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BACKGROUND: The single nucleotide polymorphisms in the TLR4 gene can decrease or increase the response to lipopolysaccharide, increasing the susceptibility to inflammatory diseases, affecting the expression or receptor function by inducing a low-grade chronic inflammatory response. PURPOSE: The objective of this study was to evaluate the association of SNPs - 2570 A > G (rs2737190), - 2081 G > A (rs10983755), 896 A > G (rs 4986790), and 1196 C > T (rs4986791) of the TLR4 gene with obesity and metabolic alterations in the young population. RESULTS: In this study, it was found that the carriers of the heterozygous genotype of the SNPs - 2081 G > A, 896 A > G, and 1196 C > T confer a higher risk of developing obesity (OR = 3.73, p = 0.018; OR = 5.66, p = 0.014, and OR = 8.95, p = 0.014, respectively). Also, with the lipid profile, the SNP - 2081 G > A was associated with total cholesterol (TC) ≥ 200 mg/dL (OR = 3.91, p = 0.020) and Kannel index > 3% (OR = 4.00, p = 0.008). The SNP 896 A > G was associated with LDL-c ≥ 100 mg/dL (OR = 3.64, p = 0.040) and Kannel index > 3% (OR = 4.33, p = 0.016), and the SNP 1196 C > T was associated with TC ≥ 200 mg/dL (OR = 4.37, p = 0.048), Castelli index > 4.5/> 5% (OR = 5.33, p = 0.016), and Kannel index > 3% (OR = 16.00, p = 0.001). Finally, the AGGT haplotype was associated with Castelli index > 4.5/> 5% (OR = 5.40, p = 0.015) and Kannel index > 3% (OR = 10.46, p < 0.001), and the AAAC haplotype was associated with obesity (OR = 3.56, p = 0.020), TC ≥ 200 mg/dL (OR = 4.04, p = 0.007), LDL-c ≥ 100 mg/dL (OR = 2.98, p = 0.030) and Kannel index > 3% (OR = 4.20, p = 0.002). CONCLUSION: The heterozygous genotype of the SNPs - 2081 G > A, 896 A > G and 1196 C > T of the TLR4 gene was associated with altered lipid profile and development of obesity in young university students of Guerrero State, Mexico.

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UNLABELLED: Prenatal diagnosis of fetal ovarian cyst, spontaneously resolved in the postnatal period. INTRODUCTION: Fetal ovarian cysts are an unusual entity, which is generally discovered during an ultrasonographic fetal examination. The objective of this report is to present a clinical case of a female fetus with an ovarian cysts which was diagnose by an ultrasound (US) at 36.5 week gestation which was spontaneously resolved in the postnatal period. CLINICAL CASE: A 22 year old woman to whom an US was performed to evaluate the gestational age due to the fact that she was to be programmed for a cesarean due to vulvovaginal condyloma. The US reported a 36.5 week gestation, the fetus was female and a cyst of 50 x 44 mm diameter was found in the fetal pelvis, lateral to the bladder. The child was born two weeks later by cesarean section and without complications. The control pelvic US at one month of age showed that the cysts was 54 x 45 mm in diameter. It was decided and wait to see what would happen. At five months of age the pelvic US showed the absence of the cyst. CONCLUSION: The diagnosis of the fetal ovarian cysts was based on three ultrasonographic criteria: 1. presence of a cystic structure of regular size which is located in the lower and lateral side of the abdomen, 2. integrity of urinary and gastrointestinal tracts, and 3. female sex of the fetus. The treatment depends on the size of the cyst and the ultrasonographic images of torsion and hemorrhage.

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OBJECTIVE: Compare the effectiveness and safety of mebendazole versus nitazoxanide in the treatment of Giardia lamblia in children. Giardiasis is an intestinal protozoan of worldwide distribution which most frequently affects the infantile population. In Mexico we have, found a frequency of three to sixty percent. We have, used different medications in it's treatment, but the experience with mebendazole and nitazoxanide is scarce. METHOD: An experimental study as a clinical assay. We included children from the ages of 4 to 12 years old, which had a positive Giardia lamblia cysts in their feces. The children were divided into to two groups: A, were a administered 100 mg of mebendazole every 12 hours, for three days; B, were administered 100 mg of nitazoxanide every 12 hours, for three days; A feces control study was performed at three, five and seven days post treatment. At the end of the treatment we asked the parents if the children had presented any adverse events during the administration of the medication. For the statistical analysis we used Student's t and Chi squared. RESULTS: We studied 82 children, 41 (50%) for each group. In group A, the control feces studies were negative 33 resulting in a 80.4% effectiveness; in group B, 32 were negative resulting in a 78.0% effectiveness, without being statistically significant with a p = 0.8. We found adverse, events in 9 (22%) of the children in group A and 16 (39%) in group B, there was, statistically significant difference with p = 0.09. However, we discovered that the children who received nitazoxanide suffered from abdominal pain more frequently. CONCLUSIONS: We can conclude that both mebendazole and nitazoxanide are efficient for use against infection due to Giardia lamblia, however, the secondary reactions with nitazoxanide were more frequent than with mebendazol.

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UNLABELLED: The adrenal myelolipoma are rare tumors that are generally asymptomatic, unilateral and nonfunctional and in the majority of the cases they are found incidentally. OBJECTIVE: Is to present a clinical case of adrenal myelolipoma, associated with gallstones. CASE REPORT: A 30 year old obese female with chronic abdominal pain, which underwent a GI series, having found a hiatal hernia and esophagitis. An ultrasound, of the gallbladder and bile ducts showed gallstones and incidentally a tumor of 9.3 x 8 x 7 cm was found between the right kidney and the liver. In the CT of the abdomen of observed, a little vascularized tumor of the adipose composition of 9.2 x 6 x 5 cm over the top of the right kidney. A cholecystectomy was performed and the resection of the tumor, histopathological study of the tumor reported normal adrenal tissues, mature adiposis and hematopoietic with all of its series. CONCLUSIONS: The association of adrenal myelolipoma and gallstones is not common and it could be an incidental association. With the new tools available we can diagnose the adrenal myelolipoma with a greater degree of certainty.

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In Latin America and the Caribbean, adolescents-persons between the ages of 10 and 19- now comprise 21 percent of the total population, or more than 100 million individuals. And while mortality rates among those adolescents are low in comparison with other age groups, there is much that can and should be done to lower death rates and improve health among these young people. Among adolescents in Latin America and the Caribbean, more deaths result from external causes-including accidents, homicides, and suicides- than from infectious diseases, circulatory diseases, and cancer combined. Vehicular deaths are the most common cause of accidental death, and the number has risen as the use of motor vehicles has become more common. Violence is also a growing problem. In the Region of the Americas, more than a quarter of the deaths due to homicide occur among adolescents. Many young people must also deal with forms of violence, including neglect and sexual and emotional abuse. Other adolescent health problems come from the use of alcohol, drugs, and tobacco, as well as poor nutrition and lack of physical activity. High levels of early and unprotected sexual activity lead to infection with HIV and other sexually transmitted diseases, unintended pregnancies, and early motherhood. Worsening that situation are the difficulties that adolescents have in accessing reproductive health services in many countries of Latin America and the Caribbean (AU)

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Bilateral kidney agenesias (Potter syndrome) in a newborn of a hyperthyroid woman receiving methimazole during early pregnancy. This is a clinical case of a hyperthyroid woman that received methimazole during early pregnancy who gave birth to a girl with bilateral kidney agenesis. The initial clinical data was the presence of oligohydramnios detected by an ultrasound (US) at 19 gestational weeks. Another US at the term of the gestation showed anhydramnios, absence of renal silhouettes and bladder, which was corroborated when the girl was born. She died two days after she was born. Sufficient evidence exists that the methimazole administered during the early pregnancy can cause diverse congenital malformations including Potter's syndrome.

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We present one case of a 23 week old fetus that was diagnosed with osteogenesis imperfecta type II via ultrasound, The principal ultrasonographic findings were; lack of mineralization in the calvaria, short, wide, and angulated femurs, with the presence of fractures, the length corresponds to a 17.5 week old gestation, more than two standard deviations below the mean for gestational age. The rest of the long bones show fractures and poor mineralization that was suggested by reduced acoustic shadowing. An elective cesarean was programmed at 39.4 weeks of gestation. The osseous lesions were confirmed postnatally by means of a conventional radiographs.

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We present two patients with congenital femoral absence, in six year period, in two hospitals of Minatitlán, Veracruz, Mexico. The first case is a six-year-old male. He begin to walk at four year old. The second case is a twelve-month female, who the walk is not started. Furthermore, she have another muscle-skeletal malformations. None of the have received surgical treatment. We give information about of several classifications of femoral congenital malformations.

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A comprehensive education strategy is presented that links training, community education, research, and mass-media efforts to enhance breastfeeding practices. Breastfeeding promotion models, an administrative system, and lessons learned during the project are described. The keys to effective breastfeeding promotion are shown to be accurate information; appropriate education, training, and follow-up; and a supportive administrative system.

PIP: An operations research project designed to determine what model of intervention was most successful in promoting breast feeding among 585 urban women in Mexico began in 1986. The interventions involved having trained promoters teach and counsel breast feeding mothers in Irapuato, program supervisors teach groups of mothers in Chihuahua, and both trained promoters and program supervisors train individuals or groups in Cuauhtemoc. Jalapa served as the control site. The breast feeding prevalence rate in the 4 communities varied from 64.5%-81.3% prior to intervention with a mean in the target group of 74.9%. The mean climbed to 88.8% for this group after intervention. Further, the breast feeding prevalence rate for Jalapa fell from 65.9%-56%. In addition, 70% of the women in the experimental group exclusively breast fed their infants during the 1st month whereas only 63.3% in the control did. Subsequent months' breast feeding prevalence rates decreased o 13.7% and 14.7% (5 months) and 9.4% and 3.3% (6 months) in the experimental and control groups respectively. Informal support groups of breast feeding mothers formed unexpectedly as a result of the educational and outreach activities. The data showed that the intervention model using the promoters was the most successful strategy. They also provided the researchers and other health care professionals interested in promoting community based breast feeding programs with guidelines. For example, supervisors should not discourage promoters from addressing other community needs since discouraging them can jeopardize their dedication to breast feeding promotion. Further, program planners should gather geographic and sociodemographic data of the area and population prior to planning and intervention.

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PIP: An experimental breastfeeding promotion project was started in Mexico in December 1986 by FEMAP, a Mexican federation of private, non-profit neighborhood health programs, in collaboration with the Georgetown University Institute for International Studies in Family Planning. The project has conducted promotion activities in 3 communities. In 1 community, activities focus on individual teaching and counseling of mothers about breastfeeding. In a 2nd community, mothers are taught in groups. A 3rd receives both individual and group counseling. A 4th community has been selected as a control site for research purposes. So far, supervisory and monitoring systems have been set up, and promotional activities begun. The next phase of the project will emphasize data collection and analysis. Research assistants have been trained in data collection, interviewing techniques, and reporting requirements. Coordinators and supervisors have received teacher training and information about lactation management. Supervisors train local "promoters," women from each community who teach breastfeeding practices on a voluntary basis. Participants have helped to develop a reference manual for supervisors and coordinators. So far, the communities have been responding positively to the program. Experience so far suggests that other groups developing breastfeeding promotional activities should: 1) take the time to properly select and train research assistants and promoters, and provide them with follow-up support; 2) make sure that staff are familiar with local culture and aware of local socio-demographic factors; 3) test research and educational materials in the local community before using them broadly; 4) remain open-minded, flexible, and adaptable to local community needs.^ieng

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Se estudia la prevalencia de lepra correspondiente a nueve areas de salud de Ciudad de La Habana. Del estudio de 139 pacientes se detectan 25 familias con mas de un enfermo en su nucleo y se relacionan con la incidencia de la enfermedad en esas areas de salud en los anos 1977-1980 sobre la base del chequeo periodico de convivientes de 1ro. y 2do. orden, logrando esto que fuera conocida la fuente de infeccion en un porcentaje alto de los casos de incidencia

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