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Genetics is responsible for 80% of androgenetic alopecia (AGA) predisposition. Several single nucleotide polymorphisms (SNPs) have been linked to AGA risk and the metabolism of its first-line therapies. Genotypic and allelic frequencies have not been described in Mexican individuals; therefore, the aim of this study was to describe the genetic distribution of SNPs associated with AGA predisposition and drug metabolism. Using Real Time-PCR, we genotyped SNPs rs4827528 (AR), rs7680591 (FGF5), rs1042028, rs1042157, rs788068 and rs6839 (SULT1A1) and rs776746 (CYP3A5) in 125 (controls = 60, cases = 65) male volunteers from Northern and Western Mexico. The SULT1A1 SNPs rs1042028 (C/T) and rs788068 (T/A/C) resulted in a 100% distribution of the ancestral allele C and mutated allele A, respectively; rs1042028 diverges from the previously reported frequency, while the rs788068 ancestral allele was found to be more predominant than the reported frequency. Rs1042028, rs788068 and rs4827528, were not in Hardy-Weinberg (HW) equilibrium; conversely, rs1042157 and rs6839, rs776746, and rs7680591 followed HW principles. A statistically significant difference (P<0.05) was obtained for the rs1042157 allelic frequency between cases and controls in Western Mexico. We reported the genotypic and allelic frequencies of seven polymorphisms in Mexican individuals from Northern and Western Mexico.
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Influenza virus causes annual epidemics of respiratory illness characterized by sudden onset of fever, malaise, myalgias, headache, cough, and other respiratory complains. Each year in the United States, it is estimated that this debilitating respiratory illness accounts for 294,000 excess hospitalizations and 36,000 attributable deaths. Epidemiological studies describe increased cardiovascular mortality during influenza seasons. Cardiovascular involvement in acute influenza infection can occur through direct effects of the virus on the myocardium or through exacerbation of existing cardiovascular disease. The purpose of this report is to document a transient atrioventricular (AV) block with hemodynamic compromise after infection with the influenza virus in a patient with underlying cardiac disease without myocarditis.
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Bloqueo Atrioventricular/virología , Virus de la Influenza A , Gripe Humana/complicaciones , Anciano de 80 o más Años , Hemodinámica , Humanos , Gripe Humana/fisiopatología , MasculinoRESUMEN
BACKGROUND: Obstructive sleep apnea (OSA) prevalence has been increasing in the past years adding significant morbidity. Perioperative management is controversial and few studies have addressed this matter. The American Society of Anesthesiology (ASA) and the American Academy of Sleep Medicine (AASM) have developed clinical practice guidelines for the perioperative management of patients with OSA. Existing evidence suggest an increase in early postoperative complications in patients with OSA. Nevertheless, data about perioperative management of OSA is limited. To our knowledge, only two studies that address this matter, none in Puerto Rico. METHODS: A questionnaire was given to participants at the annual meeting of anesthesiology in Puerto Rico. The document was then anonymously deposited into sealed box. RESULTS: The response rate was 80 %. The awareness about written postoperative policy in patients with diagnosed (23 %) and suspected (11 %) OSA was low. If a written policy were available, 46 % of patients would have gone to ICU. The most important factor for final disposition was the degree of OSA, which was decided by surgery and anesthesia (69 %). In the last year, at least one complication related to OSA was observed in 20 % of respondents. The most common preoperative screening tool was the ASA guidelines. Seventy-two percent of respondents suggested a lack of institutional policies as the main reason for disparity. CONCLUSION: There is a significant heterogeneity in the current clinical practice. The main barriers identified to achieve current recommendations were lack of institutional policies, awareness of current guideline, formal training in management of OSA, and access to a sleep specialist.
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Anestesiología , Atención Perioperativa/métodos , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/terapia , Encuestas y Cuestionarios , Anciano , Comorbilidad , Presión de las Vías Aéreas Positiva Contínua , Adhesión a Directriz , Indicadores de Salud , Humanos , Unidades de Cuidados Intensivos , Ventilación con Presión Positiva Intermitente , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Ventilación no Invasiva , Admisión del Paciente , Polisomnografía , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Garantía de la Calidad de Atención de Salud , Medición de Riesgo , Apnea Obstructiva del Sueño/diagnósticoRESUMEN
This patient presented with scimitar syndrome, a rare combination of partial anomalous pulmonary venous return, right lung hypoplasia, and dextroposition of the heart.
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INTRODUCTION: Little data is available concerning variations in the clinical characteristics of lymphoid neoplasms at presentation. We decided to investigate whether any variations in these characteristics had occurred in Spain during the last few years. MATERIALS AND METHODS: The GOTEL group database is an archive of all new lymphoma cases, regardless of their histological subtype, diagnosed in the hospitals within the group. An analysis was made of all the records between 1 January 1999 and 1 January 2009. Though the number of hospitals submitting data has changed over the course of time, data were provided by 26 hospitals from 16 Spanish provinces. RESULTS: A total of 3651 cases of lymphoma were recorded during this period. Grouped by clinical features, 42.8% (1561 patients) had low-grade lymphoma, 30.4% (1110 patients) intermediate-grade lymphoma and 15.2% (556 patients) Hodgkin's lymphoma; 208 patients had T lymphoma (5.7%), 111 patients high-grade lymphoma (3%) and 105 patients (2.9%) suffered lymphomas that were difficult to classify. A total of 6.3% of the diagnoses (231 patients) were made prior to 1999, 29.5% between 2000 and 2001, 25.7% between 2002 and 2003, 19.7% between 2004 and 2005, 11.2% between 2006 and 2007, and there were 200 entries from 2008 to the close of the study period, corresponding to 1.5% of the complete database. The median age at diagnosis was 60 (range 7-105 years), by percentiles: 25 corresponded to 44 years old, 50 to 60 years old and 75 to 71. Distribution by gender was 53.1% male and 46.9% female. An analysis was made of all the clinical variables collected, comparing their behaviour during the different diagnostic periods. The periods, gender, ECOG, stage, LDH, ß2 microglobulin, Hodgkin's or non- Hodgkin's type neoplasm, B lymphoma vs. Hodgkin's, NK or T, nodal or extra-nodal origin, median age at diagnosis and histological type by region of origin did not show any statistically significant differences in their distribution over the course of time. CONCLUSION: In our experience, there are no significant variations in clinical presentation or histological type in lymphomas diagnosed over the course of time in Spain.
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Linfoma/clasificación , Linfoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Estudios de Seguimiento , Humanos , Linfoma/mortalidad , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Pronóstico , España , Tasa de Supervivencia , Adulto JovenRESUMEN
Es importante evaluar el perfil del uso del factor estimulante de colonias granulocíticas (fec-g) en pacientes con enfermedad arterial oclusiva crónica (eaoc), mediante el análisis de aspectos como eficacia y seguridad. Se examinaron los datos obtenidos de la cohorte de pacientes con eaoc que asistían regularmente a la clínica de Cirugía Vascular del Hospital Militar Central en Bogotá. El protocolo de movilización de células CD34+ hacia sangre periférica consistió en el uso de FEC-Grh a dosis de 600 mg/día por vía subcutánea (Filgrastim fec-g 300 mg Roche®), repartido en dos dosis diarias, en forma continua durante cinco días. Al realizar la comparación de valores a partir de hemogramas realizados antes y después de la movilización, se demostró incremento significativo en el número de leucocitos así como en la proporción de neutrófilos y basófilos; mientras que las proporciones de monocitos, eosinófilos y linfocitos disminuyeron significativamente. Con respecto al comportamiento de las células CD34+, no se muestra una diferencia significativa en el comportamiento del CD34+ con la edad, así como tampoco con el índice de masa corporal (imc). En lo relacionado con el peso y los niveles de CD34+, se observó que los pacientes que lograron una buena respuesta tenían un peso de 59,7 kg, mientras que los pacientes con regular respuesta, 68,1 kg.
The analyzed aspects such as efficacy and safety are important in the use of Granulocyte Colony Stimulating Factor in patients with chronic occlusive arterial disease were analyzed data from the cohort of patients with eaoc that regularly attended the Clinic for Vascular Surgery of the Hospital Militar Central in Bogotá. The protocol for CD34+ cell mobilization into peripheral blood involved the use of FEC-Grh at a dose of 600 mg/day administered subcutaneously (Filgrastim g-csf 300 mg Roche®) divided into two daily doses, continuously for five days. By comparing the values from blood counts performed before and after mobilization showed increased significant number of leukocytes as well as proportion of neutrophils and basophiles, whereas proportions of monocytes, eosinophils and lymphocytes decreased significantly. About the CD34+ cell behavior, its not shown significant difference between the behaviors of CD34+ with age, neither the imc. The analyzed done on the weight and CD34+ levels was observed that patients achieved a good response with a weight of 59.7 kg while 68.1 kg patients with regular response.
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Filgrastim , Movilización de Célula Madre Hematopoyética , Células Madre HematopoyéticasRESUMEN
A recent article in Environmental Management by All argued that flood flows in North America's Colorado River do not reach the Gulf of California because they are captured and evaporated in Laguna Salada, a below sea-level lakebed near the mouth of the river. We refute this hypothesis by showing that (1) due to its limited area, the Laguna Salada could have evaporated less than 10% of the flood flows that have occurred since 1989; (2) low flow volumes preferentially flow to the Gulf rather than Laguna Salada; (3) All's method for detecting water surface area in the Laguna Salada appears to be flawed because Landsat Thematic Mapper images of the lakebed show it to be dry when All's analyses said it was flooded; (4) direct measurements of salinity at the mouth of the river and in the Upper Gulf of California during flood flows in 1993 and 1998 confirm that flood waters reach the sea; and (5) stable oxygen isotope signatures in clam shells and fish otoliths recorded the dilution of seawater with fresh water during the 1993 and 1998 flows. Furthermore, All's conclusion that freshwater flows do not benefit the ecology of the marine zone is incorrect because the peer-reviewed literature shows that postlarval larval shrimp populations increase during floods, and the subsequent year's shrimp harvest increases. Furthermore, freshwater flows increase the nursery area for Gulf corvina (Cynoscion othonopterus), an important commercial fish that requires estuarine habitats with salinities in the range of 26-38 per thousand during its natal stages. Although flood flows are now much diminished compared to the pre-dam era, they are still important to the remnant wetland and riparian habitats of the Colorado River delta and to organisms in the intertidal and marine zone. Only a small fraction of the flood flows are evaporated in Laguna Salada.
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Desastres , Ríos , Movimientos del Agua , Animales , México , Moluscos , Penaeidae , Comunicaciones por Satélite , Agua de Mar , Estados UnidosRESUMEN
Objetivo: reportar la experiencia del manejo endovascular en pacientes con síndrome de compresión iliocava.Materiales y métodos: durante tres años se evaluaron 84 pacientes con sospecha de compresión iliocava, cuyo diagnóstico se confirmó mediante flebografía ascendente e Iliocavografía.Se trataron 17 pacientes por vía endovascular, terapia de anticoagulación y seguimiento radiológico seriado.Resultados: en un total de 17 pacientes con edad promedio de 43 años, se observó mejoría clínica completa en 88 porciento, parcial en 6 porciento y ninguna en 6 porciento. Permeabilidad del stent en 94,12 porciento a 36 meses.Conclusión: la terapia endovascular muestra excelente permeabilidad y baja morbilidad en el tratamiento de pacientes con síndrome de compresión iliocava.
Objective: to report our experience in the intravascular management in patients with iliocaval compression syndrome. Material and methods: 84 patients with suspicion of iliocaval compression were evaluated during a three years period. This diagnosis was confirmed by ascendant phlebography and iliocavography. 17 patients received endovascular treatment, anticoagulants and serial radiological follow-up. Results: from 17 patients with mean age of 43 years, 88% had a complete clinical recovery; it was partial in 6% and absent in 6%. Stents patency was 94.12% after 36 months. Conclusion: endovascular therapy shows excellent patency and low morbidity in the treatment of patients with iliocaval compression syndrome.