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Inter-carrier interference (ICI) in vehicle to vehicle (V2V) orthogonal frequency division multiplexing (OFDM) systems is a common problem that makes the process of detecting data a demanding task. Mitigation of the ICI in V2V systems has been addressed with linear and non-linear iterative receivers in the past; however, the former requires a high number of iterations to achieve good performance, while the latter does not exploit the channel's frequency diversity. In this paper, a transmission and reception scheme for low complexity data detection in doubly selective highly time varying channels is proposed. The technique couples the discrete Fourier transform spreading with non-linear detection in order to collect the available channel frequency diversity and successfully achieving performance close to the optimal maximum likelihood (ML) detector. When compared with the iterative LMMSE detection, the proposed system achieves a higher performance in terms of bit error rate (BER), reducing the computational cost by a third-part when using 48 subcarriers, while in an OFDM system with 512 subcarriers, the computational cost is reduced by two orders of magnitude.
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Current computing platforms encourage the integration of thousands of processing cores, and their interconnections, into a single chip. Mobile smartphones, IoT, embedded devices, desktops, and data centers use Many-Core Systems-on-Chip (SoCs) to exploit their compute power and parallelism to meet the dynamic workload requirements. Networks-on-Chip (NoCs) lead to scalable connectivity for diverse applications with distinct traffic patterns and data dependencies. However, when the system executes various applications in traditional NoCs-optimized and fixed at synthesis time-the interconnection nonconformity with the different applications' requirements generates limitations in the performance. In the literature, NoC designs embraced the Software-Defined Networking (SDN) strategy to evolve into an adaptable interconnection solution for future chips. However, the works surveyed implement a partial Software-Defined Network-on-Chip (SDNoC) approach, leaving aside the SDN layered architecture that brings interoperability in conventional networking. This paper explores the SDNoC literature and classifies it regarding the desired SDN features that each work presents. Then, we described the challenges and opportunities detected from the literature survey. Moreover, we explain the motivation for an SDNoC approach, and we expose both SDN and SDNoC concepts and architectures. We observe that works in the literature employed an uncomplete layered SDNoC approach. This fact creates various fertile areas in the SDNoC architecture where researchers may contribute to Many-Core SoCs designs.
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Resumen Introducción: México tiene la mortalidad más alta a 30 días por infarto agudo de miocardio (IAM), el cual constituye una de las principales causas de mortalidad en el país: 28 % versus 7.5 % del promedio de los países de la Organización para la Cooperación y el Desarrollo Económicos. Objetivo: Establecer las rutas críticas y las estrategias farmacológicas esenciales interinstitucionales para la atención de los pacientes con IAM en México, independientemente de su condición socioeconómica. Método: Se reunió a un grupo de expertos en diagnóstico y tratamiento de IAM, representantes de las principales instituciones públicas de salud de México, así como las sociedades cardiológicas mexicanas, Cruz Roja Mexicana y representantes de la Sociedad Española de Cardiología, con la finalidad de optimizar las estrategias con base en la mejor evidencia existente. Resultados: Se diseñó una guía de práctica clínica interinstitucional para el diagnóstico temprano y tratamiento oportuno del IAM con elevación del segmento ST, siguiendo el horizonte clínico de la enfermedad, con la propuesta de algoritmos que mejoren el pronóstico de los pacientes que acuden por IAM a los servicios de urgencias. Conclusión: Con la presente guía práctica, el grupo de expertos propone universalizar el diagnóstico y tratamiento en el IAM, independientemente de la condición socioeconómica del paciente.
Abstract Introduction: Mexico has the highest 30-day acute myocardial infarction (AMI) mortality rate: 28% versus 7.5% on average for the OECD countries, and it constitutes one of the main causes of mortality in the country. Objective: To establish critical pathways and essential interinstitutional pharmacological strategies for the care of patients with AMI in Mexico, regardless of their socioeconomic status. Method: A group of experts in AMI diagnosis and treatment, representatives of the main public health institutions in Mexico, as well as the Mexican cardiology societies, the Mexican Red Cross and representatives of the Spanish Society of Cardiology, were brought together in order to optimize strategies based on the best existing evidence. Results: An interinstitutional clinical practice guideline was designed for early diagnosis and timely treatment of AMI with ST elevation, following the clinical horizon of the disease, with the proposal of algorithms that improve the prognosis of patients who attend the emergency services due to an AMI. Conclusion: With these clinical practice guidelines, the group of experts proposes to universalize AMI diagnosis and treatment, regardless of patient socioeconomic status.
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Humanos , Consenso , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Sociedades Médicas , Espanha , Biomarcadores/sangue , Reperfusão Miocárdica/métodos , Terapia Trombolítica/métodos , Causas de Morte , Eletrocardiografia , Intervenção Coronária Percutânea/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/reabilitação , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Reabilitação Cardíaca , COVID-19/prevenção & controle , MéxicoRESUMO
INTRODUCTION: Mexico has the highest 30-day mortality due to acute myocardial infarction (AMI), which constitutes one of the main causes of mortality in the country: 28 % versus 7.5 % on average for the Organization for Economic Co-operation and Development member countries. OBJECTIVE: To establish critical pathways and essential interinstitutional pharmacological strategies for the care of patients with AMI in Mexico, regardless of their socioeconomic status. METHOD: A group of experts in AMI diagnosis and treatment, representatives of the main public health institutions in Mexico, as well as the Mexican cardiology societies, the Mexican Red Cross and representatives of the Spanish Society of Cardiology, were brought together in order to optimize strategies based on the best existing evidence. RESULTS: An interinstitutional clinical practice guideline was designed for early diagnosis and timely treatment of AMI with ST-segment elevation, following the clinical horizon of the disease, with the proposal of algorithms that improve the prognosis of patients who attend the emergency services due to an AMI. CONCLUSION: With these clinical practice guidelines, the group of experts proposes to universalize AMI diagnosis and treatment, regardless of patient socioeconomic status. INTRODUCCIÓN: México tiene la mortalidad más alta a 30 días por infarto agudo de miocardio (IAM), el cual constituye una de las principales causas de mortalidad en el país: 28 % versus 7.5 % del promedio de los países de la Organización para la Cooperación y el Desarrollo Económicos. OBJETIVO: Establecer las rutas críticas y las estrategias farmacológicas esenciales interinstitucionales para la atención de los pacientes con IAM en México, independientemente de su condición socioeconómica. MÉTODO: Se reunió a un grupo de expertos en diagnóstico y tratamiento de IAM, representantes de las principales instituciones públicas de salud de México, así como las sociedades cardiológicas mexicanas, Cruz Roja Mexicana y representantes de la Sociedad Española de Cardiología con la finalidad de optimizar las estrategias con base en la mejor evidencia existente. RESULTADOS: Se diseñó una guía de práctica clínica interinstitucional para el diagnóstico temprano y tratamiento oportuno del IAM con elevación del segmento ST, siguiendo el horizonte clínico de la enfermedad, con la propuesta de algoritmos que mejoren el pronóstico de los pacientes que acuden por IAM a los servicios de urgencias. CONCLUSIÓN: Con la presente guía práctica, el grupo de expertos propone universalizar el diagnóstico y tratamiento en el IAM, independientemente de la condición socioeconómica del paciente.
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Consenso , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Biomarcadores/sangue , COVID-19/prevenção & controle , Reabilitação Cardíaca , Causas de Morte , Eletrocardiografia , Humanos , México , Reperfusão Miocárdica/métodos , Intervenção Coronária Percutânea/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/reabilitação , Sociedades Médicas , Espanha , Terapia Trombolítica/métodosRESUMO
Peritoneal dialysis (PD) is an alternative for managing the end-stage renal disease (ESRD). The peritoneal membrane (PM) is not just a membrane that passively responds to diffusion and convection. The characteristics of PM result in the peritoneal equilibrium test (PET) and with this test is possible to obtain the type of peritoneal transport (PT). The patient on PD can be classified in different types of PT as; Low, Low Average, High Average, and High. The aim of the study was to compare the inflammatory cytokines, oxidants, antioxidants, and oxidative DNA damage markers in the different types of PT. A cross-sectional analytical study of 77 adult PD patients was performed. Levels of lipoperoxides (LPO) were higher in all types of PT vs. healthy volunteer controls (HC) (p < 0.0001). Nitric oxide (NO) levels were found significantly down-regulated in all types of PT (p < 0.0001). The activity of the superoxide dismutase enzyme (SOD) was found to be significantly increased in all types of PT vs. the HC (p < 0.0001). The levels of the DNA repair enzyme were found to be decreased in all types of PT. The levels of the pro-inflammatory cytokines TNF-α, IL-6, the marker of oxidative DNA damage, 8-IP and the total antioxidant capacity (TAC) were all significantly decreased, contrary to the levels in HC, possibly by the clearance in the dialysis fluid in all types of PT or due to down-regulation of their expression. In conclusion, we found significant changes in markers of inflammation, oxidative stress, and oxidative damage to DNA in all types of PT; Low, low average, high average, and high PT in the values of D/P creatinine at 4 h compared to HC.
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INTRODUCTION: Multi-frequency bio-impedance analysis (BIA) accurately evaluates body composition. OBJECTIVE: To assess nutritional status and its relationship with body mass index (BMI) or with BIA-obtained phase angle in patients with end-stage renal disease (ESRD) on hemodialysis. METHOD: BMI, BIA and dialysis malnutrition score (DMS) were assessed in 99 patients on hemodialysis (43.6 ± 17.2 years of age, 58.8% males). Multivariate linear regression analysis was used to determine BMI and phase angle independent associations with DMS. RESULTS: Malnutrition risk (DMS > 13) showed a gradual increase among patients with normal BMI and phase angle (44.4%), low BMI (45.8%), low phase angle (64.0%), and in those with both parameters at abnormal ranges (68.0%). The phase angle was the only variable that was independently associated with patient nutritional status (standardized coefficient beta -0.372, p < 0.001), accounting for 13.8% of DMS variation. CONCLUSION: Phase angle is inversely and independently associated with malnutrition risk in patients with ESRD, which suggests that BIA-assessed body composition might be better than BMI in the clinical assessment of patients with ESRD.
INTRODUCCIÓN: La bioimpedancia eléctrica multifrecuencia (BIE) evalúa con precisión la composición corporal. OBJETIVO: Investigar el estado nutricional y su relación con el índice de masa corporal (IMC) o el ángulo fase obtenido por BIE en pacientes con enfermedad renal terminal (ERT) en hemodiálisis. MÉTODO: En 99 pacientes en hemodiálisis (43.6 ± 17.2 años, 58.8 % varones) se evaluó IMC, BIE y puntuación de desnutrición (DMS, Dialysis Malnutrition Score). La independencia de las asociaciones del IMC y el ángulo fase con el DMS se determinó con regresión lineal múltiple. RESULTADOS: El riesgo de desnutrición (DMS > 13) se incrementó gradualmente entre los sujetos con IMC y ángulo fase normales (44.4 %), IMC bajo (45.8 %), ángulo fase bajo (64.0 %) y en aquellos con ambos parámetros anormales (68.0 %). El ángulo fase fue la única variable asociada independientemente con el estado nutricional de los pacientes (coeficiente beta estandarizado −0.372, p < 0.001), lo que explicó 13.8 % de la variación en el DMS. CONCLUSIONES: El ángulo fase se asocia inversa e independientemente con el riesgo de desnutrición en pacientes con ERT, lo que sugiere que la composición corporal evaluada por BIE pudiera ser mejor que el IMC en la valoración clínica de pacientes con esta enfermedad.
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Impedância Elétrica , Falência Renal Crônica/terapia , Desnutrição/epidemiologia , Diálise Renal/métodos , Adulto , Idoso , Composição Corporal , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/etiologia , Pessoa de Meia-Idade , Estado Nutricional , Adulto JovemRESUMO
Resumen Introducción: La bioimpedancia eléctrica multifrecuencia (BIE) evalúa con precisión la composición corporal. Objetivo: Investigar el estado nutricional y su relación con el índice de masa corporal (IMC) o el ángulo fase obtenido por BIE en pacientes con enfermedad renal terminal (ERT) en hemodiálisis. Método: En 99 pacientes en hemodiálisis (43.6 ± 17.2 años, 58.8 % varones) se evaluó IMC, BIE y puntuación de desnutrición (DMS, Dialysis Malnutrition Score). La independencia de las asociaciones del IMC y el ángulo fase con el DMS se determinó con regresión lineal múltiple. Resultados: El riesgo de desnutrición (DMS > 13) se incrementó gradualmente entre los sujetos con IMC y ángulo fase normales (44.4 %), IMC bajo (45.8 %), ángulo fase bajo (64.0 %) y en aquellos con ambos parámetros anormales (68.0 %). El ángulo fase fue la única variable asociada independientemente con el estado nutricional de los pacientes (coeficiente beta estandarizado −0.372, p < 0.001), lo que explicó 13.8 % de la variación en el DMS. Conclusiones: El ángulo fase se asocia inversa e independientemente con el riesgo de desnutrición en pacientes con ERT, lo que sugiere que la composición corporal evaluada por BIE pudiera ser mejor que el IMC en la valoración clínica de pacientes con esta enfermedad.
Abstract Introduction: Multi-frequency bio-impedance analysis (BIA) accurately evaluates body composition. Objective: To assess nutritional status and its relationship with body mass index (BMI) or with BIA-obtained phase angle in patients with end-stage renal disease (ESRD) on hemodialysis. Method: BMI, BIA and dialysis malnutrition score (DMS) were assessed in 99 patients on hemodialysis (43.6 ± 17.2 years of age, 58.8% males). Multivariate linear regression analysis was used to determine BMI and phase angle independent associations with DMS. Results: Malnutrition risk (DMS > 13) showed a gradual increase among patients with normal BMI and phase angle (44.4%), low BMI (45.8%), low phase angle (64.0%), and in those with both parameters at abnormal ranges (68.0%). The phase angle was the only variable that was independently associated with patient nutritional status (standardized coefficient beta −0.372, p < 0.001), accounting for 13.8% of DMS variation. Conclusion: Phase angle is inversely and independently associated with malnutrition risk in patients with ESRD, which suggests that BIA-assessed body composition might be better than BMI in the clinical assessment of patients with ESRD.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Diálise Renal/métodos , Impedância Elétrica , Desnutrição/epidemiologia , Falência Renal Crônica/terapia , Composição Corporal , Índice de Massa Corporal , Estado Nutricional , Estudos Transversais , Desnutrição/diagnóstico , Desnutrição/etiologiaRESUMO
With the rapid deployment of the Internet of Things and cloud computing, it is necessary to enhance authentication protocols to reduce attacks and security vulnerabilities which affect the correct performance of applications. In 2019 a new lightweight IoT-based authentication scheme in cloud computing circumstances was proposed. According to the authors, their protocol is secure and resists very well-known attacks. However, when we evaluated the protocol we found some security vulnerabilities and drawbacks, making the scheme insecure. Therefore, we propose a new version considering login, mutual authentication and key agreement phases to enhance the security. Moreover, we include a sub-phase called evidence of connection attempt which provides proof about the participation of the user and the server. The new scheme achieves the security requirements and resists very well-known attacks, improving previous works. In addition, the performance evaluation demonstrates that the new scheme requires less communication-cost than previous authentication protocols during the registration and login phases.
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INTRODUCTION: Diabetic Nephropathy (DN) is the main cause of chronic kidney disease (CKD) in diabetic patients. An IL-10 imbalance could be related to renal hypertrophy and trigger to nephropathy. Three promoter polymorphisms (-1082G>A, -819C>T, and -592C>A) at IL10 gene have been associated with changes in the IL-10 expression and DN susceptibility. Therefore, the aim of this study was to analyze this association in Mexican patients with DN. METHODS: We conducted a case-control study on 128 patients with DN and 150 control subjects (CS) from western Mexico. All patients were tested for IL10 polymorphisms by PCR-RFLP. Allele frequencies, genotypes, and haplotypes were compared between groups. The significant haplotypes were correlated with patient clinical features. RESULTS: IL10 gene ATC haplotype (-1082A/-819T/-592C) was found significantly more frequent in DN patients than in CS (P < 0.001; OR = 3.6, 95% CI: 1.7-7.4). Similarly GTA (-1082G/-819T/-592A) haplotype was more frequent in DN patients than CS with significant differences (P < 0.05; OR = 4.02, 95% CI: 1.10-14.78). There were no correlations between IL10 haplotypes and clinical parameters in patients with DN. However, that there is a trend of higher serum urea levels and lower eGFR in ATC haplotype carriers compared to carriers of the other haplotypes (P < 0.05). CONCLUSIONS: These results indicate that IL10 promoter haplotypes ATC and GTA carriers have a higher risk factor to develop DN in the western Mexican population.
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Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/genética , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Interleucina-10/genética , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Haplótipos/genética , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
OBJECTIVE: The number of successful pregnancies in kidney transplant (KT) recipients has increased in recent years. Little evidence is available about the risk of in utero immunosuppressive exposure for long-term cognitive consequences. The aim of this study was to evaluate the impact of immunosuppression during pregnancy on intellectual performance of children born to KT recipients. METHODS: Using a cross-sectional design, women who had undergone KT and their children (aged 4+ years) were recruited at the outpatient follow-up in five transplant centers. Women who did not receive immunosuppression during pregnancy with similar distributions of socioeconomic status and length of gestation and their children were also recruited. Children were assessed with Wechsler Intelligence Scales. RESULTS: The study sample included 50 exposed and 50 unexposed children. No differences between groups in all the proposed confounding factors were found. Full-scale IQ did not differ significantly between both groups. Also, significant differences in any index or subscale score were not observed, with the exception of time required to complete the Wechsler preschool and primary scale of intelligence (WPPSI) Zoo locations subtest, which was done quicker in the unexposed group (p = .007). Exposure to immunosuppression during pregnancy was not a significant predictor of low IQ in logistic regression after adjustment for other factors. CONCLUSIONS: Immunosuppression therapy during pregnancy of KT women did not affect global intellectual performance of their offspring, except maybe for visuospatial working memory in preschool children.
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Imunossupressores/efeitos adversos , Inteligência/efeitos dos fármacos , Rim , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Transplantados , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Transplante de Rim , Modelos Logísticos , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Pessoa de Meia-Idade , Gravidez , Escalas de WechslerRESUMO
INTRODUCTION: Mexico is the country with the highest mortality due to acute myocardial infarction in adults older than 45 years old according to the OECD (28 vs. 7.5% of the average). The first real-world study, RENASCA IMSS, showed a high-risk population at 65%, but 50% without reperfusion strategies. The aim was to describe the clinical presentation, treatment, and outcomes of acute coronary syndromes at the IMSS. METHODS: RENASCA IMSS is a nation-wide, prospective, longitudinal-cohort study. We include consecutive patients with an Acute Coronary Syndrome diagnosis (ACC/AHA/ESC) admitted in 177 representative hospitals of the IMSS (166 of second level and 11 of third level of attention). In an electronic database clinical, paraclinical, times, reperfusion treatment, complications, and other variables were assessed. Confidentiality was maintained in data and informed consent was obtained. Registrer calibration was performed with more than 80% of the variables and 80% of the cases. RESULTS: From March 1, 2014 to December 25, 2017; 21,827 patients were enrolled presenting an average age 63.2 ± 11.7, 75% men (16,259) and 25% women (5,568). The most frequent risk factors were: hypertension (60.5%), smoking (46.8%), diabetes (45.5%), dyslipidemia (35.3%) and metabolic syndrome (39.1%). STEMI diagnosis was established in 73.2% of the patients and NSTEMI in 26.8%. The STEMI group within the Code Infarction showed an improvement in the reperfusion therapy (34.9% before vs. 71.4% after, p ≤0.0001) and reduction of mortality (21.1 vs. 9.4%, p ≤0.0001); while the NSTEMI group showed high risk set by a GRACE score of 131.5 ± 43.7 vs. 135.9 + 41.7, p ≤0.0001. Mortality was more frequent within the STEMI group (14.9 vs. 7.6%, p ≤0.0001). CONCLUSIONS: RENASCA IMSS study represents the largest Acute Coronary Syndromes real-world study in Mexico, demonstrating that the Mexican population has a high risk. Patients with a STEMI diagnosis were more frequently enrolled and were associated with higher mortality and complications; however, there is improvement in the reperfusion therapy and in mortality with the Code Infarction strategy.
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Síndrome Coronariana Aguda/epidemiologia , Infarto do Miocárdio sem Supradesnível do Segmento ST/epidemiologia , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Adulto , Idoso , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Hospitalização , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Masculino , Síndrome Metabólica/epidemiologia , México/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Fumar/epidemiologiaRESUMO
Abstract: Objective: REMEHIP is a prospective, multicentre registry on pulmonary hypertension. The main objective will be to identify the clinical profile, medical care, therapeutic trends and outcomes in adult and pediatric Mexican patients with well-characterized pulmonary hypertension. Methods: REMEHIP a multicenter registry began in 2015 with a planned recruitment time of 12 months and a 4-year follow-up. The study population will comprise a longitudinal cohort study, collecting data on patients with prevalent and incident pulmonary hypertension. Will be included patients of age >2 years and diagnosis of pulmonary hypertension by right heart catheterization within Group 1 and Group 4 of the World Health Organization classification. The structure, data collection and data analysis will be based on quality current recommendations for registries. The protocol has been approved by institutional ethics committees in all participant centers. All patients will sign an informed consent form. Currently in Mexico, there is a need of observational registries that include patients with treatment in the everyday clinical practice so the data could be validated and additional information could be obtained versus the one from the clinical trials. In this way, REMEHIP emerges as a link among randomized clinical trials developed by experts and previous Mexican experience.
Resumen: Objetivo: REMEHIP es un registro prospectivo, multicéntrico en hipertensión pulmonar. El objetivo principal será identificar el perfil clínico, atención médica, tendencias terapéuticas y evolución en pacientes mexicanos adultos y pediátricos con hipertensión pulmonar bien caracterizada. Métodos: El REMEHIP comenzó en el año de 2015 y se planea un reclutamiento de 12 meses con un seguimiento de 4 años. La población en estudio será una cohorte longitudinal y se obtendrán datos de pacientes prevalentes e incidentes con hipertensión pulmonar. Se incluirán pacientes con edad > 2 años con diagnóstico de hipertensión pulmonar demostrado por cateterismo cardiaco derecho del Grupo 1 y Grupo 4 de la clasificación de la Organización Mundial de la Salud. La estructura, colección de datos y el análisis se establecerá a través de las recomendaciones actuales de calidad para los registros. El protocolo ha sido aprobado por los comités de ética de todos los centros participantes. Todos los pacientes firmarán un consentimiento informado. Actualmente en México existe una necesidad de registros observacionales que incluyan a pacientes con tratamiento en la práctica clínica cotidiana, de tal forma que los datos obtenidos podrían validarse y el resto de la información podría compararse con la derivada de los estudios clínicos. De esta forma REMEHIP surge como un vínculo entre los estudios clínicos aleatorizados conducidos por expertos y la experiencia mexicana previa.
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Humanos , Sistema de Registros , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/terapia , Projetos de Pesquisa , Estudos Prospectivos , MéxicoRESUMO
OBJECTIVE: We describe the evolution of graft function in patients with transplant glomerulopathy measure by levels of serum creatinine, proteinuria and estimated glomerular filtration rate. METHOD: Cross-sectional study conducted in the Regional General Hospital No. 46 IMSS. Included patients with kidney allograft and diagnosis of renal biopsy of transplant glomerulopathy grafting between January 1, 2006 to April 31, 2013 serum creatinine, proteinuria and estimated glomerular filtration rate at diagnosis, 6, 12 and 24 was recorded months. The results are shown with numbers, percentages and standard deviations. RESULTS: 42 patients were included. At 6 months of diagnosis, 14% decline in graft function and 7.1% graft loss. At 12 months, 17.9% graft loss, and at 24 months 36.3% had chronic graft dysfunction and graft loss as return to dialysis. CONCLUSIONS: Evolution in our patients seems to be better to other series of cases reported in the literature.
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Rejeição de Enxerto/etiologia , Transplante de Rim/efeitos adversos , Rim/fisiopatologia , Transplantes/fisiopatologia , Adulto , Creatinina/sangue , Estudos Transversais , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Masculino , México , Proteinúria/diagnósticoRESUMO
INTRODUCTION: Glomerular disease is among the top ten leading causes of death in Mexico. AIM: To assess the frequency of glomerulopathy in western Mexico in a Regional Hospital belonging of the Instituto Mexicano Del Seguro Social. METHODS: Single hospital center retrospective analysis. We reviewed all native kidney biopsies between January 2003 and December 2011, in patients more than 16 years old, to establish clinical features, presentation, and histological report. RESULTS: A total of 163 reports were analyzed; patients with a mean age of 32.6 ± 13.3 years, 55% female, 24% had systemic arterial hypertension, and 10% with a family history of chronic renal failure. The most frequent types of primary glomerulonephritis were focal segmental glomerulosclerosis (FSGS) in 47% of cases, followed by membranous nephropathy in 15%. The most frequent types of secondary glomerulonephritis were lupus nephritis in 14%, followed by diabetic nephropathy in 4% and amyloidosis in 1.2%. CONCLUSION: Focal segmental glomerulosclerosis is the most frequent type of glomerulopathy in our population; we observed a minor percentage of Inmunoglobulin A (IgA) nephropathy compared with worldwide reports. This information is a contribution to the understanding of the prevalence of glomerulopathy in western Mexico.
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Glomerulonefrite/epidemiologia , Glomerulosclerose Segmentar e Focal/epidemiologia , Nefropatias/epidemiologia , Adolescente , Adulto , Biópsia , Bases de Dados Factuais , Feminino , Glomerulonefrite/fisiopatologia , Humanos , Hipertensão/epidemiologia , Nefropatias/fisiopatologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: The peritoneal equilibration test (PET) is a common test used in the adequacy of peritoneal dialysis (PD). AIM: To determine the frequency of presentation of different types of peritoneal transport in patients on PD ranking with Twardowski, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) and Hospital de Especialidades del Instituto Mexicano del Seguro Social Centro Médico Nacional de Occidente (IMSS-HE, CMNO) and establish themselves. METHODS: Descriptive and transversal study. Included with PET on PD patients between April 2011 to September 2012; any gender, 16 years or older, in DP minimum of 4 weeks. PEP performed standardized bags of 2.5%. RESULTS: Performed 235 PET. We can classify peritoneal transport with Twardowski in high (H) 34%, high average (HA) 37%, low average (LA) 25%, and low (L) 4% peritoneal transport rates. INCMNSZ percentages H was 34%, HA 32%, LA 23%, and L 11%; using the CMNO HE was H 26%, HA 31%, LA 31%, and L 12%. From our data, the percentage of patients with H was 22%, HA 33%, LA 32%, and L13%. CONCLUSION: Classifying patients according to type of transport with Twardowski will under-diagnose the low and overestimate high transport, and can alter survival forecasts.
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UNLABELLED: The angiotensin (Ang)-converting enzyme (ACE) insertion/deletion (I/D) polymorphism determines Ang II levels, but its relationship with lupus nephritis (LN) in different populations is controversial. OBJECTIVE: To describe the allelic and genotypic distribution of the I/D polymorphism in Mexican mestizos with LN and assess an association with histological classes. METHODS: We included 24 patients with systemic lupus erythematosus (SLE) without nephropathy, 41 with LN, 144 healthy subjects, and 36 with primary glomerulonephritis (GMN). Three ACE I/D polymorphism genotypes-ID, DD, and II--were detected by PCR using peripheral blood genomic DNA. RESULTS: Frequencies for II, ID, and DD were 0.29, 0.46, and 0.25 in the SLE group; 0.17, 0.63, and 0.20 in the LN group; 0.14, 0.5, and 0.36 in the GMN group; and 0.26, 0.52, and 0.22 among healthy subjects. The I/D polymorphism distribution according to histological class was class II: 1 II, 3 ID, and 1 DD; class III: 2 II, 10 ID, and 1 DD; class IV: 2 II, 9 ID, and 2 DD; class V: 2 II, 3 ID, and 4 DD; and class VI, 1 II. The histological classes with at least three patients had ID genotype as the most frequent except for class V. CONCLUSION: No association was identified between I/D polymorphisms of ACE and SLE, LN, or GMN in a Mexican population.
Assuntos
Nefrite Lúpica/enzimologia , Nefrite Lúpica/genética , Americanos Mexicanos/genética , Peptidil Dipeptidase A/genética , Deleção de Sequência , Adulto , Alelos , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Nefrite Lúpica/etnologia , Masculino , Mutagênese Insercional , Polimorfismo GenéticoRESUMO
El estudio de los saberes para la salud y la enfermedad y de las prácticas médicas en la población de origen indígena plantea desafíos teóricos, sociales y políticos. Desde el punto de vista del análisis, la heterogeneidad cultural en la que se encuentra obliga a considerar los procesos de modernización, lo cual implica asumir una perspectiva histórica que no siempre consideran las investigaciones sobre la sociedad y cultura andina contemporánea. Este artículo pretende avanzar en este sentido. Planteamos que el peso de la escolaridad es gravitante en la diferenciación social y cultural y por lo tanto el nivel alcanzado incide en la comprensión de la naturaleza del cuerpo y su funcionamiento y en las prácticas para la salud. Los datos coinciden en gran parte con los informados por otros investigadores; a partir de estos, proponemos que es preciso ampliar el debate sobre la cuestión de la materialidad-inmaterialidad de las bases teóricas del pensamiento médico andino.
Assuntos
Humanos , Povos Indígenas , Medicina Tradicional , Mudança Social , Chile , Terapias Complementares , Características Culturais , Sistemas de SaúdeRESUMO
Se realizó un estudio cuasiexperimental, prospectivo, simple, controlado con placebo. Se incluyeron 8 pacientes adultos del sexo femenino con rango de edad de 40 a 62 años a los cuales se les administró nifedipino con sistema terapéutico gastrointestinal (GITS), se les realizó medición convencional de la presión arterial y monitoreo ambulatorio al final de cuatro semanas de placebo y después de 16 semanas de tratamiento activo a base de nifedipino GITS, a dosis única, matutina, fija, de 30 mg/día. Después de 16 semanas de tratamiento con nifedipino GITS la presión arterial convencional sistólica y diastólica disminuyó significativamente de 155ñ13.2/103ñ4.8 a 127ñ11.5/80ñ8 mmHg (p=0.001), no así la frecuencia cardiaca (p=NS). Con monitoreo ambulatorio la presión arterial sistólica y diastólica descendió de manera estadísticamente significativa (p<0.001), y no la frecuencia cardiaca (p=NS). Consideramos a nifedipino GITS como un medicamento eficaz y seguro, ya que posee un efecto antihipertensivo durante todo el periodo de 24 horas del día, disminuyendo la carga total hipertensiva y conservando el ritmo circardiano de la presión arterial.