Potential contributions of the intrinsic retinal oscillations recording using non-invasive electroretinogram to bioelectronics.

Targeted electric signal use for disease diagnostics and treatment is emerging as a healthcare game-changer. Besides arrhythmias, treatment-resistant epilepsy and chronic pain, blindness, and perhaps soon vision loss, could be among the pathologies that benefit from bioelectronic medicine. The electroretinogram (ERG) technique has long demonstrated its role in diagnosing eye diseases and early stages of neurodegenerative diseases. Conspicuously, ERG applications are all based on light-induced responses. However, spontaneous, intrinsic activity also originates in retinal cells. It is a hallmark of degenerated retinas and its alterations accompany obesity and diabetes. To the extent that variables extracted from the resting activity of the retina measured by ERG allow the predictive diagnosis of risk factors for type 2 diabetes. Here, we provided a comparison of the baseline characteristics of intrinsic oscillatory activity recorded by ERGs in mice, rats, and humans, as well as in several rat strains, and explore whether zebrafish exhibit comparable activity. Their pattern was altered in neurodegenerative models including the cuprizone-induced demyelination model in mice as well as in the Royal College of Surgeons (RCS-/-) rats. We also discuss how the study of their properties may pave the way for future research directions and treatment approaches for retinopathies, among others.

A safe protocol to identify low-risk patients with COVID-19 pneumonia for outpatient management.

The coronavirus disease 2019 (COVID-19) outbreak has made it necessary to rationalize health-care resources, but there is little published data at this moment regarding ambulatory management of patients with COVID-19 pneumonia. The objective of the study is to evaluate the performance of a protocol for ambulatory management of patients with COVID-19 pneumonia regarding readmissions, admission into the Intensive Care Unit (ICU) and deaths. Also, to identify unfavorable prognostic factors that increase the risk of readmission. This is a prospective cohort study of patients with COVID-19 pneumonia discharged from the emergency ward of Infanta Cristina Hospital (Madrid, Spain) that met the criteria of the hospital protocol for outpatient management. We describe outcomes of those patients and compare those who needed readmission versus those who did not. We use logistic regression to explore factors associated with readmissions. A total of 314 patients were included, of which 20 (6.4%) needed readmission, and none needed ICU admission nor died. At least one comorbidity was present in 29.9% of patients. Hypertension, leukopenia, lymphocytopenia, increased lactate dehydrogenase (LDH) and increased aminotransferases were all associated with a higher risk of readmission. A clinical course of 10 days or longer, and an absolute eosinophil count over 200/µL were associated with a lower risk. After the multivariate analysis, only hypertension (OR 4.99, CI 1.54-16.02), temperature over 38 °C in the emergency ward (OR 9.03, CI 1.89-45.77), leukopenia (OR 4.92, CI 1.42-17.11) and increased LDH (OR 6.62, CI 2.82-19.26) remained significantly associated with readmission. Outpatient management of patients with low-risk COVID-19 pneumonia is safe, if adequately selected. The protocol presented here has allowed avoiding 30% of the admissions for COVID-19 pneumonia in our hospital, with a very low readmission rate and no mortality.

Teotihuacanin, a Diterpene with an Unusual Spiro-10/6 System from Salvia amarissima with Potent Modulatory Activity of Multidrug Resistance in Cancer Cells.

Teotihuacanin (1), an unusual rearranged clerodane diterpene with a new carbon skeleton containing a spiro-10/6 bicyclic system, was isolated from the leaves and flowers of Salvia amarissima. Its structure was determined through spectroscopic analyses. Its absolute configuration was established by single-crystal X-ray diffraction. Compound 1 showed potent modulatory activity of multidrug resistance in vinblastine-resistant MCF-7 cancer cell line (reversal fold, RFMCF-7/Vin+ > 10703) at 25 µg/mL.

Genetic admixture and diversity estimations in the Mexican Mestizo population from Mexico City using 15 STR polymorphic markers.

The 15 AmpFlSTR Identifiler loci D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818 and FGA were analyzed in a sample of 378 unrelated individuals from Mexico City, Mexico. Significant deviations from HW equilibrium in 14/15 STR loci alleles were not detected. The D18S51 locus had the highest power of discrimination (0.970). Genetic admixture estimations revealed a 69% of Amerindian, 26% of European and 5% of African contribution. Comparative analyses between Mexicans and other neighboring populations reveal significant differences in genetic diversity. Our results are important for future comparative genetic studies in different Latin American ethnic groups, particularly Mexican Mestizos and Amerindians. They should also be helpful in genetics, population evolution, forensic and paternity testing.

The risk of developing cervical cancer in Mexican women is associated to CYP1A1 MspI polymorphism.

The aim of the study was to evaluate the association of two CYP1A1 polymorphisms (Msp1 and exon 7) with cervical cancer in Mexican women considering their smoking habit. The polymorphisms were determined in 310 individuals (155 with cervical cancer and 155 healthy controls). Women with MspI T/C or C/C showed increased risk of developing cervical cancer (3.7- and 8.3-fold increase, respectively) compared to women with T/T genotype. When smoking habit was considered, the risk for non-smokers with T/C and C/C genotypes was similar (5.2 and 4.1, respectively), whereas smoking women with C/C genotype showed a 19.4-fold increase of cervical cancer. Number of child births, number of sexual partners and marital status were strong risk factors for developing cervical cancer in women with T/T genotype; however, in women with T/C genotype, only the number of child births and sexual partners had a significant influence. These results suggest an important role of the CYP1A1 MspI polymorphism in the risk of developing cervical cancer.

Satisfacción de los pacientes hipertensos de 60 años y más sobre la atención de enfermería en casa / Satisfaction in 60 years and older hypertensive patients regarding home nursing assistance

Introducción: La satisfacción del paciente es un resultado Importante para la evaluación de los servicios de salud. Objetivo: Evaluar la satisfacción de pacientes hipertensos de 60 años y más sobre la atención de enfermería en casa. Metodología: Estudio transversal comparativo, se midió la satisfacción de 324 derechohabientes de 60 años y más que recibieron atención de enfermería en casa. Se estudiaron variables sociodemográficas y de salud, la satisfacción se evaluó a través de la relación interpersonal; la atención técnica y la orientación e información que recibieron por la enfermera. Análisis: frecuencias, X2 y t de student con un nivel de confianza del 95% Resultados: El 73.5% de los sujetos de la muestra se sintieron satisfechos por la atención recibida. Las características de la población relacionadas con su satisfacción fueron: independencia para llevar su tratamiento farmacológico (p<0.001), independencia para desplazarse dentro o fuera de su domicilio (p=0.004). De las características de la enfermera, el tipo de relación que manifestó llevar con su familiar anciano (p=0.007). Discusión: El nivel de satisfacción es multifactorial, como ha sido descrito en investigaciones médicas. La atención personalizada sigue siendo un aspecto Importante para la satisfacción del paciente. Conclusiones: Sobre el desempeño de la enfermera, es Importante reconocer, que ya se ha hablado sobre la Importancia de rescatar las relaciones interpersonales en este binomio. Por lo que se tendrá que buscar alternativas para que formen parte de la capacitación y perfil de quienes ya ejercen la atención y de los prospectos a ejercerla. Esta capacitación mejorará la participación y el rol de la enfermera en la promoción de un envejecimiento saludable.

Introduction: Patient satisfaction is an important result for evaluation of the health services. Objective: To evaluate satisfaction in 60 year old and older hypertensive patients regarding home nursing assistance. Methodology: Comparative, transversal study; I was measured satisfaction on 324 insured 60 year old and older patients who received home nursing assistance. Socio-demographic and health variables were studied; satisfaction was evaluated through interpersonal relationship, technical assistance, orientation and information given by the nurse. Analysis: frequencies, X2 and T-student with a confidence level of 95%. Results: 73.5 % people in the sample felt satisfaction because of the received assistance. The characteristics of the population related to satisfaction were: Independency to follow their pharmacologic treatment (p<0.01) independency to move In and out of home (p=0.00). From nurses' characteristics, the type of relation manifested of getting along with the old parent. Discussion: Satisfaction level is multifactor as it has been described in medical research. Personalized assistance continues being an Important aspect for the patient's satisfaction. Conclusions: Regarding the accomplishment of the nurse, it is Important to know that it has spoken out about the necessity of rescuing interpersonal relations in this binomial interaction. Indeed, it will be necessary looking for alternatives that take part of training and traits of whom exert already that assistance and those prospects to exert it. This training will Improve the participation and roll of nurses In the promotion of healthy aging.

[Clinical guidelines for the prevention of falls in elderly people]. / Guia de práctica clínica para la prevencion de caídas en el adulto mayor.

Demographic changes in our population are focusing on the health providers to prevent or minimize functional impairments resulting from the various chronic and multiple illnesses to which the elderly are prone. Because of that, we developed strategies that can help us to take decisions in order to identify the risk factors, and to prescribe preventive and rehabilitation programs. With this background, we organized an expert team to develop this guideline with evidence based on medicine methodology, and focus on the first level treatment prescribed by the general practitioner, with the participation of the health team and the support networks.

Expression of transcription factors in endometrium during natural cycles.

PURPOSE: The sex steroid control of the endometrial cycle is mediated by transcription factors, four of which are the estrogen and progesterone receptors, c-jun and c-fos, all expressed by the endometrium. The aim of this study was to analyze the distribution of the transcription factors in the different endometrial compartments during natural cycles. METHODS: We studied 53 reproductively-normal women, of whom 26 were in the proliferative phase and 27 in the secretory phase. An endometrial biopsy was performed and serum values of LH, FSH, estradiol, and progesterone were determined. We studied the expression of transcription factors using monoclonal antibodies. RESULTS: A correlation between estrogen receptor and c-jun and c-fos expression was observed in stroma and epithelia, and progesterone receptor expression correlated with c-jun expression in epithelia. C-jun and c-fos presented greater expression in the proliferative phase than in the secretory phase, in the stroma and in both epithelia. No relation was found between estradiol serum levels and any transcription factor, but progesterone serum levels correlated significantly with most such factors. CONCLUSION: The two proto-oncogenes could play a decisive role in regulating the endometrial cycle; they could mediate the effects induced by sex steroid, and could be related to other transcription factors.

Maternal mortality regionalization and trend in Mexico (1937-1995)

Background. The objetives were to establish regions by level of maternal mortality in order to evaluate its trend from 1937-1995 and to analyze characteristics of cases which occurred from 1990-1995. Methods. Regionalization of the country by maternal mortality level was carried out using Poisson regression. Level and mortality trends were analyzed globally and compared by regions using Poisson and linear regression. Characteristics of cases were analyzed from 1990-1995 using proportions and X² test. Results. Four well-differentiated and independent regions were established. Low and medium maternal mortality rate regions were found in northern and northwestern Mexico. High and very high maternal mortality regions were found in the Southeast of the country. Even when maternal mortality had descended, the speed of the descent has decreased and in the last few years, maternal mortality has increased. The quality of health care is a challenge for regions with low mortality rates, while the problem of accessibility is present in those with very high mortality rates. Conclusion. The employment of this regionalization approach in maternal mortality analysis would be useful to determine specific problems for each region. The establishment of programs according to this analysis could contribute to decrease in maternal mortality cases in Mexico

Utilización adecuada de la atención prenatal en el Instituto Mexicano del Seguro Social / Adequate use of antenatal care in the Mexican Institute of Social Security

Objetivo. Establecer la proporción de mujeres que utilizan adecuadamente los servicios de salud para la atención prenatal y medir la asociación entre utilización adecuada y los factores obstétricos, socioeconómicos, demográficos y culturales de una población de derechohabientes embarazadas, atendidas en un hospital general de zona del Instituto Mexicano del Seguro Social. Material y métodos. Se entrevistaron 394 mujeres de 12 a 49 años de edad que cursaban con embarazo de 28 a 42 semanas. Se aplicó un cuestionario que incluyó variables demográficas sociales, económicas y culturales; conocimientos sobre el embarazo y sus complicaciones, antecedentes ginecobstétricos, y barreras para la utiización de los servicios de salud para la atención prenatal. Se hizo análisis descriptivo y se estableció la fuerza de asociación utilizando razón de momios y un modelo de regresión logística. Resultados. El 75 por ciento de las embarazadas inició su atención prenatal en el primer trimestre, de ellas el 23.8 por ciento acudió a nueve consultas o más (utilización adecuada). Los factores asociados a utilización adecuada fueron: unidad de medicina familiar (UMF) con sistema computarizado; conocimiento y conducta ante complicaciones del embarazo; paridad; atención prenatal en UMF por el mismo médico; y ocupación de las mujeres. Conclusiones. La utilización adecuada de los servicios de salud para la atención prenatal se observó en una proporción baja de mujeres. Algunos de los factores que favorecen la utilización adecuada pueden considerarse para mejorar los programas institucionales

Objective. To establish what proportion of women utilize antenatal care adequately and analyze obstetric, economic, social and cultural factors related to the adequacy of antenatal care use at the Mexican Institute of Social Security (IMSS). Material and methods. This cross-sectional study included 394 women from 12 to 49 years of age at twenty eight to forty two weeks of gestation. A questionnaire was applied that collected information on the following: demographic, social, economic and cultural variables; knowledge about pregnancy and complications; gyneco-obstetric history, and barriers to use of antenatal health care services. Data were analyzed by using descriptive statistics, odds ratios and logistic regression modelling. Results. Antenatal care was started during the first trimester by 75% of women; 23.8% of these made at least nine antenatal care visits (adequate utilization). Adequate utilization was associated to prenatal care in family medicine units with a computer system, knowledge and behavior regarding complications,parity, care by the same physician at IMSS, and the woman's occupation. Conclusions. The proportion of women who utilize prenatal care adequately is low at IMSS. Information about related factors could be used in order to improve institutional programs.

Satisfacción laboral en médicos y enfermeras / Occupational satisfaction in physicians and nurses

El objetivo es determinar el grado de satisfacción laboral del personal médico y de enfermería que ocupa puestos de confianza en las unidades médicas del Instituto Mexicano del Seguro Social en la Delegación Regional de Baja California. Se construyó un instrumento para medir la satisfacción laboral con 33 items que abordaron cinco dimensiones: relaciones profesionales y personales, recursos materiales, cargas de trabajo, autonomía y recompensas psicológicas y materiales. Se aplicó la encuesta a 69 médicos y 34 enfermeras; de éstos, 16 por ciento, manifestó satisfacción alta; 66 por ciento, satisfacción media; y 18 por ciento, satisfación baja. De las dimensiones estudiadas, la que señala el mayor número de sujetos con satisfacción alta fue la autonomía (69 por ciento); las relaciones profesionales y la cantidad de trabajo fueron los apartados en los que se encontró menor proporción de sujetos con satisfacción alta (13 por ciento cada una). La edad y la antigüedad en el puesto son las variables que están relacionadas con el nivel de satisfacción laboral.

Panorama de la investigación en medicina familiar / Overview of family medicine research

Se presenta un análisis del panorama de la investigación en medicina familiar en el Instituto mexicano del Seguro Social (IMSS). En el primer apartado se analiza la investigación en el contexto nacional, se resalta el porcentaje del Gasto Federal en Ciencia y Tecnología dedicada a la salud y el predominio de la investigación clínica (44 por ciento) sobre la investigación sociomédica (19 por ciento). En cuanto a producción científica, se presenta el índice de artículos por médico y la baja producción en revistas extranjeras. En el análisis de la situación en medicina familiar en el IMSS, se presenta la productividad en la elaboración de protocolos de los 1783 registros en 1992, correspondiendo 12 por ciento a la especialidad y de éstos 70 por ciento eran protocolos de tesis, de los cuales 57 por ciento tienen como investigador principal a un médico familiar. Dada la baja productiva de protocolos y de artículos originados en medicina familiar, se muestran las restricciones que plantea el informe de la Comisión de Investigación y se proponen algunas alternativas para mejorar las situación actual de la investigación en medicina familiar

La calidad de vida en el paciente diabético tipo II y factores relacionados / The quality of life in patients with type II diabetes and related factors

El objetivo del presente trabajo es determinar la relación entre el tiempo de evolución y otras variables; edad de inicio, sexos, obesidad, descontrol metabólico, enfermedades asociadas, compliaciones tardías, nivel socioeconómico y la calidad de vida. Se trata de una encuesta descriptiva y transversal. Se estudiaron pacientes diabéticos no dependientes de insulina; para determinar las medidas se usaron el perfil del impacto de la enfermedad (PIE) y el índice de nivel socioeconómico (INSE). Se estudiaron 100 pacientes, con predominio del sexo femenino (68 por ciento), la media de edad para este sexo fue de 45, y para el masculino de 64 años. El PIE reportó una media de 21 (intervalo de 0 a 55). Las variables más importantes asociadas a mala calidad de vida fueron tiempo de evolución (RM=3.80, IC 95 por ciento= 1.67-864, p=0.001), descontrol metabólico (RM=2.36, IC 95 por ciento= 0.99-5.58, p=0.04), enfermedades asociadas (RM=4.58, IC 95 por ciento= 1.72-12.15, p=0.002), complicaciones tardías(RM=7.20, IC 95 por ciento= 3.03-17-10, p=0.001). Los pacientes diabéticos del primer nivel de atención presentaron moderada afectación en la calidad de vida mediada por la presencia de complicaciones tardías, el descontrol metabólico, el tiempo de evolución y las enfermedades asociadas