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INTRODUCTION AND AIM: Chronic nausea and vomiting syndrome is a disorder of gut-brain interaction that affects the productive-age population. Our aim was to determine the association of this disorder with quality of life, workplace performance, and socioeconomic impact related to gastrointestinal health. METHODS: A cross-sectional study on a Mexican population was conducted. The patients were classified as having chronic nausea and vomiting syndrome or other disorders of gut-brain interaction. A comparative analysis of quality of life, workplace productivity, annual medical consultations, and digestive health-related expenses was carried out, applying a logistic regression model. RESULTS: One thousand patients were included, 79.2% of whom met the criteria for a disorder of gut-brain interaction. Of the 792 patients, 10.3% presented with chronic nausea and vomiting syndrome. Said syndrome was associated with a negative impact on usual activities (OR 4.34, 95% CI 1.90-9.30, p ≤ 0.001), pain/discomfort (OR 2.09, 95% CI 1.31-3.33, p ≤ 0.001), anxiety/depression (OR 2.08, 95% CI 1.30-3.40, p ≤ 0.001), workplace presenteeism (OR 3.96, 95% CI 2.47-6.44, p ≤ 0.001), and workplace absenteeism (OR 2.54, 95% CI 1.52-4.16, p ≤ 0.001). There was also a higher number of annual medical consultations for digestive health (p = 0.013), without generating a greater annual expense due to digestive health (p = 0.08). CONCLUSIONS: Chronic nausea and vomiting syndrome produces a negative impact on quality of life, which could be secondary to its symptomatology or its association with anxiety and depression.

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INTRODUCTION: Gastroesophageal reflux disease (GERD) is very prevalent in the general population, with a broad spectrum of clinical manifestations, requiring accurate diagnosis and treatment. AIM: The aim of this expert review is to establish good clinical practice recommendations for the diagnosis and personalized treatment of GERD. METHODS: The good clinical practice recommendations were produced by a group of experts in GERD, members of the Asociación Mexicana de Gastroenterología (AMG), after carrying out an extensive review of the published literature and discussing each recommendation at a face-to-face meeting. This document does not aim to be a clinical practice guideline with the methodology such a document requires. RESULTS: Fifteen experts on GERD formulated 27 good clinical practice recommendations for recognizing the symptoms and complications of GERD, the rational use of diagnostic tests and medical treatment, the identification and management of refractory GERD, the overlap with functional disorders, endoscopic and surgical treatment, and GERD in the pregnant woman, older adult, and the obese patient. CONCLUSIONS: An accurate diagnosis of GERD is currently possible, enabling the prescription of a personalized treatment in patients with this condition. The goal of the good clinical practice recommendations by the group of experts from the AMG presented in this document is to aid both the general practitioner and specialist in the process of accurate diagnosis and treatment, in the patient with GERD.

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Fecal incontinence is the involuntary passage or the incapacity to control the release of fecal matter through the anus. It is a condition that significantly impairs quality of life in those that suffer from it, given that it affects body image, self-esteem, and interferes with everyday activities, in turn, favoring social isolation. There are no guidelines or consensus in Mexico on the topic, and so the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, neurogastroenterologists, and surgeons) to carry out the «Mexican consensus on fecal incontinence¼ and establish useful recommendations for the medical community. The present document presents the formulated recommendations in 35 statements. Fecal incontinence is known to be a frequent entity whose incidence increases as individuals age, but one that is under-recognized. The pathophysiology of incontinence is complex and multifactorial, and in most cases, there is more than one associated risk factor. Even though there is no diagnostic gold standard, the combination of tests that evaluate structure (endoanal ultrasound) and function (anorectal manometry) should be recommended in all cases. Treatment should also be multidisciplinary and general measures and drugs (lidamidine, loperamide) are recommended, as well as non-pharmacologic interventions, such as biofeedback therapy, in selected cases. Likewise, surgical treatment should be offered to selected patients and performed by experts.

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While important research has been focused on developing surfaces that do not wet, some textures with high-wetting resistance are familiar in other applications in which the opposite is needed. A multivalued surface, common in most fabrics or meshes, allows the invading gas-liquid interface to support relatively high imposed pressures and plays a key role in producing topographic elements that avoid wetting. Here we study experimentally and theoretically the critical pressure needed to move a liquid through a network of pores and show that, for small aperture size, wetting and leaking are typical first-order transitions, with a singular behavior at the omniphobic/omniphilic limit (θc = π/2).

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Non-alcoholic fatty liver disease (NAFLD) is currently one of the main causes of chronic liver disease in Western countries, with a 25% prevalence reported in the general population worldwide. Visceral adiposity and liver fat promote a state of systemic inflammation, predisposing individuals with NAFLD to the extrahepatic pathologies of cardiovascular disease (the most common cause of death in patients with NAFLD), diabetes mellitus, chronic kidney disease, hypothyroidism, polycystic ovary syndrome, obstructive sleep apnea, and an increased risk for presenting with gastrointestinal and extraintestinal neoplasias. Different mechanisms between NAFLD and its association with extrahepatic diseases have been reported, and lipotoxicity is the main cause of inflammatory pathway activation that results in extrahepatic tissue damage.

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The use of implants carries on a series of problems, among them infections, poor biocompatibility, high levels of cytotoxicity, and significant mechanical differences between implants and host organs that promote stress shielding effects. These problems indicate that the materials used to make implants must meet essential requirements and high standards for implantations to be successful. In this work, we present the synthesis, characterization and evaluation of the antibiofilm, mechanical, and thermal properties, and cytotoxic effect of a nanocomposite-based scaffold on polyurethane (PU) and gold nanoparticles (AuNPs) for soft tissue applications. The effect of the quantity of AuNPs on the antibacterial activity of nanocomposite scaffolds was evaluated against Staphylococcus epidermidis and Klebsiella spp., with a resulting 99.99% inhibition of both bacteria using a small quantity of nanoparticles. Cytotoxicity was evaluated with the T10 1/2 test against fibroblast cells. The results demonstrated that porous nanogold/PU scaffolds have no toxic effects on fibroblast cells to the 5 day exposition. With respect to mechanical properties, stress-strain curves showed that the compressive modulus and yield strength of PU scaffolds were significantly enhanced by AuNPs (by at least 10 times). This is due to changes in the arrangement of hard segments of PU, which increase the stiffness of the polymer. Thermogravimetric analysis showed that the degradation onset temperature rises with an increase in the quantity of AuNPs. These properties and characteristics demonstrate that porous nanogold/PU scaffolds are suitable material for use in soft tissue implants.

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BACKGROUND AND AIMS: An increase in plasma branched-chain amino acids is associated with a higher risk of developing type 2 diabetes and cardiovascular diseases. However, little is known about the basal plasma amino acid concentrations in young adults. Our aim was to determine the plasma amino acid profiles of young adults and to evaluate how these profiles were modified by sex, body mass index (BMI) and insulin resistance (IR). METHODS AND RESULTS: We performed a transversal study with 608 Mexican young adults aged 19.9 ± 2.4 years who were applicants to the Universidad Autónoma de San Luis Potosí. The subjects underwent a physical examination and provided a clinical history and a blood sample for biochemical, hormonal and amino acid analyses. The women had higher levels of arginine, aspartate and serine and lower levels of α-aminoadipic acid, cysteine, isoleucine, leucine, methionine, proline, tryptophan, tyrosine, urea and valine than the men. The obese subjects had higher levels of alanine, aspartate, cysteine, ornithine, phenylalanine, proline and tyrosine and lower levels of glycine, ornithine and serine than the normal weight subjects. Subjects with IR (defined as HOMA > 2.5) had higher levels of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine and valine than the subjects without IR. Furthermore, we identified two main groups in the subjects with obesity and/or IR; one group was composed of amino acids that positively correlated with the clinical, biochemical and hormonal parameters, whereas the second group exhibited negative correlations. CONCLUSION: This study demonstrates that young adults with obesity or IR have altered amino acid profiles characterized by an increase in alanine, aspartate, proline and tyrosine and a decrease in glycine.

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Isometric deformations in thin elastic films easily form ridges to connect large flat regions or facets. Depending on the forces applied or the boundary conditions imposed, these ridges can be isometric, with no stretching or "stretching ridges" when bending and stretching are required to relax the elastic energy. Here we study a simple configuration to observe the transition between an isometric ridge to the well-known stretching ridge observed in crumpled films, and obtain the parameters that determine the ridge type. Specifically, we show that the transversal size of a stretching ridge acts as a cutoff length scale: a ridge is isometric if its width is greater than this characteristic length.

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The forkhead box P3 (Foxp3) transcription factor is one of the most studied markers used to identify CD4+CD25+ regulatory T cells (Tregs), and has been identified as a key regulator in the development and function of Tregs. Foxp3 expression has been reported in a variety of solid human tumors, including melanoma. The aims of the present study were to analyze Foxp3 expression in B16F10 melanoma cells in vitro, to determine whether this expression was affected during tumor growth in a murine melanoma model and to correlate Foxp3 expression with CD25 expression, interleukin (IL)-2 production and tumor weight. Foxp3 expression was analyzed with quantitative (q)PCR, flow cytometry and confocal microscopy. CD25 expression was analyzed by flow cytometry, and cytokine production was measured by ELISA [IL-2, interferon (IFN)-γ, transforming growth factor (TGF)-ß and IL-10] and flow cytometry (IL-2, IFN-γ, IL-4 and IL-5). Foxp3 and CD25 expression was detected in the B16F10 cells in culture and in the intratumoral B16F10 cells. An increase in Foxp3 and CD25 expression was observed in a time-dependent manner during tumor growth at 7, 14 and 21 days. The production of the IL-2, IL-10, IFN-γ and TGF-ß cytokines was observed in the B16F10 cells and also detected in the tumoral microenvironment during tumor growth (7, 14 and 21 days). An increase in IL-2 and IL-10 production was observed, whereas IFN-γ production decreased in a time-dependent manner. The production of tumor necrosis factor (TNF)-α was not observed in culture, but was detected during tumor growth, whereas the production of IL-4 and IL-5 was not detected. These data showed a positive correlation between the expression of Foxp3, CD25 and IL-2 and tumor weight in murine melanoma. From these data, it may be suggested that Foxp3 participates in melanoma growth, the modulation of the IL-2, IFN-γ and TNF-α cytokines and CD25 expression, and that it also plays a possible role in immunosuppression.

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Multiple sclerosis (MS) is a common demyelinating disease that involves the central nervous system causing focal lesions in the brain and spinal cord causing diverse neurological development deficits, many of them severe and irreversible, affecting and invaliding a large percentage of young productive-aged patients. MRI exams have improved diagnostic capability compared to computed tomography, but in this decade the development of new magnets, coils and software have allowed the development of quantitative neuroradiology which achieves the evaluation of parameters such as total brain volume, of each of its structures, as well as semi-automated or automated counting of the lesion load, allowing better monitoring of each individual patient in relation to a particular event such as a new neurological deficit in an outbreak of the disease, a previously undetected cognitive impairment or in related to a given treatment. We will show our local experience using the FreeSurfer software in our habitual practice, as well as other post-processing software, this being the first experience of its use in multiple sclerosis published in our country.

La esclerosis múltiple (EM) es una frecuente enfermedad desmielinizante que afecta el sistema nervioso central produciendo lesiones focales a nivel cerebral y medular que condicionan diversos déficit neurológicos evolutivos, muchos de ellos severos e irreversibles, afectando e invalidando un gran porcentaje de pacientes jóvenes en edad productiva. El estudio con resonancia magnética mejoró la capacidad diagnóstica respecto a la tomografía computada, pero en esta década el desarrollo de nuevos magnetos, bobinas y software han permitido desarrollar la neurorradiología cuantitativa que logra evaluar parámetros como el volumen cerebral global, de cada una de sus estructuras así como el recuento semi o automatizado de la carga lesional, lo que permite el mejor seguimiento de cada paciente individual en relación a un evento determinado como un nuevo déficit neurológico dentro de un brote de la enfermedad, un deterioro cognitivo no detectado previamente o en relación a un tratamiento determinado. Mostraremos nuestra experiencia local utilizando el software freesurfer en nuestra práctica habitual, así como otro software de postproceso, siendo la primera experiencia de su uso en esclerosis múltiple publicada en nuestro país.

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OBJECTIVE: Increasing overweight and obesity rates in Mexico have been associated with increases in mortality from cardiovascular disease (CVD). This study assessed changes in body mass index (BMI) and body weight over 1 year, and explored whether these were associated with changes in CVD risk factors of blood pressure and fasting glucose in a cohort of young Mexican adults. STUDY DESIGN: Longitudinal data were obtained from a cohort of young Mexican adults applying to college. METHODS: Data were collected from college applicants for the 2008 academic year who re-applied in 2009. In total, 795 college applicants aged 18-20 years, of both sexes (48% males and 52% females), were included in the study. The screen included height, weight, and systolic (SBP) and diastolic (DBP) blood pressure measurements plus a blood draw following an overnight fast for fasting glucose. RESULTS: At baseline, 31.8% of the participants were overweight or obese. The mean 1-year change in body weight and BMI were 0.80 kg and 0.35 kg/m(2), respectively. One-year changes in body weight and BMI were associated with increased SBP and DBP for both men and women (P < 0.05), independent of baseline BMI. A weight gain of 5% or more was positively associated with increases in blood pressure among women (P < 0.05), but not among men. A weight loss of 5% or more was associated with reductions in SBP among women. CONCLUSIONS: One-year changes in weight were associated with changes in blood pressure.

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The complex behavior that occurs when traffic lights are synchronized is studied. Two strategies are considered: all lights in phase, and a "green wave" with a propagating green signal. It is found that traffic variables such as traveling time, velocity, and fuel consumption, near resonance, follow critical scaling laws. For the green wave, it is shown that time and velocity scaling laws hold even for random separation between traffic lights. These results suggest the concept of transient resonances, which can be induced by adaptively changing the phase of traffic lights. This may be important to consider when designing strategies for traffic control in cities, where short trajectories, and thus transient solutions, are likely to be relevant.

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BACKGROUND: Rat hind-foot carrageenan induced edema (CIE) is a widely used model to evaluate anti-inflammatory drugs. It shows two well-defined phases, however a third not fully characterized phase has been observed. Superoxide dismutase (SOD) is a free radical-scavenger with anti-inflammatory activity. In our country there is not a specifically designed instrument to evaluate edema in CIE. METHODS: Edema was induced by intraplantar injection of carraageenan. Fours groups were evaluated: placebo, two different doses of SOD, and Naproxen. Edema was evaluated by a specially designed mercury plethismograph. Intensity of the inflammatory reaction was determined during the classical early and late phases and during the third very late phase. RESULTS: All treatments, but higher dose of SOD, showed good anti-inflammatory activity throughout early, late, and very late phases. Naproxen was more effective than SOD during first and second phase, however this difference disappeared during the third phase. In terms of equimolar basis the enzyme appeared 1,800 time more potent than Naproxen. Mercury plethysmometer performance was fine. CONCLUSIONS: The anti-inflammatory activity of SOD and Naproxen is extended until the very late phase in the CIE model. In this bioassay, this long lasting activity of the enzyme should be ascribed to a mechanism supplementary to its free radical-scavenger property. SOD may be indeed an alternative treatment in inflammatory diseases.

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Las anomalías dentomaxilares, después de la caries y periodonciopatías representan un problema de salud pública que afecta alrededor del 60 por ciento de niños entre 4 y 12 años de edad. Los fisurados no están ajenos a este problema, sino que es posible apreciar que todos los individuos con LLB/FVP presentan alguna anomalía dentaria y/o maxilar. Este trabajo analiza las anomalías dentarias y maxilares en 57 modelos de pacientes con LLB/FVP operados en el Instituto de Malformaciones y Deformaciones Maxilofaciales de la Facultad de Odontología de la Universidad de Chile. Los modelos con sus respectivas radiografías panorámicas y/o retroalveolares correspondían a pacientes de ambos sexos y de edades entre 3 y 23 años. Se confeccionó una ficha ad-hoc para analizar las anomalías dentarias y maxilares. Los resultados obtenidos, muestran que los pacientes con LLB/FVP presentan ciertas anomalías que son características, como las agenesias de incisivos laterales, presencia de supernumerarios y giroversiones de incisivos centrales. En relación a la oclusión, se estudiaron los modelos de los tres sentidos del espacio y además la posición de la premaxila, tanto en sentido transversal como sagital y vertical. La forma del arco maxilar siempre tiende a ser de forma de triángulo isósceles de vértice anterior. Se observan también alteraciones intermaxilares, pero más del 50 por ciento de los casos presenta neutroclusión bilateral. El resalte principalmente resultó estar invertido y el escalón frecuentemente estuvo aumentado. A nivel de los caninos, la mordida cruzada se aprecia en un alto porcentaje de casos. La inclusión en esta zona también se aprecia en un porcentaje no despreciable. Podríamos resumir diciendo que las anomalías que son propias o inherentes a la malformación, son las agenesias de incisivos laterales, las graves giroversiones de incisivos centrales supernumerarios y las dislaceraciones coronorradiculares

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The results of the electrical stimulation of the locus coeruleus in curarized cats, and the effects upon the observed cortical responses of 5,6-dihydroxytryptamine or 6-hydroxydopamine injected intracisternally or applied in the subarachnoideal space were studied. The changes were followed on the strychnine spikes produced after the topical application of this drug. Stimulation of the locus coeruleus elicited a response in every area of the cortex explored. The response was complex, showed a phase of depression and a phase of enhancement both mixed in different proportions. The depressant reaction was more marked with lower strengths of stimulation and the enhancement reactions appeared more evident with the stronger stimuli. Both these reactions were blocked by the previous administration of 6-hydroxydopamine and only the depressant one was practically abolished by 5,6-dihydroxytryptamine. It is concluded that a complex interaction exists between the noradrenergic neurons of the locus coeruleus and the serotonergic neurons, probably those of the raphe nuclei. It is suggested that the axons of the noradrenergic neurons in their way to the cortex, give off collaterals that innervate some serotonergic neurons. The monoamines liberated by these axon terminals at the cerebral cortex would act as neurohumoral agents.

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The results of the electrical stimulation of the locus coeruleus in curarized cats, and the effects upon the observed cortical responses of 5,6-dihydroxytryptamine or 6-hydroxydopamine injected intracisternally or applied in the subarachnoideal space were studied. The changes were followed on the strychnine spikes produced after the topical application of this drug. Stimulation of the locus coeruleus elicited a response in every area of the cortex explored. The response was complex, showed a phase of depression and a phase of enhancement both mixed in different proportions. The depressant reaction was more marked with lower strengths of stimulation and the enhancement reactions appeared more evident with the stronger stimuli. Both these reactions were blocked by the previous administration of 6-hydroxydopamine and only the depressant one was practically abolished by 5,6-dihydroxytryptamine. It is concluded that a complex interaction exists between the noradrenergic neurons of the locus coeruleus and the serotonergic neurons, probably those of the raphe nuclei. It is suggested that the axons of the noradrenergic neurons in their way to the cortex, give off collaterals that innervate some serotonergic neurons. The monoamines liberated by these axon terminals at the cerebral cortex would act as neurohumoral agents.

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The results of the electrical stimulation of the locus coeruleus in curarized cats, and the effects upon the observed cortical responses of 5,6-dihydroxytryptamine or 6-hydroxydopamine injected intracisternally or applied in the subarachnoideal space were studied. The changes were followed on the strychnine spikes produced after the topical application of this drug. Stimulation of the locus coeruleus elicited a response in every area of the cortex explored. The response was complex, showed a phase of depression and a phase of enhancement both mixed in different proportions. The depressant reaction was more marked with lower strengths of stimulation and the enhancement reactions appeared more evident with the stronger stimuli. Both these reactions were blocked by the previous administration of 6-hydroxydopamine and only the depressant one was practically abolished by 5,6-dihydroxytryptamine. It is concluded that a complex interaction exists between the noradrenergic neurons of the locus coeruleus and the serotonergic neurons, probably those of the raphe nuclei. It is suggested that the axons of the noradrenergic neurons in their way to the cortex, give off collaterals that innervate some serotonergic neurons. The monoamines liberated by these axon terminals at the cerebral cortex would act as neurohumoral agents.