Positive correlation between the nuclear expression of GPER and pGLI3 in prostate cancer tissues from patients with different Gleason scores.

Prostate cancer (PCa) is the most prevalent cause of death in the male population worldwide. The G Protein-Coupled Estrogen Receptor (GPER) has been gaining relevance in the development of PCa. Hedgehog (Hh) pathway activation is associated with aggressiveness, metastasis, and relapse in PCa patients. To date, no studies have evaluated the crosstalk between the GPER and the Hh pathway along different group grades in PCa. We conducted an analysis of paraffin-embedded tissues derived from patients with different prognostic grade of PCa using immunohistochemistry. Expression and correlation between GPER and glioma associated oncogene homologue (GLI) transcriptional factors in the parenchyma and stroma of PCa tumors were evaluated. Our results indicate that GPER is highly expressed in the nucleus and increases with higher grade groups. Additionally, GPER's expression correlates with pGLI3 nuclear expression across different grade groups in PCa tissues; however, whether the receptor induces the activation of GLI transcriptional factors, or the latter modulate the expression of GPER is yet to be discovered, as well as the functional consequence of this correlation.

Characterization of Three Cases of Primary Hypogalactia in Jalisco, Mexico.

INTRODUCTION: Human lactation should be taken into account as an important issue for the international agenda. Despite advances in lactation information and knowledge, insufficient milk production is still a concern for mothers and health practitioners, including International Board Certified Lactation Consultants and others. Primary hypogalactia, or insufficient milk production is uncommon, but should be considered when there is poor weight gain and decreased urine output in infants despite good latch-on and suckling, or anatomic differences in the physical exam of the lactating breast. MAIN ISSUE: This case series presents three cases illustrating insufficient milk production resulting in infants who experienced significant dehydration and poor weight gain. MANAGEMENT: Primary hypoplasia was diagnosed by means of a thorough interview and physical examination that entailed a consultation with a physician who was also an International Board Certified Lactation Consultant. CONCLUSION: Awareness of an infant's feeding needs and proper evaluation of a child's health status is paramount if health care providers are to identify the important factors contributing to breastfeeding problems. In some instances, breastfeeding goals cannot be achieved, and then the provider's role becomes support in coming to terms with persistent insufficient milk production, and coordinating appropriate supplementation to meet each baby's nutritional needs.

Frequency of urinary pesticides in children: a scoping review.

Pesticides are any mix of ingredients and substances used to eliminate or control unwanted vegetable or animal species recognized as plagues. Its use has been discussed in research due to the scarcity of strong scientific evidence about its health effects. International literature is still insufficient to establish a global recommendation through public policy. This study aims to explore international evidence of the presence of pesticides in urine samples from children and their effects on health through a scoping review based on the methodology described by Arksey and O'Malley. The number of articles resulting from the keyword combination was 454, and a total of 93 manuscripts were included in the results and 22 were complementary. Keywords included in the search were: urinary, pesticide, children, and childhood. Children are exposed to pesticide residues through a fruit and vegetable intake environment and household insecticide use. Behavioral effects of neural damage, diabetes, obesity, and pulmonary function are health outcomes for children that are commonly studied. Gas and liquid chromatography-tandem mass spectrometry methods are used predominantly for metabolite-pesticide detection in urine samples. Dialkylphosphates (DAP) are common in organophosphate (OP) metabolite studies. First-morning spot samples are recommended to most accurately characterize OP dose in children. International evidence in PubMed supports that organic diets in children are successful interventions that decrease the urinary levels of pesticides. Several urinary pesticide studies were found throughout the world's population. However, there is a knowledge gap that is important to address (public policy), due to farming activities that are predominant in these territories.

Non-traditional risk factors of progression of chronic kidney disease in adult population: a scoping review.

Chronic kidney disease (CKD) has become a public health concern over the last several years. Nowadays developed countries spend around 3% of their annual health-care budget on patients with CKD. According to the scientific community the most remarkable risk factors for CKD are diabetes and hypertension. Unknown CKD etiology has been reported as a global phenomenon including uncommon risk factors such as: dehydration, leptospirosis, heat stress, water quality, and others. This study aims to report non-traditional risk factors for ESRD based on a scoping review methodology. The scoping review methodology described by Arksey and O'Malley was used by performing an extensive review of the information. A total of 46 manuscripts were reviewed. The non-traditional ESRD risk factors are depicted based on six categories. Gender and ethnicity have been considered as risk factors for ESRD. Erythematous systemic lupus (ESL) is reported as an important risk factor for ESRD. Pesticide use has been an significant risk factor due to its effects on human and environmental health. Some compounds commonly used in homes against insects and plants are related to ESRD. Congenital and hereditary diseases in the urinary tract have been studied as a cause of ESRD in children and young adults. End-stage renal disease is a major concern for public health on a global level. As it can be seen, non-traditional risk factors are several and have different etiologies. It is necessary to put the issue on the table and add it to the public agenda in order to find multidisciplinary solutions.

Rabies, the cause of fatal encephalitis.

To describe the clinical progression and medical protocols applied in a 41 year old man who was bited by a bat three months before. The patient did not ask for medical care until acute tremor and pain in the right thoracic limb and hydro-phobia started. For a history of a wild animal bite associated with a unique clinical condition, we suspected of rabies encephalitis, confirming the diagnostic by pathology after his death. This case ocurred in Guadalajara, Jalisco, México, in April, 2022. The last case of human rabies reported in Jalisco secondary to bat bite was almost 30 years ago. As an uncomon disease, medical personnel and facilities should be prepared to attend this sort of cases after clinical suspicion. For the present case, the medical history was the key for diagnosis. Rabies is a disease caused by the neurotropic virus belonging to the Rhabdoviridae family whose prognosis is bleak, with mortality close to 100% and therapeutic options limited. This case emphasizes the high mortality of rabies virus infection and the importance of increasing awareness and education to the public in general, with regard to applying the vaccine as post-exposure prophylaxis.

Prophylactic Unfractionated Subcutaneous Heparin Does Not Increase Postoperative Hemorrhage in Elderly Patients Undergoing Emergency Neurosurgical Procedures.

Purpose The purpose of this study is to evaluate the impact in the development of intracerebral hemorrhage in elderly critically ill patients who received prophylactic subcutaneous unfractionated heparin (SCUFH) less than 24 hours after undergoing emergency neurosurgery.  Methods A retrospective analysis was performed on patients who underwent emergency neurosurgery and were admitted to the surgical intensive care unit (SICU) at a tertiary care center over a 10-year period. Administration of prophylactic SCUFH within 24 hours of neurosurgery was required for inclusion. Demographic and clinical characteristics were recorded. The primary outcome was a rate of postoperative hemorrhagic complications with respect to age. Results We identified 223 emergency neurosurgical patients: 100 (45%) patients did not receive prophylactic SCUFH and were excluded. The remaining 123 (55%) patients met all inclusion criteria, of whom 73 (59%) patients were under 65 years old, and 50 (41%) patients were over 65 years old. Patients under 65 years old had significantly lower body mass index (BMI), lower Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, and Simplified Acute Physiology Score (SAPS) scores, and shorter median SICU length of stay compared to patients over 65 years old. No statistically significant difference in the rate of postoperative hemorrhagic or non-hemorrhagic neurological complications was observed between patients in either age group.  Conclusion Age over 65 years was not associated with a higher risk of postoperative hemorrhage in patients who received SCUFH after emergency neurosurgery. SCUFH can be safely used as a chemoprophylactic agent against venous thromboembolism for elderly patients when used within 24 hours after emergency neurosurgery.

Incidence of fever and bleeding after percutaneous nephrolithotomy: a prospective cohort study.

OBJECTIVE: Despite relative agreement on the need for immediate peri-operative antibiotic prophylaxis in percutaneous nephrolithotomy (PCNL), there is no consensus regarding antibiotic use the days leading up to PCNL. This study aimed to report the incidence of complications during and after PCNL based on a cohort study design. MATERIAL AND METHODS: We included 101 patients in a prospective schedule for PCNL. Patients were divided into 2 groups. In the exposed patients (positive urine culture) the antibiotic was indicated according to the antibiogram report, 7 days before surgery, and 7 days after surgery, and in the non-exposed patient's intravenous antibiotic empirically was administered 8 h and 1 h before surgery. RESULTS: The incidence of complications for both groups was 19%. The exposed group presented complications in 27%, and 16% for the non-exposed. The relative risk of complications, in general, was 1.68 (95% CI, 0.77-3.6), the attributable risk was 11.09, and the percentage of attributable risk was 40.68%. CONCLUSIONS: The presence of positive urine culture is the main risk factor for the development of post-PCNL fever. Each treatment center needs to standardize its protocols to reduce the morbidity associated with surgery and to identify the main risk factors.

OBJETIVO: El objetivo de este estudio es reportar la incidencia de complicaciones durante y después de la nefrolitotomía percutánea (NLP) con base en un diseño de cohorte prospectivo. MATERIAL Y MÉTODOS: Se incluyeron 101 pacientes de forma prospectiva programados para NLP. Los pacientes fueron divididos en 2 grupos. En el grupo de expuestos (cultivo de orina positivo) el antibiótico se indicó según el reporte del antibiograma, 7 días antes y 7 días después de la cirugía. En los pacientes no expuestos (cultivo de orina negativo) se administró empíricamente antibiótico intravenoso 8 h y 1 h antes de la cirugía. RESULTADOS: La incidencia de complicaciones para ambos grupos fue del 19%. El grupo de expuestos presentó ­complicaciones en 27% mientras que para los no expuestos fue de 16%. El riesgo relativo de complicaciones en general fue de 1.68 (IC 95%, 0.77-3.6), el riesgo atribuible fue de 11.09 y el porcentaje de riesgo atribuible fue de 40.68%. CONCLUSIONES: la presencia de urocultivo positivo es el principal factor de riesgo para el desarrollo de fiebre post-NLP. Es importante que cada centro de tratamiento estandarice sus protocolos para reducir la morbilidad asociada con la cirugía e identificar los principales factores de riesgo.

Quality of Life in Pediatric Minimally Invasive Surgery: Cost-Utility Analysis of Laparoscopic Versus Open Appendectomy.

Background: Economic evaluation in health care is becoming increasingly important. Laparoscopic appendectomy (LAp) is one of the most frequent minimally invasive procedures in the pediatric population. The increased costs of this approach in any indication could be justified by proving its cost-utility in terms of health-related quality of life (HRQoL). We aim to perform a cost-utility analysis between open and LAp (open appendectomy [OAp] and LAp). Materials and Methods: We included the data of children operated for acute noncomplicated appendicitis, who agreed to answer a validated quality of life (QoL) questionnaire. Costs were calculated for each patient. We established a threshold for cost-effectiveness (λ) of 20,000 to 30,000€ per quality adjusted life year (QALY) according to previous research. Results: A total of 53 patients were included. Overall mean costs in the OAp were 758.98€ and in the LAp 1525.50€. The incremental cost-effectiveness ratio was 18,000€/QALY, under the threshold of cost-effectiveness, therefore favoring the laparoscopic approach as it improves HRQoL despite the costs. Conclusions: Economic evaluation studies in Pediatric Surgery are scarce and rarely measure outcomes in terms of QoL. This information is important in the decision-making process for institutions and health-care professionals. Our results encourage the use of laparoscopy in pediatric appendectomy to improve HRQoL in our patients.

Seasonal Urinary Levels of Glyphosate in Children From Agricultural Communities.

BACKGROUND: Glyphosate is one of the most commonly used pesticides in agricultural activities worldwide. For the last 20 years, its use has increased rapidly becoming a public health concern. The IARC classified glyphosate as probably carcinogenic; however, the reported evidence is not enough to establish a statement. OBJECTIVE: This work aimed to measure glyphosate levels in the urine of children from a single rural community in an endemic region of chronic kidney disease and malnutrition. METHODS: A cross-sectional study was carried out in a rural community in western Mexico. The study included 95 children between the ages of 6 and 16. A urine sample (first-morning spot) was obtained from children and processed to measure glyphosate levels using high-performance liquid chromatography coupled with tandem mass spectrometry. RESULTS: All samples tested positive for glyphosate levels. Urine glyphosate levels were related to the season and the age of the children. CONCLUSION: Glyphosate is present in children of all ages in the community even if they were not in direct contact with it. No toxicity cases were reported, nor were there other health problems related to glyphosate. However, more long-term studies should be done that provide a statement regarding the harmful effects that glyphosate has on public health.

The role of estradiol in the immune response against COVID-19.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen agent causing coronavirus disease (COVID)-19, which was declared a global pandemic in 2020. The spike protein of this virus and the angiotensin-converter enzyme (ACE)-2 in host cells in humans play a vital role in infection and in COVID-19 pathogenesis. Estradiol is known to modulate the actions of immune cells, and, therefore, the antiviral mechanisms of these cells could also be modified by this hormone stimulus. Even though estradiol is not considered a protective factor, evidence shows that women with high levels of this hormone have a lower risk of developing severe symptoms and an even a lower incidence of death. Understanding the mechanism of action of estradiol with regard to viral infections and COVID-19 is essential for the improvement of therapeutic strategies. This review aims to describe the effects that estradiol exerts on immune cells during viral infections and COVID-19.

Frequency and Risk Factors for Spontaneous Pneumomediastinum in COVID-19 Patients.

Background: Spontaneous pneumomediastinum (SPM) is an uncommon condition in COVID-19 patients. No information about outcome or risk factors is available at the time. The aim of this research is to report on the frequency and risk factors of spontaneous pneumomediastinum in COVID-19 patients. Materials and Methods: An unmatched case-control study was carried out in a tertiary health-care facility for patients with COVID-19. Electronic files were reviewed to identify patients with confirmed COVID-19 infection by RT-PCR. Univariate analysis was used to describe demographic data. Mean differences were calculated using the Mann-Whitney test. Frequency and odds ratios were calculated by standard operations. Results: A total of 271 patients were included in the study. Nine patients showed spontaneous pneumomediastinum and four of them presented associated spontaneous pneumothorax. The most common risk factors associated with poor outcomes in COVID-19 patients were not considered as risk factors for spontaneous pneumomediastinum development. Conclusion: Spontaneous pneumomediastinum is an uncommon clinical feature in COVID-19 patients. More research is necessary to formulate statements regarding prevalence, risk factors, and outcome.

Sensitizing the cytotoxic action of Docetaxel induced by Pentoxifylline in a PC3 prostate cancer cell line.

BACKGROUND: Prostate cancer is one of the most frequently diagnosed types of cancers worldwide. In its initial period, the tumor is hormone-sensitive, but in advanced states, it evolves into a metastatic castration-resistant tumor. In this state, chemotherapy with taxanes such as Docetaxel (DTX) comprises the first line of treatment. However, the response is poor due to chemoresistance and toxicity. On the other hand, Pentoxifylline (PTX) is an unspecific inhibitor of phosphodiesterases; experimental, and clinically it has been described as sensitizing tumor cells to chemotherapy, increasing apoptosis and decreasing senescence. We study whether the PTX sensitizes prostate cancer cells to DTX for greater effectiveness. METHODS: PC3 human prostate cancer cells were treated in vitro at different doses and times with PTX, DTX, or their combination. Viability was determined by the WST-1 assay by spectrophotometry, cell cycle progression, apoptosis, generic caspase activation and senescence by flow cytometry, DNA fragmentation and caspases-3, -8, and -9 activity by ELISA. RESULTS: We found that PTX in PC3 human prostate cancer cells induces significant apoptosis per se and increases that generated by DTX, while at the same time it reduces the senescence caused by the chemotherapy and increases caspases-3,-8, and -9 activity in PTX + DTX-treated cells. Both treatments blocked the PC3 cell in the G1 phase. CONCLUSIONS: Our results show that PTX sensitizes prostate tumor cells to apoptosis induced by DTX. Taken together, the results support the concept of chemotherapy with rational molecular bases.

Microbiological profile of urinary tract infections in a tertiary medical facility in Western Mexico: An update.

Urinary tract infections (UTIs) are one of the most important issues in modern medicine. In developing countries, the use of antibiotics is a common practice, and due to this, antibiotic resistance has increased. The objective of this research was to update and report on the microbiological profile of urinary tract infections based on the number of positive urine cultures (UCs), resistance, sensitivity, and the prevalence of bacterial strains. The results were obtained from the database of a tertiary medical facility in Western Mexico. The number of positive UCs was 1769 from inpatients and outpatients who were users of medical services in the hospital from January to December of 2017. The most commonly isolated microorganism was E. coli, with 1225 cases, of which 603 (49.2%) were ESBL (Extended-Spectrum Beta-Lactamase-producing bacteria) strains. The resistance rate of nitrofurantoin was 36.6%, and meropenem showed the most promising results with a resistance rate of only 7.1%. Resistances to quinolones and cephalosporins among the isolates investigated were 51%-67%. Based on our results, it is necessary to increase controls and to improve management protocols in order to achieve better medical practices by reducing antibiotic resistance.

Diagnóstico de hernia diafragmática congénita de presentación tardía mediante ecografía a pie de cama / Diagnosis of a late-onset congenital diaphragmatic hernia using bedside ultrasound

No disponible

Distribution and Effects of Estrogen Receptors in Prostate Cancer: Associated Molecular Mechanisms.

Estrogens are hormones that have been extensively presented in many types of cancer such as breast, uterus, colorectal, prostate, and others, due to dynamically integrated signaling cascades that coordinate cellular growth, differentiation, and death which can be potentially new therapeutic targets. Despite the historical use of estrogens in the pathogenesis of prostate cancer (PCa), their biological effect is not well known, nor their role in carcinogenesis or the mechanisms used to carry their therapeutic effects of neoplastic in prostate transformation. The expression and regulation of the estrogen receptors (ERs) ERα, ERß, and GPER stimulated by agonists and antagonists, and related to prostate cancer cells are herein reviewed. Subsequently, the structures of the ERs and their splice variants, the binding of ligands to ERs, and the effect on PCa are provided. Finally, we also assessed the contribution of molecular simulation which can help us to search and predict potential estrogenic activities.

Validating 3D indexes in the non-surgical pectus excavatum patient.

BACKGROUND/PURPOSE: In recent years there has been an increased interest in three-dimensional (3D) imaging for the assessment of chest wall deformities. Some studies have proven a correlation between 3D and traditional cross-sectional images but only for patients who already had an indication for a computed tomography (CT) scan prior to surgery; mainly due to their severity. Our aim is to determine the accuracy and reliability of the measures obtained by a portable 3D scanner in a cohort of pectus excavatum (PE) patients with different severity grades, as well as in controls. METHODS: We conducted a study comparing radiological and optical indexes on magnetic resonance imaging (MRI) and 3D surface images. We used a hand-held 3D scanner to obtain the optical Haller Index (3DHI) and Correction Index (3DCI) and a limited MRI scan to obtain the traditional indexes. A statistical analysis was carried out to determine the correlation between optical and radiological measures, plus a subjective severity evaluation. RESULTS: Twenty-eight patients and controls were enrolled in the study. In both the control and PE groups, there was a significant positive correlation between the indexes, especially for the CI. There were no differences in correlation regarding gender, age or severity. CI appears to better discriminate amongst the different severity groups and controls. CONCLUSION: 3D surface imaging is feasible and appropriate to use to assess PE, regardless of the severity or characteristics of the individual patient. Even with a small hand-held device, we can obtain accurate images and measures which are especially useful for the assessment of the nonsurgical pectus patient.

Ecografía a pie de cama en el diagnóstico precoz de la enterocolitis necrosante: una estrategia para mejorar el pronóstico / Bedside ultrasound in the early diagnosis of necrotising enterocolitis: A strategy to improve the prognosis

No disponible

Hand metastasis in a patient with cervical cancer: A case report.

INTRODUCTION: Acrometastasis is infrequent and generally indicates a wider spread of metastasis with poor prognosis. The diagnosis is challenging, as it might mimic an infectious, inflammatory, or metabolic disease. Acrometastasis are most commonly found in patients with lung, gastrointestinal, kidney, and breast cancer. Only 3 cases of cervical cancer associated with hand metastasis have been reported in the literature. PATIENT CONCERNS: Herein, we report a 58-year-old patient with locally advanced cervical cancer and recurrence in the right thumb as presentation of widespread disseminated disease. She initially presented with adenocarcinoma of the uterine cervix and was treated with concurrent chemoradiation followed by high-dose rate brachytherapy. Six months later, she developed an insidious onset of pain and swelling in the right thumb, erythema, and edema, mimicking cellulitis. DIAGNOSIS: A biopsy of the soft tissues of the thumb was performed, and the histopathology indicated metastasis of adenocarcinoma to the bone and soft tissues. INTERVENTIONS AND OUTCOMES: The patient rejected further treatment and died of progressive disease 4 months after the diagnosis of the recurrence. CONCLUSION: Metastases in unusual sites are a diagnostic challenge, and there is no standardized treatment. Timely diagnosis and treatment can improve the prognosis of these patients and might preserve their quality of life.