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The proliferation of radio frequency (RF) devices in contemporary society, especially in the fields of smart homes, Internet of Things (IoT) gadgets, and smartphones, underscores the urgent need for robust identification methods to strengthen cybersecurity. This paper delves into the realms of RF fingerprint (RFF) based on applying the Jensen-Shannon divergence (JSD) to the statistical distribution of noise in RF signals to identify Bluetooth devices. Thus, through a detailed case study, Bluetooth RF noise taken at 5 Gsps from different devices is explored. A noise model is considered to extract a unique, universal, permanent, permanent, collectable, and robust statistical RFF that identifies each Bluetooth device. Then, the different JSD noise signals provided by Bluetooth devices are contrasted with the statistical RFF of all devices and a membership resolution is declared. The study shows that this way of identifying Bluetooth devices based on RFF allows one to discern between devices of the same make and model, achieving 99.5% identification effectiveness. By leveraging statistical RFFs extracted from noise in RF signals emitted by devices, this research not only contributes to the advancement of the field of implicit device authentication systems based on wireless communication but also provides valuable insights into the practical implementation of RF identification techniques, which could be useful in forensic processes.

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Resumen OBJETIVO: Determinar la incidencia del espectro del acretismo placentario en pacientes ingresadas a la unidad de cuidados intensivos obstétricos del Hospital de la Mujer, Culiacán, Sinaloa. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo fundamentado en el análisis de la base de datos del Hospital de la Mujer de pacientes internadas entre los años 2017 a 2020 con diagnóstico de espectro de placenta acreta, referidas o diagnosticadas en la institución e intervenidas para histerectomía por la complicación estudiada. RESULTADOS: Se analizaron 22 pacientes con diagnóstico de acretismo placentario que dieron una incidencia de 0.09%; de éstas, a 1 se le indicó cesárea; 19 de las 22 pacientes tenían antecedente de cicatriz uterina previa, todas con placenta previa. El promedio de edad fue de 30.86 ± 4 años. La cesárea se practicó, en promedio, a las 34 semanas de embarazo con dos técnicas quirúrgicas. El sangrado promedio estimado fue de 1.947 mL. Las complicaciones transoperatorias fueron las lesiones: ureteral (n = 2) y vesical (n = 1). La principal complicación posoperatoria fue la fístula vesicouterina (n = 1). El promedio de estancia fue de 2 días en 16 de las 22 pacientes y de 7 días en las 6 restantes. CONCLUSIONES: Lo importante del acretismo placentario es el diagnóstico oportuno que permita derivar a las pacientes a centros hospitalarios que cuenten con especialistas experimentados en la atención de estos casos.

Abstract OBJECTIVE: To determine the incidence of placental accretism spectrum in pregnant women admitted to the obstetric intensive care unit of the Hospital de la Mujer, Culiacán, Sinaloa. MATERIALS AND METHODS: Retrospective, cross-sectional, descriptive study based on the analysis of the database of the Hospital de la Mujer of patients admitted between 2017 and 2020 with a diagnosis of placenta accreta spectrum, referred or diagnosed at the institution and underwent hysterectomy for the complication studied. RESULTS: Twenty-two patients with a diagnosis of placenta accreta were analysed, giving a prevalence of 0.09%; of these, caesarean section was indicated in 0.2%. 19 of the 22 patients had a history of previous uterine scarring, all with placenta praevia. Mean age was 30.86 ± 4 years. Caesarean section was performed at a mean gestational age of 34 weeks using two surgical techniques. The mean estimated blood loss was 1,947 mL. The most common operative complications were ureteral (n = 2) and bladder (n = 1) injuries. The most common postoperative complication was vesico-uterine fistula (n = 1). The mean length of stay was 2 days in 16 of the 22 patients and 7 days in the remaining 6 patients. CONCLUSIONS: The most important aspect of placenta accreta is early diagnosis, which allows referral to hospital centres with specialists experienced in the management of these cases.

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OBJECTIVE: To evaluate the association between patients' characteristics and disease activity in an Argentine lupus registry. METHODS: Cross-sectional study. Disease activity was stratified into: Remission off-treatment: SLEDAI = 0, without prednisone and immunosuppressive drugs. Low disease activity Toronto Cohort (LDA-TC): SLEDAI ≤2, without prednisone or immunosuppressive drugs. Modified lupus low disease activity (mLLDAS): SLEDAI score of ≤4, with no activity in major organ systems and no new features, prednisone of ≤10 mg/day and/or immunosuppressive drugs (maintenance dose) and Active disease: SLEDAI score of >4 and prednisone >10 mg/day and immunosuppressive drugs. A descriptive analysis and logistic regression model were performed. RESULTS: A total of 1346 patients were included. Of them, 1.6% achieved remission off steroids, 0.8% LDA-TC, 12.1% mLLDAS and the remaining 85.4% had active disease. Active disease was associated with younger age (p ≤ 0.001), a shorter time to diagnosis (p ≤ 0.001), higher frequency of hospitalizations (p ≤ 0.001), seizures (p = 0.022), serosal disease (p ≤ 0.001), nephritis (p ≤ 0.001), higher SDI (p ≤ 0.001), greater use of immunosuppressive therapies and higher doses of prednisone compared to those on mLLDAS. In the multivariable analysis, the variables associated with active disease were the presence of pleuritis (OR 2.1, 95% CI 1.2-3.9; p = 0.007), persistent proteinuria (OR 2.5, 95% CI 1.2-5.5; p ≤ 0.011), nephritis (OR 2.5, 95% CI 1.2-5.6; p = .018) and hospitalizations (OR 8.9, 95% CI 5.3-16.0; p ≤ 0.001) whereas age at entry into the registry was negatively associated with it (OR 0.9, 95% CI 0.9-1.0; p = 0.029). CONCLUSION: Active disease was associated with shorter time to diagnosis, worse outcomes (SDI and hospitalizations) and renal, neurological and serosal disease.

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Resumen ANTECEDENTE: El síndrome de Karsch-Neugebauer o ectrodactilia del pie o pie hendido, es una enfermedad congénita sumamente rara, caracterizada por aplasia-hipoplasia de las falanges y metatarsianos del pie. Cuando aparece de forma aislada se debe a una forma autosómica dominante de expresión variable, aunque también puede ser de carácter autosómico recesivo. CASO CLÍNICO: Paciente de 31 años, sin antecedentes heredofamiliares de importancia, con IMC de 25.95 kg/m2, signos vitales en parámetros normales. Con dos embarazos, cesárea previa sin complicaciones. El ultrasonido estructural 20 a 23.6 semanas del embarazo actual reportó un feto vivo, de sexo femenino y 22.2 semanas de gestación, con múltiples alteraciones anatómicas: arteria umbilical única, hueso nasal hipoplásico, micrognatia en ángulo facial y miembros inferiores con ectrodactilia bilateral. CONCLUSIONES: Los estudios ultrasonográficos, en especial el de las semanas 20 a 23.6 de gestación son decisivos para la detección de malformaciones congénitas. Sin embargo, a partir de las 11 a 13.6 semanas es posible establecer diagnósticos estructurales de manera temprana. Muchas alteraciones y síndromes, como el de Karsch-Neugebauer, suelen ser incapacitantes y al combinarse con otras anomalías pueden llegar a ser incompatibles con la vida. Se requieren diagnósticos tempranos para la toma de decisiones de manera consensuada con la familia y el equipo multidisciplinario.

Abstract BACKGROUND: Karsch-Neugebauer syndrome, or ectrodactyly of the foot or cleft foot, is an extremely rare congenital disorder characterized by aplasia-hypoplasia of the phalanges and metatarsals of the foot. When it occurs in isolation, it is due to an autosomal dominant form of variable expression, although it can also be autosomal recessive. CLINICAL CASE: 31-year-old female patient with no significant hereditary family history, BMI of 25.95 kg/m2, vital signs within normal parameters. With two pregnancies, previous caesarean section without complications. Structural ultrasound 20 to 23.6 weeks of the current pregnancy showed a live fetus, female sex and 22.2 weeks gestation, with multiple anatomical anomalies: single umbilical artery, hypoplastic nasal bone, micrognathia in the facial angle and lower limbs with bilateral ectrodactyly. CONCLUSIONS: Ultrasound examinations, especially at 20 to 23.6 weeks of gestation, are crucial for the detection of congenital malformations. However, from 11 to 13.6 weeks it is possible to make early structural diagnoses. Many disorders and syndromes, such as Karsch-Neugebauer syndrome, are often disabling and, in combination with other anomalies, can become incompatible with life. Early diagnosis is necessary to make informed decisions with the family and the multidisciplinary team.

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Resumen ANTECEDENTES: Las quemaduras son la forma más severa de estrés que el cuerpo puede sufrir; pueden generarse por diferentes agentes térmicos y químicos. CASO CLÍNICO: Paciente de 25 años, con dolor intenso en la región genital de 12 horas de evolución, secundario a la introducción en la vagina de una piedra de alumbre. Se le hicieron múltiples irrigaciones con solución salina al 0.9% sin obtener el resto de la piedra de alumbre. Se le aplicó sulfadiazina de plata en la cavidad vaginal cada 12 horas, óvulos vaginales de ketanserina, miconazol y metronidazol cada 8 horas, ketorolaco por vía oral 10 mg cada 8 horas. Durante su estancia hospitalaria tuvo buena evolución, con disminución de la inflamación en la zona genital, epitelización adecuada. Al tercer día se dio de alta del hospital con cita para valoración a los siete días. CONCLUSIÓN: El tratamiento de las quemaduras en el área genital, por agentes químicos, tiene como piedra angular la identificación del agente causante de la lesión que permita actuar de forma inmediata y evitar las secuelas físicas, sexuales y psicológicas mediante el lavado exhaustivo con solución o agua estéril para remover el agente causal y disminuir que continúe actuando en el sitio afectado.

Abstract BACKGROUND: Burns are the most severe form of stress that the body can suffer; they can be caused by various thermal and chemical agents. CLINICAL CASE: A 25-year-old female patient presented with severe genital pain of 12 hours' duration, secondary to the introduction of an alum stone into the vagina. She underwent several irrigations with 0.9% saline without obtaining the rest of the alum stone. She was given vaginal silver sulfadiazine every 12 hours, vaginal ketanserin, miconazole and metronidazole every 8 hours and oral ketorolac 10 mg every 8 hours. During her stay in hospital, she progressed well, with a decrease in genital inflammation and adequate epithelialisation. She was discharged on the third day with an appointment for a seven-day follow-up. CONCLUSION: The management of genital burns caused by chemical agents is based on the identification of the agent causing the lesion, which allows immediate action and prevents physical, sexual and psychological sequelae by thorough washing with sterile solution or water to remove the causative agent and reduce its continued action in the affected area.

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A proper valorization of biological waste sources for an effective conversion into composites for tissue engineering is discussed in this study. Hence, the collagen and the phenolic compound applied in this investigation were extracted from waste sources, respectively, fish industry rejects and the peels of the mangosteen fruit. Porous scaffolds were prepared by combining both components at different compositions and mineralized at different temperatures to evaluate the modifications in the biomimetic formation of apatite. The inclusion of mangosteen extract showed the advantage of increasing the collagen denaturation temperature, improving the stability of its triple helix. Moreover, the extract provided antioxidant activity due to its phenolic composition, as confirmed by 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) antioxidant assays. Mineralization was successfully achieved as indicated by thermogravimetry and scanning electron microscopy. A higher temperature and a lower extract concentration reduced the calcium phosphate deposits. The extract also affected the pore size, particularly at a lower concentration. The X-ray diffraction pattern identified a low degree of crystallization. A high mineralization temperature induced the formation of smaller crystallites ranging from 18.9 to 25.4 nm. Although the deposited hydroxyapatite showed low crystallinity, the scaffolds are suitable for bone tissue applications and may be effective in controlling the resorbability rate in tissue regeneration.

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This study aimed to evaluate markers of the CLOCK gene rs1801260 and rs4864548 in Mexican adolescents, addressing clinical and biological aspects previously associated with ADHD. 347 Mexican adolescents were assessed for mental disorders, metabolic disruption and related conditions, circadian preference, as well as genotyping for the CLOCK. We found a significant association between ADHD and the AA and AG genotypes of rs1801260. Also, we identified in the ADHD group that the total Triiodothyronine and total Thyroxine values were respectively 10 ng/dl units and 0.58 ug/dl units lower in females than in males. Previously reported common variations of the CLOCK gene have been associated with ADHD like the Rs1801260 polymorphism hereby we could consider it as risk factor, but genetic, biochemical and clinical studies in the Mexican population are entailed.

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Nursing homes are institutions with high prevalence of urinary tract infections caused by ESBL-producing E. coli with several virulence factors. The aim of this study was to determine the frequency of the bla CTX-M gene and eight virulence genes in 35 ESBL-producing uropathogenic E. coli from six nursing homes in Peru during 2018. Of the E. coli samples, 57.1% (20/35) were carriers of the bla CTX-M gene. Furthermore, we obtained frequencies of 46% (15/35) and 37% (13/35) for hly-alpha and cnf-1, respectively; we also found high presence of the iucC (63%, 22/35), aer (94%, 33/35) and chuA genes (94%, 33/34) as well as a frequency of 46% (16/35) and 91% (32/34) for the pap GII and nanA genes, respectively. The bla CTX-M gene is predominant and a high frequency of exotoxins gives it a competitive advantage for spreading into the bloodstream.

Los asilos de ancianos son instituciones con una alta prevalencia de infecciones del tracto urinario ocasionado por Escherichia coli productoras de ß-lactamasas de espectro extendido (BLEE), con diversos factores de virulencia. El objetivo del estudio fue determinar la frecuencia del gen bla CTX-M y de ocho genes de virulencia en 35 E. coli uropatógenas productoras de BLEE provenientes de seis asilos en Perú, durante el 2018. El 57,1% (20/35) de las E. coli fueron portadores del gen bla CTX-M. Además, se obtuvo una frecuencia del 46% (15/35) y 37% (13/35) de hly-alfa y cnf-1, respectivamente; elevada presencia de los genes iucC (63%, 22/35), aer (94%, 33/35) y chuA (94%, 33/34) y una frecuencia del 46% (16/35) y del 91% (32/34) de los genes pap GII y nanA, respectivamente. Existe predominancia en la distribución del gen bla CTX-M, además de una alta frecuencia de exotoxinas que le confieren una ventaja competitiva para diseminarse hacia el torrente sanguíneo.

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RESUMEN Los asilos de ancianos son instituciones con una alta prevalencia de infecciones del tracto urinario ocasionado por Escherichia coli productoras de ß-lactamasas de espectro extendido (BLEE), con diversos factores de virulencia. El objetivo del estudio fue determinar la frecuencia del gen bla CTX-M y de ocho genes de virulencia en 35 E. coli uropatógenas productoras de BLEE provenientes de seis asilos en Perú, durante el 2018. El 57,1% (20/35) de las E. coli fueron portadores del gen bla CTX-M. Además, se obtuvo una frecuencia del 46% (15/35) y 37% (13/35) de hly-alfa y cnf-1, respectivamente; elevada presencia de los genes iucC (63%, 22/35), aer (94%, 33/35) y chuA (94%, 33/34) y una frecuencia del 46% (16/35) y del 91% (32/34) de los genes pap GII y nanA, respectivamente. Existe predominancia en la distribución del gen bla CTX-M, además de una alta frecuencia de exotoxinas que le confieren una ventaja competitiva para diseminarse hacia el torrente sanguíneo.

ABSTRACT Nursing homes are institutions with high prevalence of urinary tract infections caused by ESBL-producing E. coli with several virulence factors. The aim of this study was to determine the frequency of the bla CTX-M gene and eight virulence genes in 35 ESBL-producing uropathogenic E. coli from six nursing homes in Peru during 2018. Of the E. coli samples, 57.1% (20/35) were carriers of the bla CTX-M gene. Furthermore, we obtained frequencies of 46% (15/35) and 37% (13/35) for hly-alpha and cnf-1, respectively; we also found high presence of the iucC (63%, 22/35), aer (94%, 33/35) and chuA genes (94%, 33/34) as well as a frequency of 46% (16/35) and 91% (32/34) for the pap GII and nanA genes, respectively. The bla CTX-M gene is predominant and a high frequency of exotoxins gives it a competitive advantage for spreading into the bloodstream.

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Introducción: el lupus es una enfermedad compleja y varias veces de difícil abordaje. Alcanzar la remisión es uno de los objetivos, incorporando opciones terapéuticas. Objetivos: describir las características generales de los pacientes según el estado de la enfermedad y el uso de belimumab. Materiales y métodos: estudio de corte transversal, registro RELESSAR. Se definió el estado de la enfermedad como: remisión: SLEDAI=0 y sin corticoides; baja actividad de la enfermedad: SLEDAI >0 y ≤4 y sin corticoides; control no óptimo: SLEDAI >4 y cualquier dosis de corticoides. Resultados: se incluyeron 1.277 pacientes, 23,4% en remisión, 12,6% en baja actividad y 63,8% con control no óptimo. En este último grupo eran más jóvenes y con menor duración de la enfermedad; presentaban mayores índices de actividad y cronicidad, y mayor empleo de inmunosupresores. Solo el 22,3% de los pacientes con criterio potencial de uso de belimumab (lupus eritematoso sistémico activo a pesar del tratamiento estándar) lo recibía en ese momento. Las variables asociadas a hospitalizaciones fueron: terapia con corticoides, ciclofosfamida y mayor SLICC. Conclusiones: se refleja la complejidad del manejo de estos pacientes y se visualizan aspectos estructurales como la desigualdad. El uso del belimumab resultaría beneficioso en los pacientes seleccionados.

Introduction: lupus is a complex disease and often difficult to approach. Achieving remission is one of the objectives, incorporating therapeutic options. Objectives: to describe the characteristics of the patients and the use of belimumab, according to the status of the disease. Materials and methods: cross-sectional study. Patients of the RELESSAR registry. Stratification: Remission: SLEDAI=0 and without corticosteroids. Low disease activity SLEDAI> 0 and ≤4 and without corticosteroids and non-optimal control: SLEDAI> 4 and any dose of corticosteroids. Results: a total of 1,277 patients were included, 23.4% in remission, 12.6% in low disease activity and 63.8% in non-optimal control. The last group was younger and had a shorter duration of the disease. They had higher activity and chronicity indices and greater use of immunosuppressants. Only 22.3% of the patients with potential criteria for the use of belimumab (activity disease despite standard treatment) were receiving it. The variables associated with hospitalizations were: corticosteroids, cyclophosphamide and higher SLICC. Those associated with severe infection: mycophenolate mofetil, azathioprine, corticosteroids, and higher SLICC. Conclusions: the complexity of the management of these patients is reflected, visualizing structural aspects such as inequality. The use of belimumab could be beneficial in selected patients.

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Introducción: el lupus es una enfermedad compleja y varias veces de difícil abordaje. Alcanzar la remisión es uno de los objetivos, incorporando opciones terapéuticas. Objetivos: describir las características generales de los pacientes según el estado de la enfermedad y el uso de belimumab. Materiales y métodos: estudio de corte transversal, registro RELESSAR. Se definió el estado de la enfermedad como: remisión: SLEDAI=0 y sin corticoides; baja actividad de la enfermedad: SLEDAI >0 y ≤4 y sin corticoides; control no óptimo: SLEDAI >4 y cualquier dosis de corticoides. Resultados: se incluyeron 1.277 pacientes, 23,4% en remisión, 12,6% en baja actividad y 63,8% con control no óptimo. En este último grupo eran más jóvenes y con menor duración de la enfermedad; presentaban mayores índices de actividad y cronicidad, y mayor empleo de inmunosupresores. Solo el 22,3% de los pacientes con criterio potencial de uso de belimumab (lupus eritematoso sistémico activo a pesar del tratamiento estándar) lo recibía en ese momento. Las variables asociadas a hospitalizaciones fueron: terapia con corticoides, ciclofosfamida y mayor SLICC. Conclusiones: se refleja la complejidad del manejo de estos pacientes y se visualizan aspectos estructurales como la desigualdad. El uso del belimumab resultaría beneficioso en los pacientes seleccionados.

Introduction: lupus is a complex disease and often difficult to approach. Achieving remission is one of the objectives, incorporating therapeutic options. Objectives: to describe the characteristics of the patients and the use of belimumab, according to the status of the disease. Materials and methods: cross-sectional study. Patients of the RELESSAR registry. Stratification: Remission: SLEDAI=0 and without corticosteroids. Low disease activity SLEDAI> 0 and ≤4 and without corticosteroids and non-optimal control: SLEDAI> 4 and any dose of corticosteroids. Results: a total of 1,277 patients were included, 23.4% in remission, 12.6% in low disease activity and 63.8% in non-optimal control. The last group was younger and had a shorter duration of the disease. They had higher activity and chronicity indices and greater use of immunosuppressants. Only 22.3% of the patients with potential criteria for the use of belimumab (activity disease despite standard treatment) were receiving it. The variables associated with hospitalizations were: corticosteroids, cyclophosphamide and higher SLICC. Those associated with severe infection: mycophenolate mofetil, azathioprine, corticosteroids, and higher SLICC. Conclusions: the complexity of the management of these patients is reflected, visualizing structural aspects such as inequality. The use of belimumab could be beneficial in selected patients.

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PURPOSE: Mexico is considered endemic for Leishmania; recent reports indicate autochthonous human and canine leishmaniasis caused by Leishmania mexicana in Sinaloa state. Lutzomyia sand fly are the primary vector of the parasite, although no records of phlebotomine vectors of Leishmania exist from Sinaloa. Other hematophagous dipterans, like Culicoides, could represent possible vectors of Leishmania in absence of phlebotomines. The known distribution of Culicoides includes the southern portion of Sinaloa state, in northwestern Mexico, with records of Culicoides furens. However, no studies have demonstrated the presence of Leishmania in C. furens or its possible participation in the parasite's life cycle in Mexico. This study, therefore, sought to detect DNA of Leishmania in C. furens captured in an endemic area of autochthonous canine leishmaniasis in northwestern Mexico. METHODS: Culicoides were captured with CDC light traps, identified morphologically, and organized in pools. DNA was extracted, and used to amplify the ribosomal ITS1 region of Leishmania. PCR products were digested with HaeIII endonuclease; the banding patterns obtained were compared to reference strains. RESULTS: Leishmania mexicana DNA was detected in five out of nine pools (55%) of female C. furens. CONCLUSION: This study offers the first evidence of L. mexicana DNA in C. furens, in an endemic area of canine leishmaniasis in northwestern Mexico, where no evidence exists of the presence of phlebotomine sand fly.

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Dentro del espectro de enfermedad trofoblástica gestacional, una de las entidades menos frecuente es la coexistencia, en un embarazo gemelar bicorial biamniótico, de una mola hidatiforme completa y un feto viable normal. El diagnóstico de esta condición requiere un cuidadoso examen ecográfico, con el fin de descartar la presencia de dos importantes patologías que componen los principales diagnósticos diferenciales en estos casos: la mola hidatiforme parcial y la displasia mesenquimal placentaria. Siguiendo de forma acuciosa el protocolo de ecografía obstétrica, y utilizando los conocimientos como explorador, se puede realizar el diagnóstico con precisión, diferenciando entre estas dos entidades. A continuación, se presenta el caso de un embarazo gemelar con mola hidatiforme completa y feto normal coexistentes, un hallazgo poco frecuente. Se realiza revisión de la literatura en cuanto a manejo y seguimiento de esta entidad dada su propensión a causar complicaciones en la gestación y a presentar comportamiento maligno.

Included in the spectrum of gestational trophoblastic disease, as one of the least frequent entities, is the coexistence, in a biamniotic twin pregnancy, of a complete hydatidiform mole and a normal viable fetus. The diagnosis of this condition requires a careful and thorough ultrasonographic examination, which will help in excluding the two main differential diagnosis in this scenario: partial hydatidiform mole and mesenchymal placental dysplasia. By following the obstetric examination protocol, and using academic radiologic knowledge, the examiner might reach a precise diagnosis. Here we present a case of a twin pregnancy with complete hydatidiform mole and coexistent fetus, a rare finding. We also present a short literature review on the topic of clinical management, given the fact that this disease might be associated with pregnancy complications and high risk of malignant behavior.

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Resumen: El choque cardiogénico es la mayor catástrofe del infarto agudo al miocardio y de las cardiopatías en general. Se define como un estado en el cual el gasto cardiaco es ineficiente para perfundir y oxigenar los tejidos, por lo que se manifiesta con signos de hipoperfusión tisular y congestión capilar. Aunque las últimas guías no exijan el diagnóstico por medio de medidas hemodinámicas, el basarse sólo en lo clínico puede generar errores hasta en 30%. Las causas se dividen en isquémicas y no isquémicas, siendo la primera la más común. Pese a la aparición de nuevos dispositivos mecánicos, aunados al soporte médico, sólo se ha demostrado la mejora de los desenlaces con las terapias endovasculares.

Abstract: Cardiogenic shock (CSh) is the major catastrophe of acute myocardial infarction (AMI) and heart disease in general. It is defined as a state in which cardiac output (CO) is inefficient to perfuse and oxygenate tissues, which is why it manifests with signs of tissue hypoperfusion and capillary congestion. Although the latest guidelines do not require diagnosis with hemodynamic measures, relying only on the clinical can generate errors up to 30%. The causes are divided into ischemic (AMI) and non-ischemic, with the former being the most common. Despite the appearance of new mechanical devices, coupled with medical support, it has only shown the improvement of outcomes with endovascular therapies.

Resumo: O choque cardiológico (ChC) é a principal catástrofe do infarto agudo do miocárdio (IAM) e das cardiopatias em geral. Definida como um estado no qual o débito cardíaco (DC) é ineficiente para perfundir e oxigenar os tejidos, razão pela qual se manifiesta com sinais de hipoperfusão tecidual e congestão capilar. Embora as diretrizes mais recentes não exijam diagnóstico por meio de medidas hemodinâmicas, depender apenas da clínica pode gerar erros de até 30%. As causas são divididas em isquêmicas (IAM) e não isquêmicas, sendo a primeira a mais comum. Apesar do surgimento de novos dispositivos mecânicos aliados ao suporte médico, só demonstrou-se a melhora dos resultados com terapias endovasculares.

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El objetivo de este trabajo fue evaluar el cuerpo de agua y los sedimentos de una charca estacional, además de describir el ciclo de vida y proporciones de sexo de Dendrocephalus affinis en condiciones de laboratorio. La charca se muestreó desde 2010 hasta 2012, la cual se caracterizó la fisicoquímica del agua y la granulometría y metales pesados del sedimento. Simultáneamente se tomaron muestras de sedimento para recolectar los quistes usados para la descripción del ciclo de vida, la supervivencia y proporción de sexo de D. affinis en laboratorio. La charca mostró condiciones mesotróficas en época de lluvia y mayor carga orgánica en época seca. El suelo dominante fue lodoso, lo cual facilitó la retención de agua. Los metales pesados mostraron concentraciones dentro del rango habitual en estos ambientes. Los macroinvertebrados asociados estuvieron conformados por representantes de siete órdenes y 28 géneros, de los cuales los órdenes Hemiptera y Coleoptera fueron los más abundantes con el 39.7 y 31.8 % respectivamente. El ensayo de laboratorio mostró que los nauplios de D. affinis vivieron 30 días, y tuvieron una supervivencia del 31.6 %. Este trabajo también contribuyó con una descripción una charca estacional del ciclo de vida de D. affinis en condiciones de laboratorio. Dendrocephalus affinis mostró ser un organismo con corto ciclo de vida, de crecimiento rápido y alta tasa de supervivencia, lo cual favorece su uso como potencial alimento vivo en la acuicultura.

The aim of this work was to evaluate the water system and the sediments of a temporary pond, in addition to describe the life cycle and asses sex proportions of D. affinis in laboratory conditions. The pond was sampled during the years 2010 - 2012, the physicochemical of the water, granulometry and heavy metals of the sediment were also evaluated. Simultaneously, we took samples of the sediment to collect the cysts that were used to describe the life cycle, survival and sex proportions at laboratory. During the rainy season, the pond showed mesotrophic conditions and in the dry season high organic load. The muddy soil was dominant and allowed the water retention. The heavy metals values were found in the normal ranges of similar systems. The macroinvertebrates associated to the pond were formed by seven orders and 28 genera, which Hemiptera and Coleoptera orders were the most abundant with 39.7 and 31.8 % respectively. Laboratory essays showed that nauplus of D. affinis lived 30 days and had a survival of 31.6%. This work also contributed with a description of a temporary pond and of the life cycle of D. affinis in laboratory conditions. Dendrocephalus affinis showed be organisms with short life cycle, fast grown and high survival ratio, this favor its use as live food potential in the aquaculture.

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OBJECTIVE: To analyze the mortality trend of lung cancer (LC) in Mexico, according to the municipality marginalization index (MMI) by age group and sex, during the period 1998-2016. MATERIALS AND METHODS: The information on mortality, population and MMI was obtained from the National Institute of Statistics and Geography (INEGI) and the National Council of Population (Conapo). The adjusted LC mortality rate trends were analyzed using the joinpoint regression analysis. A total of 126 132 deaths were included. RESULTS: The adjusted LC mortality rate decreased from 7.83 to 4.97 100 000 inhabitants during the period from 1998-2016, but the decrease was found to be less in women and in areas with very high marginalization. CONCLUSIONS: Unequal reduction in LC mortality according to the degree of marginalization are related to early diagnosis, timely treatment and inequity in medical services. This inequity affects mainly the populations of women, highly marginalized groups and older populations.

OBJETIVO: Analizar la tendencia de mortalidad por cáncer de pulmón (CP) en México, según el índice de marginación municipal (IMM) por grupo de edad y sexo, de 1998 a 2016. MATERIAL Y MÉTODOS: La información sobre mortalidad, población e IMM se obtuvo del Instituto Nacional de Estadística y Geografía (INEGI) y del Consejo Nacional de Población (Conapo). Las tendencias de la tasa de mortalidad ajustada para CP se analizaron mediante el análisis de regresión de joinpoint. Se incluyeron 126 132 defunciones. RESULTADOS: La tasa de mortalidad ajustada por CP disminuyó de 7.83 a 4.97 por 100 000 habitantes durante el periodo 1998-2016. CONCLUSIONES: La reducción desigual en la mortalidad por CP, de acuerdo con el grado de marginación, está relacionada con en el diagnóstico temprano, el tratamiento oportuno y la inequidad en los servicios médicos. Esta inequidad afecta principalmente a las mujeres, a los grupos altamente marginados y a las poblaciones más envejecidas.

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Abstract: Objective: To analyze the mortality trend of lung cancer (LC) in Mexico, according to the municipality marginalization index (MMI) by age group and sex, during the period 1998-2016. Materials and methods: The information on mortality, population and MMI was obtained from the National Institute of Statistics and Geography (INEGI) and the National Council of Population (Conapo). The adjusted LC mortality rate trends were analyzed using the joinpoint regression analysis. A total of 126 132 deaths were included. Results: The adjusted LC mortality rate decreased from 7.83 to 4.97 100 000 inhabitants during the period from 1998-2016, but the decrease was found to be less in women and in areas with very high marginalization. Conclusions: Unequal reduction in LC mortality according to the degree of marginalization are related to early diagnosis, timely treatment and inequity in medical services. This inequity affects mainly the populations of women, highly marginalized groups and older populations.

Resumen: Objetivo: Analizar la tendencia de mortalidad por cáncer de pulmón (CP) en México, según el índice de marginación municipal (IMM) por grupo de edad y sexo, de 1998 a 2016. Material y métodos: La información sobre mortalidad, población e IMM se obtuvo del Instituto Nacional de Estadística y Geografía (INEGI) y del Consejo Nacional de Población (Conapo). Las tendencias de la tasa de mortalidad ajustada para CP se analizaron mediante el análisis de regresión de joinpoint. Se incluyeron 126 132 defunciones. Resultados: La tasa de mortalidad ajustada por CP disminuyó de 7.83 a 4.97 por 100 000 habitantes durante el periodo 1998-2016. Conclusiones: La reducción desigual en la mortalidad por CP, de acuerdo con el grado de marginación, está relacionada con en el diagnóstico temprano, el tratamiento oportuno y la inequidad en los servicios médicos. Esta inequidad afecta principalmente a las mujeres, a los grupos altamente marginados y a las poblaciones más envejecidas.

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Indoor and outdoor air pollution has been considered a serious public health problem worldwide, and is associated annually with around 7 million deaths (4.8 million associated with outdoor air and 2.2 million indoor air). The main reasons for these deaths include: chronic obstructive pulmonary diseases, pneumonia, ischemic cardiopathy and lung cancer. In addition, epidemiological studies have associated exposure to this type of pollutants with a greater susceptibility to the development of infectious and non-infectious diseases. One of the most important infectious diseases is tuberculosis, which over the years has worsened with the emergence of resistant multi-drug strains, as well as with association with other diseases such as diabetes mellitus type 2 and the acquired immune deficiency syndrome (AIDS). In fact, despite efforts made by the World Health Organization to stop the epidemic, a large number of deaths (about 1.7 million worldwide) are still caused by this disease. In this review, a brief summary will be made of the effects of exposure to indoor and outdoor air pollution on the innate immune response against tuberculosis, and how these alterations could be linked to the development of pulmonary tuberculosis.

La contaminación del aire de interiores y de exteriores ha sido considerada un serio problema de salud pública a nivel mundial, el cual se asocia anualmente con alrededor de 7 millones de muertes (4.8 millones asociadas con el aire de exteriores y 2.2 millones con el aire de interiores). Entre las principales razones ligadas a estas muertes se encuentran: enfermedad pulmonar obstructiva crónica, neumonía, cardiopatía isquémica y cáncer de pulmón. Además, estudios epidemiológicos han asociado la exposición a este tipo de contaminantes con mayor susceptibilidad para la aparición de enfermedades infecciosas y no infecciosas. Entre las enfermedades infecciosas, una de las más importantes es la tuberculosis, la cual, durante el transcurso de los años, ha empeorado con el surgimiento de cepas resistentes a múltiples fármacos, así como por la asociación con otras afecciones como la diabetes mellitus tipo 2 y el síndrome de inmunodeficiencia adquirida (sida). A pesar del esfuerzo realizado por la Organización Mundial de la Salud (OMS) por detener esta epidemia, aún existen anualmente un gran número de muertes causadas por esta enfermedad: alrededor de 1.7 millones a nivel mundial. En esta revisión se hará un breve resumen de los efectos que tiene la exposición a la contaminación del aire de interiores y de exteriores en la respuesta inmune innata en contra de la tuberculosis, y cómo estas alteraciones pueden estar ligadas a la aparición de tuberculosis pulmonar.

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RESUMEN Para lograr un análisis integral de los pacientes con trastorno por déficit de atención e hiperactividad, a partir de las insuficiencias en su diagnóstico, se asume como objetivo el proponer ejes de peritaje de los niños con esta dolencia, que aporten una compresión integral. Se concluye que un proceso de evaluación diagnóstica debe ser: exhaustivo, con enfoque a la potencialidad, personalizado, contextualizado, sistémico, con visión evolutiva y que considere la respuesta al tratamiento, lo cual se refleja en los ejes, en correspondencia con los síntomas nucleares predominantes, los trastornos mentales comórbidos, las alteraciones somáticas asociadas, los factores etiológicos identificados, el rendimiento escolar: las potencialidades socio-compensatorias, la respuesta al tratamiento, las características de los entornos de interacción, de acuerdo con la evolución, y el pronóstico del trastorno.

ABSTRACT To determine insufficiencies in the diagnostic evaluation of patients with attention deficit hyperactivity disorder, for a complete assessment. We propose axes for diagnostic evaluation of children with attention deficit hyperactivity disorder, for its better comprehension. We conclude that a diagnostic evaluation process of attention deficit hyperactivity disorder should be: comprehensive, focused on potential, personalized, contextualized, systemic, with an evolutionary vision including treatment response. In relation to predominant nuclear symptoms, axes reflect comorbid mental disorders, associated somatic alterations, etiological factors identified, school performance: socio-compensatory potential, response to treatment, characteristics of the interaction environments, evolution and prognosis of the disorder.

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A new species of Gymnopus is described on the basis of collections from the subtropical cloud forest of eastern Mexico. Macro- and micromorphological characters, in combination with ITS sequences obtained from fruit body tissues, were used for its taxonomic circumscription. Basidiomata of this species were found growing scattered on fallen twigs of Quercus and also developing abundant long, black, wiry rhizomorphs. The authors discovered that these latter are used as part of nesting material by Myonectesoleaginous (Tyrannidae) inhabiting the subtropical cloud forest studied. A macro- and microscopical description as well as a discussion and illustrations are provided. A new combination in Gymnopus is proposed for Marasmiuswestii, a synonym of Marasmiusbrevipes.