RESUMEN

Carbon capture, utilization, and storage (CCUS) technology offer promising solution to mitigate the threatening consequences of large-scale anthropogenic greenhouse gas emissions. Within this context, this report investigates the influence of NiO deposition on the Li4SiO4 surface during the CO2 capture process and its catalytic behavior in hydrogen production via dry methane reforming. Results demonstrate that the NiO impregnation method modifies microstructural features of Li4SiO4, which positively impact the CO2 capture properties of the material. In particular, the NiO-Li4SiO4 sample captured twice as much CO2 as the pristine Li4SiO4 material, 6.8 and 3.4 mmol of CO2 per gram of ceramic at 675 and 650 °C, respectively. Additionally, the catalytic results reveal that NiO-Li4SiO4 yields a substantial hydrogen production (up to 55 %) when tested in the dry methane reforming reaction. Importantly, this conversion remains stable after 2.5 h of reaction and is selective for hydrogen production. This study highlights the potential of Li4SiO4 both a support and a captor for a sorption-enhanced dry reforming of methane. To the best of our knowledge, this is the first report showcasing the effectiveness of Li4SiO4 as an active support for Ni-based catalysis in the dry reforming of methane. These findings provide valuable insights into the development of this composite as a dual-functional material for carbon dioxide capture and conversion.

RESUMEN

Addiction is a chronic and potentially deadly disease considered a global health problem. Nevertheless, there is still no ideal treatment for its management. The alterations in the reward system are the most known pathophysiological mechanisms. Dopamine is the pivotal neurotransmitter involved in neuronal drug reward mechanisms and its neuronal mechanisms have been intensely investigated in recent years. However, neuroglial interactions and their relation to drug addiction development and maintenance of drug addiction have been understudied. Many reports have found that most neuroglial cells express dopamine receptors and that dopamine activity may induce neuroimmunomodulatory effects. Furthermore, current research has also shown that pro- and anti-inflammatory molecules modulate dopaminergic neuron activity. Thus, studying the immune mechanisms of dopamine associated with drug abuse is vital in researching new pathophysiological mechanisms and new therapeutic targets for addiction management.

Asunto(s)

Conducta Adictiva , Trastornos Relacionados con Sustancias , Dopamina , Neuronas Dopaminérgicas , Humanos , Neuroglía , Recompensa

RESUMEN

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ'≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources.

Asunto(s)

Alelos , Genética de Población/métodos , Antígenos HLA/genética , Complejo Mayor de Histocompatibilidad/genética , Polimorfismo de Nucleótido Simple , ADN/genética , ADN/aislamiento & purificación , Frecuencia de los Genes , Genoma Humano , Haplotipos , Humanos , Desequilibrio de Ligamiento , México

RESUMEN

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 88 Mexicans from the state of Querétaro living in the city of Querétaro (N = 45) and rural communities (N = 43), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes in the state of Querétaro include seven Native American, two European and one Asian haplotype. Admixture estimates revealed that the main genetic components in the state of Querétaro are Native American (51.82 ±â€¯4.42% by ML; 42.61% of Native American haplotypes) and European (48.18 ±â€¯3.55% by ML; 46.02% of European haplotypes), with a virtually absent African genetic component (0.00 ±â€¯4.25% by ML; 4.55% of African haplotypes).

Asunto(s)

Etnicidad/genética , Variación Genética , Genética de Población , Antígenos HLA/genética , Alelos , Frecuencia de los Genes , Genotipo , Geografía , Haplotipos , Humanos , Desequilibrio de Ligamiento , México , Población Rural

RESUMEN

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1217 Mexicans from the Mexico City Metropolitan Area living in the northern (N = 751), southern (N = 52), eastern (N = 79), western (N = 33), and central (N = 152) Mexico City, and rural communities (N = 150), to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes include 11 Native American haplotypes. Admixture estimates revealed that the main genetic components are Native American (63.85 ±â€¯1.55% by ML; 57.19% of Native American haplotypes) and European (28.53 ±â€¯3.13% by ML; 28.40% of European haplotypes), and a less apparent African genetic component (7.61 ±â€¯1.96% by ML; 7.17% of African haplotypes).

Asunto(s)

Etnicidad/genética , Variación Genética , Genética de Población , Antígenos HLA/genética , Alelos , Ciudades , Frecuencia de los Genes , Geografía , Haplotipos , Humanos , Desequilibrio de Ligamiento , México , Población Rural

RESUMEN

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 173 Mexicans from the state of Chiapas living in the city of Tuxtla Gutiérrez (N = 52) and rural communities (N = 121), to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes in Chiapas include 12 Native American and one European haplotype. Admixture estimates revealed that the main genetic components in Chiapas are Native American (71.61 ±â€¯0.58% by ML; 53.16% of Native American haplotypes) and European (26.39 ±â€¯5.05% by ML; 25.86% of European haplotypes), and a less prominent African genetic component (2.00 ±â€¯5.20% by ML; 9.77% of African haplotypes).

Asunto(s)

Etnicidad/genética , Variación Genética , Genética de Población , Antígenos HLA/genética , Alelos , Ciudades , Frecuencia de los Genes , Geografía , Haplotipos , Humanos , Desequilibrio de Ligamiento , México , Población Rural

RESUMEN

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 122 Mexicans from the state of Hidalgo living in the city of Pachuca (N = 41) and rural communities (N = 81), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes in Hidalgo include eight Native American and one European haplotypes. Admixture estimates revealed that the main genetic components in Hidalgo are Native American (58.93 ±â€¯2.16% by ML; 54.51% of Native American haplotypes) and European (32.49 ±â€¯2.88% by ML; 28.69% of European haplotypes), and a relatively high African genetic component (8.58 ±â€¯0.93% by ML; 6.97% of African haplotypes).

Asunto(s)

Etnicidad/genética , Variación Genética , Genética de Población , Antígenos HLA/genética , Alelos , Frecuencia de los Genes , Genotipo , Geografía , Humanos , Desequilibrio de Ligamiento , México , Población Rural

RESUMEN

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 144 Mexicans from the state of Guerrero to obtain information regarding allelic and haplotypic frequencies. We find that the ten most frequent haplotypes in the state of Guerrero include eight Native American and two European haplotypes. Admixture estimates revealed that the main genetic components in the state of Guerrero are Native American (61.36 ±â€¯2.69% by ML; 54.17% of Native American haplotypes) and European (35.01 ±â€¯4.59% by ML; 32.29% of European haplotypes), and a relatively low African genetic component (3.63 ±â€¯2.38% by ML; 5.90% of African haplotypes).

Asunto(s)

Etnicidad/genética , Variación Genética , Genética de Población , Antígenos HLA/genética , Alelos , Frecuencia de los Genes , Genotipo , Geografía , Haplotipos , Humanos , Desequilibrio de Ligamiento , México

RESUMEN

Introduction: Chemotherapy (CT) is one of the most commonly used pharmacological approaches in cancer treatment. However, CT induces damage to several tissues causing significant deleterious effects in cancer survivors being chemotherapy-induced neuropathic pain (CINP) among the most commonly reported. CINP is thought to be present in up to 68.1% of the patients within 1 month of receiving CT. Due to the fact that reliable statistic information is scarce in several Latin American countries' diagnosis and treatment of this side-effect may be delayed directly affecting patients. Therefore, the aim of the present study was to determine and present the incidence and features of CINP in patients with cancer attending the Pain Management Clinic at Mexicos' National Institute of Cancerology in Mexico City. Methods: We performed a retrospective, file-based analysis of all the patients treated in the Pain Management Clinic at the National Institute at Cancer in Mexico from January 2016 to January 2017. Results: CINP was found in 30.9% of the patients. The basal VAS was on average 2.5 upon arrival to the Pain Management Unit and 2.4 at the end of treatment (p>0.05). The patients with the highest risk of developing CINP were those treated with paclitaxel Odds ratio 8.3 (p<0.01), followed by platins OR 4 (p<0.01), vincristine OR 1.5 (p=0.01) and thalidomide OR 1.1 (p=0.01). Conclusion: Incidence of CINP was similar to previous reports; however, the number of variables related to this type of pain in our cohort may open a new line of research and highlight the importance of this particular issue to our health system. It is necessary to develop a mechanism to predict the risk of patients to suffer CINP and to search the mechanism to control and reduce the suffering related to the current treatments.

RESUMEN

OBJECTIVE: To characterize cognitive function in patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) in comparison with other chronic conditions, and to investigate its association with disease activity, and other psychological factors. METHODS: Cross-sectional study including patients with AAV, rheumatoid arthritis (RA) (n = 30), and chronic kidney disease (CKD) (n = 29). Patients underwent a standardized neuropsychological battery (NEUROPSI). Sleep quality, fatigue, depression, and anxiety levels were assessed. RESULTS: A total of 60 patients with AAV were included, median age of 54 years, and disease duration of 5.6 years. Prevalence of cognitive dysfunction (CD) in AAV patients was similar to RA and CKD (35%, 40%, and 39.3%, respectively, p = .88). When AAV patients with (n = 21) and without (n = 39) CD were compared, significantly more patients with CD had high disease activity (67% vs. 31%, p = .009). Abnormal performance was more frequent in the executive functions in the three groups (45% AAV, 51.7% RA, and 50% CKD), followed by language (25%, 13.8%, and 25%, respectively). Verbal and visual attentional tests were more frequently impaired in patients from the CKD group (p = .021), and psychomotor functions were more frequently affected in AAV patients (p < .05). Hospital Anxiety and Depression Scale (HADS) total score (especially anxiety) was higher in patients with memory impairment than in those with normal memory function (M = 6.79, SD = 4.53 vs. M = 4.5, SD = 3.6, p < .01). Neither Sleep Quality Index nor fatigue scale scores differed between those cognitively impaired and not impaired. CONCLUSIONS: No statistically significant differences were found in the frequency of CD among the three clinical populations. (JINS, 2019, 25, 595-602).

Asunto(s)

Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/epidemiología , Artritis Reumatoide/epidemiología , Disfunción Cognitiva/epidemiología , Insuficiencia Renal Crónica/epidemiología , Adulto , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Disfunción Cognitiva/etiología , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia

RESUMEN

INTRODUCTION: Ceftriaxone (CFX) and clavulanic acid (CA) are 2 ß-lactam molecules widely used as antibiotics. However, several reports of their antiallodynic properties have been published in recent years. Although this effect has been considered mostly due to a GLT1 overexpression, these molecules have also been proven to induce direct immunomodulation. In this work, we determine the acute analgesic effect of CFX and CA in an inflammatory pain model and assess if their administration may induce anti-inflammatory effects. METHODS: The carrageenan (Carr) test was used as an inflammatory pain model. Both mechanical and thermal responses were analyzed after CFX and CA administration at different times. A plethysmometer was used to determine inflammation. Also, TNF-α and IL-10 serum concentrations were determined by enzyme-linked immunosorbent assay. RESULTS: Both CFX and CA induced a significant thermal antiallodynic effect 3 and 24 h after administration. Furthermore, CA induced a mechanical antiallodynic effect 30, 60, and 90 min after administration. Moreover, a significant anti-inflammatory effect was found for both molecules 24 h after Carr injection. Also, both CA and CFX modulated TNF-α and IL-10 serum concentrations at different times. CONCLUSION: Our results provide evidence that both CFX and CA cause an analgesic effect on a Carr inflammatory pain model and that said analgesic effect differs between each ß-lactam molecule. Furthermore, this effect may be related to an anti-inflammatory effect of both molecules and a direct TNF-α and IL-10 serum concentration modulation.

RESUMEN

The objective of this study is to describe aspects of health-related quality of life (HRQOL) in Mexican patients with antineutrophil cytoplasmic-associated vasculitis (AAV). Cross-sectional comparison study includes patients with established AAV and a comparison group with rheumatoid arthritis (RA), chronic kidney disease (CKD), and healthy subjects. Variables considered were: socio-demographic data, comorbidities, laboratory, disease activity, damage, and Physician's and Patient's Global Assessment (PhGA and PtGA). The following measurements were done: Pittsburg sleep quality index, Multidimesional Fatigue Inventory (MFI-20), Hospital Anxiety and Depression Scale, Short Form 36 questionnaire (SF-36), and Health Assessment Questionnaire. 60 patients with AAV were included, median age 54 years, and 60% female. Significant differences were found only in the bodily pain domain of the SF-36 (p = 0.01). Aspects of disease relevant for AAV patients were: fatigue and lack of energy; visual abnormalities; neuropathy; renal impairment; arthritis, and sinusitis. Greater total score on MFI-20 (p < 0.001) and worse PtGA (p = 0.01) were associated with worse physical health. Higher PhGA values were associated with worse physical quality of life (p = 0.01). Greater fatigue score (p = 0.002), greater anxiety-depression score (p = 0.005), and worse PtGA (p = 0.01) were associated with worse mental health quality of life. No differences were found in prevalence of sleep impairment, anxiety, depression, or disability between groups. AAV patients experienced more general and physical fatigue (p < 0.0001), and reduced activity (p = 0.01) than healthy subjects, but similar to RA and CKD patients. Vasculitis has negative effects on patients' physical and mental HRQOL.

Asunto(s)

Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/psicología , Actitud del Personal de Salud , Conocimientos, Actitudes y Práctica en Salud , Pacientes/psicología , Médicos/psicología , Calidad de Vida , Adulto , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnóstico , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/epidemiología , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/fisiopatología , Ansiedad/epidemiología , Ansiedad/fisiopatología , Ansiedad/psicología , Estudios de Casos y Controles , Comorbilidad , Costo de Enfermedad , Estudios Transversales , Depresión/epidemiología , Depresión/fisiopatología , Depresión/psicología , Evaluación de la Discapacidad , Fatiga/epidemiología , Fatiga/fisiopatología , Fatiga/psicología , Femenino , Humanos , Masculino , Salud Mental , México/epidemiología , Persona de Mediana Edad , Dimensión del Dolor , Medición de Resultados Informados por el Paciente , Prevalencia , Pronóstico , Factores de Riesgo , Índice de Severidad de la Enfermedad , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/fisiopatología , Trastornos del Sueño-Vigilia/psicología , Adulto Joven

RESUMEN

Clinical and histological factors have been identified as predictors of early and late renal outcome in ANCA-associated vasculitides (AAV). The presence and severity of kidney involvement at diagnosis are associated with poor prognosis in both patient and renal survival. Histologic findings remain the gold standard for diagnosing patients with AAV. In order to quantify the extent of the morphological parameters in the renal biopsies and to identify the histopathological lesions that predict renal outcome, several scoring systems have been proposed to systematically assess kidney biopsies in AAV. Renal pathologists from an international working group proposed in 2010 a new histopathological classification. This scheme comprises four general categories, based on the predominance of the glomerular histological lesions: focal (≥50% normal glomeruli); crescentic (≥50% glomeruli with cellular crescents); mixed (<50% normal, <50% crescentic, <50% globally sclerotic glomeruli), and sclerotic (≥50% globally sclerotic glomeruli). This article reviews the background and the main studies that have validated the histopathologic classification of ANCA-associated glomerulonephritis, the conclusions derived from these studies, and the perspectives for the assessment of renal outcome in AAV.

Asunto(s)

Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/patología , Glomerulonefritis/clasificación , Glomerulonefritis/patología , Riñón/patología , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnóstico , Anticuerpos Anticitoplasma de Neutrófilos/análisis , Humanos

RESUMEN

Introducción: El síndrome de apnea obstructiva del sueño (SAOS) ha aumentado su incidencia en los últimos años, con repercusiones importantes en la salud, su tratamiento debe ser elaborado por un equipo multidisciplinario según las necesidades de cada paciente. Los dispositivos de avance mandibular pueden ser una herramienta útil y no invasiva. Objetivo: Evaluar el efecto que tienen los dispositivos de avance mandibular (DAM) en pacientes con SAOS de intensidad severo, en quienes presentan como único sitio de obstrucción la base de lengua y son candidatos para utilizar el dispositivo. Diseño: Estudio cuasi-experimental no controlado de antes y después. Materiales y Métodos: Se incluyeron 30 pacientes con diagnóstico de SAOS de intensidad severo, con único sitio de obstrucción en la base de lengua, que fueran candidatos al uso de dispositivos de avance mandibular, también se realizó polisomnografía de noche dividida de control, comparándose índice de apnea hipopnea (IAH) e índice de ronquido (IR) antes y después del tratamiento. Resultados: En el estudio polisomnográfico de noche dividida de control, se encontró diferencia significativa p<0,001 al comparar el índice de apnea hipopnea e índice de ronquido antes y después de usar el dispositivos de avance mandibular. Discusión: Los dispositivos de avance mandibular pueden ser una herramienta considerada en el manejo del SAOS con cualquier grado de intensidad, siempre y cuando el sitio de obstrucción sea evaluado adecuadamente mediante un grupo multidisciplinario, donde se individualice a cada paciente.

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Introduction: The obstructive sleep apnea syndrome (OSAS) has increased its incidence in the last years, with important health repercussions, treatment should be developed by a multidisciplinary team according to the needs of each patient. Mandibular advancement devices can be a useful noninvasive tool. Objective: To evaluate the effect of mandibular advancement devices in patients with severe OSAS, with base of the tongue as the only obstruction site and who are candidates to use the device. Design: Quasi-experimental uncontrolled before and after study. Materials and methods: 30 patients with a diagnosis of severe OSAS, with an unique site of obstruction at the base of tongue, who meet the mandibular advancement devices use criteria; split night polysomnography control was also performed, comparing apnea hypopnea index (AHI) and snoring index (SI) before and after treatment. Results: There is a significance difference p<0,005 between AHI and SI before and after use the mandibular advancement devices in the control split-night polysomnography. Discussion: The mandibular advancement devices may be a treatment tool in OSAS regardless of the severity; a multidisciplinary group should determine the obstruction site, to select a specific treatment in each patient.

Asunto(s)

Síndromes de la Apnea del Sueño , Terapéutica , Avance Mandibular

RESUMEN

Introducción: El Síndrome de Apnea Obstructiva del Sueño (SAOS) es uno de los trastornos de sueño más frecuentes, asociada con el riesgo cardiovascular. En la actualidad se ha descrito el uso de esclerosantes en el manejo del ronquido simple, no en la apnea del sueño leve. Objetivo: Evaluar la eficacia de este procedimiento para los pacientes con SAOS de intensidad leve con sitio exclusivo de obstrucción en paladar blando. Diseño: Estudio cuasi-experimental no controlado de antes y después. Métodos:Se incluyeron 11 pacientes con SAOS leve, con sitio de obstrucción exclusivo en paladar blando. Se realizó polisomnografía basal y de control a los 6 meses del tratamiento. Se usó tetradecil sulfato de sodio 3%, submucoso en paladar blando 1ml. en la línea media y 0.5 ml paramedial. Se evaluó el índice de ronquido, de apnea/hipopnea (IAH), saturación de oxígeno y despertares. Discusión: Aunque el número de pacientes es muy pequeño, este es el único antecedente del uso de esclerosantes en el tratamiento de apnea del sueño leve, siendo un procedimiento rápido, económico y poco molesto. Se observó mejoría en los parámetros evaluados exceptuando los despertares. Conclusiones: La inyección de esclerosantes podría ser un tratamiento de elección en pacientes con SAOS leve que cumplan con los criterios de obstrucción ya nombrados.

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Introduction: The obstructive sleep apnea syndrome (OSAS) is a frequent sleep disorder, and is linked with cardiovascular risk. Actually the sclerotherapy was described in the snoring therapy, but not in the mild OSAS patients. Objective: To evaluate the efficacy of this procedure for patients with mild OSAS with exclusive site of obstruction in the soft palate. Design: Quasi-experimental uncontrolled before and after study. Methods: We collected 11 patients with mild OSAS, only with obstruction in soft palate. The assessment was done by basal and control polysomnography 6 months later of the treatment. The sodium tetradecyl sulfate was used in the submucosal space in the soft palate with 1 ml in the midline and 0,5 ml in the paramedian location. We evaluated snoring index, apnea hyponea index (AHI), oxygen saturation and arousals number. Discussion: Despite the small sample, this is the only report in the literature that describes the use of sclerotherapy in the mild OSAS, it's a quick, low cost and not annoying procedure with a significant improve in all the parameters with an exception in the arousals. Conclusions: Sclerotherapy may be a treatment option in patients with mild OSAS, with the inclusion criteria mentioned above.

Asunto(s)

Síndromes de la Apnea del Sueño , Terapéutica , Escleroterapia

RESUMEN

Es muy importante establecer el sitio de obstrucción en la vía aérea, en pacientes con sospecha de apnea obstructiva del sueño (AOS); la obstrucción ocurre mientras dormimos, por lo tanto ¿la evaluación en posición supina debería dar una mejor información del estado de la vía aérea? Establecer la correlación y diferencias entre la evaluación en posición supina y sentado, mediante el examen físico y endoscópico. Métodos: Cohorte longitudinal, observacional, prospectiva, analítica y prolectiva. Se evaluaron 63 pacientes con sospecha de AOS mediante: posición de la lengua según Friedman, maniobra de Müller y evaluación endoscópica de la vía aérea en posición supina y sentado. Se evaluó la correlación y diferencias entre cada grupo. Resultados: No hay diferencia significativa entre la posición supina y sentado tanto en la evaluación física y endoscópica de la vía aérea, sin ser modificado por sexo o IMC. Se encontró un coeficiente de correlación > 0,8 con p=<0,001 entre la evaluación sentado y en supino. Conclusiones: No hay diferencia entre la evaluación de la vía aérea en posición supino y sentado, pero con una correlación significativa de los hallazgos de estos dos grupos, por esta razón no es necesario evaluar la vía aérea en posición supina...

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Introduction: It is very important to establish the site of obstruction in the airway, in patients with obstructive sleep apnea (OSA) suspicion. All these events occur in the supine position while the patient is sleeping; therefore the evaluation in the supine position would give a better assessment of the airway obstruction? Objective: establish the correlation and difference between supine and sitting position evaluation of the physical and endoscopic assessment of the airway. Methods: This was a longitudinal, observational, prospective, analytic study and prolective cohort. We collected 63 patients with suspicion of OSA, they were assessed with the Friedman tongue position, Müller maneuver and endoscopic evaluation of the airway in supine and sitting position. We evaluate the correlation and differences of each one. Results: There is no statistical significance between sitting and supine position findings in the physical and endoscopic evaluation, without influence by sex or BMI. With correlation coefficient >0,8 with a statistical significance p=<0,001 between sitting and supine evaluation. Conclusion: No difference in the evaluation of the airway in sitting and supine position, but with a significance correlation between the findings. For this reason is not necessary to do the airway evaluation in the supine position...

Asunto(s)

Humanos , Nasofaringe , Otolaringología , Salud , Síndromes de la Apnea del Sueño

RESUMEN

Introducción: El examen físico no ha demostrado una predicción diagnóstica significativa en la apnea obstructiva del sueño (AOS). Aunque la polisomnografía es el estándar de oro, sus costos y disponibilidad la hacen difícil de realizar en algunos casos; así, es importante encontrar otras herramientas que brinden una aproximación referente a la severidad de la AOS. Objetivo: Establecer la relación entre la circunferencia del cuello y los parámetros polisomnográficos. Métodos: Estudio longitudinal, prolectivo, observacional, analítico en una cohorte prospectiva. Se reclutaron pacientes con sospecha de AOS en la consulta de Otorrinolaringología; se les practicó polisomnografía y medición de la circunferencia del cuello (CC). Se realizó prueba T para muestras independientes y parámetros descriptivos en el análisis estadístico. Resultados: Se evaluaron 141 pacientes, 95 hombres (67%); CC, 30-59 cm; saturación mínima de oxígeno, 35-91%; saturación promedio con rango de 65-96%; índice de apnea-hipopnea, 0,6-173 eventos/hora. Se encontraron diferencias significativas, p < 0,05, entre los parámetros medidos en los pacientes con circunferencia del cuello mayor de 43 cm. Conclusión: La CC mayor de 43 cm se asocia con peores resultados en los parámetros polisomnográficos, lo cual indica la asociación de la CC con la severidad de la AOS...

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Introduction: Physical assessment hasn’t shown a very strong predictive severity diagnostic value in the obstructive sleep apnea (OSA). Polysomnography is the gold standard diagnostic tool, but it is expensive and difficult to get it in some cases. Therefore it is important to find other diagnostic studies that may give us an approximation to the severity of OSA. Objective: To establish the relationship between neck circumference and polysomnography parameters. Methods: This was a longitudinal - observational and analytic study in a population-based prospective and prolective cohort. We collected the patients with suspicion of OSA, in the Otolaryngology clinics; they were assessed with the neck circumference measure and diagnostic Polysomnography. We determined the Independent samples T- Test, and the descriptive parameters in the statistical analysis. Results: We evaluated 141 patients, 95 males (67,4%), neck circumference (NC) range: 30 – 59 cm; minimal oxygen saturation range: 35– 91% with a mean of 72%; mean oxygen saturation range: 65 – 96% with a mean of 88,9%; apnea hipopnea index (AHI) range: 0,6 – 173 events/hour with a mean 52,6 events/hour. There is a statistical significance p value lesser than 0,05 between the NC greater than 43 cm and NC lesser than 43 cm group, in these parameters: minimal saturation, mean saturation and AHI. Conclusion: The NC greater than 43 cm was associated with the worse results in the following polysomnography parameters: minimal saturation, mean saturation and AHI. These findings may give us an association between NC and the severity of the OSA...

Asunto(s)

Humanos , Apnea Obstructiva del Sueño , Apnea Obstructiva del Sueño/diagnóstico , Cuello/fisiología

RESUMEN

PURPOSE: To compare the prevalence and clinical course of giant cell arteritis (GCA) among Hispanic and non-Hispanic patients. DESIGN: Comparative case series. METHODS: Two hundred fifty-seven consecutive patients who underwent temporal artery biopsy in our institution from 1996 to 2002 were studied. A prospective telephone survey was conducted to determine race and Hispanic origin separately by means of methodology of the US Census Bureau. RESULTS: One hundred thirty-four patients completed the interview, with 65 (49%) identifying themselves as Hispanic and 69 (51%) as non-Hispanic. Of the 32 respondents with biopsy-proven GCA, all identified themselves racially as white, and 13 (41%) were Hispanic and 19 (59%) were non-Hispanic (P = .32). Statistically significant differences in age, presenting symptoms, and final visual acuity were not observed among Hispanic and non-Hispanic patients with GCA. CONCLUSIONS: Although GCA has been reported to be rare in Hispanics, we found the prevalence and clinical course of GCA to be similar in Hispanic and non-Hispanic patients.

Asunto(s)

Arteritis de Células Gigantes/etnología , Anciano , Biopsia , Femenino , Arteritis de Células Gigantes/diagnóstico , Hispánicos o Latinos/etnología , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Arterias Temporales/patología

RESUMEN

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Summary During the decade of 1880, Paul Briquet made a well detailed description of a syndrome named after him, characterized by a series of unexplainable medical symptoms that appeared in a hideous way, with clinical curse and without the paroxysmal seizures mentioned by Charcot in his description of hysteria. Nevertheless, all the patients that showed these symptoms were diagnosed as hysteric. Nowadays, the clinical scenery is substituting the term of hysteria in favour of its components and giving it different names such as dissociative disorder, conversive disorder, and disorder caused by somatic symptoms of somatoform. Other terms such as "functional somatic syndrome" or "medically unexplainable symptoms" have been added to the list. In spite of these denominations no explanation has been given to the etiology of hysteria. Each medical specialty has to contend with some functional somatic syndrome: gastroenterology presents irritable colon; cardiology, precordial pain; neurology, tensional cephalalgia; stomatology presents tempomandibular dysfunction, and ginecology, chronic pelvic pain. Lumbar pain is present in orthopedia, chronic fatigue in cases of infectiousness, and finally, in rheumatology, there is fibromyalgia. In spite of their differences, these symptoms have some likenesses: they are associated to depression and anxiety, and have a high comorbidity with personality disorders; patients show major emotional distress, they share stories of either psychological, physical or sexual abuse during childhool, and suffer from some type of chronic pain. Although having visited several specialists in their search for explanations and treatment, results have been poor and patients have been labelled, in a pejorative way, as hysteric or hypochondriac. When diagnosed with any of these syndromes, patients' stress is reduced while having to face the invisible, uncontrollable and unpredictable fact implied by suffering from the symptoms that are typical. In particular, fibromyalgia assembles all the characteristics mentioned above. Turk and Cathébras proposed that establishment and exacerbation of the main symptoms of fibromyalgia (pain and fatigue) still constitute and model of respondent conditioning and that repeated exposure to certain stimulus generalizes learning. Also, they affirm that the same symptoms create later a cycle that perpetuates fibromyalgia. Once that symptom have been installed and strengthened, patients avoid all kind of activities, they get involved in legal procedures to obtain leave or else, they look for labour prerogatives. Besides, patients with fibromyalgia show the classic behaviour described for hysteria: "belle indifference", secondary advantages, dramatizing, blaming for their sufferings events which are out of their daily routine, and scarce tolerance. The purpose of this study is to present quantitatively, in patients diagnosed with fibromyalgia, the following agents: symptoms severity, prevalent personality, comorbidity with personality disorders, and degree of severity of depression and anxiety. Qualitatively, we wish to demonstrate the presence of the cycle that sustains the given symptoms. Participants: Ten patients with fibromyalgia participated in our study, 9 women and 1 man, diagnosed according to the criteria of the American College of Rheumatology, aged 37.9 ± 8.8 and with a medium time of evolution of 3 (2-23) years. Quantitative variables: Physical status and syndrome's severity were assessed using the Fibromyalgia Impact Questionnaire (FIQ); for personality, disorders were evaluated with the Revised Personality Diagnose Questionnaire (PDQ-R); depression, with Beck's Inventory, and anxiety with Spielberger's Trait State Inventory. Qualitative theoretical focus: Life experiences narrated by patients in their daily record of events, emotions and thoughts associated with pain, are presented. Procedure: All patients were evaluated individually at the beginning of a cognitive behavioural intervention. Qualitative data was obtained from daily records kept during at least three weeks or a maximum of 12. Texts were transcribed and the words most mentioned were identified, as well as those scarcely reported, thus propitiating descriptive categories. Results: The American College of Rheumatology established as one of the diagnose criteria for fibromyalgia, the presence of al least 11 of a total of 18 hypersensitive sites. Patients presented in average 16.3 ± 2.5 painful sites. Incapability was measured by patients in 2.3 ± 2.2 in a scale of 0 to 3 points; they reported to have felt well 1.1 ± 1.2 days per week; they didn't work 1.0 ± 1.1 days per week. The following measures are reported in scale from 1 to 10 points. Laboural interference was calculated in 7.3 ± 2.3; intensity of pain was 8.1 ± 1.4, day long fatigue, 8.4 ± 1.9, morning fatigue was 8.5 ± 2.3. Rigidity was 7.5 ± 3.0; anxiety perceived, 7.5 ± 2.6 (FIQ), and anxiety state along 12 weeks was 38.5 ± 10.3. Anxiety trait during the same period was 50.9 ± 9.7; perceived depression, 6.9 ± 3.4 (FIQ), and cognitive depression 14.7 ± .5. In the scale of personality it was found that six patients reached punctuations higher than T60 in neuroticism, and two other punctuated below T40 in extroversion. Regarding personality disorders it was found an average for 1.8 ± 1.1 disorders per patient; those more frequent were the following: histrionic (4), borderline (3), passive aggressive (2) and schizoid (2). Qualitative data support the existence of the typical symptoms described for hysteria. Conclusions: According to the results obtained from the quantitative analysis of this group of patients with fibromyalgia, we can conclude that they suffer from a disorder that generates major incapability accompanied of pain and fatigue. Nevertheless, their personality characteristics show that they have high levels of neuroticism with presence of personality disorders and at the same time important levels of depression and anxiety, predominating in the former, anxiety as a trait. Manifestations described by patients in their daily record of events, emotions and thoughts associated with pain and fatigue, confirm the presence of the classic symptoms that typified the construct of hysteria. These patients are vulnerable to their surroundings, have a story of childhood sufferings, and assumed an adult role from a very early age. Symptoms appear to be the only mechanism which at a given moment in life allowed them to get rid of the responsibilities that burdened them from childhood. Unfortunately, this symptom was associated to their environment, according to the laws of learning. It is concluded that fibromyalgia, as nosologic entity accomplishes the characteristics of hysteria, although as etiology it is established by learning.

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Objetivo: Identificar las necesidades de las mujeres respecto a cómo involucrar a los hombres para la transformación de la inequidad en el ejercicio de las mujeres de los derechos sexuales y reproductivos y evaluar las respuestas masculinas. Material y métodos: Este estudio es la segunda parte de uno similar realizado seis años atrás para evaluar cómo definen las mujeres sus derechos sexuales y reproductivos. El presente trabajo es una investigación cualitativa dividida en dos fases: En la primera se realizaron entrevistas colectivas con mujeres para validar los resultados de la investigación previa sobre cómo negocian las mujeres sus derechos sexuales y reproductivos, y el tipo de participación masculina que deseaban; en la segunda, se realizaron entrevistas colectivas e individuales con hombres planteando lo vertido por las mujeres. Se exploraron las percepciones sobre el ejercicio del poder y las visiones de cambio que sostenían los entrevistados. Las entrevistas se realizaron en Sonora, Ciudad de México y Puebla, fueron 11 colectivas con mujeres y un total de 30 individuales y cinco colectivas con hombres. Resultados: Las mujeres están construyendo el liderazgo de cambio social, pero sin por ello involucrarse en la organización colectiva, asumen un papel como educadoras y moderadoras del impacto del cambio en el ámbito familiar. Los hombres mantienen posiciones reactivas que preservan espacios ancestrales de poder, se mantienen abiertos a un cambio que consideran debe darse desde el ámbito institucional para continuarlo en el doméstico. Conclusiones: Cualquier estudio o intervención sobre masculinidades debe tomar como referencia las necesidades de las mujeres.

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Objective: To identify women's needs regarding how to engage men in the transformation of social inequality of their sexual and reproductive rights. Material and methods: This is a qualitative and interdisciplinary study, divided in two phases: a) women were interviewed to find out what kind of involvement in their sexual and reproductive-health responsibilities they want from the men in their lives, b) men were interviewed, individually and in groups, to understand their own perceptions on the same concerns and also in response to the perceptions women articulated. The research was carried out in three locations in Mexico, in Sonora, Puebla and the Federal District. A total of 11 collective interviews with women took place, 30 individual with men and 5 collective with men. Results: Women are in increasingly constructed a social leadership that does not necessarily translate in collective organizing, and assume the role of educators and moderators as means to act as buffers of the transformation experienced at the family, parental and community levels. Men interviewed hold a reactive position to change that expressed in their resistance to become agents of change, men assume that change should occur first at institutional levels before it carries on at domestic sphere. Conclusions: New insights can be gained in the study and interventions designed in the field of male involvement by taking women's needs as a point of departure. These findings raise awareness of the need to deepen the dialogue between men and women in order to produce better understanding and successful decision-making for both parties in the arena of sexuality and reproduction.