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Resumen La exencefalia es una malformación fetal, donde restos de materia encefálica se encuentran afuera de la bóveda craneal. Las malformaciones congénitas constituyen un problema de salud en nuestro país, la tasa de malformaciones es del orden del 2 al 6% de los recién nacidos. Las malformaciones del sistema nervioso central ocupan el segundo lugar en población de México. Al igual que la mayoría de las malformaciones congénitas, las del sistema nervioso central son un grupo de afecciones de etiología multifactorial, producto de una interacción de factores genéticos, infecciosos, ambientales, raciales, agentes físicos y químicos, y la deficiencia o alteración en el metabolismo del ácido fólico. Se presenta un caso de exencefalia, así como una revisión de la embriología de esta entidad, con énfasis en la importancia del uso del ácido fólico en la etapa de embriogénesis del sistema nervioso central, así como la importancia del abordaje prenatal.
Abstract Exencephaly is a type of cephalic disorder, where the brain is located outside of the skull. Congenital malformations constitute a public health problem in Mexico, affecting approximately 2-6% of newborns. Central nervous system malformations are the second most frequent malformations in the population of Mexico. As with most congenital malformations, the etiology of central nervous system anomalies is multifactorial, resulting from interactions among genetic, infectious, environmental, racial, physical and chemical factors, and deficiency or alteration of folic acid metabolism. We also review the embryology of this entity, with emphasis of the importance of folic acid intake at the stage of central nervous system embryogenesis, and also the importance of the prenatal care.
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Chia seeds (CS) and sprouts are rich in bioactive compounds. This study aimed to assess the effects of germination and chemical elicitation (salicylic acid [SA]; hydrogen peroxide [H2 O2 ]) on proximate chemical, total phenolics compounds (TPC), non-extractable proanthocyanidins (NEPA), and carotenoids content of chia sprouts; besides, the effects of their supplementation on obesity-associated complications in rats fed with high-fat and fructose diet (HFFD) were evaluated. Protein, carbohydrate, TPC, NEPA, and carotenoids content were higher in sprouts than CS; elicitation enhanced TPC and carotenoids compared to non-elicited (NE) sprouts. CS, NE, and elicited chia sprouts ameliorated insulin resistance and dyslipidemia at the same level in HFFD-fed rats. NE and SA-chia sprouts exerted the biggest reduction in hepatic triglycerides, which could be partially related to inhibition of pancreatic lipase activity. In addition, SA elicitation induced the greatest effect on insulin levels and corporal weight. CS and their sprouts decreased obesity and its complication, mainly SA-elicited sprouts. PRACTICAL APPLICATIONS: The growing epidemic of non-communicable diseases such as diabetes and obesity has led to the search for prevention and treatment through lifestyle changes, including the consumption of foods rich in bioactive compounds, such as seeds and their sprouts. Since sprouts contain higher concentrations of bioactive compounds and nutrients than seed, germination is a natural alternative to produce ready-to-eat functional foods. Chemical elicitation is a strategy to increase even more the bioactivity of sprouts. CS has been recognized for its beneficial health effects ameliorating dyslipidemia and insulin resistance. This study demonstrates that elicitation, with SA and H2 O2 , during germination of CS, increases the nutrient and phytochemical content of sprouts, with beneficial effects on body weight gain, insulin resistance, dyslipidemia, and prevention of NAFLD progression in diet-induced obese rats. Therefore, chia sprouts, natural and elicited, may be used as potential nutraceutical foods for the prevention and treatment of obesity and its complications.
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Dislipidemias , Hígado Graso , Resistencia a la Insulina , Animales , Carotenoides/análisis , Dieta Alta en Grasa , Suplementos Dietéticos , Dislipidemias/tratamiento farmacológico , Dislipidemias/etiología , Obesidad/tratamiento farmacológico , Obesidad/metabolismo , Fenoles/análisis , Ratas , Semillas/químicaRESUMEN
RESUMEN La mortalidad materna y perinatal representan un asunto prioritario de salud pública cuyo control reviste especial dificultad en zonas de frontera. Objetivos. Describir el comportamiento de la mortalidad materna y perinatal en los territorios fronterizos de Colombia, entre 1998 y 2016 y establecer su asociación con factores sociodemográficos, geográficos y de atención sanitaria. Métodos. Estudio observacional retrospectivo, basado en registros oficiales. Se calcularon las razones de mortalidad materna (RMM) y perinatal (RMP) para el período 1998-2016, identificando los puntos de inflexión mediante análisis de Joinpoint. Así mismo, se realizaron análisis bivariados y multivariados. Resultados. De los 54 municipios y 12 corregimientos de frontera, pertenecientes a 12 Departamentos, se obtuvieron 687 registros de mortalidad materna y 12,786 de mortalidad perinatal. Las razones observadas fueron 88 x 100,000 NV para la RMM y 16 x 1,000 NV para la RMP. La tendencia de estos tipos de mortalidad fue descendente, Los valores más altos de mortalidad perinatal se asociaron significativamente con la edad materna de 35 a 54 años, atención por régimen subsidiado, nivel educativo bajo, mujeres sin pareja, y embarazos múltiples. Conclusión. La mortalidad materna y perinatal registrada en los municipios fronterizos está por encima del promedio nacional.
ABSTRACT Abstract: Maternal and perinatal mortality is a priority public health issue that is particularly difficult to control in border areas. Objectives: To describe the behavior of maternal and perinatal mortality in the border territories of Colombia, between 1998 and 2016; and to establish its association with sociodemographic, geographic and health care factors. Methods: Retrospective observational study, based on official records. Maternal mortality ratio (MMR) and perinatal mortality ratio (RMP) were calculated for the period 1998-2016, identifying inflection points through Joinpoint analysis. Likewise, bivariate and multivariate analyses were performed. Results: From 54 municipalities and 12 borders townships belonging to 12 Departments, 687 records maternal mortality records and 12,786 perinatal mortality records were obtained. The ratios observed were 88 x 100,000 BA for MMR and 16 x 1,000 NV for PMR. The trend of these types of mortality was downward. The highest values of perinatal mortality were significantly associated with maternal age 35-54 years, care by subsidized regime, low educational level, women without a partner, and multiple pregnancies. Conclusion: Maternal and perinatal mortality registered in border municipalities is above the national average.
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RESUMEN Se presenta caso de una niña de 10 años con cuadro de epilepsia mioclónica juvenil severa en la infancia, que a los 6 meses de edad debutó con crisis tónico-clónicas generalizadas (TCG) luego de la administración de una dosis de vacuna DPT, con posteriores crisis TCG, mioclónicas y múltiples episodios de estado epiléptico refractarios a fármacos antiepilépticos (FAE) de primera y segunda línea durante los primeros 5 años. Las crisis se asociaron a retraso global en el desarrollo luego del primer episodio. Durante la evolución se realizaron estudios que incluyen resonancia magnética cerebral que fue normal y tomografía por emisión de positrones (PET-CT) que evidenció alteraciones en el metabolismo en región temporal izquierda, además de estudios para inmunodeficiencias y trombofilias sin alteraciones. Los electroencefalogramas iniciales fueron normales, pero video electroencefalograma de 12 horas mostró actividad irritativa en la región central con diseminación bilateral. Los estudios genéticos identificaron una mutación en el marco de lectura de tipo "frameshift" del gen SCN1A mediante secuenciación de la región codificante. Luego de los primeros años de vida, la paciente presenta, atípicamente, remisión progresiva de las crisis con posterior desmonte de FAE y mejoría del neuro-desarrollo en el proceso interdisciplinario de rehabilitación.
SUMMARY We report the case of a 10-year-old female with a history of severe myoclonic epilepsy of infancy who presents with generalized tonic-clonic (GTC) seizures at 6 months of age after administration of a DPT vaccine, who then begins to present frequent and severe GTC seizures, myoclonic seizures and multiple refractory status epilepticus poorly controlled with first and second line anti-epileptic drugs (AEDs). This was accompanied by development delay. Studies performed on the patient included brain MRI which was normal, immunodeficiency and trombophilic studies which were normal and electroencephalographs: studies (EEG) that were at first mostly normal. The most significant findings were seen during a 12-hour video-EEG which reported epileptogenic activity in central region with bilateral dissemination and a PET-CT that showed metabolism alterations in the left temporal region. Due to this presentation a channelopathy was suspected and a coding region sequentiation study was performed which identified a frameshift mutation of the SCN1A gene confirming the diagnosis. Atipically, after 5 years the patient begins to present a favorable evolution with significant seizure remission even allowing the progressive weaning of AEDs and a remarkable stalemate of developmental delay after interdisciplinary rehabilitation process was started.
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Movilidad en la CiudadRESUMEN
Hablar sobre el enfoque gestáltico en la intervención comunitaria, se convierte para mí en un pretexto, para compartir con ustedes algo del trabajo realizado por el proyecto de intervención Cultura Amigó durante este semestre, más específicamente lo relacionado con la evolución en el acompañamiento al grupo juvenil líderes barriales, del barrio Nueva Villa de La Iguaná.
Talking about the Gestalt approach in community intervention becomes a pretext for me to share with you some of the work done by the Cultura Amigó intervention project during this semester, more specifically what is related to the evolution in the accompaniment of the youth group neighborhood leaders, from the Nueva Villa de La Iguaná neighborhood.
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Humanos , Terapia Gestalt , Psicología Social , Terapia Socioambiental , Participación de la Comunidad/psicologíaRESUMEN
ObjetivoDescribir y comparar el grado de conocimiento sobre el VIH/sida con el uso del preservativo por la población inmigrante.MétodosEstudio transversal mediante encuesta semiestructurada y entrevista personal realizada en centros asistenciales de las regiones sanitarias de Barcelona y Barcelonés Norte y Maresme a 238 usuarios latinoamericanos y magrebíes en 2003. El cuestionario incluía variables sociodemográficas, de conducta sexual, de conocimientos generales sobre VIH/sida, y sobre la transmisión y la prevención. Para identificar determinantes del conocimiento inadecuado del VIH/sida se aplicó un modelo de regresión logística.ResultadosEl 53,8% de los encuestados tenían un conocimiento inadecuado del VIH/sida. En el análisis univariado se asociaban con este desconocimiento los magrebíes, los que no vivían en Barcelona, los que no tenían trabajo y los que no tenían estudios; en el multivariado se asociaban los magrebíes con una situación más desfavorecida respecto a los latinoamericanos [odds ratio (OR)=4,99; intervalo de confianza del 95% (IC 95%): 2,73-9,10] y los inmigrantes sin trabajo (OR=2,59; IC 95%: 1,42-4,73). El uso del preservativo fue valorado como un método de prevención eficaz, pero el 42,1% de los encuestados no lo utilizaba en sus relaciones ocasionales.ConclusionesEs necesario mejorar el conocimiento sobre los mecanismos de transmisión del VIH/sida y eliminar concepciones erróneas de la infección entre los inmigrantes latinoamericanos y magrebíes. La población inmigrante es vulnerable y prioritaria para impulsar intervenciones preventivas, adaptadas a sus especificidades lingüísticas y culturales. Monitorizar la falta de información, las concepciones erróneas y sus conductas sexuales es esencial para evaluar la efectividad de las intervenciones efectuadas(AU)
ObjectivesTo describe and compare levels of knowledge about HIV/AIDS and condom use in the immigrant population.MethodWe performed a cross-sectional study by means of a semi-structured questionnaire and face-to face interviews in 238 Latin American and Maghrebi users of medical centers in the Barcelona and North Barcelona-Maresme health areas. The questionnaire included sociodemographic variables and questions on sexual behavior and general knowledge about HIV/AIDS, transmission mechanisms, and means of prevention. A logistic regression model was used to identify the determinants of inadequate knowledge of HIV/AIDS.ResultsA total of 53.8% of interviewees had inadequate knowledge of HIV/AIDS. Univariate analysis showed inadequate knowledge to be associated with being from the Maghreb, not living in Barcelona, being without work and not having educational qualifications. Multivariate analysis revealed that the only variables significantly associated with inadequate knowledge were being from the Maghreb as opposed to being from Latin America (OR=4.99; 95% CI: 2.74-5.10) and being unemployed as opposed to being employed (OR=2.59; 95% IC: 1.42-4.73). Condoms were seen as an effective prevention method, but 42.1% of interviewees did not use them in occasional relationships.ConclusionsKnowledge of routes of HIV transmission should be improved and mistaken ideas about infection should be eliminated among Latin American and Maghrebi immigrants. The immigrant population is a vulnerable group that ought to be prioritized to promote prevention programs adapted to its linguistic and cultural specificities. Evaluating the effectiveness of the interventions performed is essential to monitor lack of information, mistaken ideas and sexual behavior in this group(AU)
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Conocimientos, Actitudes y Práctica en Salud , Infecciones por VIH/psicología , Emigrantes e Inmigrantes/psicología , Enfermedades de Transmisión Sexual/psicología , Condones , Estudios Transversales , Infecciones por VIH/etnología , Emigrantes e Inmigrantes , América Latina/etnología , África del Norte/etnología , Encuestas y Cuestionarios , Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/etnología , Factores Socioeconómicos , España/epidemiologíaRESUMEN
OBJECTIVES: To describe and compare levels of knowledge about HIV/AIDS and condom use in the immigrant population. METHOD: We performed a cross-sectional study by means of a semi-structured questionnaire and face-to face interviews in 238 Latin American and Maghrebi users of medical centers in the Barcelona and North Barcelona-Maresme health areas. The questionnaire included sociodemographic variables and questions on sexual behavior and general knowledge about HIV/AIDS, transmission mechanisms, and means of prevention. A logistic regression model was used to identify the determinants of 'inadequate knowledge of HIV/AIDS'. RESULTS: A total of 53.8% of interviewees had inadequate knowledge of HIV/AIDS. Univariate analysis showed inadequate knowledge to be associated with being from the Maghreb, not living in Barcelona, being without work and not having educational qualifications. Multivariate analysis revealed that the only variables significantly associated with inadequate knowledge were being from the Maghreb as opposed to being from Latin America (OR=4.99; 95% CI: 2.74-5.10) and being unemployed as opposed to being employed (OR=2.59; 95% IC: 1.42-4.73). Condoms were seen as an effective prevention method, but 42.1% of interviewees did not use them in occasional relationships. CONCLUSIONS: Knowledge of routes of HIV transmission should be improved and mistaken ideas about infection should be eliminated among Latin American and Maghrebi immigrants. The immigrant population is a vulnerable group that ought to be prioritized to promote prevention programs adapted to its linguistic and cultural specificities.