (WD) increase the likelihood for pro-atherogenic remodeling. However, it is unknown if old age and/or a WD modify the pro-atherogenic response to disturbed blood flow. We induced disturbed blood flow by partial carotid ligation (PCL) of the left carotid artery in young and old, normal chow (NC) or WD fed male B6D2F1 mice. Three weeks post-PCL, ligated carotid arteries had greater intima media thickness, neointima formation, and macrophage content compared with un-ligated arteries. WD led to greater remodeling and macrophage content in the ligated artery compared with NC mice, but these outcomes were similar between young and old mice. In contrast, nitrotyrosine content, a marker of oxidative stress, did not differ between WD and NC fed mice, but was greater in old compared with young mice in both ligated and un-ligated carotid arteries. In primary vascular smooth muscle cells, aging reduced proliferation, whereas conditioned media from fatty acid treated endothelial cells increased proliferation. Taken together, these findings suggest that the remodeling and pro-inflammatory response to disturbed blood flow is increased by WD, but is not increased by aging.

Cierre de conducto arterioso con paracetamol: estudio piloto / Ductus arteriosus closure with paracetamol: a pilot study

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Experiencia en el cierre quirúrgico de ducto arterioso permeable en la Unidad de Cuidados Intensivos Neonatales (UCIN) de un hospital de segundo nivel en Guadalajara, Jalisco, México / Experience in the surgical closure of patent ductus arteriosus in the Neonatal Intensive Care Unit of a second-level hospital in Guadalajara, Jalisco, Mexico

Introducción. El ducto arterioso permeable (DAP) es la cardiopatía congénita más frecuente; afecta hasta el 80% de los recién nacidos pretérmino de extremado bajo peso al nacer (<1 000 g). Actualmente se considera un importante problema de salud pública. El objetivo de este trabajo es demostrar que es posible realizar cierre quirúrgico de DAP en pacientes prematuros, en un hospital de 2° nivel que cuente con un cirujano pediatra entrenado. Métodos. Se analizaron los antecedentes, evolución clínica y manejo quirúrgico de 31 pacientes con diagnóstico de DAP. Los criterios para cierre quirúrgico fueron: 1) fracaso al cierre farmacológico, 2) hipertensión pulmonar moderada a severa con flujo de izquierda a derecha, 3) ecocardiograma con conducto mayor de 1.5 mm y relación Qs/Qp mayor de 1.5:1, 4) más de 5 días de vida extrauterina con DAP-HS. El abordaje fue por toracotomía posterolateral izquierda con disección extrapleural y cierre del DAP con doble ligadura de seda 2-0. Resultados. Se estudiaron 31 pacientes, 19 masculinos y 12 femeninos. La edad varió entre 30 y 35 semanas de gestación; el peso osciló entre 1 y 1.5 kg. El ecocardiograma confirmó el diagnóstico en el 100% de los pacientes. Todos se operaron entre 7 y 10 días de vida extrauterina, 15 de ellos no recibieron tratamiento farmacológico por haber sido diagnosticados tardíamente, 12 por falla al tratamiento farmacológico y 4 hubo alguna contraindicación médica para cierre farmacológico (sepsis, Insuficiencia renal aguda y/o alteraciones de la coagulación). No hubo muertes a consecuencia de la cirugía; los pacientes que fallecieron (5) fue entre 15-20 días posteriores a la cirugía, por otros problemas agregados. Todos los pacientes que sobrevivieron (26 pacientes) pudieron extubarse en un periodo de 2-5 días después de la cirugía. Conclusiones. El cierre quirúrgico de DAP es factible de llevar a cabo en un hospital de 2° nivel, cuando las indicaciones para cierre farmacológico no son posibles. Es un procedimiento sencillo, con complicaciones mínimas, que puede realizarse en la misma Unidad de Cuidados Intensivos Neonatales (UCIN), como demuestran nuestros resultados, con nula mortalidad transoperatoria.

Background: Patent ductus arteriosus (PDA) is the most common congenital cardiac defect affecting 80% of very low birth weight preterm newborns (<1 000 g) and is considered an important public health issue. The aim was to demonstrate that it is possible to perform surgical closure of PDA on premature newborns in a second-level hospital. Methods: We analyzed backgrounds and clinical evolution of 31 surgically treated patients with PDA. Criteria for surgical closure were 1) pharmacological closure failure, 2) pulmonary hypertension with left to right shunt, 3) echocardiogram with ductal diameter >1.5 mm, and Qs/Qp ratio (>1.5:1. 4) at >5 days of extrauterine life. All patients were operated using left posterolateral thoracotomy with extrapleural dissection and ductus closure with a 2-0 double silk ligature. Results: We studied 31 patients: 19 males and 12 females. Age range was between 30 and 35 weeks of gestational age. Birth weight was between 1 and 1.5 kg. Echocardiogram was confirmatory in 100% of patients; 15 patients did not have pharmacological closure, 12 had pharmacological closure failure, and 4 had medical contraindication for pharmacological closure (sepsis, renal failure and coagulation disturbances). There was no surgical mortality. In patients who died (five patients), it was after 15 or 20 postoperative days and due to problems unrelated to the surgical procedure. Conclusions: Surgical closure of PDA is feasible to perform in a second-level hospital with minimal complications. This was demonstrated with our results in those patients in whom pharmacological closure failed or was not indicated.

[Proximal pancreatectomy in a case of nesidioblastosis]. / Pancreatectomía proximal en nesidioblastosis.

A 19 moth-old child who presented seizures secondary to intractable hypoglycemia, fulfilling the clinical and biochemical criteria for hyperinsulinism was studied. Histopathological findings of the pancreas showed the presence of small clusters of b cell islets throughout acinar tissue near ducts, in both the head and the proximal third of the body. Proximal pancreatectomy (60%) and distal pancreatic-jejunostomy (Roux-in-Y) were performed. This procedure was effective in reverting hypoglycemia and constitutes the first successful alternative treatment.

Pancreatectomía proximal en nesidioblastosis / Proximal pancreatectomy in case of nesidioblastosis

En 1938 Laidiaw acuñó el término de nesidioblastosis refiriéndose a una neodiferenciación de los islotes de Langerhans, originada del epitelio de los conductos pancreáticos. Se presenta un caso clínico de un niño de 19 meses de edad, con convulsiones secundarias a hipoglucemia intratable. Se diagnosticó hiperinsulinismo con base en criterios clínicos y bioquímicos. Los hallazgos histopatológicos del páncreas mostraron la presencia de racimos de islotes de células P por todo el tejido acinar localizados en cabeza y un tercio proximal del cuerpo. Se realizó el diagnóstico de nesidioblastosis y para su tratamiento se practicó pancreatectomía proximal (60%), con una pancreático yeyunostomía distal (Y en Roux). Después del tratamiento, el paciente tuvo normalización de los niveles séricos de glucosa y de insulina. Se concluye que este procedimiento resultó efectivo al revertir la hipoglucemia, por lo que constituye el primer tratamiento alternativo al método convencional.

A 19 month old child who presented seizures secondary to intractable hypoglycemia, fulfilling the clinical and biochemical criteria for hyperinsulinism was studied. Histopathological findings of the pancreas showed the presence of small clusters of b cell islets throughout acinar tissue near ducts, in both the head and the proximal third of the body. Proximal pancreatectomy (60%) and distal pancreatic jejunostomy (Roux in Y) were performed. This procedure was effective in reverting hypoglycemia and constitutes the first successful alternative treatment.

Cáncer del seno y factores asociados en el Instituto Nacional de Cancerología enero-junio 1990 / Breast cancer and associated factors

Se estudió la frecuencia de aparición del cáncer de seno asociada a la presencia de ciertos factores que se han encontrado involucrados en esta patología clasificados en dos grupos en esta patología clasificados en dos grupos principales: Factores de riesgo: edad, secuencia, sexo menarquia, menopausia, edad de primer parto, número de hijos, zona de procedencia del país, antecedente de cáncer de seno o de otro cáncer en la familia, lactancia materna, uso de anovulatorios y antecedente de enfermedad fibroquística en la paciente. Como factores pronósticos se tomaron tipo histológico, metástasis, lado, cuadrante, estado se analizó como una variable de control. Se tomó para este estudio el universo de pacientes que acudieron a consulta de seno del Instituto Nacional de Cancerología (INC), durante el primer semestre de 1990, teniendo en cuenta que este centro asistencial sirve como fuente de remisión de todo el país. Se encontró que las edades de mayor frecuencia de aparición están entre los 40 y 44 años y entre los 60 y 64 años. Las pacientes del grupo que tuvieron una menopausia tardía con menarquia temprana fueron las de menor frecuencia de aparición, contradiciendo diversos estudios. La zona urbana se encontró con mayor incidencia de presentación de cáncer. Se presentó una menor incidencia de cáncer de seno en pacientes con un mayor número de hijos. Los antecedentes negativos de cáncer en alguno de los miembros de ella. Este estudio debe completarse con estudios posteriores que amplíen los conocimientos en temas referentes ya sea a pronóstico o a tratamiento, ya que este trabajo no profundizó en el tema de pronóstico y no se evaluó el tópico del tratamiento