Primovist® (Gadotrexate disodium) magnetic resonance use in benign and malignant kidney diagnosis. / Uso de la resonancia magnetica con Primovist® (Gadotrexate disodio) para diagnostico de lesiones renales benignas y malignas.

OBJECTIVE: To evaluate the quality of the contrast images obtained with a Primovist® (gadoxetate disodium) Magnetic Resonance Image in order to diagnose benign, malignant and malformations in the urinary tract. MATERIAL AND METHODS: A retrospective image and diagnosis review of Primovist® MRI studies performed in liver insufficient patients without apparent renal abnormalities was done, in order to evaluate the urinary tract for irregularities. RESULTS: A total of 117 Primovist® MRI studies performed between july 2014 and November 2018 were reviewed, 5 were excluded because they were incomplete. The average age was 59.6 ± 16.6 years old. The following diagnosis were encountered: 36 simple cysts, 6 perirenal fibrosis after pyelonephritis, 1 renal cancer, 1 renal atrophy, 1 proximal uretheric flexure, 1 bilateral hydronephrosis due to lower urinary obstruction because of benign prostatic hyperplasia and 1 complex cyst. No MRI study was indicated with suspicions of renal abnormalities. Relevant images are included that demonstrate the capability of Primovist® MRI to diagnose renal abnormalities. CONCLUSION: Even though none of the Primovist® MRI studies was done with suspicious of renal abnormalities it was possible to diagnose incidental benign, malignant and malformations of the urinary tract. This study shows how Primovist® MRI can be useful contrast study for urinary tract irregularities.

OBJETIVO: Evaluar la calidad de las imágenes contrastadas del tracto urinario que permitan diagnosticar patologías benignas, malignas y malformaciones con el uso de una resonancia magnética contrastada con Primovist® (gadoxetato disodio). MATERIAL Y METODOS: Se realizó una revisión de las imágenes y diagnósticos del servicio de radiología de manera retrospectiva de pacientes con una resonancia magnética contrastada con Primovist® por padecer insuficiencia hepática sin aparente patología urinaria, con el objeto de buscar diagnósticos incidentales en el tracto urinario superior e inferior. RESULTADOS: Se revisaron durante el periodo de julio del 2014 a noviembre del 2018, 117 estudios, se excluyeron 5 por no contar con el estudio completo para su revaloración. La edad promedio fue de 59,6±16,6 años. Se encontraron 48 anormalidades urinarias sin previa sospecha diagnóstica por lo que fueron considerados como incidentales. A continuación se enumeran los hallazgos renales diagnosticados: 36 quistes simples, 6 cambios perirenales compatibles con secuelas de pielonefritis, 1 cáncer renal, 1 hipotrofia renal, 1 angulación funcional del uréter proximal sin cruce vascular con pelvis extrarenal contralateral, 1 hidronefrosis bilateral secundaria a obstrucción vesical por hiperplasia prostática y 1 quiste complejo. Ningún estudio se indicó por sospecha de anormalidades del tracto urinario. CONCLUSIONES: Aun cuando no era la indicación del estudio de resonancia, fue posible encontrar algunas patologías renales como hallazgos que incluyeron patología benigna, maligna y malformaciones, demostrando que la resonancia magnética con Primovist® se podría realizar como estudio contrastado para patologías renales.

Uso de la resonancia magnetica con primovist® (gadotrexate disodio) para diagnóstico de lesiones renales benignas y malignas / Use of magnetic resonance imaging with primovist® (gadoterate disodium) for the diagnosis of benign and malignant renal lesions

Objetiv: Evaluar la calidad de lasimágenes contrastadas del tracto urinario que permitandiagnosticar patologías benignas, malignas y malformaciones con el uso de una resonancia magnética contrastada con Primovist® (gadoxetato disodio).Material y métodos: Se realizó una revisión de lasimágenes y diagnósticos del servicio de radiología demanera retrospectiva de pacientes con una resonanciamagnética contrastada con Primovist® por padecerinsuficiencia hepática sin aparente patología urinaria,con el objeto de buscar diagnósticos incidentales en eltracto urinario superior e inferior. Resultados: Se revisaron durante el periodo de juliodel 2014 a noviembre del 2018, 117 estudios, se excluyeron 5 por no contar con el estudio completo parasu revaloración. La edad promedio fue de 59,6±16,6años. Se encontraron 48 anormalidades urinarias sinprevia sospecha diagnóstica por lo que fueron considerados como incidentales. A continuación se enumeranlos hallazgos renales diagnosticados: 36 quistes simples, 6 cambios perirenales compatibles con secuelasde pielonefritis, 1 cáncer renal, 1 hipotrofia renal, 1angulación funcional del uréter proximal sin cruce vascular con pelvis extrarenal contralateral, 1 hidronefrosisbilateral secundaria a obstrucción vesical por hiperplasia prostática y 1 quiste complejo. Ningún estudio se indicó por sospecha de anormalidades del tracto urinarioConclusiones: Aun cuando no era la indicacióndel estudio de resonancia, fue posible encontrar algunas patologías renales como hallazgos que incluyeronpatología benigna, maligna y malformaciones, demostrando que la resonancia magnética con Primovist® sepodría realizar como estudio contrastado para patologías renales.(AU)

Objetive: To evaluate the quality of thecontrast images obtained with a Primovist® (gadoxetatedisodium) Magnetic Resonance Image in order to diagnose benign, malignant and malformations in the urinarytract. Material and methods: A retrospective image anddiagnosis review of Primovist® MRI studies performed inliver insufficient patients without apparent renal abnormalities was done, in order to evaluate the urinary tractfor irregularities.Results: A total of 117 Primovist® MRI studies performed between july 2014 and November 2018 werereviewed, 5 were excluded because they were incomplete. The average age was 59.6 ± 16.6 years old.The following diagnosis were encountered: 36 simplecysts, 6 perirenal fibrosis after pyelonephritis, 1 renalcancer, 1 renal atrophy, 1 proximal uretheric flexure, 1bilateral hydronephrosis due to lower urinary obstructionbecause of benign prostatic hyperplasia and 1 complexcyst. No MRI study was indicated with suspicions ofrenal abnormalities. Relevant images are included thatdemonstrate the capability of Primovist® MRI to diagnose renal abnormalities.Conclusion: Even though none of the Primovist®MRI studies was done with suspicious of renal abnormalities it was possible to diagnose incidental benign,malignant and malformations of the urinary tract. Thisstudy shows how Primovist® MRI can be useful contraststudy for urinary tract irregularities.(AU)

Microorganisms associated to thyroid autoimmunity.

Autoimmune thyroid diseases are a group of diseases characterized by a dysfunction of the immune system concerning the thyroid gland, associated with hypothyroidism or hyperthyroidism. The thyroid gland autoimmunity has been recognized as multifactorial. It has been reported that microorganisms may play a role on the pathogenesis of Hashimoto's thyroiditis and Graves´ disease. These could explain the high incidence of the autoimmune thyroid diseases. Helicobacter Pylori (H. pylori) and Hepatitis C virus (HCV) are the microorganisms in which the association with autoimmune thyroid diseases is clearer. The pathophysiologic mechanisms are still not well defined. For H. pylori, molecular mimicry has been the most accepted mechanism. It has been proposed Hepatitis C virus as the trigger of the thyroid autoimmunity by exacerbating the production of thyroid auto-antibodies, while some mention that the real factor that triggers the thyroid autoimmunity is the treatment with Interferon alpha (IFN-alpha) by upregulating MHC class I and inducing ligation of CD40+ cells to thyrocytes. Other microorganisms such as Toxoplasma gondii, Human Immunodeficiency virus, Herpes virus and others have reported information about their association with thyroid autoimmune diseases There are no proposals on how these last microorganisms induce thyroid autoimmunity. There is still a lack of evidence on this topic. Further research must be done to determine the interaction of these microorganisms and the best way to manage these patients.

Misinformation of COVID-19 on the Internet: Infodemiology Study.

BACKGROUND: The internet has become an important source of health information for users worldwide. The novel coronavirus caused a pandemic search for information with broad dissemination of false or misleading health information. OBJECTIVE: The aim of this study was to evaluate the quality and readability of online information about the coronavirus disease (COVID-19), which was a trending topic on the internet, using validated instruments and relating the quality of information to its readability. METHODS: The search was based on the term "Wuhan Coronavirus" on the Google website (February 6, 2020). At the search time, the terms "COVID-19" or "SARS-CoV-2" (severe acute respiratory syndrome coronavirus 2) did not exist. Critical analysis was performed on the first 110 hits using the Health on the Net Foundation Code of Conduct (HONcode), the Journal of the American Medical Association (JAMA) benchmark, the DISCERN instrument, and Google ranking. RESULTS: The first 110 websites were critically analyzed, and only 1.8% (n=2) of the websites had the HONcode seal. The JAMA benchmark showed that 39.1% (n=43) of the websites did not have any of the categories required by this tool, and only 10.0% (11/110) of the websites had the four quality criteria required by JAMA. The DISCERN score showed that 70.0% (n=77) of the websites were evaluated as having a low score and none were rated as having a high score. CONCLUSIONS: Nonhealth personnel and the scientific community need to be aware about the quality of the information they read and produce, respectively. The Wuhan coronavirus health crisis misinformation was produced by the media, and the misinformation was obtained by users from the internet. The use of the internet has a risk to public health, and, in cases like this, the governments should be developing strategies to regulate health information on the internet without censuring the population. By February 6, 2020, no quality information was available on the internet about COVID-19.

Determine safety of outpatient chemotherapy and autotransplants using refrigerated, non-frozen grafts in persons with multiple sclerosis.

BACKGROUND: Persons with multiple sclerosis are increasingly treated with intermediate- or high-dose chemotherapy and a hematopoietic cell autotransplant. This is often done in an inpatient setting using frozen blood cell grafts. OBJECTIVE: Determine if chemotherapy and a hematopoietic cell autotransplant can be safely done in an outpatient setting using refrigerated, non-frozen grafts. METHODS: We developed an autotransplant protocol actionable in an outpatient setting using a refrigerated, non-frozen blood graft collected after giving cyclophosphamide, 50 mg/kg/d × 2 days and filgrastim, 10 µg/kg/d. A second identical course was given 9 days later followed by infusion of blood cells stored at 4°C for 1-4 days. The co-primary outcomes were rates of granulocyte and platelet recovery and therapy-related mortality. RESULTS: We treated 426 consecutive subjects. Median age was 47 years (range, 21-68 years). A total of 145 (34%) were male. Median graft refrigeration time was 1 day (range, 1-4 days). Median interval to granulocytes >0.5 × 10E + 9/L was 8 days (range, 2-12) and to platelets >20 × 10E + 9/L, 8 days (range, 1-12). Only 15 subjects (4%) were hospitalized, predominately for iatrogenic pneumothorax (N = 5) and neutropenic fever (N = 4). There was only 1 early death from infection. CONCLUSION: Intermediate-dose chemotherapy and a hematopoietic cell autotransplant can be safely done in an outpatient setting using, refrigerated, non-frozen grafts.

Metabolic Changes in Children that Received Chemotherapy.

Cancer treatments are associated with short and long-effects. Epidemiological reports have revealed clinical features of metabolic syndrome (MS), obesity or overweight in young cancer survivors. The aim of the study was to examine the prevalence of unhealthy weight status and risk factors associated with MS related to chemotherapy. We study 52 pediatric cancer patients and analyze cholesterol, triglycerides, glycosylated hemoglobin, body mass index, waist circumference (WC), FINDRISC test. All the parameters were analyzed according to the percentile corresponding to sex and age of each child. The data show an important modification in weight, body mass index, and WC as in triglycerides, and cholesterol that could be associated with the development of MS. The variance analysis showed that the WC, triglycerides, and cholesterol are statistically correlated in our population. A follow-up for MS in children cancer survivor should be considered necessary.

P-glycoprotein Activity Correlates With Treatment Response in 2 Leukemia Child Patients.

Acute lymphoblastic leukemia is the most important childhood cancer. Multidrug resistance is an important factor of poor prognosis. We present the P-glycoprotein (P-gp) activity in 2 patients with different outcomes. Both patients had B-cell acute lymphoblastic leukemia; they were responding properly to the treatment, but one of them had an increment in the P-gp activity that correlates with an increment in the disease manifestation, the patient had to be hospitalized and developed sepsis and subsequently died. P-gp levels were correlated with disease progression. P-gp activity needs to be evaluated during treatment to assess and prevent disease relapse or the patient´s death.

Development of Metabolic Syndrome Associated to Cancer Therapy: Review.

Long-term childhood cancer survivors are at great risk of developing late adverse effects after treatment, such as, reduced growth, obesity, decreased fertility, high blood pressure, cardiovascular diseases, impaired glucose, another form of cancer, among others organ dysfunctions, some of them are part of the metabolic syndrome. Metabolic syndrome and cancer connection is still not entirely understood, but there are some notions about it. Metabolic alterations produced during childhood cancer are more likely determined by treatments like radiotherapy, chemotherapy, glucocorticoids therapy, and surgery. Cancer treatment is associated to vascular alterations, hormone deficiencies, changes in insulin sensitivity, lipid metabolism, and inflammatory mediators. Obesity has been considered a crucial component in metabolic syndrome; obesity risk factors during childhood cancer include cranial radiation, female gender, and exposure to glucocorticoids such as dexamethasone. In addition, local radiotherapy or surgery may cause endocrine deficiencies, depends on the directly damage of endocrine organs. Patients who received some types of cancer treatment should be evaluated periodically to early diagnostic metabolic disorders associated to antineoplastic therapy.

Hematoma paravesical espontáneo posterior a dosis única profiláctica de enoxaparina en cirugía ortopédica. Presentación de un caso / Spontaneous paravesical hematoma at a single prophylactic doses of enoxaparin in Orthopedic surgery. Case report

El hematoma paravesical espontáneo es una complicación infrecuente, con pocos casos reportados en la literatura. Aproximadamente el 2 % de los pacientes que se traten con enoxaparina profiláctica tendrán complicaciones hemorrágicas, de las cuales el 20 % son hematomas retroperitoneales o intracraneales, en dependencia de los factores de riesgo. Por tales razones se presenta el caso de un paciente de 35 años de edad, previamente sano, que fue sometido a una sutura de tendón de Aquiles después de sufrir un trauma, al que se le administró profilácticamente una sola dosis de enoxaparina en el posoperatorio inmediato y 24 horas después comenzó a quejarse de dolor en fosa iliaca derecha y disuria. El ultrasonido abdominal demostró un hematoma paravesical, que fue confirmado por topografía. Se manejó conservadoramente con sonda intravesical por diez días. Se realizó seguimiento del paciente, sin que se encontraran secuelas. Los autores infieren que el sangrado fue secundario a una sobredistensión vesical secundaria a la anestesia que provocó el sangrado de la pared de la vejiga. Este reporte demuestra que la enoxaparina profiláctica puede causar hematomas paravesicales espontáneos asociados a la sobredistención vesical. Sin embargo son necesarios otros reportes similares para confirmar lo anteriormente planteado.

Spontaneous paravesical hematoma is an infrequent complication, with a few reported cases in literature. Approximately 2 % of the patients treated with prophylactic enoxoparin will have hemorrhagic complications, from which 2 0% are retroperitoneal or intracranial hematomas depending on the risk factors. For such reasons it is presented a 35 year old patient, previously healthy, who was performed to a suture of the Achilles tendon after suffering a trauma. He was administered prophylactically a single doses of enoxoparin in the immediate post surgery and 24 hours later he started to complain of pain in the right lower quadrant and dysuria. Abdominal ultrasound showed a paravesical hematoma secondary to anesthesia which caused bleeding of the vesicle walls. This report shows prophylactic exoparin may produce spontaneous paravesical hematomas associated to vesical overdistention. However it is necessary other similar reports to confirm the previous statement.

Th1, Th2, Th17 and Treg levels in umbilical cord blood in preeclampsia.

INTRODUCTION: Preeclampsia is one of the major causes of maternal and neonatal mortality. During pregnancy, the immune system must maintain the tolerance to the fetus, thus changes in the cytokine balance may result in a disturbed pregnancy. T helper cells play an important role in modulation of the immune system and are involved in this cytokine balance. OBJECTIVE: Many studies have been performed to study the T cell composition in different compartments during pregnancy, although this is the first study in which T cells are evaluated in umbilical cord blood. STUDY DESIGN: Intracellular expression of INF-gamma, IL-17, IL-4 and forkhead foxP3 in CD4+ T cells was evaluated in umbilical blood from healthy pregnant and preeclamptic women using a flow cytometer. RESULTS: Th2 and Treg cells levels were significantly diminished in preeclamptic compared to the healthy women, but no difference in Th1 and Th17 levels were found between both groups. CONCLUSIONS: Our data suggest that the cytokine balance is broken, encouraging the development of an exacerbated inflammatory response. Our results show that there is a shift, in the Th1/Th2, and the Th17/Treg balance, favoring skewness towards a proinflammatory status in the umbilical cord blood in preeclampsia.

Respuesta a acetazolamida en paciente con calcinosis tumoral / Response to acetazolamide in a patient with tumoral calcinosis

No disponible

Outcome of Recipients of Hematopoietic Stem Cell Transplants Who Require Intensive Care Unit Support: A Single Institution Experience.

Admission to the intensive care unit (ICU) of a patient who has been grafted with hematopoietic stem cells is a serious event, but the role of the ICU in this setting remains controversial. Data were analyzed from patients who underwent autologous or allogeneic bone marrow transplantation at the Centro de Hematología y Medicina Interna de Puebla, México, between May 1993 and October 2014. In total, 339 patients were grafted: 150 autografts and 189 allografts; 68 of the grafted patients (20%) were admitted to the ICU after transplantation: 27% of the allografted and 11% of the autografted patients (p = 0.2). Two of 17 autografted patients (12%) and 5 of 51 allografted patients (10%) survived. All patients who required insertion of an endotracheal tube died, whereas 7 of 11 patients without invasive mechanical ventilation survived (p = 0.001). Only 10% of the grafted patients survived their stay in the ICU; this figure is lower than those reported from other centers and may reflect several facts, varying from the quality of the ICU support to ICU admission criteria to the initial management of all the grafts in an outpatient setting, which could somehow delay the arrival of patients to the hospital.

Relación del consumo de productos para bajar de peso con el sobrepeso y la obesidad en profesores universitarios de Puebla, México / The relation between overweight and obesity with the use of weight loss products in university professors of Puebla, Mexico

Antecedentes. Las tendencias de obesidad y sobrepeso en México muestran un significativo incremento en las últimas encuestas nacionales. Esto se ve reflejado en el incremento de las enfermedades crónicas no transmisibles, además de un mayor consumo de agentes para pérdida de peso. Objetivo. Encontrar la relación entre el consumo de productos adelgazantes, el sobrepeso y la obesidad en profesores de una universidad privada de Puebla, México. Materiales y métodos. Se realizó un diseño no experimental, transversal descriptivo, utilizando un muestreo probabilístico aleatorio simple, en el que participaron 100 profesionistas; 27 hombres y 73 mujeres. Se aplicó un cuestionario para conocer los hábitos, el consumo de agentes para pérdida de peso, además de mostrárseles modelos anatómicos que determinaron la percepción de la persona con su cuerpo. Finalmente se realizó la medición antropométrica y se obtuvo el cálculo de su índice de masa corporal (IMC). Resultados. El 45% de las personas involucradas presentan sobrepeso y obesidad.38% consumen productos para bajar de peso; de estos, 84,2% eran mujeres. Entre mayor índice de masa corporal (IMC) mayor consumo de productos para bajar de peso (p<0.05). Se observa una relación inversa entre mayor obesidad y menor número de comidas al día, a la par con un menor número de horas de ejercicio. Finalmente, la mayoría de las personas con sobrepeso se perciben con un IMC mayor. Conclusión. El consumo de agentes para pérdida de peso se relaciona con el incremento del sobrepeso y la obesidad en los profesionistas.

Background. Current tendencies in obesity and overweight in México shows a significant increase in the last National Nutrition and Health Surveys, which is reflected in the rise of chronic non-transmissible diseases and an increase of anti-obesity drugs. Objective. Find the relationship between the consumption of anti-obesity drugs, overweight and obesity in teachers at a private university of Puebla city, in Mexico. Materials and methods. This is a non-experimental, cross-sectional descriptive design, where a simple random probability sampling was used. 100 professional workers at a private university of Puebla city participated, 27 men and 73 women. It was applied a test to each one of them, in order to identify their habits and consume of anti-obesity drugs. Anatomical models were presented to the participants to determinate their self-perception of body image. Finally anthropometric measures were done and body mass index was calculated. Results. 45% of participants presented overweight and obesity; 38% consume anti-obesity drugs, of these, 84.2% are women. It was observed that higher body mass index (BMI) gives a higher consume of anti-obesity drugs (p<0.05). It was determined an inversed relationship between a higher obesity degree and a lower number of meals a day, correlated also with a lower number of exercise hours. Finally people with a healthy BMI, have adequate self-perception of body image and the majority of people with overweight, perceived themselves with a higher BMI. Conclusions. The consumption of anti-obesity drugs is related to the increase of overweight and obesity in professional workers.

A comprehensive review of urologic complications in patients with diabetes.

Diabetes Mellitus (DM) is a chronic disease characterized by hyperglycemia, as a result of abnormal insulin production, insulin function, or both. DM is associated with systemic complications, such as infections, neuropathy and angiopathy, which involve the genitourinary tract. The three most significant urologic complications include: bladder cystopathy, sexual dysfunction and urinary tract infections. Almost half of the patients with DM have bladder dysfunction or cystopathy, which can be manifested in women as hypersensitivity (in 39-61% of the diabetic women) or neurogenic bladder. In males it can be experienced as lower urinary tract symptoms (in 25% of diabetic males with a nearly twofold increased risk when seen by age groups). Additionally, an increased prostate volume affects their micturition as well as their urinary tract. Involving sexual dysfunction in women, it includes reduced libido, decreased arousal, clitoral erectile dysfunction and painful or non-sensitive intercourse; and in diabetic males it varies from low libido, ejaculatory abnormalities and erectile dysfunction. Globally, sexual disorders have a prevalence of 18-42%. Erectile dysfunction is ranked as the third most important complication of DM. Urinary tract infections are observed frequently in diabetic patients, and vary from emphysematous infections, Fournier gangrene, staghorn infected lithiasis to repetitive bacterial cystitis. The most frequent finding in diabetic women has been lower urinary tract infections. Because of the high incidence of obesity worldwide and its association with diabetes, it is very important to keep in mind the urologic complication associated with DM in patients, in order to better diagnose and treat this population.

Sertoli-Leydig cell tumor in a 12-year-old girl: a review article and case report.

BACKGROUND: The Sertoli and Leydig cell tumor is an unusual neoplasm that belongs to the sex cord-stromal tumors. Generally these tumors are associated with good prognosis. These tumors usually present virilizing symptoms such as oligomenorrhea or amenorrhea, hirsutism, voice raucity, laryngeal protuberance and clitoromegaly. CASE PRESENTATION: A 12 year old girl referred acute abdominal pain with no other clinical manifestations. An abdominal ultrasound showed a semisolid mass suggestive of ovarian tumor. The diagnosis was confirmed by a computed tomography. A unilateral salpingo oophorectomy was performed and the pathologist reported a Sertoli-Leydig tumor with intermediate differentiation. The outcome was excellent. CONCLUSIONS: These tumors represent a rare condition in children. However, they can occur at any age, therefore it is important to acknowledge the clinical manifestations, diagnostic approach and therapeutic options. In this case the patient presented unusual symptoms which makes it more interesting.

Antiphospholipid antibodies in Mexican HIV-positive patients

Several studies have shown that HIV patients tend to develop autoimmune diseases, and have numerous antibodies, such as antiphospholipid antibodies. Antiphospholipid antibodies are the serological markers used in the diagnosis of the antiphospholipid syndrome. However, antiphospholipid antibodies also appear to exist in infectious diseases. Objective: TomeasurethetitersofantiphospholipidantibodiesinhealthyandinHIVpositiveMexican mestizo patients, and correlate them with the patient clinical manifestations to identify possible findings compatible with an autoimmune disease. Material and methods: A case control study was conducted on 50 healthy mixed race Mexican subjects andin50 randomly selectedHIV-positive patients from the (..) (AU)

Varios estudios han demostrado que los pacientes con VIH tienden a desarrollar enfermedades autoinmunes, presentando diversos anticuerpos como los anticuerpos antifosfolípidos. Los anticuerpos antifosfolípido son los marcadores serológicos que se emplean en el diagnóstico del síndrome antifosfolípido. Sin embargo los anticuerpos antifosfolípido también suelen existir en enfermedades infecciosas específicas. Objetivo: Medir los títulos de anticuerpos antifosfolípido en pacientes mexicanos mestizos sanos y VIH positivos y correlacionarlos con las manifestaciones clínicas de los pacientes para identificar posibles hallazgos compatibles con alguna enfermedad autoinmune. Material y métodos: Se trata de un estudio de casos y controles en el que se evaluaron (..) (AU)

Frequency of diabetes, impaired fasting glucose, and glucose intolerance in high-risk groups identified by a FINDRISC survey in Puebla City, Mexico.

BACKGROUND: As a first step in the prevention of diabetes, the International Diabetes Federation recommends identification of persons at risk using the Finnish type 2 Diabetes Risk Assessment (FINDRISC) survey. The frequency of diabetes mellitus, impaired fasting glucose, and glucose intolerance in high-risk groups identified by FINDRISC is unknown in our country. The aim of this study was to determine the frequency of diabetes mellitus, impaired fasting glucose, and glucose intolerance in higher-risk groups using a FINDRISC survey in an urban population. METHODS: We used a television program to invite interested adults to fill out a survey at a television station. An oral glucose tolerance test was performed in all persons with a FINDRISC score ≥ 15 points (high-risk and very high-risk groups). Patients were classified as normal (fasting glucose < 100 mg/dL and 2-hour glucose < 140 mg/dL), or having impaired fasting glucose (fasting glucose 100-125 mg/dL and 2-hour glucose < 140 mg/dL), glucose intolerance (fasting glucose < 126 mg/dL and 2-hour glucose 140-199 mg/dL), and diabetes mellitus (fasting glucose ≥ 126 mg/dL or 2-hour glucose ≥ 200 mg/dL). We describe the frequency of each diagnostic category in this selected population according to gender and age. RESULTS: A total of 186 patients had a score ≥ 15. The frequencies of diabetes mellitus, impaired fasting glucose, glucose intolerance, and normal glucose levels were 28.6%, 25.9%, 29.2%, and 16.2%, respectively. We found a higher frequency of diabetes mellitus and impaired fasting glucose in men than in women (33% versus 27% and 40% versus 21%, respectively) and more glucose intolerance in women than in men (34% versus 16%, P < 0.05). Patients with diabetes mellitus (52.55 ± 9.2 years) were older than those with impaired fasting glucose (46.19 ± 8.89 years), glucose intolerance (46.15 ± 10.9 years), and normal levels (41.9 ± 10.45 years, P < 0.05). We found a higher frequency of diabetes mellitus in those aged over 50 years than in younger subjects (46.15% versus 15.88%, respectively). CONCLUSION: The FINDRISC survey is a very useful tool for identifying individuals at high risk of developing diabetes and prediabetic states, especially in those older than 50 years.

Focal dermal hypoplasia with uterus bicornis and renal ectopia: case report and review of the literature.

Focal dermal hypoplasia (FDH) is a rare inherited genodermatosis with an X-linked dominant trait. FDH is associated with skin defects and other abnormalities of bone, nails, hair, limbs, teeth and eyes. We present the case of a 26-year-old female in the 27th pregnancy week and a previous history of miscarriage. After careful physical examination and dermal biopsy, histopathology revealed that the patient was a carrier of FDH. This is the first report in the literature describing that FDH is associated with uterus bicornis and renal ectopia. Our association could be attributable to early embryonic abnormalities related with FDH because both the uterus bicornis and the renal ectopia originate around the 3th-6th week of embryonic development. We are unable to confirm that the miscarriages were caused by inherited FDH or that uterus bicornis was the cause. We conducted a literature review using the following terms: FDH, Goltz syndrome, uterus bicornis, and renal ectopia.