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To evaluate the influence of mitochondrial DNA haplogroups on the risk of knee OA in terms of their interaction with obesity, in a population from Mexico. Samples were obtained from (n = 353) knee OA patients (KL grade ≥ I) and (n = 364) healthy controls (KL grade = 0) from Mexico city and Torreon (Mexico). Both Caucasian and Amerindian mtDNA haplogroups were assigned by single base extension assay. A set of clinical and demographic variables, including obesity status, were considered to perform appropriate statistical approaches, including chi-square contingency tables, regression models and interaction analyses. To ensure the robustness of the predictive model, a statistical cross-validation strategy of B = 1000 iterations was used. All the analyses were performed using boot, GmAMisc and epiR package from R software v4.0.2 and SPSS software v24. The frequency distribution of the mtDNA haplogroups between OA patients and healthy controls for obese and non-obese groups showed the haplogroup A as significantly over-represented in knee OA patients within the obese group (OR 2.23; 95% CI 1.22-4.05; p-value = 0.008). The subsequent logistic regression analysis, including as covariate the interaction between obesity and mtDNA haplogroup A, supported the significant association of this interaction (OR 2.57; 95% CI 1.24-5.32; p-value = 0.011). The statistical cross-validation strategy confirmed the robustness of the regression model. The data presented here indicate a link between obesity in knee OA patients and mtDNA haplogroup A.

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This rapid evidence assessment (REA) was conducted to explore the burden of weight-bearing joint osteoarthritis in the developing countries of Latin America. REA methodology used a standardized search strategy to identify observational studies published from 2010 to 23 April 2020 that reported outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from each included study were used to populate bespoke data extraction tables and qualitatively analyzed. Thirteen publications were identified that reported on knee and hip osteoarthritis in the Latin American region. Overall prevalence of physician-diagnosed symptomatic knee osteoarthritis in adults ranged from 1.55% in Peru to 7.4% in Ecuador. Total prevalence of grade ≥ 2 radiographic knee osteoarthritis was 22% among those ≥ 39 years of age in Brazil and 25.5% among those ≥ 40 years of age in Mexico. The prevalence of symptomatic/radiographic knee osteoarthritis was 7.1% in people ≥ 18 years of age in Mexico and 17.6% among those ≥ 40 years of age. Prevalence of hip osteoarthritis was similar to or slightly lower than knee osteoarthritis. The limited data available indicates weight-bearing osteoarthritis negatively affects quality of life and that the economic burden may vary between countries with different healthcare systems. The limited evidence found in the published literature suggests the burden of osteoarthritis in Latin America is substantial. Our analysis identified several evidence gaps, particularly for health-related quality of life and socioeconomic outcomes. Further research is of particular importance in areas where government-subsidized healthcare and resources are scarce.

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Las neoplasias malignas en cabeza y cuello son usualmente tratadas con cirugía combinada con radioterapia en algunos casos, provocando alteraciones en las estructuras maxilofaciales, dejando secuelas en los tejidos relacionados a la articulación temporomandibular (ATM) y la musculatura asociada. La literatura no es clara sobre la evaluación y diagnóstico pretratamiento del paciente oncológico ni su correcta evaluación, por lo que los diagnósticos podrían estar errados. Se realizó una revisión sistemática exploratoria de la literatura presentando la información más actualizada respecto a diagnósticos y alcances relevantes sobre trastornos temporomandibulares (TTMs) en pacientes tratados con radioterapia por cáncer de cabeza y cuello. Se revisaron 4 bases bibliográficas electrónicas incluyendo artículos en inglés originales de enero de 2010 a julio de 2020 enfocados en la evaluación y diagnóstico de TTMs y tejidos asociados morfofuncionalmente en estre grupo de pacientes Se encontraron 353 artículos que aplicados los criterios de inclusión y exclusión se obtuvieron 7 artículos pertinentes para evaluación. La asociación entre el grado de exposición a radioterapia y los cambios moleculares en los tejidos inductores de hipometría mandibular puede ser discutible debido a no considerar un estudio acucioso de la ATM y sus tejidos asociados ni un diagnóstico específico preradioterapia para determinar la preexistencia algún TTM, induciendo su agravamiento o perpetuación. La literatura no es explícita respecto a los signos y síntomas asociados a un correcto examen de la articulación temporomandibular y estructuras asociadas preradioterapia. El trismus es sólo un signo de alteración funcional del sistema estomatognático, pero no un diagnóstico en sí el que debe ser realizado en base a criterios estandarizados y realizado por un Especialista en Dolor Orofacial. Hasta donde sabemos, esta es la primera revisión que intenta resumir la evidencia más actual y relevante sobre los diagnósticos de trastornos temporomandibulares diferentes a "trismus" en este grupo de pacientes.

Head and neck malignant neoplasms are usually treated with surgery combined with radiotherapy, causing alterations in the maxillofacial structures, leaving sequelae in the tissues related to the temporomandibular joint (TMJ) and associated muscles. The literature is not clear about the pretreatment evaluation and diagnosis of cancer patients or their correct evaluation, so the diagnoses could be wrong. An scoping review of the literature was carried out presenting the most up-to-date information regarding the diagnoses and relevant outcomes of temporomandibular disorders (TMDs) in patients treated with radiotherapy for head and neck cancer. Four (4) electronic bibliographic databases were reviewed including original articles in English from January 2010 to July 2020 focused on the evaluation and diagnosis of TTMs and morphofunctionally associated tissues in a narrow group of patients. 353 articles were found that applied the inclusion and exclusion criteria. 7 relevant articles for evaluation. The association between the degree of exposure to radiotherapy and the molecular changes in the tissues that induce mandibular hypometry may be debatable due to not considering a careful study of the TMJ and its associated tissues, nor a specific pre-radiotherapy diagnosis to determine the preexistence of some TMD, inducing its aggravation or perpetuation. The literature is not explicit regarding the signs and symptoms associated with a correct examination of the temporomandibular joint and associated structures prior to radiotherapy. Trismus is only a sign of functional alteration of the stomatognathic system, but not a diagnosis in itself, which must be made based on standardized criteria and performed by an Orofacial Pain Specialist. To our knowledge, this is the first review that attempts to summarize the most current and relevant evidence on the diagnoses of temporomandibular disorders other than "trismus" in this group of patients.

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El COVID-19 ha representado un esfuerzo social por prevenir y prever diferentes escenarios de propagación del virus SARS-CoV-2, donde las actividades culturales han sufrido una disminución en su afluencia, llegando a suspenderse por la alta convocatoria que estos presentan. Los músicos han sido afectados dentro de este contexto, tanto por el cese de su actividad, como por la exposición que pueden sufrir a dicho virus. Especialmente los instrumentos de viento, por su característica ejecución, son vectores de contagio que pueden ser tratados con algunas maniobras de cuidado especial, previniendo la infección en los ejecutantes, permitiendo la continuación de la actividad musical, arte tan vital dentro un contexto tan adverso.

COVID-19 has represented a social effort to prevent and anticipate different scenarios for the spread of the SARS-CoV-2 virus, where cultural activities have suffered a decrease in their influx, even being suspended due to the high number of people they present. Musicians have been affected within this context, by the cessation of their activity and the exposure they may suffer to said virus. Especially wind instruments, due to their characteristic execution, are vectors of contagion that can be treated with some special care, preventing infection in the performers, allowing the continuation of musical activity, a vital art in an adverse context.

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Recientemente, en abril de 2020, fue aprobada por la Food and Drugs Administration de los Estados Unidos, el comienzo de las pruebas clínicas para la detección de la infección por el virus "Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)" a través de muestras de saliva en los centros de salud que tienen convenio con la Universidad de Rutgers, institución que diseñó el test. Históricamente, las muestras de saliva han sido utilizadas con finalidad diagnóstica de forma satisfactoria en la detección de otras infecciones virales tales como Virus de Papiloma Humano (VPH), Hepatitis (A-E) y de la Inmunodeficiencia Humana (VIH). Es una prueba que es fácilmente aplicable, económica, menos invasiva con el paciente y no requiere prácticamente de la exposición del personal médico a los pacientes sospechosos de infección, por lo que se constituye como una alternativa diagnóstica válida en las circunstancias de urgencias que está desafiando los sistemas de salud a nivel mundial.

Recently, in April 2020, it was approved by the FDA (Food and Drugs Administration of the United States), the beginning of clinical tests for the detection of infection by the virus "Severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2)" through saliva samples in health centers that have an agreement with Rutgers University, the institution that designed the test. Historically, saliva samples have been successfully used for diagnostic purposes in the detection of other viral infections such as Human Papillomavirus (HPV), Hepatitis (A-E) and Human Immunodeficiency (HIV). It is a test that is easily applicable, inexpensive, less invasive with the patient and practically does not require exposure of medical personnel to patients suspected of infection, so it constitutes a valid diagnostic alternative in the emergency circumstances that it is challenging health systems in the world.

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In Mexico, osteoporosis is a public health problem. In this document, the Mexican Association for Bone and Mineral Metabolism defines its position on calcium, vitamin D supplement use, and physical activity as an effective, safe, and cost-effective initiatives to prevent low bone mass. INTRODUCTION: In Mexico, osteoporosis is a public health problem that is expected to increase in the decades ahead. Generally, modifiable risk factors for bone health are related with lifestyles, especially nutrition and physical activity. METHODS: In this position paper, the Mexican Association for Bone and Mineral Metabolism (AMMOM, by its acronym in Spanish), which is a multidisciplinary group of researchers, dietitians, epidemiologists, nurses, and physicians who study bone and related tissues and communicate the best strategies for diagnosis, treatment, and prevention of bone problems, aims to analyze the association between nutrition and bone health, risk behaviors for low bone mass, and the economic impact that prevention of low bone mass represents for the health care system. RESULTS: Addressing therapeutic management with pharmacological and non-pharmacological approaches, we emphasize the important role the patient plays in the doctor-patient relationship, both in the consulting room and in daily life. Furthermore, the AMMOM defines its position on calcium and vitamin D supplement use as an effective, safe, and cost-effective initiative to prevent low bone mass. CONCLUSIONS: In summary, most research and clinical practice related to osteoporosis have focused on diagnosis and treatment, but general measures for primary prevention based on addressing modifiable risk factors as a public health priority to delay the onset of loss of bone mass have not been considered by Mexican authorities. Consequently, the AMMOM task force also seeks to provide information on concrete actions to prevent low bone mass.

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To assess the inter- and intra-observer reproducibility of musculoskeletal ultrasonography among rheumatologist in detecting inflammatory and morphostructural changes in small joints of the hands in patients with rheumatoid arthritis (RA). Five members of the "Escuela de Ecografía del Colegio Mexicano de Reumatología" tested their inter- and intra-observer reliabilities in the assessment of basic sonographic findings of joint inflammation and bone erosion. Their results were compared to those obtained by a group of international experts from European League Against Rheumatism. A clinical rheumatologist evaluated eight RA patients. Five Siemens Acuson Antares ultrasound machines (7-13 MHz linear probes) were used. The OMERACT preliminary definitions of joint effusion, synovial hypertrophy, bone erosions and tenosynovitis were adopted. Inter-observer and intra-observer agreement was calculated by overall agreement and kappa statistics. Mean kappa value for joint effusion was good, 0.654 (85%); synovial hypertrophy, 0.550 (77.2%); power Doppler signal, 0.550 (82.5%); bone erosions, 0.549 (81%); and tenosynovitis, 0.500 (91.5%). Mean and overall intra-observer agreement for semiquantitative score was good for joint effusion, 0.630 (77.2%) and bone erosions, 0.605 (56.25%); and moderate to synovial hypertrophy, 0.476 (65%) and power Doppler signal, 0.471 (80%). Mean kappa value for joint effusion was 0.381 (95%), synovial hypertrophy, 0.447 (72%); power Doppler signal, 0.496 (81%); bone erosions, 0.294 (81%); and tenosynovitis, 0.030 (66%). Mean and overall inter-observer agreement for semiquantitative score was poor for joint effusion, 0.325 (57%) and bone erosions, 0.360 (43%); and moderate to synovial hypertrophy, 0.431 (55%) and power Doppler signal, 0.496 (81%). Intra-observer variability reached the highest levels of agreement. Factors related to the experience of the rheumatologist, the time spent in each examination and knowledge of the software ultrasound equipment could influence the lower level of inter-observer agreement in this study.

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Introduction. Rheumatoid arthritis (RA) can involve the incudomalleolar or incudostapedial articulations. Objective. To know the punctual prevalence of audiological alterations in patients with RA. Patients and Methods. RA patients and their controls (Cs), were evaluated by Tonal Audiometry (AU); if there were alterations in the air conduction (AC), bone conduction (BC), Logoaudiometry (LG), and Tympanometry (T) were performed. Results. 45 RA patients and 45 Cs were evaluated. RA patients had 40% of bilateral and 17.8% unilateral alteration versus Cs with 22.2% bilateral and 4.4% unilateral alteration versus Cs with 22.2% bilateral and 4.4% unilateral in AC audiometry. In conventional T (CT) As-type curves in patients with RA, there were 22 LE (48.8%) and 26 RE (57.7%) versus Cs, there were16 RE (35.5%) and 20 LE (44.4%). In High-frequency T (HFT): the 3B1G pattern in RA more frequent versus Controls (Cs) in RE (P = .002 and LE (P = .01). There were no differences according to RA activity or RA disease evolution. Conclusions. There is a greater tendency of auditive loss of As curves in CT (rigidity in ossicular chain) and of the 3B1G pattern in HFT in RA.

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The diagnostic imaging of osteomyelitis can require the combination of diverse imaging techniques for an accurate diagnosis. Conventional radiography should always be the first imaging modality to start with, as it provides an overview of the anatomy and the pathologic conditions of the bone and soft tissues of the region of interest. Sonography is most useful in the diagnosis of fluid collections, periosteal involvement, and surrounding soft tissue abnormalities and may provide guidance for diagnostic or therapeutic aspiration, drainage, or tissue biopsy. Computed tomography scan can be a useful method to detect early osseous erosion and to document the presence of sequestrum, foreign body, or gas formation but generally is less sensitive than other modalities for the detection of bone infection. Magnetic resonance imaging is the most sensitive and most specific imaging modality for the detection of osteomyelitis and provides superb anatomic detail and more accurate information of the extent of the infectious process and soft tissues involved. Nuclear medicine imaging is particularly useful in identifying multifocal osseous involvement.