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Neo-formed contaminants (NFCs) are common in many foods, especially those subjected to high-temperature processing. Among these contaminants, products arising from the Maillard reaction, sugar reduction, thermal degradation of polyphenols and lipid oxidation, including acrylamide, furan, furfuryl alcohol, and hydroxymethylfurfural, are consistently linked to potential neoplastic effects. NFCs are found in globally traded commodities like coffee and cocoa, posing a significant risk due to their frequent consumption by consumers. A direct correlation exists between consumption frequency, exposure levels, and health risks. Hence, it's crucial to establish reliable methods to determine levels in both matrices, aiming to mitigate their formation and minimise risks to consumers. This review offers a comprehensive examination, discussion, and identification of emerging trends and opportunities to enhance existing methodologies for extracting and quantifying NFCs in coffee and cocoa. By presenting an in-depth analysis of performance parameters, we aim to guide the selection of optimal extraction techniques for quantifying individual NFCs. Based on the reviewed data, headspace extraction is recommended for furan, while solid and dispersive solid phase extractions are preferred for acrylamide when quantified using gas and liquid chromatography, respectively. However, it is worth noting that the reported linearity tests for certain methods did not confirm the absence of matrix effects unless developed through standard addition, leading to uncertainties in the reported values. There is a need for further research to verify method parameters, especially for determining NFCs like furfuryl alcohol. Additionally, optimising extraction and separation methods is essential to ensure complete compound depletion from samples. Ideally, developed methods should offer comprehensive NFC determination, reduce analysis time and solvent use, and adhere to validation parameters. This review discusses current methods for extracting and quantifying NFCs in coffee and cocoa, highlighting emerging trends and emphasising the need to improve existing techniques, especially for compounds like furfuryl alcohol.

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Introducción: El ciclismo es una actividad física que se practica de forma recreativa y como actividad laboral, en base a esto los beneficios en la salud varían. Sus efectos pueden extenderse en la regulación de la expresión de citocinas proinflamatorias en la obesidad; sin embargo, se deben estudiar detalles en los indicadores clínicos asociados a otras enfermedades crónico-degenerativas. Objetivo: Identificar los cambios en los parámetros clínicos que sirven como indicadores de riesgo metabólico en personas que realizan ciclismo como ejercicio habitual y como actividad laboral. Métodos: Se realizó una investigación de diseño transversal, descriptivo en el Estado de México, México. Se formaron 3 grupos de 16 participantes provenientes de Toluca y municipios aledaños. Se realizaron mediciones de composición corporal y análisis bioquímicos para identificar las diferencias entre los grupos a través de la prueba t- student y el análisis de varianza ANOVA. Resultados: Los análisis estadísticos reportaron diferencias significativas en las concentraciones de lipoproteínas de alta densindad y triglicéridos. Para el grupo de los conductores de bicitaxi fue más favorable, se detalla como el tiempo de la actividad ayuda a mantener los parámetros de composición corporal como el porcentaje del tejido muscular y adiposo. Conclusiones: Los beneficios del ciclismo se presentaron con diferentes grados de eficiencia de acuerdo con la modalidad en la que se practican. Las variables no cambian de forma significativa en ningún grupo, pueden ser dependientes de otras variables como la alimentación(AU)

Introduction: Cycling is a physical activity, which is practiced recreationally and as a work activity. Its effects may extend to the regulation of the expression of proinflammatory cytokines in obesity; however, details should be studied in the clinical indicators associated with other chronic-degenerative diseases. Objective: To identify changes in clinical parameters that serve as indicators of metabolic risk in people who perform cycling as a regular exercise and as a work activity. Methods: A cross-sectional and descriptive design research was carried out in the State of Mexico, Mexico. Three groups of 16 participants were formed from Toluca and surrounding municipalities. Body composition measurements and biochemical analyzes were performed to identify differences between groups through Student's t test and ANOVA analysis of variance. Results: Statistical analyzes reported significant differences in HDL and triglyceride concentrations. For the group of pedicab drivers it was more favorable, it is detailed how the time of the activity helps to maintain body composition parameters such as the percentage of muscle and adipose tissue. Conclusions: The benefits of cycling were presented with different degrees of efficiency according to the modality in which they are practiced. The variables do not change significantly in any group and may be dependent on other variables such as diet(AU)

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Epidemiological data indicate that Mexico holds the 19th place in cumulative cases (5506.53 per 100,000 inhabitants) of COVID-19 and the 5th place in cumulative deaths (256.14 per 100,000 inhabitants) globally and holds the 4th and 3rd place in cumulative cases and deaths in the Americas region, respectively, with Mexico City being the most affected area. Several modifiable and non-modifiable risk factors have been linked to a poor clinical outcome in COVID-19 infection; however, whether socioeconomic and welfare factors are associated with clinical outcome has been scanty addressed. This study tried to investigate the association of Social Welfare Index (SWI) with hospitalization and severity due to COVID-19. A retrospective analysis was conducted at the Centro Médico Nacional "20 de Noviembre"-ISSSTE, based in Mexico City, Mexico. A total of 3963 patients with confirmed or suspected COVID-19, registered from March to July 2020, were included, retrieved information from the Virology Analysis and Reference Unit Database. Demographic, symptoms and clinical data were analyzed, as well as the SWI, a multidimensional parameter based on living and household conditions. An adjusted binary logistic regression model was performed in order to compare the outcomes of hospitalization, mechanical ventilation requirement (MVR) and mortality between SWI categories: Very high (VHi), high (Hi), medium (M) and low (L). The main findings show that lower SWI were independently associated with higher probability for hospital entry: VHi vs. Hi vs. M vs. L-SWI (0 vs. +0.24 [OR = 1.24, CI95% 1.01-1.53] vs. +0.90 [OR = 1.90, CI95% 1.56-2.32] vs. 0.73 [OR = 1.73, CI95% 1.36-2.19], respectively); Mechanical Ventilation Requirement: VHi vs. M vs. L-SWI (0 vs. +0.45 [OR = 1.45, CI95% 1.11-1.87] vs. +0.35 [OR = 1.35, CI95% 1.00-1.82]) and mortality: VHi vs. Hi vs. M (0 vs. +0.54 [OR = 1.54, CI95% 1.22-1.94] vs. +0.41 [OR = 1.41, CI95% 1.13-1.76]). We concluded that SWI was independently associated with the poor clinical outcomes in COVID-19, beyond demographic, epidemiological and clinical characteristics.

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OBJECTIVES: To determine whether youth with white coat hypertension on initial ambulatory blood pressure monitoring (ABPM) continue to demonstrate the same pattern on repeat ABPM. STUDY DESIGN: Retrospective longitudinal cohort study of patients referred for high blood pressure (BP) and diagnosed with white coat hypertension by ABPM who had follow-up ABPM 0.5-4.6 years later at 11 centers in the Pediatric Nephrology Research Consortium. We classified ABPM phenotype using the American Heart Association guidelines. At baseline, we classified those with hypertensive BP in the clinic as "stable white coat hypertension," and those with normal BP as "intermittent white coat hypertension." We used multivariable generalized linear mixed effect models to estimate the association of baseline characteristics with abnormal ABPM phenotype progression. RESULTS: Eighty-nine patients met the inclusion criteria (median age, 13.9 years; 78% male). Median interval time between ABPM measurements was 14 months. On follow-up ABPM, 61% progressed to an abnormal ABPM phenotype (23% ambulatory hypertension, 38% ambulatory prehypertension). Individuals age 12-17 years and those with stable white coat hypertension had greater proportions progressing to either prehypertension or ambulatory hypertension. In the multivariable models, baseline wake systolic BP index ≥0.9 was significantly associated with higher odds of progressing to ambulatory hypertension (OR 3.07, 95% CI 1.02-9.23). CONCLUSIONS: The majority of the patients with white coat hypertension progressed to an abnormal ABPM phenotype. This study supports the 2017 American Academy of Pediatrics Clinical Practice Guideline's recommendation for follow-up of ABPM in patients with white coat hypertension.

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Resumen Con el advenimiento de la terapia antirretroviral (ART), la infección por el virus de inmunodeficiencia humana (VIH) se ha convertido en una enfermedad crónica con complicaciones metabólicas importantes más acentuadas que en la población general. Mientras no se tenga una vacuna que erradique las tasas de infección y no exista una cura para esta pandemia, se debe ser más incisivo en el controlar las comorbilidades, entre las que destacan las alteraciones en el perfil de lípidos pues aumentan el riesgo cardiovascular.

Abstract With the advent of antiretroviral therapy (ART), infection with the human immunodeficiency virus (HIV) has become a chronic disease with major metabolic complications more pronounced than in the general population. While there is no vaccine to eradicate infection rates and there is no cure for this pandemic, it should be more incisive in controlling comorbidities, among which alterations in the lipid profile stand out as they increase cardiovascular risk.

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INTRODUCTION: Introduction: dietary patterns (DP) analyse the relationship between consumption of foods or nutrients and disease or health outcomes. High prevalence of obesity in adults in Mexico is associated with factors such as high consumption of certain food groups and nutrients. However, few studies have been conducted to explore associations between dietary patterns and obesity in apparently healthy adults. Objective: to identify major dietary patterns (DP) associated with central-obesity (CO) and lipid concentrations in healthy adults. Methods: longitudinal study including usual dietary intakes derived from multiple 24-hour-recalls. Waist-circumference (WC) and biochemical measurements were obtained by standardized procedures and DP by principal component analysis. Adjusted-logistic regression was used to examine associations between DP, CO and serum-lipid concentrations. Results: three DP were identified: healthy-DP, risky-DP and empty-DP. Participants in the healthy-DP were more likely to have lower risk for central-obesity according to WC criteria (OR = 0.31, CI = 0.12, 0.82), p = 0.017, but also had the highest risk for elevated LDL-cholesterol (OR = 2.98, CI = 1.16, 7.66), p = 0.030. There was no significant association between risky and empty DP with obesity or overweight by body mass index (BMI), central-obesity by WC or serum lipid abnormalities. Conclusions: the healthy-DP is associated with lower risk for CO, with higher risk for elevated LDL-cholesterol. It is necessary to develop longitudinal studies of foods and nutritional analysis of the diet to clarify these associations, to promote the reduction of modifiable risk factors.

INTRODUCCIÓN: Introducción: los patrones de dieta (PD) analizan la relación entre el consumo de alimentos o nutrimentos con la salud y el desarrollo de enfermedades en poblaciones. La elevada prevalencia de obesidad en adultos mexicanos se asocia con factores como el elevado consumo de ciertos grupos de alimentos y nutrimentos. Sin embargo, pocos estudios han explorado la asociación entre los patrones dietéticos y la obesidad en adultos aparentemente sanos. Objetivo: identificar los patrones dietéticos (PD) asociados con la obesidad central (OC) y las concentraciones séricas de lípidos en adultos. Métodos: estudio longitudinal del consumo dietético obtenido de múltiples recordatorios de consumo de 24 horas. La circunferencia de cintura (CC) y las mediciones bioquímicas se obtuvieron mediante procedimientos estandarizados; los PD, por análisis del componente principal. Mediante regresión logística se identificaron las asociaciones entre PD, OC y las concentraciones séricas de lípidos. Resultados: se identificaron tres PD: PD saludable, PD de riesgo y PD vacío. Los participantes del PD saludable presentaron menor riesgo de OC de acuerdo con los criterios de la CC (OR = 0.31, CI = 0.12, 0.82), p = 0.017, pero también fueron los que presentaron mayor riesgo de cifras elevadas de colesterol-LDL (OR = 2.98. CI = 1.16, 7.66), p = 0.030. No hubo asociación estadísticamente significativa entre el PD de riesgo y el PD vacío con obesidad o sobrepeso por IMC, OC por CC o con la presencia de dislipidemias. Conclusiones: el PD saludable se asocia con un menor riesgo para OC pero con mayor riesgo de elevación del colesterol-LDL. Se necesitan estudios longitudinales para esclarecer estas asociaciones para promover la reducción de factores de riesgo modificables.

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OBJECTIVES: Fetuses continue to be exposed to renin angiotensin system (RAS) blockers despite their known teratogenicity and a black box warning. We hypothesized that fetopathy from in utero exposure to RAS blockers has a broader spectrum of clinical manifestations than described previously and that there are a variety of clinical scenarios leading to such exposures. STUDY DESIGN: This was a retrospective study performed through the Midwest Pediatric Nephrology Consortium. Cases of RAS blocker fetopathy were identified, with determination of renal and extrarenal manifestations, timing of exposure, and the explanation for the fetal exposure. RESULTS: Twenty-four cases were identified. RAS blocker exposure after the first trimester was associated with more severe renal manifestations. Chronic dialysis or kidney transplantation was required in 8 of 17 (47%) patients with RAS blocker exposure after the first trimester and 0 of 7 patients with exposure restricted to the first trimester (P = .05). Extrarenal manifestations, some not previously noted in the literature, included central nervous system anomalies (cystic encephalomalacia, cortical blindness, sensorineural hearing loss, arachnoid cysts) and pulmonary complications (pneumothorax, pneumomediastinum). RAS blocker exposure usually was secondary to absent or poor prenatal care or undiagnosed pregnancy. CONCLUSION: RAS blocker fetopathy continues to be a cause of considerable morbidity, with more severe renal manifestations associated with exposure after the first trimester. A variety of significant extrarenal manifestations occur in these patients. Clinicians should emphasize the risk of fetopathy when prescribing RAS blockers to women of childbearing age.

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Objetivo: Describir la prevalencia de alcoholismo en trabajadores de la industria cuero-calzado como consecuencia de estrés laboral. Justificación: Aumentar la calidad de vida en el trabajador debido a que el alcohol es utilizado para disminuir el cansancio, y el estrés disminuye los estados fisiológicos y de rendimiento laboral. Método: Se aplicó el cuestionario AUDIT (uso de alcohol [OMS]). El tipo de muestreo fue aleatorio con un I.C. al 90% = 50 cuestionarios. Resultados: El 60% estuvo integrado por mujeres y 40% por hombres. La media de edad fue de 28. El 70% de las mujeres obtuvo 21 puntos (elevado nivel de alcoholismo), y en los hombres fue de 33 puntos. Los hombres en fines de semana ingieren más alcohol que en jornadas acumuladas (2:1) por desestrés, p < 0,05 (prueba de X2). Existió una correlación significativa entre ser hombre e ingerir más alcohol en fines de semana (p < 0,05). Conclusión: Se observa una tendencia en el sexo femenino a ingerir cada vez más alcohol a corta edad sobre todo cuando se sienten estresadas, pero el género masculino ingiere grandes cantidades y lo siente habitual en fines de semana.

Objective: To describe the prevalence of alcoholism in workers as a result of the work stress. Justification: Increase the quality of life in the worker because the alcohol is used to reduce fatigue and stress decreases physiological states and work. Method: We applied the AUDIT questionnaire (alcohol use [WHO]). The type of sampling was random with an I.C. of 90% = 50 questionnaires. Results: The 60% were women and the 40% male. The age mean was 28. The 70% of women obtained 21 points (high level of alcoholism), and in men was 33 points. Men ingest more alcohol on weekends than in the cumulative working days (2:1) due de-stress, p < 0.05 (X2 test). There was a significant correlation between being a man and to ingest more alcohol on weekends (p < 0.05). Conclusion: It is observed a tendency in women to ingest alcohol at a more early age especially when they feel stressed, but males ingest more large amounts being it normal on weekends.

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Background: Nutritional supplementation before breeding (Flushing) has become a common practice and is a reliable method to improve lambing and twining rates in sheep. The improvement of the body condition of a ewe is reflected in a higher number of ovulatory follicles and is termed "static effect of nutrition". Shorter periods of nutritional supplementation can also affect follicular development in the absence of changes in the body condition and weight of the animal, which is known as "acute effect of nutrition". Studies of follicular development in small ruminants have shown that 4 to 5 follicular waves occur during the estrous cycle, and that waves emerge every 5 to 7 days. However, the selection phase of the follicular wave occurs within 3 to 4 days, thus the length of flushing could last merely the time needed to push follicles over the selection threshold. Review: Here we examined the evidence produced by our research on the minimum length and appropriate timing of nutrient supplementation needed to enhance ovulation rate and prolificacy in sheep. Ewes have follicles ready to reach ovulatory size at any time of the estrous cycle and, when a follicular phase is induced, most show estrus and ovulate within 60 to 80 h. Hence, ovulatory follicles should commit for ovulation shortly after the decline in progesterone if they are to achieve ovulatory competence. We showed that an ultrashort flushing (USF) given as a single administration of a glycogenic substance at the time of prostaglandin-induced luteolysis (Control =1.6 ± 0.06 vs. USF= 2.08± 0.06) or progestin withdrawal (Control =1.64 ± 0.07 vs. USF= 2.41± 0.09) increased ovulation rate (P < 0.01). This increase was associated with elevated glucose and insulin concentrations for 12 h after USF (P < 0.01). However, the diameter of the three largest follicles did not change between the day of flushing and the day of estrus and did not differ between the control and the USF (P > 0.10). The USF could act either by advancing follicle maturation, or by affecting the feedback loop between the ovaries and gonadotrophin secretion. Therefore, we measured mRNA abundance for LH receptor (LHr), 3ß-hydroxysteroid dehydrogenase (3ß-HSD) and P450 aromatase at 0, 12, 24 and 48 h after the start of luteolysis in ewes treated or not with USF. Aromatase mRNA decreased in large follicles 12 h after USF (P < 0.01), with no changes on mRNA for LHr or 3ß-HSD. Further, we observed that the in vitro rumen fermentation and the in vivo glucose plasma concentrations in response to an isoenergetic (1470.83 kcal) single oral drench of glycerol, propylene glycol or molasses differed. The longer time to begin fermentation of glycerol allows for its absorption and its direct use for glucose production in the liver. Molasses was preferably fermented to butyrate, whereas propylene glycol was preferably fermented to propionic acid thus serving as glycogenic substrate. Glycerol and propylene glycol increased glucose and insulin concentrations in vivo, whereas molasses did not, thus the later may not be suitable for the USF. An increase in ovulation rate and prolificacy was also obtained with treatments that cause nutrient redistribution in the animal such as beta adrenergic receptor agonists and bovine somatotropin. Conclusions: We have developed an ultrashort flushing with glycogenic solutions that when applied at luteolysis will increase ovulation rate in sheep. This hyper-acute effect of nutrition caused a reduction in mRNA for P450 aromatase 12 hours after the glycogenic drench. In addition, from our results we can infer that ovine follicles can develop ovulatory capacity within 48 h after being selected when coinciding with the follicular phase.

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Los tumores primarios malignos de cabeza y cuello en niños son raros, éstos se presentan en nasofaringe solo en un 1 por ciento. El carcinoma nasofaríngeo es el más frecuente, mientras que el rabdomiosarcoma ocupa el segundo lugar. Este trabajo reporta el caso de una escolar de 8 años que ingresa al Hospital con un mes de evolución, presentando parálisis facial e hipoestesia izquierda, así como diplopia, estrabismo convergente, hipoacusia ipsilateral y pérdida de peso. Se realizaron estudios de imagen, encontrándose tumoración en nasofaringe con extensión a otras estructuras. Se describen las medidas que se tomaron para llegar al diagnóstico de rabdomiosarcoma embrionario y la terapéutica empleada.

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Presentamos el caso de un paciente con disfonía espasmódica en abducción por superposición de bandas ventriculares, con larga evolución y acompañado de distonía cervical. El paciente fue manejado con toxina botulínica, obteniendo buenos resultados.

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Los feocromocitomas son tumores pocos frecuentes productores de catecolaminas y representan una causa rara, pero importante de hipertensión secundaria. Se analizaron retrospectivamente las historias de seis pacientes con diagnóstico de Feocromocitoma que fueron atendidos en nuestra institución desde el 15/06/94 hasta el 01/03/96. Tres maculinos y tres femeninos. Edad promedio: 28 años. La clínica predominante fue cefalea pulsátil, mareos, diaforesis e hipertensión arterial refractaria al tratamiento médico. La evolución fue de cuatro meses a diez años. Se practicó en todos los pacientes ecosonogramas, TAC abdominal y determinación de catecolaminas. El 33 por ciento de los tumores fueron bilaterales, el resto, unilaterales. Se bloquearon adrenergicamente con Labetalol y Prazosin en el preoperatorio. El control transoperatorio fue a través de presiones intraarteriales con catéter y PVC. Utilizamos toracofrenolaparotomia de Chevron para los tumores unilaterales y bilaterales respectivamente. Un caso presentó taquicardia supraventricular que cedió al pinzar la vena suprarrenal. El promedio de hospitalización postoperatorio fue de seis días sin mayores complicaciones. Todos los pacientes han evolucionado satisfactoriamente manteniendose normotensos y sin tratamiento médico. El manejo de los pacientes con feocromocitoma debe ser en equipo multidisciplinario y la base fundamental del éxito quirúrgico depende del cumplimiento cabal del protocolo preoperatorio y el óptimo control de la Tensión Arterial, así como del uso de agentes anestésicos apropiados

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Los condrosarcomas de laringe son extremadamente raros, abarcan el 1 por ciento de todos los tumores malignos de laringe. El presente caso es una mujer de 79 años de edad, a quien se diagnóstico condrosarcoma laríngeo por biopsia tomada por laringoscopía directa. Se hizo laringectomía total, encontrándose libre de tumor tres años después

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En este trabajo se presentaron 179 casos que se trataron en el INOR durante los años 1972 a 1980. El carcinoma basal fue el tumor maligno más frecuente. El sitio de mayor incidencia correspondió al parpado inferior. El tratamiento que se utilizó fue radioterapia y corugía. La supervivencia es mayor del 90

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