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PURPOSE: A variable number of tandem repeats (VNTR) in the insulin gene (INS) control region may be involved in type 2 diabetes (T2D). The TH01 microsatellite is near INS and may regulate it. We investigated whether the TH01 microsatellite and INS VNTR, assessed via the surrogate marker single nucleotide polymorphism rs689, are associated with T2D and serum insulin levels in a Mexican population. METHODS: We analyzed a main case-control study (n = 1986) that used univariate and multivariate logistic regression models to calculate the risk conferred by TH01 and rs689 loci for T2D development; rs689 results were replicated in other case-control (n = 1188) and cross-sectional (n = 1914) studies. RESULTS: TH01 alleles 6, 8, 9, and 9.3 and allele A of rs689 were independently associated with T2D, with differences between sex and age at diagnosis. TH01 alleles with ≥ 8 repeats conferred an increased risk for T2D in males compared with ≤ 7 repeats (odds ratio, ≥ 1.46; 95% confidence interval, 1.1-1.95). In females, larger alleles conferred a 1.5-fold higher risk for T2D when diagnosed ≥ 46 years but conferred protection when diagnosed ≤ 45 years. Similarly, rs689 allele A was associated with T2D in these groups. In males, larger TH01 alleles and the rs689 A allele were associated with a significant decrease in median fasting plasma insulin concentration with age in T2D cases; the reverse occurred in controls. CONCLUSION: Larger TH01 alleles and rs689 A allele may potentiate insulin synthesis in males without T2D, a process disabled in those with T2D.

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PURPOSE: Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (-174 G>C) SNP and a higher risk for POAG is present in western Mexican population. METHODS: One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. RESULTS: There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (p > 0.05). CONCLUSION: Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population.

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BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.

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Clostridium difficile is a Gram-positive bacillus that has become one of the main hospital-acquired human gastrointestinal infections in recent years. Its incidence is on the rise, involving more virulent strains, affecting new and previously uncontemplated groups of patients, and producing changes in clinical presentation and treatment response that influence disease outcome. Early diagnosis and disease stratification based on the severity of C.difficile infection are essential for therapeutic management and the implementation of containment measures. However, the speed at which new strains with greater pathogenicity are developing is surpassing that of the development of new drugs, making it necessary to validate other therapeutic options. The present article is a review of the epidemiologic, pathophysiologic, diagnostic, and therapeutic aspects of C.difficile infection, from its first isolation to the present date, that aims to contribute to the preparation of general physicians and specialists, so that patients with this infection receive opportune and quality medical attention.

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The effect of LiCl additions on the in vitro bioactivity, hemolysis, cytotoxicity, compressive strength and setting time of calcium aluminate cements was studied. Calcium aluminate clinker (AC) was obtained via solid state reaction from reagent grade chemicals of CaCO3 and Al2O3. Calcium aluminate cements (CAC) were prepared by mixing the clinker with water or aqueous LiCl solutions (0.01, 0.0125 or 0.015M (M)) using a w/c ratio of 0.4. After 21days of immersion in a simulated body fluid (SBF) at physiological conditions of temperature and pH, a Ca-P rich layer, identified as hydroxyapatite (HA), was formed on the cement without LiCl and on the cement prepared with 0.01M of LiCl solution. This indicates the high bioactivity of these cements. The cements setting times were significantly reduced using LiCl. The measured hemolysis percentages, all of them lower than 5%, indicated that the cements were not hemolytic. The compressive strength of the cements was not negatively affected by the LiCl additions. The obtained cement when a solution of LiCl 0.010M was added, presented high compressive strength, appropriated bioactivity, no cytotoxicity and low setting time, making this material a potentially bone cement.

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The aim of this study was to determine the biocompatibility and potential toxicity of apatite-coated magnetite nanoparticles. The in vitro biocompatibility with human red blood cells was evaluated, not hemolytic effects were found at concentrations lower than 3 mg/ml. For the in vivo study, Balb/c mice were used. The animals were injected intravenously or intraperitoneally, the doses ranged from 100 to 2,500 mg/Kg. All the injected animals showed normal kidney and liver function. No significant changes were found in the body weight, the organs weight and the iron levels in liver due to the administration. In conclusion, apatite-coated magnetite nanoparticles did not induce any abnormal clinical signs in the laboratory animals. The results demonstrated that apatite-coated magnetite nanoparticles of 8 ± 2 nm in size did not have hemolytic effect in human erythrocytes and did not cause apparent toxicity in Balb/c mice under the experimental conditions of this study.

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The present article describes four cases of patients with chronic kidney disease who arrived at the emergency room in critical condition, needing acute dialysis for severe hyperkalemia and metabolic acidosis. These four patients were treated acutely with automated peritoneal dialysis (APD) using a Tenckhoff catheter placed percutaneously at the bedside in the emergency room. All patients were discharged in good condition and with APD as their chronic renal replacement therapy (RRT). APD is a RRT, that may be considered a frontline acute therapy option for renal failure patients in an emergency room. Coordinated teamwork between emergency and nephrology medical and nursing staff is the key to a successful outcome in these life threatening situations.

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This study compares the detection of Mycobacterium tuberculosis through bacilloscopy (Ziehl-Neelsen stain), growth in Lowenstein-Jensen medium, and polymerase chain reaction (PCR) carried out with DNA taken directly from various types of samples. A total of 252 samples were analyzed (114 sputum, 96 urine, 15 cerebrospinal fluid, and 27 of other types) from 160 patients with any form of suspected tuberculosis who came to the Clinical Pathology Laboratory of the Specialties Hospital of the Western National Medical Center of the Mexican Social Security Institute. In all cases Ziehl-Neelsen stains were done, as were also cultures with Lowenstein-Jensen medium and PCR amplification of a segment of 285 base pairs specific to the M. tuberculosis complex. Of the 252 samples, with the culture, 18 were positive for nontuberculous mycobacteria. Of the 234 others, 12 (5.1%) were positive with the PCR and the culture, 174 (74.4%) negative in both tests, 47 (20.1%) positive with the PCR and negative with the culture, and 1 (0.4%) negative with the PCR and positive with the culture. Using the culture as the reference test, the PCR provided a sensitivity of 92.3%, a specificity of 78.7%, a positive predictive value of 20.3%, and a negative predictive value of 99.4%. The PCR detection limit with DNA taken from culture was 10 fg, equivalent to four or five mycobacteria. Also in comparison with the culture, the PCR correctly identified the totality of the mycobacteria of the M. tuberculosis complex. Taking the culture as the reference test, when analyzing just the sputum samples, the direct PCR provided a sensitivity of 90.9%, a specificity of 89.5%, a positive predictive value of 52.6%, and a negative predictive value of 98.7%. The PCR is a sensitive and specific technique for detecting the M. tuberculosis complex in both positive and negative bacilloscopy samples. A controlled PCR procedure makes it possible to establish or to exclude the diagnosis of tuberculosis in a time that is reduced from more than three weeks to just 24 to 48 hours. This is particularly useful when an early diagnosis is needed to establish a patient's prognosis or in organ transplant cases.

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The effects of a paraquat commercial herbicide formulation on an early stage of the development of Plecostomus commersoni were evaluated. Mortality, opercular ventilation rate, cardiac contraction rate and body length and weight were examined every 12 hr. The effects of the paraquat formulation on the morphology of the branchial epithelium were also examined by light microscopy. The assayed paraquat formulation significantly affected cardiac contraction and opercular ventilation. Ecotoxicologically, this could represent an important deleterious effect for early development of the catfish. Mortality data may not be sufficient for an appropriate evaluation of secondary environmental hazards associated with the application of paraquat formulation because: a) The LC-50 values for Plecostomus commersoni fry were higher than the recommended individual application rate of paraquat for aquatic weed control (0.1-2.0 mg/L). b) The estimated maximum acceptable toxicant concentration (MATC) resulted in a concentration similar to the application rate when calculated from acute toxicity tests. When the MATC was estimated from opercular ventilation or cardiac contraction rates, it was lower and fell within the recommended single application rate.

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1. In spontaneously beating preparations of sinus venosus of the chilean frog Caudiverbera caudiverbera, the electrophysiological effects of 7-O-demethylisothalicberine (7-O-DI) on transitional pacemaker cells were investigated. 2. 7-O-DI in concentration 1 x 10(-4) M blocked the action potential of transitional cells. This blockade was preceded by subthreshold oscillations and depolarization of membrane potential. 3. Lower concentration of the drug to induce complete blockade (5 x 10(-5) M), allowed to observe a great depression of bioelectric cell characteristics in transitional fibres. 4. 7-O-DI induced blockade of transitional cells action potential was preceded by the appearance of a notch in their upstroke and the persistence of a fast depolarizing activity that remained unblocked. This 7-O-DI resistant fast component of the upstroke was blocked by tetrodotoxin. 5. Transitional cells completely blocked by 7-O-DI were depolarized to about 40 mV. 6. The results indicate a close similarity between 7-O-DI and verapamil effects on action potential configuration.

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