2,4-Dichlorophenol Shows Estrogenic Endocrine Disruptor Activity by Altering Male Rat Sexual Behavior.

Chlorophenols (CPs) have been extensively used worldwide as a treatment to prevent the growth and proliferation of different microorganisms, mainly in the wood and farm industries. Chlorine has been used for water disinfection, and phenol groups are water contaminants; these two groups can react with each other to form species such as 2,4-dichlorophenol (2,4-DCP). 2,4-DCP is still used as an herbicide in many countries such as Mexico. CPs have been largely analyzed, like bisphenol A, for their probable endocrine-disrupting effects in humans and aquatic animals. We still do not understand whether these endocrine responses can be manifested as an impairment in sexual behavior in rodents. With the present toxicology study, the endocrine-disrupting effects of 2,4-DCP on male sexual behavior were investigated. Sexually naïve male Wistar rats were used to assess the endocrine-disrupting effects of 2,4-DCP. The rats were divided into two groups: one control group and one experimental group that was administered 1.25 mg/day of 2,4-DCP for 45 days. After completing treatment, the male sexual behavior of the rats was evaluated. The results of this investigation demonstrated that 2,4-DCP affected male sexual behavior. A decrease in mount latency, intromission latency, and post ejaculation period compared with the control animals was found.

Piezoelectric signals of HAp and collagen with different glucose concentrations: A method for diabetes detection.

Piezoelectric signals were obtained from samples based on hydroxyapatite (HAp) and collagen (C) containing different glucose (G) concentrations. HAp was obtained by coprecipitation using Ca2+ and HPO42- as precursor ions in solution. C and G were added at the beginning of the coprecipitation method during the HAp growth. The presence of glucose in HAp and collagen samples drastically reduces the voltage amplitudes and considerably increases the relaxation times of the piezoelectric signals. HAp and collagen are the main constituents of bone, muscle, etc., then, it is possible to use piezoelectric technology for local and early detection of high glucose concentrations: small pressures applied by electrodes or by actuators placed in appropriate places on the body to establish a background concentration and, from this, to determine regions of the body with high local glucose concentrations: weak signals and large relaxation times are associated with a diminishing in the sensitivity, and are indicative of the presence of regions of abnormally high glucose concentrations.

Improving thromboprophylaxis in the medical inpatients: The role of the resident in an academic hospital.

INTRODUCTION: Venous thromboembolism (VTE) is one of the main causes of preventable in-hospital death. It is recommended for hospitals to have an appropriate thromboprophylaxis (TP) protocol to avoid VTE complications. OBJECTIVE: To determine the effect of the resident physician feedback to the staff physician in TP appropriateness after the Caprini RAM score implementation. METHODS: Caprini RAM was implemented by the residents in medical patients. Patients were divided in low, moderate, high, and highest-risk groups, with TP recommendation accordingly. In cases with inadequate TP, the resident provided feedback to the staff physician for adjustment. Change to appropriate TP was assessed retrospectively. RESULTS: A total of 265 records were included. Before intervention, 193 (72.8%) patients had appropriate TP and post-intervention, 207 (78.1%) patients received adequate TP (p < .001). CONCLUSIONS: Feedback from the internal medicine resident to staff physician improves appropriate TP in medical inpatients as a quality of care strategy.

The Golden Compass Program: Overview of the Initial Implementation of a Comprehensive Program for Older Adults Living with HIV.

The population with HIV is aging and has unique health needs. We present findings from an evaluation of the geriatric-HIV program, Golden Compass, at San Francisco General Hospital. We used the implementation science framework, RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) to guide the evaluation and used quantitative and qualitative methods to assess RE-AIM dimensions. From January 2017 to June 2018, 198 adults age ≥50 years participated in the program, with an estimated reach of 17%. Providers and patients indicated high acceptability of the program and were satisfied with clinics and classes. Colocation of services, specific pharmacy and geriatric assessments, and social support from classes were valued (effectiveness). Provider adoption was high, and the program was implemented as originally designed. Areas for improvement included challenges of framing aging services to patients. Future efforts will focus on expanding the reach of the program and examining long-term outcomes.

Lebedev scheme for ultrasound simulation in composites.

The growing use of composite materials for aerospace applications has resulted in a need for quantitative nondestructive evaluation (NDE) methods appropriate for characterizing damage in composite components. NDE simulation tools, such as ultrasound models, can aid in enabling optimized inspection methods and establishing confidence in inspection capabilities. In this paper a mathematical approach using the Lebedev Finite Difference (LFD) method is presented for ultrasonic wave simulation in composites. Boundary condition equations for implementing stress-free boundaries (necessary for simulation of NDE scenarios) are also presented. Quantitative comparisons between LFD guided wave ultrasound simulation results, experimental guided wave data, and dispersion curves are described. Additionally, stability tests are performed to establish the LFD code behavior in the presence of stress-free boundaries and low-symmetry anisotropy. Results show that LFD is an appropriate approach for simulating ultrasound in anisotropic composite materials and that the method is stable in the presence of low-symmetry anisotropy and stress-free boundaries. Studies presented in this paper include guided wave simulation in hexagonal, monoclinic, triclinic and layered composite laminates.

Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis.

Patients with rheumatoid arthritis (RA) have a high risk for comorbid conditions which increase mortality, hospital admissions, costs of care and inability. To evaluate the prevalence of comorbidities in Mexican mestizo patients with RA and determine the associated risk factors. Cross-sectional study in which RA patients admitted to our outpatient clinic were consecutively enrolled. We collected data regarding demographics, disease characteristics and comorbidities at the time of the patient's visit to the clinic. We analyzed 225 patients. Their mean age was 55.7 ± 8.3 years; disease duration, 9.5 (3.8-15.5) years; female gender, 93.8%; Disease Activity Score using 28 joints-C-reactive protein, 3 (2-4); methotrexate use, 84.9%; use of any other conventional disease modifying anti-rheumatic drug, 65.7%; use of biological agents, 8%. The most frequently associated diseases were: hypertension, 29.8%; dyslipidemia, 27.1%; osteoporosis, 19.1%; diabetes, 12.4%; hypothyroidism, 6.2%; solid malignancies 4.4%. Risk factors were also evaluated, the most prevalent was overweight in 101 (44.9%) of our patients. A total of 71 (31.6%) had obesity. We also detected high blood pressure in 12.4%, hyperglycemia in 27.1% and hyperlipidemia in 49.8%. Due to the high frequency of comorbidities among RA patients, it is important to follow existing recommendations for their timely detection and management. Cardiovascular diseases must be evaluated with priority. The initial evaluation should include a thorough examination to prevent the deleterious effect of comorbidities in RA.

Body frame size in school children is related to the amount of adipose tissue in different depots but not to adipose distribution.

OBJECTIVES: The main aim of this study was to test the hypothesis that body frame size is related to the amount of fat in different adipose tissue depots and to fat distribution in schoolchildren. METHODS: Children aged between 5 and 10 years were included in this cross-sectional study (n = 565). Body frame size, adiposity markers (anthropometric, skinfolds thickness, and ultrasound measures), and fat distribution indices were analyzed. Correlation coefficients adjusted by reliability were estimated and analyzed by sex; the significance of the difference between two correlation coefficients was assessed using the Fisher z-transformation. RESULTS: The sample included primarily urban children; 58.6% were normal weight, 16.1% overweight, 19.6% obese, and the rest were underweight. Markers of subcutaneous adiposity, fat mass and fat-free mass, and preperitoneal adiposity showed higher and significant correlations with the sum of the biacromial + bitrochanteric diameter than with the elbow diameter, regardless of sex. The fat distribution conicity index presented significant but weak correlations; and visceral adipose tissue, hepatic steatosis, and the waist-for-hip ratio were not significantly correlated with body frame size measures. CONCLUSIONS: Body frame size in school children was related to the amount of adipose tissue in different depots, but not adipose distribution. More studies are needed to confirm this relationship and its importance to predict changes in visceral fat deposition during growth.

Synthesis and characterization of a HAp-based biomarker with controlled drug release for breast cancer.

A biocompatible hybrid porous polymer-ceramic material was synthesized to be used as a biomarker in the treatment of breast cancer. This device was equipped with the capacity to release medicaments locally in a controlled manner. The biomaterial was Hydroxyapatite(HAp)-based and had a controlled pore size and pore volume fraction. It was implemented externally using a sharp end and a pair of barbed rings placed opposite each other to prevent relative movement once implanted. The biomarker was impregnated with cis-diamine dichloride platinum (II) [Cl2-Pt-(NH3)2]; the rate of release was obtained using inductively coupled plasma atomic emission spectroscopy (ICP-AES), and release occurred over the course of three months. Different release profiles were obtained as a function of the pore volume fraction. The biomaterial was characterized using scanning electron microscopy (SEM) and Raman spectroscopy.

Determination of lead ion removal from a flowing electrolyte in the presence of a magnetic field using Raman spectroscopy.

PURPOSE: The authors report on the development of a new, noninvasive method to efficiently remove metal ions in aqueous solution flowing in a tube and to quantify the concentrations of those ions. Such a technique could be used to remove toxic ions in the interiors of arteries and veins in patients intoxicated by the ingestion of metal ions. METHODS: A magnetic field is applied to an aqueous electrolyte flowing in a specially designed rectangular cell in order to deflect the ion trajectories and concentrate them at one side of a cell. Once the ions are concentrated, they can be removed. Raman spectroscopy is used to promptly determine the concentration of the removed lead ions. RESULTS: It is possible to increase, on one side of the cell, the ion concentration by more than 80% with respect to the average concentration; the removed ions were taken from this high concentration region. This approach is a rapid, efficient, and noninvasive method for the removal of ions in aqueous solution. Raman spectroscopy was found to be a suitable technique to determine the amount of removed ions. CONCLUSIONS: The results indicate that the ion concentration can be increased more than 80% in a region where they can be removed. The increment in the ion concentration produced by the deflection due to the magnetic field, together with the use of Raman spectroscopy, allows for a rapid analysis of the removed ions without any previous preparation. The proposed method is a potentially useful method for metal ion separation of interest in the medical physics field.

[Pituitary tumor detected prenatally]. / Tumor hipofisiario detectado prenatalmente.

INTRODUCTION: Brain tumors are present in 2.9 per 100,000 newborn. Craniopharyngioma is a benign and slow growing brain tumor, frequently localized in the sellar and suprasellar region. There are few reports of pituitary tumor detected prenatally. CASE REPORT: We report a neonate with a craniopharyngioma detected prenatally as a pituitary tumor. In a 23 year old mother, second gestation, with no important history, was detected a sellar tumor at 31 gestation weeks, the obstetric ultrasound reported a suprasellar tumor of 2 per 3 cm diameter. Pregnancy ended in a vaginal delivery at 39 weeks, and obtained a 3.9 kg female, with cephalic diameter of 37.5 cm, the Apgar score was 8-9 at 1st and 5th minutes. In early neonatal period was scanned and confirmed a 3.2/2.3/2.9 cm suprasellar tumor with calcium deposits. The Paediatric Oncology department suggested a surgery and was realized a craniotomy at 3rd week of age. The surgery allowed to obtain 30% of the tumor and confirmed by histology craniopharyngioma. Patient had favourable evolution and was discharged at 3 months of age. CONCLUSIONS: We report a neonate in who was detected by prenatal ultrasound the presence of a suprasellar solid tumor, scan and magnetic resonance images in neonatal period defined its size and location and a craniopharyngioma was confirmed by histology. Patient had a satisfactory postsurgical evolution and was discharged at 3 months of age.

Infarto cerebral espontáneo en un recién nacido de término / Spontaneous cerebral infarction in a full-term neonate

Introducción. Un accidente cerebro-vascular de origen isquémico y/o hemorrágico aumenta la morbi-mortalidad neonatal. Se estima que ocurre en 1:4,000 recién nacidos. En este trabajo se reporta un recién nacido de término con un accidente cerebro-vascular aparentemente espontáneo. Caso Clínico. Se trata de un recién nacido, madre de 31 años, segunda gesta de término que cursó con diabetes gestacional y fue tratada sólo con dieta. Inició con trabajo de parto a las 41.5 semanas de gestación por FUM; se efectuó cesárea por desproporción céfalo pélvica. Se obtuvo producto femenino de 3,640 g calificado con Apgar 8-9, se le aplicaron sólo pasos iniciales de reanimación. En el primer día de vida presentó desviación de la comisura labial a la derecha y movimientos tónico-clónicos en hemicuerpo derecho en 2 ocasiones; se inició fenobarbital. Los resultados de laboratorio para glucemia, sodio, calcio, potasio, creatinina, tiempos de coagulación y biometría hemática fueron normales; los cultivos de líquido cefalo-raquídeo fueron negativos, la punción lumbar se consideró traumática. El ultrasonido fontanelar no mostró alteraciones sugestivas de un evento hemorrágico ni alteraciones a nivel ventricular; sin embargo, al tercer día de vida se practicó tomografía axial computarizada de cráneo simple visualizándose una zona hipodensa con un patrón geográfico hacia la región tempo-parietal izquierda con aspecto de evento vascular isquémico en el territorio de la arteria cerebral media. Conclusiones. Se continuó con fenobarbital y ácido acetilsalicílico. Permaneció asintomática por lo que se egresó al séptimo día de vida. Se citó a consulta externa en Neurología Pediátrica.

Background. Cerebral vascular accident (CVA) is an important cause of hemorrhagic or ischemic cerebral injury and increases neonatal morbidity and mortality. It occurs in 1/4000 term neonates. We report a case of a neonate with a spontaneous CVA. Case report. We present the case of a newborn (NB) who was delivered from a 31-year old mother. It was the second pregnancy with 41.5 gestation weeks. The mother presented gestational diabetes controlled only by dietary therapy. A 3640 g, apparently healthy female was obtained by cesarean delivery that was indicated due to cephalopelvic disproportion. Apgar scores were 8-9 according to the conventional time points. The pediatrician used only initial steps of reanimation. During the first day of life, the infant presented a deviation of the right mouth commissure and tonic-clonic movements on the right half of the body two times. The newborn was treated with phenobarbital intravenous infusion. Laboratory tests were all normal, and cultures of cerebrospinal fluid and blood were considered negative. A head sonogram showed no evidence of hemorrhage or ventricular distortion but a cranial CT reported a low-density zone suggesting a cerebral infarction in the left parietal and temporal regions. Conclusions. We continued to treat with phenobarbital and acetylsalicylic acid and the patient remained asymptomatic prior to discharge at the 7th day of life, recommending follow-up with a pediatric neurologist.

[Prenatal dexametasone and periventricular leucomalacia in prematures]. / Uso prenatal de dexametasona para leucomalacia periventricular en niños prematuros.

BACKGROUND: Prematurity is observed in 5-8% of deliveries, and is frequent cause of handicap. Premature have 5-24% risk for developing periventricular leukomalacia (PLM). The use of antenatal steroids (AS) is controversial for preventing PLM. METHODS: We studied 110 premature neonates < 1500 g, divided in 2 groups: control (group 1, n = 55), and group 2 (n = 55) who received antenatal dexamethasone. We registered clinical data, evolution and use of oxygen or mechanical ventilation. At one month age a transfontanelar ultrasound was done looking specific PLM. RESULTS: In group 1, found 6/55 (10.9%) with PLM and 3/55 (5.4%) in group 2, RR = 0.5, CI 95% (0.13-1.90). In group 1: 30/55 (54.54%) the ultrasound was normal; in 16 (29%) had intraventricular haemorrhage, and in 3 cases (5.45%) had severe hydrocephalus. In group 2: 32/55 (58.18%) ultrasound was normal, 16/55 (29%) had intraventricular haemorrhage, 4/55 (7.27%) had severe hydrocephalus. We did not find significant difference between other variables in both groups. CONCLUSIONS: There was no significant difference in PLM incidence between patients who did or did not received antenatal dexamethasone.

[Prenatal diagnosis of pulmonary valve stenosis and immediate neonal valvuloplasty]. / Diagnóstico prenatal de estenosis pulmonar grave y valvuloplastia neonatal inmediata. Reporte de un caso.

UNLABELLED: There are few reports of prenatal diagnosis of severe pulmonary valvar stenosis (PVS). It affects 1/22,000 newborn and represents 8-10% of total congenital cardiac defects. Clinic CASE: we report a case of a neonate in which was prenatally detected a pulmonary valvar stenosis and was successfully corrected with early valvuloplasty. From a 36-Year-old woman sent to evaluation to the fetal maternal unit because a tricuspid valvar insufficiency detected at 36 gestation weeks (GW). A VPS was suspected before born and a pregnancy ended in programated caesarean delivery at 38 GW, obtaining a 3 kg male, in which early echocardiography reported a severe PVS, promptly was initiated prostaglandin E1 (PgE1) infusion avoiding patent ductus arteriosus (PDA) closure, following a percutaneus balloon dilatation valvuloplasty at 48 hours, improving cyanosis and transvalvular Doppler flow. CONCLUSION: we report a neonate referred with an opportune prenatal diagnosis of tricuspid insufficiency and confirmed a severe PVS, PgE1 was infused immediately after born, allowing successfully balloon dilatation valvuloplasty in first 48 hours.

Acalasia, alacrima sin insuficiencia suprarrenal, con disfunción neurológica periférica y autonómica (síndrome de Allgrove) / Achalasia, alacrima without adrenal insufficiency, with pheripheral and autonomic neurological dysfunction (Allgrove's syndrome)

Objetivo. Presentar un paciente con síndrome de Allgrove y disfunción neurológica periférica y autonómica. Un caso no informado previamente en la literatura médica nacional. Antecedentes. El síndrome de Allgrove es una entidad patológica poco común caracterizada por acalasia, alacrima (ausencia de lágrimas) e insuficiencia suprarrenal el cual se presenta por lo general en niños. En la literatura se han descrito casos aislados. La serie más grande, consistente en 20 pacientes procedentes de varios países de Europa, fue publicada en 1993. Método. Se describe un caso clínico compatible con síndrome de Allgrove y se realiza un revisión bibliográfica haciendo énfasis en las alteraciones neurológicas las cuales no han sido bien caracterizadas en estos pacientes. Resultados. Se presenta un paciente de 12 años de edad quien fue admitido al hospital por sifagia. Se sospechó el diagnóstico de acalasia por endoscopia, esofagograma y se confirmó por manometría. El examan clínico mostró además alacrima y datos de disfunción neurológica y del intelecto. La prueba de estimulación suprarrenal con ACTH (Cortosin) fue normal. La evaluación neurológica mostró datos de neuropatía periférica de predominio motor y axonal; datos clínicos de neuropatía autonómica; afección de la vía corticoespinal y retraso psicomotor y del coeficiente intelectual. Conclusiones. El síndrome de Allgrove debe incluirse en el diagnóstico diferencial de los infantes con acalasia. La insuficiencia suprarrenal podría aparecer después de realizado el diagnóstico de la enfermedad. La disfunción neurológica parece ser la lesión más prominente de este síndrome

Diagnóstico de insulinoma por resonancia magnética / Insulinoma diagnosis by magnetic resonance imaging

Objetivo. El propósito de este reporte es el de dar relevancia al uso de la imagen por resonancia magnética, método que brinda una excelente caracterización de tejidos, siendo sumamente útil en el diagnóstico de pequeños tumores del páncreas. Antecedente. La tomografía axial y la angiografía han sido empleados como los métodos tradicionales en la detección de neoplasias pancreáticas, dependiendo ambos métodos de grandes cantidades de contraste intravenoso para identificar básicamente lesiones bien vascularizadas. Método. Se utilizó un equipo de resonancia de medio campo magnético (.5 Tesla) pra descartar tumor pancreático en una paciente femenina de 37 años con hipoglicemia y que en forma previa había sido tratada por crisis convulsivas. Resultado. Se identificó un nódulo hipointenso de 1.0 cm en la unión del cuerpo y la cola del páncreas, corroborado por cirugía y patología como tumor de células insulares. Conclusiones. La imagen por resonancia magnética, por su capacidad de proporcionar contraste de tejidos y amplia resolución espacial, como en el caso aquí presentado, es el método no invasivo ideal en la identificación de tumores insulares del páncreas

Drenaje percutáneo y escleroterapia de quistes hepáticos simples no parasitarios / Percutaneous drainage and sclrotherapy of non parasitic simple liver cysts

Se informan las historias de dos pacientes con diagnóstico de quistes simples no parasitarios del hígado que dado su gran volumen, daban sintomatología importante. El manejo, tradicionalmente quirúrgico fue efectuado mediante punción y drenaje percutáneo colocando un catéter externo para su drenaje completo. El procedimiento fue guiado mediante ultrasonido. la posibilidad de recidiva fue descartada mediante la esclerosis de las paredes del quiste con la administracíon de hidropolietoxidodecano