Testicular Evaluation Using Shear Wave Elastography (SWE) in Patients with Varicocele.

PURPOSE: To assess the possible influence of the presence of varicocele on the quantification of testicular stiffness. METHODS: Ultrasound with shear wave elastography (SWE) was performed on 48 consecutive patients (96 testicles) referred following urology consultation for different reasons. A total of 94 testes were studied and distributed in three groups: testes with varicocele (group A, n = 19), contralateral normal testes (group B; n = 13) and control group (group C, n = 62). Age, testicular volume and testicular parenchymal tissue stiffness values of the three groups were compared using the Kruskal-Wallis test. RESULTS: The mean age of the patients was 42.1 ± 11.1 years. The main reason for consultation was infertility (64.6%). The mean SWE value was 4 ± 0.4 kPa (kilopascal) in group A, 4 ± 0.5 kPa in group B and 4.2 ± 0.7 kPa in group C or control. The testicular volume was 15.8 ± 3.8 mL in group A, 16 ± 4.3 mL in group B and 16.4 ± 5.9 mL in group C. No statistically significant differences were found between the three groups in terms of age, testicular volume and tissue stiffness values. CONCLUSION: Tissue stiffness values were higher in our control group (healthy testicles) than in patients with varicocele.

Current and Advanced Applications of Gadoxetic Acid-enhanced MRI in Hepatobiliary Disorders.

Gadoxetic acid is an MRI contrast agent that has specific applications in the study of hepatobiliary disease. After being distributed in the vascular and extravascular spaces during the dynamic phase, gadoxetic acid is progressively taken up by hepatocytes and excreted to the bile ducts during the hepatobiliary phase. The information derived from the enhancement characteristics during dynamic and hepatobiliary phases is particularly relevant in the detection and characterization of focal liver lesions and in the evaluation of the structure and function of the liver and biliary system. The use of new MRI sequences and advanced imaging techniques (eg, relaxometry, multiparametric imaging, and analysis of heterogeneity), the introduction of artificial intelligence, and the development of biomarkers and radiomic and radiogenomic tools based on gadoxetic acid-enhanced MRI findings will play an important role in the future in assessing liver function, chronic liver disease, and focal liver lesions; in studying biliary pathologic conditions; and in predicting treatment responses and prognosis. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.

[Economic cost of pregnancy care attributable to the failure of Mexico's teenage pregnancy prevention policy]. / Costo económico de atención de embarazos atribuibles a la falla de la política de prevención del embarazo adolescente en México.

The objective was to estimate the direct medical cost of pregnancy care attributable to the failure of Mexico's teenage pregnancy prevention policy. From the provider's perspective, this economic study estimated the mean cost of prenatal care, childbirth, puerperium, abortion and complications. To quantify the costs attributable to policy failure, three scenarios were constructed: (a) total number of pregnancies; (b) number of pregnancies above the target; (c) number of unwanted pregnancies. The cost of providing contraceptive methods was also estimated and the characteristics of pregnant adolescents were described. Of the adolescents (n = 5,477,027), 30.2% were sexually active; 46.8% used contraception; 44.1% had become pregnant and 9.1% had an abortion. Most pregnant women (65%) attended secondary school or under; 30% dropped out of school; 72.5% lived with a partner; 72.3% had complications. The mean cost of pregnancy care was estimated at USD 2,210.55 and the mean cost of providing contraceptives at USD 64.95. The total cost of policy failure was estimated for each scenario (in millions): (a) USD 1,614.39, (b) USD 876.61 and (c) USD 171.50, respectively; whereas the annual cost of providing contraceptives in each scenario was estimated in: (a) USD 47.43, (b) USD 25.76 and (c) USD 5.04. The failure of the policy is expressed in the high frequency of pregnancy in low-income adolescents and in high costs for the health system. The provision of contraceptives is 34 times cheaper than pregnancy care and could, together with improved living conditions, contribute to reduce the frequency of adolescent pregnancies.

El objetivo fue estimar el costo médico directo de la atención a embarazos atribuibles a la falla en la política de prevención de embarazos adolescentes en México. Estudio económico que estimó, desde la perspectiva del proveedor, el costo medio de atención prenatal, parto, puerperio, aborto y complicaciones. Para cuantificar los costos atribuibles a la falla de la política, se construyeron tres escenarios: (a) embarazos totales; (b) embarazos por arriba de la meta; (c) embarazos no deseados. También se estimó el costo de proveer anticonceptivos y se describieron características de las adolescentes embarazadas. De las adolescentes (n = 5.477.027), 30,2% había iniciado vida sexual; 46,8% usaba anticonceptivo; 44,1% se había embarazado y 9,1% abortó. La mayoría de embarazadas (65%) estudió secundaria o menos; 30% abandonó la escuela; 72,5% vivían en pareja; 72,3% presentó complicaciones. El costo medio de atención del embarazo se estimó en USD 2.210,55 y el de proveer anticonceptivos en USD 64,95. El costo total por la falla de la política se estimó para cada escenario (en millones): (a) USD 1.614,39, (b) USD 876,61 y (c) USD 171,50, respectivamente; mientras que el costo anual de proveer anticonceptivos en cada escenario se estimó en: (a) USD 47,43, (b) USD 25,76 y (c) USD 5,04. La falla de la política se expresa en alta frecuencia de embarazo en adolescentes de bajos ingresos y en altos costos para el sistema de salud. La provisión de anticonceptivos es 34 veces más barata que la atención de embarazos y podría, aunado al mejoramiento de las condiciones de vida, contribuir a disminuir la frecuencia de embarazos en adolescentes.

O objetivo deste estudo foi estimar os custos médicos diretos da assistência à gravidez relacionados ao fracasso da política de prevenção à gravidez na adolescência no México. Este estudo econômico avaliou, a partir da perspectiva da prestação de serviços, os custos médios do pré-natal, parto, puerpério, aborto e complicações da gravidez na adolescência. Para quantificar os custos relacionados ao fracasso dessa política de assistência, foram analisados três cenários: (a) total das gestações; (b) gravidez acima da média; (c) gravidez indesejada. Também foi estimado o custo do fornecimento de anticoncepcionais e descritas as características da gravidez na adolescência. Do total de adolescentes grávidas (n = 5.477.027), 30,2% tinham iniciado a vida sexual; 46,8% usavam métodos anticoncepcionais; 44,1% engravidaram e 9,1% abortaram. A maioria das grávidas (65%) tinha o ensino médio completo ou nível de escolaridade inferior; 30% abandonaram a escola; 72,5% moravam com o companheiro; e 72,3% apresentaram complicações. O custo médio da assistência à gravidez foi estimado em USD 2.210,55, e o do fornecimento de anticoncepcionais em USD 64,95. O custo total do fracasso dessa política foi estimado para cada cenário (em milhões): (a) USD 1.614,39, (b) USD 876,61 e (c) USD 171,50, respectivamente; enquanto o custo anual do fornecimento de contraceptivos em cada cenário foi: (a) USD 47,43, (b) USD 25,76 e (c) USD 5,04. O fracasso dessa política esteve relacionado à alta frequência de gravidez em adolescentes de baixa renda e aos altos custos para o sistema de saúde. A oferta de anticoncepcionais é 34 vezes mais barata do que a assistência à gravidez e pode contribuir para a redução da gravidez na adolescência, junto com uma melhoria nas condições de vida dessa população.

Costo económico de atención de embarazos atribuibles a la falla de la política de prevención del embarazo adolescente en México / Economic cost of pregnancy care attributable to the failure of Mexico's teenage pregnancy prevention policy / Custo econômico da assistência à gravidez atribuível ao fracasso da política de prevenção à gravidez na adolescência no México

El objetivo fue estimar el costo médico directo de la atención a embarazos atribuibles a la falla en la política de prevención de embarazos adolescentes en México. Estudio económico que estimó, desde la perspectiva del proveedor, el costo medio de atención prenatal, parto, puerperio, aborto y complicaciones. Para cuantificar los costos atribuibles a la falla de la política, se construyeron tres escenarios: (a) embarazos totales; (b) embarazos por arriba de la meta; (c) embarazos no deseados. También se estimó el costo de proveer anticonceptivos y se describieron características de las adolescentes embarazadas. De las adolescentes (n = 5.477.027), 30,2% había iniciado vida sexual; 46,8% usaba anticonceptivo; 44,1% se había embarazado y 9,1% abortó. La mayoría de embarazadas (65%) estudió secundaria o menos; 30% abandonó la escuela; 72,5% vivían en pareja; 72,3% presentó complicaciones. El costo medio de atención del embarazo se estimó en USD 2.210,55 y el de proveer anticonceptivos en USD 64,95. El costo total por la falla de la política se estimó para cada escenario (en millones): (a) USD 1.614,39, (b) USD 876,61 y (c) USD 171,50, respectivamente; mientras que el costo anual de proveer anticonceptivos en cada escenario se estimó en: (a) USD 47,43, (b) USD 25,76 y (c) USD 5,04. La falla de la política se expresa en alta frecuencia de embarazo en adolescentes de bajos ingresos y en altos costos para el sistema de salud. La provisión de anticonceptivos es 34 veces más barata que la atención de embarazos y podría, aunado al mejoramiento de las condiciones de vida, contribuir a disminuir la frecuencia de embarazos en adolescentes.

The objective was to estimate the direct medical cost of pregnancy care attributable to the failure of Mexico's teenage pregnancy prevention policy. From the provider's perspective, this economic study estimated the mean cost of prenatal care, childbirth, puerperium, abortion and complications. To quantify the costs attributable to policy failure, three scenarios were constructed: (a) total number of pregnancies; (b) number of pregnancies above the target; (c) number of unwanted pregnancies. The cost of providing contraceptive methods was also estimated and the characteristics of pregnant adolescents were described. Of the adolescents (n = 5,477,027), 30.2% were sexually active; 46.8% used contraception; 44.1% had become pregnant and 9.1% had an abortion. Most pregnant women (65%) attended secondary school or under; 30% dropped out of school; 72.5% lived with a partner; 72.3% had complications. The mean cost of pregnancy care was estimated at USD 2,210.55 and the mean cost of providing contraceptives at USD 64.95. The total cost of policy failure was estimated for each scenario (in millions): (a) USD 1,614.39, (b) USD 876.61 and (c) USD 171.50, respectively; whereas the annual cost of providing contraceptives in each scenario was estimated in: (a) USD 47.43, (b) USD 25.76 and (c) USD 5.04. The failure of the policy is expressed in the high frequency of pregnancy in low-income adolescents and in high costs for the health system. The provision of contraceptives is 34 times cheaper than pregnancy care and could, together with improved living conditions, contribute to reduce the frequency of adolescent pregnancies.

O objetivo deste estudo foi estimar os custos médicos diretos da assistência à gravidez relacionados ao fracasso da política de prevenção à gravidez na adolescência no México. Este estudo econômico avaliou, a partir da perspectiva da prestação de serviços, os custos médios do pré-natal, parto, puerpério, aborto e complicações da gravidez na adolescência. Para quantificar os custos relacionados ao fracasso dessa política de assistência, foram analisados três cenários: (a) total das gestações; (b) gravidez acima da média; (c) gravidez indesejada. Também foi estimado o custo do fornecimento de anticoncepcionais e descritas as características da gravidez na adolescência. Do total de adolescentes grávidas (n = 5.477.027), 30,2% tinham iniciado a vida sexual; 46,8% usavam métodos anticoncepcionais; 44,1% engravidaram e 9,1% abortaram. A maioria das grávidas (65%) tinha o ensino médio completo ou nível de escolaridade inferior; 30% abandonaram a escola; 72,5% moravam com o companheiro; e 72,3% apresentaram complicações. O custo médio da assistência à gravidez foi estimado em USD 2.210,55, e o do fornecimento de anticoncepcionais em USD 64,95. O custo total do fracasso dessa política foi estimado para cada cenário (em milhões): (a) USD 1.614,39, (b) USD 876,61 e (c) USD 171,50, respectivamente; enquanto o custo anual do fornecimento de contraceptivos em cada cenário foi: (a) USD 47,43, (b) USD 25,76 e (c) USD 5,04. O fracasso dessa política esteve relacionado à alta frequência de gravidez em adolescentes de baixa renda e aos altos custos para o sistema de saúde. A oferta de anticoncepcionais é 34 vezes mais barata do que a assistência à gravidez e pode contribuir para a redução da gravidez na adolescência, junto com uma melhoria nas condições de vida dessa população.

Efectos de un programa de ejercicio aeróbico submáximo sobre el rendimiento cardiorrespiratorio y la potencia anaeróbica

Introducción: Existen beneficios en salud al realizar ejercicio físico, sin embargo, son pocas las investigaciones que reportan el rendimiento anaeróbico y su correlación con indicadores cardiorrespiratorios. Por tal motivo, el propósito de esta investigación fue determinar valores de rendimiento cardiorrespiratorio y aptitud anaeróbica después de un programa de ejercicio aeróbico en el cual se determinó la correlación entre ellos. Métodos: 22 hombres (20±2 años) conformaron dos grupos, G1-(entrenamiento), 6 semanas/tres días por semana, intensidad horaria de 45 minutos/día, G2-(Control). Antes y después realizaron un test de Wingate y una prueba de esfuerzo de predominancia aeróbica. Resultados: Aumentos significativos entre el pre-pos en G1 en VO2máx y vatios que mejoraron 7,6 % y 15,9 % respectivamente, diferencia significativa en la PP y en PM/kg con una mejora del 18,8 % y 18,9 %, respectivamente. Conclusión: Un programa de ejercicio aeróbico submáximo en bicicleta estática aumenta el rendimiento cardiorrespiratorio y rendimiento anaeróbico sin que exista una relación de dependencia entre las diferentes variables.

Introduction: There are health benefits when performing physical exercise, however, there are few investigations that report anaerobic performance and its correlation with cardiorespiratory indicators, for this reason, the purpose of this research was to determine the values of cardiorespiratory performance and anaerobic fitness after an aerobic exercise program determining the correlation between them. Method: 22 men (20 ± 2 years), were divided into two groups, G1 (training), 6 weeks, three days a week with an hourly intensity of 45 minutes per day, G2 (control). Before and after exercise they performed a Wingate test and a predominantly aerobic stress test. Results: Significant increases between pre-post in G1 in VO2Max and watts improving 7.6% and 15.9% respectively, a significant difference in PP and PM/kg improving 18.8% and 18.9% respectively. Conclusion: A submaximal aerobic exercise program on a stationary bike increases cardiorespiratory performance and anaerobic performance without a dependency relationship between the different variables.

Obesity is the main determinant of insulin resistance more than the circulating pro-inflammatory cytokines levels in rheumatoid arthritis patients / A obesidade é um determinante da resistência à insulina mais importante do que os níveis circulantes de citocinas pró-inflamatórias em pacientes com artrite reumatoide

ABSTRACT Background: Systemic blockade of TNF-α in Rheumatoid arthritis with insulin resistance seems to produce more improvement in insulin sensitivity in normal weight patients with Rheumatoid arthritis than in obese patients with Rheumatoid arthritis, suggesting that systemic-inflammation and obesity are independent risk factors for insulin resistance in Rheumatoid arthritis patients. Objectives: To evaluate the insulin resistance in: normal weight patients with Rheumatoid arthritis, overweight patients with Rheumatoid arthritis, obese Rheumatoid arthritis patients, and matched control subjects with normal weight and obesity; and its association with major cytokines involved in the pathogenesis of the disease. Methods: Assessments included: body mass index, insulin resistance by Homeostasis Model Assessment, ELISA method, and enzymatic colorimetric assay. Results: Outstanding results from these studies include: (1) In Rheumatoid arthritis patients, insulin resistance was well correlated with body mass index, but not with levels of serum cytokines. In fact, levels of cytokines were similar in all Rheumatoid arthritis patients, regardless of being obese, overweight or normal weight (2) Insulin resistance was significantly higher in Rheumatoid arthritis with normal weight than in normal weight (3) No significant difference was observed between insulin resistances of Rheumatoid arthritis with obesity and obesity (4) As expected, levels of circulating cytokines were significantly higher in Rheumatoid arthritis patients than in obesity. Conclusions: Obesity appears to be a dominant condition above inflammation to produce IR in RA patients. The dissociation of the inflammation and obesity components to produce IR suggests the need of an independent therapeutic strategy in obese patients with RA.

RESUMO Introdução: O bloqueio sistêmico do Fator de Necrose Tumoral-α (TNF-α) nos indivíduos com artrite reumatoide (AR) com resistência à insulina (RI) parece produzir mais melhoria na sensibilidade à insulina em pacientes com AR com peso normal do que em pacientes obesos com AR. Isso sugere que a inflamação sistêmica e a obesidade são fatores de risco independentes para a RI em pacientes com AR. Objetivos: Avaliar a resistência à insulina em pacientes com peso normal com AR (AR-PN), pacientes com sobrepeso com AR (AR-SP), pacientes com AR obesos (AR-OB) e indivíduos controle com peso normal (PN) e obesidade (OB) pareados; e a associação com as principais citocinas envolvidas na patogênese da doença. Métodos: As avaliações incluíram: índice de massa corporal (IMC), resistência à insulina com o modelo de avaliação da homeostase (Homa-IR), método Elisa e ensaio colorimétrico enzimático. Resultados: Os resultados marcantes do presente estudo incluíram: (1) Em pacientes com AR, a RI estava bem correlacionada com o Índice de Massa Corporal (quanto maior o IMC, maior a RI), mas não com os níveis séricos de citocinas. Na verdade, os níveis de citocinas eram semelhantes em todos os pacientes com AR, independentemente de serem obesos, com sobrepeso ou peso normal. (2) A RI foi significativamente maior no grupo AR-PN do que no grupo PN. (3) Não houve diferença estatisticamente significativa entre a RI de pacientes AR-OB e OB. (4) Como esperado, os níveis circulantes de citocinas foram significativamente maiores em pacientes com AR do que em OB. Conclusões: A obesidade parece ser uma condição mais importante do que a inflamação em produzir RI em pacientes com AR. A dissociação dos componentes da inflamação e da obesidade na produção de RI sugere a necessidade de uma estratégia terapêutica independente em pacientes obesos com AR.

Obesity is the main determinant of insulin resistance more than the circulating pro-inflammatory cytokines levels in rheumatoid arthritis patients.

BACKGROUND: Systemic blockade of TNF-α in Rheumatoid arthritis with insulin resistance seems to produce more improvement in insulin sensitivity in normal weight patients with Rheumatoid arthritis than in obese patients with Rheumatoid arthritis, suggesting that systemic-inflammation and obesity are independent risk factors for insulin resistance in Rheumatoid arthritis patients. OBJECTIVES: To evaluate the insulin resistance in: normal weight patients with Rheumatoid arthritis, overweight patients with Rheumatoid arthritis, obese Rheumatoid arthritis patients, and matched control subjects with normal weight and obesity; and its association with major cytokines involved in the pathogenesis of the disease. METHODS: Assessments included: body mass index, insulin resistance by Homeostasis Model Assessment, ELISA method, and enzymatic colorimetric assay. RESULTS: Outstanding results from these studies include: (1) In Rheumatoid arthritis patients, insulin resistance was well correlated with body mass index, but not with levels of serum cytokines. In fact, levels of cytokines were similar in all Rheumatoid arthritis patients, regardless of being obese, overweight or normal weight (2) Insulin resistance was significantly higher in Rheumatoid arthritis with normal weight than in normal weight (3) No significant difference was observed between insulin resistances of Rheumatoid arthritis with obesity and obesity (4) As expected, levels of circulating cytokines were significantly higher in Rheumatoid arthritis patients than in obesity. CONCLUSIONS: Obesity appears to be a dominant condition above inflammation to produce IR in RA patients. The dissociation of the inflammation and obesity components to produce IR suggests the need of an independent therapeutic strategy in obese patients with RA.

Satisfacción y calidad percibida de afiliados al Sistema de Protección Social en Salud de México. Fundamentos metodológicos / Satisfaction and perceived quality of people insured by the Social Health Protection in Mexico. Methodological foundations

Resumen: Objetivo: Describir el marco conceptual, metodología de implementación y análisis de la Encuesta de Satisfacción de Usuarios del Sistema de Protección Social en Salud de México. Material y métodos: Se analizan los elementos metodológicos de los estudios de 2013, 2014 y 2015, incluyendo el instrumento utilizado, el muestreo y el diseño del estudio, el modelo conceptual, las características y los indicadores del análisis. Resultados: La encuesta captura información sobre calidad percibida y satisfacción. El muestreo tiene representación nacional y estatal. Se construyen y describen indicadores simples y compuestos (índice de satisfacción y porcentaje de problemas de calidad reportados). El análisis se completa mediante diagramas de Pareto, correlación entre indicadores y asociación con la satisfacción mediante modelos multivariados. Conclusiones: La medición de satisfacción y calidad percibida es un proceso complejo pero necesario para cumplir con la normativa y para identificar estrategias de mejora. La encuesta descrita presenta diseño y análisis rigurosos enfocados en su utilidad para mejorar.

Abstract: Objective: To describe the conceptual framework and methods for implementation and analysis of the satisfaction survey of the Mexican System for Social Protection in Health. Materials and methods: We analyze the methodological elements of the 2013, 2014 and 2015 surveys, including the instrument, sampling method and study design, conceptual framework, and characteristics and indicators of the analysis. Results: The survey captures information on perceived quality and satisfaction. Sampling has national and State representation. Simple and composite indicators (index of satisfaction and rate of reported quality problems) are built and described. The analysis is completed using Pareto diagrams, correlation between indicators and association with satisfaction by means of multivariate models. Conclusions: The measurement of satisfaction and perceived quality is a complex but necessary process to comply with regulations and to identify strategies for improvement. The described survey presents a design and rigorous analysis focused on its utility for improving.

[Satisfaction and perceived quality of people insured by the Social Health Protection in Mexico. Methodological foundations]. / Satisfacción y calidad percibida de afiliados al Sistema de Protección Social en Salud de México. Fundamentos metodológicos.

OBJECTIVE:: To describe the conceptual framework and methods for implementation and analysis of the satisfaction survey of the Mexican System for Social Protection in Health. MATERIALS AND METHODS:: We analyze the methodological elements of the 2013, 2014 and 2015 surveys, including the instrument, sampling method and study design, conceptual framework, and characteristics and indicators of the analysis. RESULTS:: The survey captures information on perceived quality and satisfaction. Sampling has national and State representation. Simple and composite indicators (index of satisfaction and rate of reported quality problems) are built and described. The analysis is completed using Pareto diagrams, correlation between indicators and association with satisfaction by means of multivariate models. CONCLUSIONS:: The measurement of satisfaction and perceived quality is a complex but necessary process to comply with regulations and to identify strategies for improvement. The described survey presents a design and rigorous analysis focused on its utility for improving.

[Retrospective analysis of Mexican National Addictions Survey, 2008. Bias identification and correction]. / Análisis retrospectivo de la Encuesta Nacional de Adicciones 2008. Identificación y corrección de sesgo.

OBJECTIVE: To determine the presence of bias on the estimation of the consumption sometime in life of alcohol, tobacco or illegal drugs and inhalable substances, and to propose a correction for this in the case it is present. MATERIALS AND METHODS: Mexican National Addictions Surveys (NAS) 2002, 2008, and 2011 were analyzed to compare population estimations of consumption sometime in life of tobacco, alcohol or illegal drugs and inhalable substances. A couple of alternative approaches for bias correction were developed. RESULTS: Estimated national prevalences of consumption sometime in life of alcohol and tobacco in the NAS 2008 are not plausible. There was no evidence of bias on the consumption sometime in life of illegal drugs and inhalable substances. New estimations for tobacco and alcohol consumption sometime in life were made, which resulted in plausible values when compared to other data available. CONCLUSION: Future analyses regarding tobacco and alcohol using NAS 2008 data will have to rely on these newly generated data weights, that are able to reproduce the new (plausible) estimations.

Análisis retrospectivo de la Encuesta Nacional de Adicciones 2008: Identificación y corrección de sesgo / Retrospective analysis of Mexican National Addictions Survey, 2008: Bias identification and correction

OBJETIVO: Investigar la existencia de sesgo en la estimación de las prevalencias de consumo "alguna vez" en la vida de alcohol, tabaco y drogas ilegales e inhalables, para luego proponer una corrección al mismo, si existiera. MATERIAL Y MÉTODOS: Se analizaron las Encuestas Nacionales de Adicciones (ENA) 2002, 2008 y 2011 para comparar estimaciones de parámetros poblacionales sobre el consumo "alguna vez" en la vida de tabaco, alcohol y drogas ilegales e inhalables. Se desarrollaron dos métodos para corregir el sesgo. RESULTADOS: Las prevalencias nacionales estimadas de consumo "alguna vez" de alcohol y tabaco de la ENA 2008 no son plausibles. En contraste, no se encontró evidencia que apoyara un subregistro o sobrerregistro del consumo "alguna vez" de drogas ilegales e inhalables. Se obtuvieron nuevas estimaciones de las prevalencias de consumo "alguna vez" de alcohol y tabaco; las nuevas estimaciones resultaron ser plausibles al contrastarse con otras fuentes de información disponibles. CONCLUSIONES: Los nuevos análisis sobre alcohol y tabaco que se realicen deberán usar los factores de expansión corregidos de la ENA 2008 para poder incorporar las nuevas estimaciones de consumo "alguna vez" de alcohol y tabaco obtenidas en este trabajo.

OBJECTIVE: To determine the presence of bias on the estimation of the consumption sometime in life of alcohol, tobacco or illegal drugs and inhalable substances, and to propose a correction for this in the case it is present. MATERIALS AND METHODS: Mexican National Addictions Surveys (NAS) 2002, 2008, and 2011 were analyzed to compare population estimations of consumption sometime in life of tobacco, alcohol or illegal drugs and inhalable substances. A couple of alternative approaches for bias correction were developed. RESULTS: Estimated national prevalences of consumption sometime in life of alcohol and tobacco in the NAS 2008 are not plausible. There was no evidence of bias on the consumption sometime in life of illegal drugs and inhalable substances. New estimations for tobacco and alcohol consumption sometime in life were made, which resulted in plausible values when compared to other data available. CONCLUSION: Future analyses regarding tobacco and alcohol using NAS 2008 data will have to rely on these newly generated data weights, that are able to reproduce the new (plausible) estimations.

Receptor-independent effects of 2'(3')-O-(4-benzoylbenzoyl)ATP triethylammonium salt on cytosolic pH.

The effect of the relatively potent P2X7 receptor agonist 2'(3')-O-(4-benzoylbenzoyl)adenosine 5'-triphosphate triethylammonium salt (BzATP-TEA) on cytosolic pH (pHi) was studied using MC3T3-E1 osteoblast-like cells, which endogenously express P2X7 receptors. pHi was measured fluorimetrically using the pH-sensitive dye 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein. BzATP-TEA (0.3-1.5 mM) elicited fast-onset alkalinization responses. In contrast, adenosine 5'-triphosphate disodium salt (5 mM) failed to reproduce the BzATP-TEA-induced responses, indicating a P2 receptor-independent mechanism. We speculated that triethylamine, which is present in solutions of BzATP-TEA, permeates the plasma membrane, and is protonated intracellularly, leading to an increase in pHi. Consistent with this hypothesis, triethylammonium (TEA) chloride mimicked the effects of BzATP-TEA on pHi. Moreover, measurements using a Cytosensor microphysiometer revealed that TEA chloride transiently suppressed proton efflux from cells, whereas washout of TEA transiently enhanced proton efflux. BzATP-TEA also elicited a sustained increase in proton efflux that was blocked specifically by the P2X7 antagonist A-438079. Taken together, we conclude that BzATP-TEA-induced alkalinization is unrelated to P2X7 activation, but is due to the presence of TEA. This effect may confound assessment of the outcomes of P2X7 activation by BzATP-TEA in other systems. Thus, control experiments using TEA chloride are recommended to distinguish between receptor-mediated and nonspecific effects of this widely used agonist. We performed such a control and confirmed that BzATP-TEA, but not TEA chloride, caused the elevation of cytosolic free Ca(2+) in MC3T3-E1 cells, ruling out the possibility that receptor-independent effects on pHi underlie BzATP-TEA-induced Ca(2+) signaling.

Characterization of an outward rectifying chloride current of Xenopus tropicalis oocytes.

Here, we describe an outward rectifying current in Xenopus tropicalis oocytes that we have called xtClC-or. The current has two components; the major component is voltage activated and independent of intracellular or extracellular Ca(2+), whereas the second is a smaller component that is Ca(2+) dependent. The properties of the Ca(2+)-independent current, such as voltage dependence and outward rectification, resemble those of ClC anion channels/transporters. This current is sensitive to NPPB and NFA, insensitive to 9AC and DIDS, and showed a whole-cell conductance sequence of SCN(-)>I(-)>Br(-)>CI(-). RT-PCR revealed the expression in oocytes of ClC-2 to ClC-7, and major reductions of current amplitudes were observed when a ClC-5 antisense oligonucleotide was injected into oocytes. The Ca(2+)-dependent component was abated after injection of 10mM BAPTA or EGTA, whereas 10mMMg(2+) inhibited the current to 26±3.1%. This component was blocked by 9-AC, NFA, and NPPB, whereas DIDS did not elicit any evident effect. The ion sequence selectivity was SCN=I(-)>Br(-)>Cl(-). To try to determine the molecular identity that gives rise to this component we assessed by RT-PCR the expression of the Ca(2+)-dependent Cl(-) channel TMEM16A, which was found to be present in the oocytes. However, injection of antisense TMEM16A oligonucleotides did not inhibit the transient outward current. This result fits well with the electrophysiological data. Together, these results suggest that ClC-5 is a major, but not the sole channel responsible for this outwardly rectifying Cl(-) current.

Principales hallazgos en el programa de crecimiento y desarrollo de los niños hasta los 60 meses de edad en ASSBASALUD ESE (Manizales, Colombia) entre los años 2002-2007 / Main findings of the program of children growth and development till 60 months old, at the ASSBASALUD ESE clinic (Manizales, Colombia) between 2002-2007

Antecedentes: La consulta de crecimiento y desarrollo es ofrecida para controlar niños saludables buscando que sigan sanos, gracias a una supervisión apropiada. Materiales y métodos: Se realizó un estudio de corte transversal. La población de estudio consistió en seiscientos cuarenta niños del programa de crecimiento y desarrollode la clínica ASSBASALUD ESE (Manizales, Colombia). Resultados: Comparadas las medianas encontrados de las variables antropométricas (peso, talla y perímetro cefálico) en el presente estudio y comparadas con las reportadas por Correa, Gómez y Posada en Medellín en el 2006; se encuentra, peso al momento del nacimiento es de 3.500 gramos y en este estudio fue de 3.300 gramos. En la variable de perímetro cefálico al nacimiento se encontró que no hay casilla de registro en las historias revisadas. La mediana de perímetro cefálico a los 24 meses esde 47,0 centímetros y en el estudio mencionado es de 48,5 centímetros. Se encontró relación significativa entre grado de nutrición y medidas antropométricas y lactancia materna y enfermedades respiratorias (p=0,014). Conclusiones: Se encuentra que en esta muestra infantil de Manizales, tanto el grado deficiente de nutrición como aspectos fenotípicos, afectan de manera negativalos índices de talla, peso y perímetro cefálico, encontrándose por debajo de la media poblacional estándar. Fueron demasiadas las historias excluidas por ausencia de la información completa; hay falencias en el diligenciamiento de las historias clínicas en el programa de crecimiento y desarrollo de ASSBASALUD ESE que ameritan ser solucionadas...

Functional interactions between P2X4 and P2X7 receptors from mouse salivary epithelia.

Mouse parotid acinar cells express P2X4 and P2X7 receptors (mP2X4R and mP2X7R) whose physiological function remains undetermined. Here we show that mP2X4R expressed in HEK-293 cells do not allow the passage of tetraethylammonium (TEA+) and promote little, if any, ethidium bromide (EtBr) uptake when stimulated with ATP or BzATP. In contrast, mP2X7R generates slowly decaying TEA+ current, sustained Na+ current and promotes robust EtBr uptake. However, ATP-activated TEA+ current from acinar cells was unlike that generated by mP2X7R or mP2X4R. Functional interactions between mP2X4R and mP2X7R were investigated in HEK cells co-transfected with different mP2X4 : mP2X7 cDNA ratios and using solutions containing either TEA+ or Na+ ions. Co-expressed channels generated a TEA+ current that displayed faster decay during ATP stimulation than mP2X7R alone. Moreover, cells transfected with a 2 : 1 cDNA ratio displayed decaying kinetics similar to those observed in acinar cells. Concentration-response curves in Na+-containing solutions were constructed for heterologously expressed mP2X4R, mP2X7R and mP2X4R:mP2X7R co-expressions as well as acinar cells. The EC50 values determined were 11, 220, 434 and 442 microM, respectively. Na+ currents generated by expressing mP2X4R or mP2X7R alone were potentiated by ivermectin (IVM). In contrast, IVM potentiation in acinar cells and HEK cells co-expressing P2X4 and P2X7 (1 : 1 or 2 : 1 cDNA ratios) was seen only when the ATP concentration was lowered from 5 to 0.03 mM. Taken together our observations indicate a functional interaction between murine P2X7 and P2X4 receptors. Such interaction might occur in acinar cells to shape the response to extracellular ATP in salivary epithelia.

Na+ modulates anion permeation and block of P2X7 receptors from mouse parotid glands.

We previously reported that mouse parotid acinar cells display anion conductance (I(ATPCl)) when stimulated by external ATP in Na+-free extracellular solutions. It has been suggested that the P2X7 receptor channel (P2X7R) might underlie I(ATPCl). In this work we show that I (ATPCl) can be activated by ATP, ADP, AMP-PNP, ATPgammaS and CTP. This is consistent with the nucleotide sensitivity of P2X7R. Accordingly, acinar cells isolated from P2X7R( -/- ) mice lacked I(ATPCl). Experiments with P2X7R heterologously expressed resulted in ATP-activated currents (I(ATP-P2X7)) partially carried by anions. In Na(+)-free solutions, I (ATP-P2X7) had an apparent anion permeability sequence of SCN(-) > I(-) congruent with NO3(-) > Br(-) > Cl(-) > acetate, comparable to that reported for I(ATPCl) under the same conditions. However, in the presence of physiologically relevant concentrations of external Na+, the Cl(-) permeability of I(ATP-P2X7) was negligible, although permeation of Br(-) or SCN(-) was clearly resolved. Relative anion permeabilities were not modified by addition of 1 mM: carbenoxolone, a blocker of Pannexin-1. Moreover, cibacron blue 3GA, which blocks the Na(+) current activated by ATP in acinar cells but not I(ATPCl), blocked I(ATP-P2X7) in a dose-dependent manner when Na+ was present but failed to do so in tetraethylammonium containing solutions. Thus, our data indicate that P2X7R is fundamental for I(ATPCl) generation in acinar cells and that external Na+ modulates ion permeability and conductivity, as well as drug affinity, in P2X7R.