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Cuticular hydrocarbon (CHCs) variation has been detected in various insect taxa, but the potential contribution of cuticular compounds for analyzing intraspecific diversity at the population level has been little explored. Here we assess for the first time intraspecific variation in the CHC profile of stingless bees, using the species Melipona beecheii and Nannotrigona perilampoides. The objective is determining whether intraspecific variation can be useful for population identification. We found species-specific chemical patterns and extensive variation within each species. Notably, chemotypes were significantly associated to geographic origin in N. perilampoides but less so in M. beecheii and we discuss possible explanations for these patterns. Our results support the use of CHCs in conjunction with other methods in emerging problems such as undetected colony mobilization across regions. As CHCs are involved in several aspects of stingless bee recognition and interactions, it would be essential to unravel how these chemical signatures evolve across populations.
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Hidrocarbonetos , Animais , Abelhas/metabolismo , Hidrocarbonetos/análise , Hidrocarbonetos/metabolismo , Especificidade da EspécieRESUMO
BACKGROUND/AIM: Renin-angiotensin system (RAS) is present in a diverse type of cells and plays an important role in lung physiology and pathophysiology. Angiotensin converting enzymes (ACE) are part of the RAS system. There are still controversies about the association of I/D polymorphisms of ACE1 with COVID-19 severity. The goal of the study was to determine whether there is an association of the I/D polymorphism with severity of COVID-19 in Mexican patients. PATIENTS AND METHODS: The study included voluntary participants: 53 healthy individuals negative to RT-PCR COVID-19 (control), and 165 patients positive to COVID-19. Severity was defined by the need of hospitalization, invasive ventilation, shock, or multiple organ failure. The patient group consisted of 28 asymptomatic, 82 with mild, and 55 with severe COVID-19. I/D polymorphism was determined by PCR. Rutinary laboratory tests were performed in all the participants. RESULTS: DD polymorphism was significantly associated with severe COVID-19, independently of comorbidities, or any other variable. Receiver operator characteristic curves demonstrated association of low total cholesterol, low high-density lipoproteins, and high c-reactive protein with severity of COVID-19. CONCLUSION: The DD polymorphism was associated with the course of the infection and severity of COVID-19 in a sample of Mexican patients.
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COVID-19 , Humanos , COVID-19/genética , Lipídeos/sangue , Polimorfismo Genético , Sistema Renina-Angiotensina/genéticaRESUMO
Resumen Objetivo: Reportar la implementación y los beneficios del Modelo de atención integral en el segundo nivel: Experiencia de la Unidad de Especialidades Médicas, su utilidad en el manejo y seguimiento de los pacientes con enfermedades crónicas. Material y métodos: Se lograron implementar 9 consultorios de atención médica de la siguiente forma, 2 de Endocrinología, 3 consultorios de Clínica de Enfermedades Crónicas, uno de educación en diabetes e hipertensión, así como 3 de apoyo nutricional. Se midió valores absolutos del número de consultas durante los años 2017, 2018, 2019 y parte del 2020. Así mismo se buscó identificar las patologías más prevalentes con la idea en tener un mejor control y seguimiento de los pacientes, con una mejor organización de personal de atención médico y de enfermería. Resultados y discusión: Se lograron incrementar los números de consulta, con un control y seguimiento más estricto de los pacientes, además de los beneficios en cuanto a la formación y capacitación de médicos residentes, generales tanto militares como profesionales de la salud civiles para enfrentar estos padecimientos prevalentes en nuestro país.
Abstract Objective: To report the implementation as well as the benefits of the Comprehensive Care Model at the second level: Experience of the Medical Specialties Unit, and assess its usefulness in the management and monitoring of patients with chronic diseases. Material and methods: 9 medical care clinics were implemented as follows, 2 for Endocrinology, 3 Clinics for Chronic Diseases, one for education in diabetes and hypertension, as well as 3 for nutritional support. Absolute values of the number of consultations were measured during the years 2017, 2018, 2019 and part of 2020. Likewise, it was sought to identify the most prevalent pathologies with the idea of having a better control and monitoring of patients, with a better organization of medical and nursing care personnel. Results and discussion: It was possible to increase the consultation numbers, with a stricter control and monitoring of patients, in addition to the benefits in terms of training and training of resident doctors, both military generals and civilian health professionals to face these prevalent conditions in our country.
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This is a preliminary study conducted to analyze the presence and concentration of pesticides in honey obtained from honey bee colonies located in two regions with managed ecosystems that differ in the intensity and technification of agricultural practices. Fourteen pesticides at variable concentrations were detected in 63% of the samples analyzed. The pesticides most frequently found at higher concentrations were insecticides (neonicotinoids, followed by organophosphates), herbicides, and fungicides. The number, frequency, and concentration of pesticides were higher in samples collected from hives located where intensive and highly-technified agriculture is practiced. Forty-three percent of the samples from that zone had residues of imidacloprid, compared with only 13% of the samples from the less-technified zone. Furthermore, 87.5% of those samples had imidacloprid concentrations that were above sublethal doses for honey bees (>0.25 ng/g) but that are not considered hazardous to human health by the European Commission. The results of this study suggest that honey can be used as a bioindicator of environmental contamination by pesticides, which highlights the need to continue monitoring contaminants in this product to determine the risks of pesticide impacts on pollinator health, on ecosystems, and on their potential implications to human health and other non-target organisms.
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Inseticidas , Praguicidas , Agricultura , Animais , Abelhas , Ecossistema , Humanos , Inseticidas/análise , Inseticidas/toxicidade , NeonicotinoidesRESUMO
This study was conducted to analyze the effect of genotype and climate on the resistance of honey bee (Apis mellifera) colonies to parasitic and viral diseases. The prevalence and intensity of parasitism by Varroa destructor, or infection by Nosema spp., and four honey bee viruses were determined in 365 colonies of predominantly European or African ancestry (descendants of A. m. scutellata) in subtropical and temperate regions of Mexico. Varroa destructor was the most prevalent parasite (95%), whilst N. ceranae was the least prevalent parasite (15%). Deformed wing virus (DWV) and black queen cell virus (BQCV) were the only viruses detected, at frequencies of 38% and 66%, respectively. Varroa destructor was significantly more prevalent in colonies of European ancestry (p < 0.05), and the intensity of parasitism by V. destructor or infection by DWV and BQCV was also significantly higher in colonies of European descent than in African descent colonies (p < 0.01), although no genotype−parasite associations were found for N. ceranae. Additionally, significant and positive correlations were found between V. destructor and DWV levels, and the abundance of these pathogens was negatively correlated with the African ancestry of colonies (p < 0.01). However, there were no significant effects of environment on parasitism or infection intensity for the colonies of both genotypes. Therefore, it is concluded that the genotype of honey bee colonies, but not climate, influences their resistance to DWV, BQCV, and V. destructor.
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El embarazo añoso representa una problemática de salud pública debido a sus repercusiones en el binomio madre-hijo. Objetivo. Determinar las complicaciones materno-fetales en embarazadas añosas atendidas en el Centro de Salud Tipo C San Jacinto de Buena Fe durante el periodo enero y diciembre del 2020. Materiales y métodos. El diseño de investigación observacional, cuantitativo, retrospectivo, descriptivo de corte transversal con una muestra de 80 gestantes mayores de 35 años, como instrumento se empleó un formulario de recolección de datos que constó de 12 ítems validados por un juicio de expertos. Resultados. Las caracteristicas sociodemográficas de interés en las pacientes del estudio fueron: grupo etario de 35-37 años con el 67,2 %, unión libre con 52,5 %, grado de instrucción primario con el 46,3 % y procedencia rural en el 95 %; entre las complicaciones maternas: ruptura prematura de membranas con el 25 %, trastornos hipertensivos en el 16,2 % y aborto espontáneo con el 13,7 %; las complicaciones fetales: prematuridad con el 17,5 %, bajo peso al nacer con el 17,5 % y síndrome de dificultad respiratoria con el 11,2%. Conclusión. Fue posible establecer las características sociodemográficas de interés en la muestra de estudio, identificar algunos factores de riesgo de complicaciones y determinar las complicaciones que comprometen a la madre y al hijo/a en embarazos de edad avanzada.
Elderly pregnancy represents a public health problem due to its repercussions on the mother-child binomial. Objective. To determine the maternal-fetal complications in elderly pregnant women treated at the San Jacinto de Buena Fe Type C Health Center during the period January and December 2020. Materials and methods. The observational, quantitative, retrospective, descriptive cross-sectional research design with a sample of 80 pregnant women over 35 years of age, as an instrument a data collection form that consisted of 12 items validated by an expert judgment was used. Results. The sociodemographic characteristics of interest in the study patients were age group 35-37 years with 67.2%, free union with 52.5%, grade of primary education with 46.3% and rural origin in 95 %; among maternal complications: premature rupture of membranes with 25%, hypertensive disorders in 16.2% and spontaneous abortion with 13.7%; fetal complications: prematurity with 17.5%, low birth weight with 17.5% and respiratory distress syndrome with 11.2%. Conclusion. It was possible to establish the sociodemographic characteristics of interest in the study sample, identify some risk factors for complications, and determine the complications that affect the mother and the child in older pregnancies(AU)
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Humanos , Feminino , Gravidez , Adulto , Gravidez , Fatores de Risco , Idade Materna , Recém-Nascido Prematuro , Aborto Espontâneo , Grupos EtáriosRESUMO
La diabetes Mellitus es un padecimiento que empieza cuando el páncreas no realiza un uso adecuado de la insulina que produce o no puede lograr producir insulina. Se descomponen en glucosa en la sangre todos los alimentos ricos en hidratos de carbono; la insulina da ayuda a la glucosa para que esta pueda ingresar en las células. Los niveles de azúcar en la sangre al no funcionar bien el páncreas suben, lo cual debe ser controlado por medio de un tratamiento médico de por vida, y lo más importante la persona debe cambiar de hábitos en su salud. Objetivo: El objetivo principal de esta investigación es definir el efecto que produce la adherencia a la insulinoterapia en los pacientes con diabetes tipo II del Hospital del Día Mariana de Jesús. Materiales y Métodos: Se utilizó una investigación cuantitativa, transversal ya que se realizó una encuesta a los pacientes, la cual se procedió a la recolección y análisis e interpretación de datos. La muestra trabajada fue de 100 pacientes, los cuales fueron atendidos en el Hospital por concepto de diabetes tipo II en el área de emergencia. Resultados: Como resultado de la investigación tenemos que el 76% de los encuestados conocen sobre el tratamiento de la insulinoterapia, el 85% se rehusó a utilizar insulina cuando inició su tratamiento, el 75% ha tenido dificultad para la conservación de la insulina, el 63% considera que el uso de la insulina es riesgos, el 53% indicó haber recibido asesoría sobre los posibles efectos de la insulina, al 65% de encuestados su jornada laboral no le permite asistir a su control médico, el 72% ha sentido un desmejoro en su salud al dejar el tratamiento y el 63% de los encuestados indicó que ha abandonado en algún momento su tratamiento por temor a los efectos secundarios que dicen tener. Conclusiones: Se estableció el tipo de complicaciones que se dan en los pacientes ante la no adherencia a la insulinoterapia, uno de ellos fue, que al dejar el tratamiento los pacientes sintieron un desmejoro en su estado de salud, así también, los pacientes han abandonado el tratamiento en algún momento por miedo a los efectos secundarios que dicen tener la insulina(AU)
Diabetes Mellitus is a condition that begins when the pancreas does not make proper use of the insulin it produces or cannot achieve produce insulin. All foods rich in glucose are broken down into glucose in the blood. carbohydrates; insulin helps glucose to enter the cells cells. When the pancreas does not work well, blood sugar levels rise, which must be controlled by lifelong medical treatment, and most importantly the person must change their health habits. Objective: The main objective of this research is to define the effect produced by adherence to insulin therapy in patients with type II diabetes at Hospital del Día Mariana de Jesús. Materials and Methods: A quantitative, cross-sectional investigation was used since a patient survey which proceeded to the collection and analysis and interpretation of data. The sample worked was 100 patients who were treated at the Hospital for type II diabetes concept in the emergency area. Results: Like result of the investigation we have that 76% of the respondents know about the insulin therapy treatment, 85% refused to use insulin when they started their treatment, 75% have had difficulty conserving insulin, 63% considers that the use of insulin is risky, 53% indicated having received counseling about the possible effects of insulin, 65% of those surveyed did not care about their working hours. allows them to attend their medical control, 72% have felt a deterioration in their health when leaving the treatment and 63% of those surveyed indicated that they had abandoned their treatment at some point. treatment for fear of the side effects they claim to have. Conclusions: If established the type of complications that occur in patients due to non-adherence to insulin therapy, one of them was that when leaving the treatment the patients felt a deterioration in their state of health, as well as the patients have abandoned the treatment at some point for fear of the side effects that they claim to have insulin(AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Terapêutica , Diabetes Mellitus Tipo 2/complicações , Insulina , Pâncreas/fisiopatologia , Glicemia , Inquéritos e Questionários , Tratamento Farmacológico , Estilo de VidaRESUMO
More than 7 thousand wildfires were recorded over Mexico in 2019, affecting almost 640 thousand hectares. Most of these fires occurred during the spring season generating dense smoke plumes, impacting urban areas in the central part of the Mexican plateau. From May 10 to 17, 2019, biomass burning (BB) plumes affected Mexico City (MC) and diffused across the basin, producing PM2.5 levels ~ 2 times higher than the nation's air quality standards. Average PM2.5 concentrations increased sharply from 29.4 ± 7.2 µg m-3 to 65.1 ± 13.6 µg m-3 when the dense smoke plumes were detected. The higher particle concentration impacted the aerosol optical depth (AOD) as values ~ 3 times greater than the annual mean (0.32 ± 0.12) were measured, which resulted in a 17% loss of global horizontal irradiation (GHI). Under these severe pollution conditions, the visibility (Va) was reduced by ~ 80%. The high incidence of strong absorbent particles, such as soot and tarballs was revealed through electron microscopy and X-ray fluorescence (XRF) analysis. These techniques show chemical similarities between MC aerosols and those from the high-altitude (~ 4010 m. a. g. l.) Altzomoni Atmospheric Observatory, evidencing a strong influence of the BB emissions, suggesting a regional transport of these pollutants.
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AIMS: Type 1 diabetes (T1D) is a growing chronic disease. Evidence of whether the healthcare setting affects management and glycemic control is scarce. We evaluate outcomes in patients with T1D in private and public healthcare settings in Mexico, registered in the National T1D Registry in Mexico (RENACED-DT1). METHODS: Biochemical parameters, diabetes education, and treatment were analyzed considering the data registered in the last visit. Development of chronic complications was determined during follow-up. RESULTS: We included 1,603 patients; 71.5% (n = 1,146) registered in the public system, and 28.5% (n = 457) in a private institution. Patients in the public setting had higher HbA1c (8.6%, IQR: 7.3%-10.5% vs 7.7%, IQR: 7.0%-8.8%; p < 0.001). Indicators of diabetes education, glucose monitoring, and use of insulin-pumps were lower in the public setting. Patients in the public setting were at higher risk of diabetic chronic kidney disease, retinopathy, and neuropathy. Diabetes knowledge was a mediator between type of healthcare setting and the likelihood of achieving glycemic control. CONCLUSIONS: Patients registered in public healthcare settings have an adverse metabolic profile and higher risk of complications. Social factors need to be addressed in order to implement multidisciplinary measures focused on diabetes education for patients with T1D in Mexico.
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Diabetes Mellitus Tipo 1 , Glicemia , Automonitorização da Glicemia , Atenção à Saúde , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Hemoglobinas Glicadas/análise , Controle Glicêmico , Humanos , México/epidemiologiaRESUMO
BACKGROUND: Familial hypercholesterolemia (FH) remains underdiagnosed and undertreated. OBJECTIVE: Report the results of the first years (2017-2019) of the Mexican FH registry. METHODS: There are 60 investigators, representing 28 federal states, participating in the registry. The variables included are in accordance with the European Atherosclerosis Society (EAS) FH recommendations. RESULTS: To date, 709 patients have been registered, only 336 patients with complete data fields are presented. The mean age is 50 (36-62) years and the average time since diagnosis is 4 (IQR: 2-16) years. Genetic testing is recorded in 26.9%. Tendon xanthomas are present in 43.2%. The prevalence of type 2 diabetes is 11.3% and that of premature CAD is 9.8%. Index cases, male gender, hypertension and smoking were associated with premature CAD. The median lipoprotein (a) level is 30.5 (IQR 10.8-80.7) mg/dl. Statins and co-administration with ezetimibe were recorded in 88.1% and 35.7% respectively. A combined treatment target (50% reduction in LDL-C and an LDL-C <100 mg/dl) was achieved by 13.7%. Associated factors were index case (OR 3.6, 95%CI 1.69-8.73, P = .002), combination therapy (OR 2.4, 95%CI 1.23-4.90, P = .011), type 2 diabetes (OR 2.8, 95%CI 1.03-7.59, P = .036) and age (OR 1.023, 95%CI 1.01-1.05, P = .033). CONCLUSION: The results confirm late diagnosis, a lower than expected prevalence and risk of ASCVD, a higher than expected prevalence of type 2 diabetes and undertreatment, with relatively few patients reaching goals. Recommendations include, the use of combination lipid lowering therapy, control of comorbid conditions and more frequent genetic testing in the future.
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Hiperlipoproteinemia Tipo II , Adulto , Humanos , Pessoa de Meia-IdadeRESUMO
A real-world setting study of familial hypercholesterolemia (FH) patients who received Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in a specialized referral center in Mexico City. Ten patients between the ages of 18 and 70 years, with a diagnosis of FH according to Dutch Lipid Clinic Network (DLCN) criteria, with failure to achieve their Low-density lipoprotein Cholesterol (LDL-C) goals, and with standard therapy between 2016 and 2017 enrolled in a simple randomization in which a group of 5 participants received alirocumab (75 mg every 2 weeks) and the remaining 5 patients received evolocumab (140 mg every 2 weeks). Comparative analysis was made, analyzing the means of LDL at baseline at 4, 6, and 12 weeks. The evolocumab group had an average initial LDL-C of 277 mg/dL, which, after 12 weeks of treatment, was significantly reduced to 116 mg/dL; Pâ =â 0.04 (95% confidence interval [CI]: 11.5-310.9). The alirocumab group with a mean initial LDL-C of 229 mg/dL showed a reduction of LDL-C levels at 12 weeks of treatment to 80 mg/dL; Pâ =â 0.008 (95% CI: 63.8-233.7). In conclusion, PCSK9 inhibitors are an excellent treatment option in patients with FH who do not reach their LDL-C goals with standard therapy or due to intolerance to the standard therapy. There is no difference in the lipid-lowering effect between both PSCK9 inhibitors.
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The microsporidian parasite Nosema ceranae and neonicotinoid insecticides affect the health of honey bees (Apis mellifera). However, there is limited information about the effect of these stressors on other pollinators such as stingless bees (Hymenoptera: Meliponini). We examined the separate and combined effects of N. ceranae and the neonicotinoid thiamethoxam at field-exposure levels on the survivorship and cellular immunity (hemocyte concentration) of the stingless bee Melipona colimana. Newly-emerged bees were subjected to four treatments provided in sucrose syrup: N. ceranae spores, thiamethoxam, thiamethoxam and N. ceranae, and control (bees receiving only syrup). N. ceranae developed infections of > 467,000 spores/bee in the group treated with spores only. However, in the bees subjected to both stressors, infections were < 143,000 spores/bee, likely due to an inhibitory effect of thiamethoxam on the microsporidium. N. ceranae infections did not affect bee survivorship, but thiamethoxam plus N. ceranae significantly increased mortality. Hemocyte counts were significantly lower in N. ceranae infected-bees than in the other treatments. These results suggest that N. ceranae may infect, proliferate and cause cellular immunosuppression in stingless bees, that exposure to sublethal thiamethoxam concentrations is toxic to M. colimana when infected with N. ceranae, and that thiamethoxam restrains N. ceranae proliferation. These findings have implications on pollinators' conservation.
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Abelhas/microbiologia , Tolerância Imunológica/efeitos dos fármacos , Inseticidas/toxicidade , Nosema , Esporos Fúngicos , Tiametoxam/toxicidade , Animais , Abelhas/efeitos dos fármacosRESUMO
OBJECTIVE: Characterize homozygous familial hypercholesterolemia (HoFH) individuals from Iberoamerica. Approach and Results: In a cross-sectional retrospective evaluation 134 individuals with a HoFH phenotype, 71 adults (age 39.3±15.8 years, 38.0% males), and 63 children (age 8.8±4.0 years, 50.8% males) were studied. Genetic characterization was available in 129 (96%). The majority (91%) were true homozygotes (true HoFH, n=79, 43.0% children, 46.8% males) or compound heterozygotes (compound heterozygous familial hypercholesterolemia, n=39, 51.3% children, 46.2% males) with putative pathogenic variants in the LDLR. True HoFH due to LDLR variants had higher total (P=0.015) and LDL (low-density lipoprotein)-cholesterol (P=0.008) compared with compound heterozygous familial hypercholesterolemia. Children with true HoFH (n=34) tended to be diagnosed earlier (P=0.051) and had a greater frequency of xanthomas (P=0.016) than those with compound heterozygous familial hypercholesterolemia (n=20). Previous major cardiovascular events were present in 25 (48%) of 52 children (missing information in 2 cases), and in 43 (67%) of 64 adults with LDLR variants. Children who are true HoFH had higher frequency of major cardiovascular events (P=0.02), coronary heart (P=0.013), and aortic/supra-aortic valve diseases (P=0.022) than compound heterozygous familial hypercholesterolemia. In adults, no differences were observed in major cardiovascular events according to type of LDLR variant. From 118 subjects with LDLR variants, 76 (64%) had 2 likely pathogenic or pathogenic variants. In 89 subjects with 2 LDLR variants, those with at least one null allele were younger (P=0.003) and had a greater frequency of major cardiovascular events (P=0.038) occurring at an earlier age (P=0.001). CONCLUSIONS: There was a high frequency of cardiovascular disease even in children. Phenotype and cardiovascular complications were heterogeneous and associated with the type of molecular defect.
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Doenças Cardiovasculares/epidemiologia , LDL-Colesterol/sangue , Homozigoto , Hiperlipoproteinemia Tipo II/genética , Mutação , Proteínas Adaptadoras de Transdução de Sinal/genética , Adolescente , Adulto , Fatores Etários , Apolipoproteína B-100/genética , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Predisposição Genética para Doença , Humanos , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fenótipo , Pró-Proteína Convertase 9/genética , Receptores de LDL/genética , Estudos Retrospectivos , Fatores de Risco , América do Sul/epidemiologia , Adulto JovemRESUMO
PURPOSE: To describe pre- to post-treatment changes in clinical activity score (CAS) and exophthalmometry in patients with Graves orbitopathy treated with tocilizumab (TCZ). MATERIAL AND METHODS: Eight Mexican patients presenting with active Graves orbitopathy (CAS>3/7) previously treated with glucocorticoids received 1 monthly dose of TCZ for 6 months. CAS, EUGOGO severity assessment and exophthalmometry were used to evaluate clinical status, with serum measurement of thyroid-stimulating hormone receptor antibodies (TR-Ab) for biochemical evaluation before and after application of TCZ. RESULTS: Eight patients were analyzed: 6 male (75%), 2 female (25%): mean age, 45.9±11.2 years; mean weight, 85±18.3 kg. Mean TR-Ab level at treatment outset was 291.9±96.4%, mean CAS 4.1±0.3 and mean exophthalmometry 21.2±3.2 mm. After TCZ treatment, mean TR-Ab level fell to 172.7±54% (P=0.001), mean CAS to 1.1±0.6 (P=0.001) and mean exophthalmometry to 19.3±2 mm (P=0.02). CONCLUSIONS: TCZ is a therapeutic option for glucocorticoid-resistant orbitopathy, and should be considered in second line due to the cost of treatment or in first line in patients with contraindications to intravenous GC pulse therapy.
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Anticorpos Monoclonais Humanizados/uso terapêutico , Resistência a Medicamentos/efeitos dos fármacos , Glucocorticoides/uso terapêutico , Oftalmopatia de Graves/tratamento farmacológico , Adulto , Estudos de Coortes , Feminino , Oftalmopatia de Graves/sangue , Oftalmopatia de Graves/patologia , Humanos , Imunoglobulinas Estimuladoras da Glândula Tireoide/sangue , Masculino , México , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
We report on the case of an 8-year-old Mexican male, with a 3-year-old clinical diagnosis of familial hypercholesterolemia, and the difficulties encountered in his treatment while in our care. His treatment started with a regimen consisting of ezetimibe/simvastatin, cholestyramine, and a dietary plan of 1600 calories, with a limited intake of 200 mg of cholesterol per day. Problems arose when the patient's low-density lipoprotein cholesterol (LDL) levels did not meet ideal targets, which prompted the use of LDL cholesterol apheresis (not available in Mexico) for 6 months. As a last resort, PCSK9 inhibitors were administered but the LDL levels remained in the 600 mg/dL range. AmbryGenetics conducted a genetic test employing the Sanger method. The results suggested that there were 2 different mutations for each allele of the same LDL receptor gene (c.249delTinsGG and p.(Cys109Arg)), located in exons 3 and 4, respectively. We identified compound heterozygous mutations in our index case, with him having both the p.C109R mutation (from the maternal lineage), as well as a c.249delTinsGG mutation (from the paternal lineage). The p.C109R mutation has been previously reported, not only in Mexico, but in European regions (Germany, Czech Republic, Ireland, Italy) as well. Functional studies indicated a residual enzymatic activity of 15% to 30% for heterozygotes. To date, the variant c.249delTinsGG has not been reported. This case study illustrates the fact that in Mexico there are limited options available for treatment in such a scenario. As medical professionals, we are limited by the tools at our disposal.
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We determined the presence of six viruses in different bee species collected in subtropical environments. Deformed wing virus (DWV) and black queen cell virus (BQCV) were detected in >90% of honey bee samples and in 50-100% of four stingless bee, two bumble bee and one solitary bee species. Additionally, minus DWV and BQCV RNA strands were detected, indicating that the viruses replicate in several hosts. This is the first report of honey bee viruses replicating in six wild bee species in the tropics. If pathogenic to them, viral infections could result in negative impacts in agricultural and unmanaged ecosystems.
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Abelhas/virologia , Dicistroviridae/isolamento & purificação , Vírus de RNA/isolamento & purificação , Viroses/transmissão , Animais , Animais Selvagens , Reservatórios de Doenças , Ecossistema , México , Polinização , Replicação ViralRESUMO
BACKGROUND: Strongyloidiasis can be fatal in immunocompromised patients, but few epidemiological studies investigated the burden of this neglected tropical disease among these populations, particularly in low- and middle-income countries such as Bolivia. This study aimed to fill in this gap by estimating prevalence rate and risk factors associated with strongyloidiasis among patients at high risk of complications. METHODS: A cross-sectional study was carried out in Santa Cruz (elevation 400 meters, tropical climate) and Cochabamba (elevation 2,500 meters, temperate climate), among patients with cancer, HIV infection and rheumatic or hematologic disease, using four coproparasitological techniques and one serological (ELISA) test. RESULTS: In total, 1,151 patients participated in this study, including individuals who were HIV-positive (30%) or with rheumatic (29%), oncologic (32%) or hematologic (9%) diseases. The serological and coproparasitological prevalence was 23.0% (95% confidence interval [CI], 20.7-25.5; n = 265/1151) and 7.6% (95% CI, 6.2-9.3; n = 88/1151), respectively, with an estimated actual prevalence of 20.2% (95% CI, 17.9-22.5). Positive serology and positive coproparasitology were associated with younger age and lower education levels. There was no significant difference in prevalence between Cochabamba and Santa Cruz as defined by coproparasitology (6.4% vs. 8.9%; p = 0.11) or serology (24.0% vs. 22.0%; p = 0.4). Among 64 patients in Cochabamba who had never travelled to the tropical lowlands, 5 (7.8%) had a positive coproparasitology. CONCLUSIONS: Strongyloidiasis is widely prevalent in Bolivia among vulnerable patients at increased risk of life-threatening complications. Transmission of the parasite occurs both in tropical lowlands and temperate elevation (≥ 2,500 m). Control strategies to prevent transmission and complications of this serious parasitic disease should be urgently reinforced.
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Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Bolívia/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Fezes/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Resumen La obesidad representa uno de los problemas más importantes de salud de nuestros tiempos; hoy en día se considera un desafío sanitario en los países desarrollados, así como en los que se encuentran en vías de desarrollo, ya que han adoptado los hábitos alimenticios típicos del mundo desarrollado pero, además, por todas las comorbilidades asociadas. La obesidad se asocia con un espectro muy amplio de alteraciones fisiopatológicas como: sobrecarga de volumen, hipertensión, desregulación metabólica, activación neurohumoral e inflamación sistémica. Los genes involucrados en la obesidad son varios y se relacionan con diferentes procesos: en la regulación del apetito, los comportamientos de búsqueda de alimentos y la eficiencia metabólica. La pérdida de peso con cambios de estilo de vida (alimentación y ejercicio) es un camino adecuado para mejorar la salud en pacientes con factores de riesgo asociados a la obesidad. Aunque existen tratamientos medicamentosos y quirúrgicos para lograr la pérdida de peso, éstos no son elegidos de primera intención y sólo son usados cuando el tratamiento primario ha fallado.
Abstract Obesity represents one of the most important health problems of our times, nowadays it is considered a health challenge in developed countries, as well as in those that are developing, as they have adopted the typical eating habits of the developed world, but also because of all the associated comorbidities. Obesity is associated with a very broad spectrum of pathophysiological changes such as: volume overload, hypertension, metabolic dysregulation, neurohumoral activation and systemic inflammation. The genes involved in obesity are several and are related to different processes: in the regulation of appetite, the behaviors of food search and metabolic efficiency. Weight loss with changes in lifestyle (diet and exercise) is an adequate way to improve health in patients with risk factors associated with obesity. Although there are medical and surgical treatments to achieve weight loss, these are not chosen as first intention and are only used when the primary treatment has failed.
RESUMO
La Listeria monocytogenes es un bacilo o cocobacilo grampositivo, móvil, anaerobio, facultativo e intracelular que se adapta a los cambios ambientales extremos. Se transmite por alimentos contaminados. Infecta a recién nacidos, pacientes inmunosuprimidos, adultos mayores y mujeres embarazadas. Se la ha asociado con una elevada mortalidad fetal o neonatal. Puede cursar con un cuadro sintomático leve y autolimitado, pseudogripal inespecífico o tener graves repercusiones maternas y fetales. Se presenta el caso clínico de una paciente primigesta con embarazo de 19 semanas y corioamnionitis por Listeria monocytogenes. El tratamiento antibiótico iniciado oportunamente es fundamental para lograr la mejoría de la evolución materno-fetal y revertir el cuadro.
Listeria monocytogenes is a Grampositive bacillus or coco-bacillus, mobile, anaerobic facultative and intracellular that adapts to extreme environmental changes. It is transmitted by contaminated food. It infects newborns, immunosuppressed patients, older adults and pregnant women. It has been associated with high fetal or neonatal mortality. May present with a mild and self-limiting condition, non-specific pseudo-flu condition or have serious maternal or fetal repercussions. We present the clinical case of a primiparous patient with a 19-week pregnancy and chorioamnionitis due to Listeria monocytogenes. The antibiotic treatment of opportune initiation is fundamental to achieve the improvement of the maternal-fetal evolution and to revert the clinical profile.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Gravidez , Corioamnionite , Mortalidade Fetal , Aborto , Listeria monocytogenesRESUMO
Resumen El síndrome de Prader-Willi en un trastorno multisistémico; se caracteriza en la infancia por hipotonía, dificultades para la alimentación, retraso en el desarrollo e hipoplasia genital. En la adolescencia y edad adulta, la problemática se centra en las alteraciones del comportamiento, la ausencia de saciedad y el retraso mental leve o moderado. Su diagnóstico temprano requiere una alta sospecha clínica y estudios especiales (estudios de metilación e hibridación fluorescente in situ). La detección temprana se realiza con el fin de disminuir la morbilidad y mortalidad de los pacientes. Existe una clara necesidad de un enfoque multidisciplinario para facilitar el diagnóstico temprano y optimizar el manejo y tratamiento para mejorar la calidad de vida. Se presentan seis casos de SPW que tienen seguimiento en la Unidad de Especialidades Médicas a fin de conocer la prevalencia del SPW, ya que en la actualidad no se cuenta con ningún registro que la documente.
Abstract Prader-Willi syndrome in a multisystem disorder; it is characterized in childhood by hypotonia, feeding difficulties, developmental delay and genital hypoplasia. In adolescence and adulthood, the problem focuses on behavioral changes, the absence of satiety and mild or moderate mental retardation. Its early diagnosis requires a high clinical suspicion and special studies (methylation studies and fluorescent in situ hybridization). An early detection reduces the morbidity and mortality of patients. There is a clear need for a multidisciplinary approach to facilitate early diagnosis and optimize management and treatment to improve quality of life. There are six cases of SPW that are followed in the Medical Specialties Unit; we report them in order to know the prevalence of PWS, since at present there is no record documenting it.