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Garambullo is a plant with little industrial application. However, garambullo contains betalains, photosensitive phytochemical compounds, which through microencapsulation can be used in chitosan-polyvinyl alcohol (PVOH) films for application in tomato coatings. These biopackages were characterized by physical tests, water vapor permeability, puncture tests, extension, color, differential scanning calorimetry (DCS), Fourier transform infrared (FTIR) spectroscopy, and antioxidant and antimicrobial activity analyses. The influence of the biopackages on the tomato coatings was measured using parameters such as minimum weight loss close to 2% at day 9, pH of 4.6, Brix of 5.5, titratable acidity of 1 g acid/100 mL sample, and shelf life of up to 18 days. The biopackages containing betalain microcapsules had a water vapor permeability of 2 × 10-14 g/h·m·Pa and an elongation of 5 ± 0.5%, indicating that the package did not stretch. The deformation at the breaking point for the package without and with microcapsules was 0.569 and 1.620, respectively. With respect to color, adding white microcapsules and betalains can cause the material to darken, resulting in a yellowish color. Furthermore, the phenolic content was greater for the biopackages with betalains, while there was no significant difference in the antioxidant activity since the active compounds were not released. According to the in vitro results, the inhibition of B. cinerea was achieved on the eighth day when the active compounds were released from the microcapsules. The tomato with betalains lost 2% of its weight, and B. cinerea was inhibited, extending its shelf life to 18 days. The proposed biopackages have good properties as biopolymers and inhibit the presence of B. cinerea.
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El reposicionamiento labial es un procedimiento quirúrgico mínimamente invasivo que se utiliza para tratar una sonrisa gingival, la cual, es una afección en la que una cantidad significativa de la encía queda expuesta cuando una persona sonríe y puede deberse a una variedad de factores, como un exceso de tejido gingival, un labio superior corto o músculos hiperactivos del labio superior, entre otros. El alargamiento clínico de la corona, por otro lado, consiste en eliminar el exceso de tejido gingival y, si es necesario, el tejido óseo para exponer una mayor parte de la corona natural del diente. Se reporta un caso clínico de paciente femenino de 31 años que presentó una sonrisa gingival provocada por hipermovilidad de labio superior y un exceso de tejido gingival localizado. El plan de tratamiento involucró una combinación de reposicionamiento labial y alargamiento de corona. Los resultados estéticos fueron significativos, con la sonrisa del paciente más equilibrada y proporcionada. Se redujo la cantidad de tejido gingival expuesto cuando la paciente sonreía y la longitud de los dientes fue más visible, lo que dio como resultado una sonrisa de aspecto más natural, además de aumentar su aceptación al sonreír.
SUMMARY: Lip repositioning is a minimally invasive surgical procedure used to treat a gummy smile, which is a condition in which a significant amount of the gum is exposed when a person smiles and may be due to a variety of factors, such as excess gum tissue, a short upper lip or overactive muscles of the upper lip, among others. Clinical crown lengthening, on the other hand, involves removing excess gingival tissue and, if necessary, bone tissue to expose more of the natural crown of the tooth. Clinical case: A clinical case of a 31-year-old female patient who presented a gummy smile caused by hypermobility of the upper lip and an excess of localized gingival tissue is reported. The treatment plan involved a combination of lip repositioning and crown lengthening. The aesthetic results were significant, with the patient's smile more balanced and displayed. The amount of the patient's exposed gum tissue when smiled was reduced and the length of the teeth was more visible, resulting in a more natural-looking smile, as well as increasing their acceptance of smiling.
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Isolated right ventricular myocardial infarction is an extremely rare condition, and its diagnosis may be challenging. We present the case of a 63-year-old man who arrived at the emergency department with chest pain; electrocardiogram showed ST-segment elevation in precordial leads, for which, the diagnosis of anterior ST-elevation myocardial infarction was initially made. Coronary angiography showed diffuse coronary artery ectasia and total thrombotic occlusion of the right coronary artery that was treated by angioplasty and stenting, resulting in resolution of the chest pain and ST-segment elevation. Echocardiogram showed right ventricular systolic dysfunction and cardiac magnetic resonance confirmed the diagnosis of isolated right ventricular myocardial infarction. We highlight the value of invasive and non-invasive tests to diagnose this rare condition.
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Abstract Objective: Women with ST-segment elevation myocardial infarction (STEMI) have worst outcomes than men. The objective of the study was to determine gender differences in mortality in patients with STEMI. Methods: Cohort study including patients with STEMI. We recorded demographic and clinical data, laboratory tests, and in-hospital mortality in patients who underwent primary angioplasty and pharmacoinvasive strategy. Kaplan-Meier analysis was used to assess mortality differences between both genders. Results: A total of 340 patients were analyzed, 296 males and 44 females. Mean age of the female group was 64.3 ± 12.3 years. About 98% of females were among Killip-Kimball Class I-II. They had higher risk scores compared to man, longer ischemic time and first medical contact with a difference in comparison to man of 47 and 60 min, respectively. Mortality was 9.1% (4) in the female group. Conclusions: Although the proportion of women had higher mortality than man, we did not found any difference with statistical significance probably due to the lack of representation. We need more awareness in the female population about STEMI, since longer first medical contact time and longer total ischemic time might be one possible explanation of a higher mortality.
Resumen Objetivo: Las mujeres con infarto agudo al miocardio con elevación del segmento ST (SICA CEST) tienen peor pronóstico que los hombres. El objetivo fue determinar las diferencias de mortalidad en género en pacientes con SICA CEST. Metodos: Estudio de cohorte de pacientes con SICA CEST. Se recolectaron datos demográficos, clínicos, de laboratorio y mortalidad intrahospitalaria. Se realizó un análisis de Kaplan-Meier para valorar la mortalidad y determinar diferencias de género. Resultados: Se analizaron 340 pacientes, 296 hombres y 44 mujeres. Se observó que las mujeres tuvieron mayores puntajes en los scores de riesgo, mayor tiempo de primer contacto y tiempo total de isquemia encontrando una diferencia con el grupo de hombres de 47 y 60 minutos respectivamente. La mortalidad intrahospitalaria fue de 9.1% (4) sin diferencia estadísticamente significativa en comparación con los hombres. Conclusiones: Aunque la proporción de mujeres tuvo mayor mortalidad no se encontró diferencia estadísticamente significativa en comparación con los hombres probablemente por el tamaño de la muestra debido a baja representación del grupo femenino. Se necesita mayor conciencia en relación al infarto en el grupo de mujeres, ya que mayor tiempo de primer contacto y mayor tiempo total de isquemia pueden ser una posible explicación de una mayor mortalidad.
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BACKGROUND: Women with ST-segment elevation myocardial infarction (STEMI) have worst outcomes than men. OBJECTIVE: The objective of the study was to determine gender differences in mortality in patients with STEMI. METHODS: Cohort study including patients with STEMI. We recorded demographic and clinical data, laboratory tests, and in-hospital mortality in patients who underwent primary angioplasty and pharmacoinvasive strategy. Kaplan-Meier analysis was used to assess mortality differences between both genders. RESULTS: A total of 340 patients were analyzed, 296 males and 44 females. Mean age of the female group was 64.3 ± 12.3 years. About 98% of females were among Killip-Kimball Class I-II. They had higher risk scores compared to man, longer ischemic time and first medical contact with a difference in comparison to man of 47 and 60 min, respectively. Mortality was 9.1% (4) in the female group. CONCLUSIONS: Although the proportion of women had higher mortality than man, we did not found any difference with statistical significance probably due to the lack of representation. We need more awareness in the female population about STEMI, since longer first medical contact time and longer total ischemic time might be one possible explanation of a higher mortality.
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Objective: The objective of PHASE-MX registry is to validate the efficacy and safety of the pharmacoinvasive strategy in comparison with percutaneous coronary intervention (PCI) in patients with acute myocardial infarction with ST segment elevation (STEMI) in a metropolitan region of Mexico. The primary outcome will consist of the composite of cardiovascular death, re-infarction, stroke and cardiogenic shock. Methods: The PHASE-MX registry will include a prospective cohort of patients with STEMI who received reperfusion treatment (mechanical of pharmacological) in the first 12 h after the onset of symptoms. The registry is designed to compare the efficacy and safety of primary PCI and pharmacoinvasive strategy. The simple size was calculated in 344 patients divided into two groups, with an estimated loss rate of 10%. Patients included in the PHASE-MX cohort will be followed for up to one year. Conclusion: In Mexico, only 5 out of 10 patients with STEMI have access to reperfusion therapy. Pharmacoinvasive strategy is takes advantage of the accessibility of fibrinolysis and the effectiveness of PCI. The present research protocol aims to provide information that serves as a link between information derived from controlled clinical trials and records derived from real world experience.
Objetivo: El objetivo del registro PHASE-MX es validar la eficacia y seguridad de la estrategia farmacoinvasiva en comparación con la angioplastia coronaria transluminal percutánea primaria (ACTPp) en pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMCEST) en una región metropolitana de México. El desenlace primario es el compuesto de muerte cardiovascular, reinfarto, accidente vascular cerebral y choque cardiogénico. Métodos: El registro PHASE-MX es una cohorte prospectiva de pacientes con IAMCEST que recibieron tratamiento de reperfusión (mecánico o farmacológico) en las primeras 12 horas desde el inicio de los síntomas, atendidos en el Instituto Nacional de Cardiología Ignacio Chávez. El análisis estadístico se basa en la no inferioridad de la estrategia farmacoinvasiva en comparación con la ACTPp. Se calcula un tamaño de muestra de 344 pacientes divididos en dos grupos (angioplastia primaria y estrategia farmacoinvasiva), considerada una tasa de pérdidas de 10%. Los pacientes incluidos en la cohorte PHASE-MX se seguirán durante un año. Discusión: En México, sólo 5 de cada 10 pacientes con IAMCEST tienen acceso al tratamiento de reperfusión. La estrategia farmacoinvasiva aprovecha la accesibilidad de la fibrinólisis y la efectividad de la ACTPp, por lo que podría resultar el método de elección en el tratamiento del IAMCEST en la mayoría de los casos. El presente protocolo de investigación pretende aportar información que sirva como enlace entre la información derivada de los estudios clínicos controlados y los registros derivados de la experiencia del mundo real.
Assuntos
Intervenção Coronária Percutânea/métodos , Reperfusão/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , México , Intervenção Coronária Percutânea/efeitos adversos , Estudos Prospectivos , Sistema de Registros , Projetos de Pesquisa , Choque Cardiogênico/epidemiologia , Acidente Vascular Cerebral/epidemiologiaRESUMO
Abstract Objective: The objective of PHASE-MX registry is to validate the efficacy and safety of the pharmacoinvasive strategy in comparison with percutaneous coronary intervention (PCI) in patients with acute myocardial infarction with ST segment elevation (STEMI) in a metropolitan region of Mexico. The primary outcome will consist of the composite of cardiovascular death, re-infarction, stroke and cardiogenic shock. Methods: The PHASE-MX registry will include a prospective cohort of patients with STEMI who received reperfusion treatment (mechanical of pharmacological) in the first 12 h after the onset of symptoms. The registry is designed to compare the efficacy and safety of primary PCI and pharmacoinvasive strategy. The simple size was calculated in 344 patients divided into two groups, with an estimated loss rate of 10%. Patients included in the PHASE-MX cohort will be followed for up to one year. Conclusion: In Mexico, only 5 out of 10 patients with STEMI have access to reperfusion therapy. Pharmacoinvasive strategy is takes advantage of the accessibility of fibrinolysis and the effectiveness of PCI. The present research protocol aims to provide information that serves as a link between information derived from controlled clinical trials and records derived from real world experience.
Resumen Objetivo: El objetivo del registro PHASE-MX es validar la eficacia y seguridad de la estrategia farmacoinvasiva en comparación con la angioplastia coronaria transluminal percutánea primaria (ACTPp) en pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMCEST) en una región metropolitana de México. El desenlace primario es el compuesto de muerte cardiovascular, reinfarto, accidente vascular cerebral y choque cardiogénico. Métodos: El registro PHASE-MX es una cohorte prospectiva de pacientes con IAMCEST que recibieron tratamiento de reperfusión (mecánico o farmacológico) en las primeras 12 horas desde el inicio de los síntomas, atendidos en el Instituto Nacional de Cardiología Ignacio Chávez. El análisis estadístico se basa en la no inferioridad de la estrategia farmacoinvasiva en comparación con la ACTPp. Se calcula un tamaño de muestra de 344 pacientes divididos en dos grupos (angioplastia primaria y estrategia farmacoinvasiva), considerada una tasa de pérdidas de 10%. Los pacientes incluidos en la cohorte PHASE-MX se seguirán durante un año. Discusión: En México, sólo 5 de cada 10 pacientes con IAMCEST tienen acceso al tratamiento de reperfusión. La estrategia farmacoinvasiva aprovecha la accesibilidad de la fibrinólisis y la efectividad de la ACTPp, por lo que podría resultar el método de elección en el tratamiento del IAMCEST en la mayoría de los casos. El presente protocolo de investigación pretende aportar información que sirva como enlace entre la información derivada de los estudios clínicos controlados y los registros derivados de la experiencia del mundo real.
Assuntos
Humanos , Masculino , Feminino , Reperfusão/métodos , Intervenção Coronária Percutânea/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Projetos de Pesquisa , Choque Cardiogênico/epidemiologia , Sistema de Registros , Estudos Prospectivos , Estudos de Coortes , Seguimentos , Acidente Vascular Cerebral/epidemiologia , Intervenção Coronária Percutânea/efeitos adversos , MéxicoRESUMO
Objective: The objective of PHASE-MX registry is to validate the efficacy and safety of the pharmacoinvasive strategy in comparison with percutaneous coronary intervention (PCI) in patients with acute myocardial infarction with ST segment elevation (STEMI) in a metropolitan region of Mexico. The primary outcome will consist of the composite of cardiovascular death, re-infarction, stroke and cardiogenic shock. Methods: The PHASE-MX registry will include a prospective cohort of patients with STEMI who received reperfusion treatment (mechanical of pharmacological) in the first 12 h after the onset of symptoms. The registry is designed to compare the efficacy and safety of primary PCI and pharmacoinvasive strategy. The simple size was calculated in 344 patients divided into two groups, with an estimated loss rate of 10%. Patients included in the PHASE-MX cohort will be followed for up to one year. Conclusion: In Mexico, only 5 out of 10 patients with STEMI have access to reperfusion therapy. Pharmacoinvasive strategy is takes advantage of the accessibility of fibrinolysis and the effectiveness of PCI. The present research protocol aims to provide information that serves as a link between information derived from controlled clinical trials and records derived from real world experience.
Objetivo: El objetivo del registro PHASE-MX es validar la eficacia y seguridad de la estrategia farmacoinvasiva en comparación con la angioplastia coronaria transluminal percutánea primaria (ACTPp) en pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMCEST) en una región metropolitana de México. El desenlace primario es el compuesto de muerte cardiovascular, reinfarto, accidente vascular cerebral y choque cardiogénico. Métodos: El registro PHASE-MX es una cohorte prospectiva de pacientes con IAMCEST que recibieron tratamiento de reperfusión (mecánico o farmacológico) en las primeras 12 horas desde el inicio de los síntomas, atendidos en el Instituto Nacional de Cardiología Ignacio Chávez. El análisis estadístico se basa en la no inferioridad de la estrategia farmacoinvasiva en comparación con la ACTPp. Se calcula un tamaño de muestra de 344 pacientes divididos en dos grupos (angioplastia primaria y estrategia farmacoinvasiva), considerada una tasa de pérdidas de 10%. Los pacientes incluidos en la cohorte PHASE-MX se seguirán durante un año. Discusión: En México, sólo 5 de cada 10 pacientes con IAMCEST tienen acceso al tratamiento de reperfusión. La estrategia farmacoinvasiva aprovecha la accesibilidad de la fibrinólisis y la efectividad de la ACTPp, por lo que podría resultar el método de elección en el tratamiento del IAMCEST en la mayoría de los casos. El presente protocolo de investigación pretende aportar información que sirva como enlace entre la información derivada de los estudios clínicos controlados y los registros derivados de la experiencia del mundo real.
Assuntos
Intervenção Coronária Percutânea/métodos , Reperfusão/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Estudos de Coortes , Seguimentos , Humanos , México , Intervenção Coronária Percutânea/efeitos adversos , Estudos Prospectivos , Sistema de Registros , Reperfusão/efeitos adversos , Choque Cardiogênico/etiologia , Acidente Vascular Cerebral/etiologiaRESUMO
RESUMEN Fundamento: la estomatitis subprótesis lleva a los pacientes portadores de prótesis a acudir a una consulta estomatológica frecuentemente. El manejo de estos por el personal de salud, a veces, no es adecuado, pues no se evalúan todos los factores de riesgo que predisponen a la enfermedad. Objetivo: describir factores de riesgo que pueden incidir en la aparición de estomatitis subprótesis. Métodos: estudio descriptivo de corte transversal realizado en el Departamento de Estomatología del Policlínico Área VI, de Cienfuegos, desde enero de 2015 a diciembre de 2016, que incluyó 59 pacientes portadores de estomatitis subprótesis. Para determinar el grado de lesión se realizó una observación de la cavidad bucal. Se analizaron las variables: edad, sexo, grado de la lesión, tipo de base de la prótesis, localización de la lesión, así como factores de riesgo para la aparición de la enfermedad. Resultados: a medida que avanzó la edad, existió mayor incidencia de la enfermedad, el sexo femenino fue el más afectado, con predominio del grado I. La mayoría de los pacientes mantenía un uso continuo de la prótesis y los más afectados fueron aquellos que portaban prótesis con base acrílica. La mayor cantidad de lesiones se localizaron en la zona media. La deficiente higiene bucal, protésica y el uso continuo de la prótesis, jugaron un papel fundamental en la aparición de la enfermedad. Conclusiones: la deficiente higiene bucal y de la prótesis, el uso continuo de la aparatología, así como la presencia de prótesis desajustadas, constituyeron los principales factores de riesgo que predisponían a la aparición y empeoramiento de la estomatitis subprótesis.
ABSTRACT Foundation: sub-prosthesis stomatitis leads patients with prostheses to attend a dental consultation frequently. Their management by the health personnel, sometimes, is not adequate, since not all the risk factors that predispose to the disease are evaluated. Objective: to describe risk factors that can affect the appearance of subprosthesis stomatitis. Methods: descriptive cross-sectional study conducted in the Dentistry Department of Area VI Polyclinic, Cienfuegos, from January 2015 to December 2016, which included 59 patients with stomatitis sub-prostheses. To determine the degree of injury, an observation of the oral cavity was made. The variables were analyzed: age, sex, degree of the lesion, type of base of the prosthesis, location of the lesion, as well as risk factors for the onset of the disease. Results: as age progressed, there was a higher incidence of the disease; the female sex was the most affected, with predominance of grade I. Most patients maintained a continuous use of the prosthesis and the most affected were those who carried prosthesis with acrylic base. The greatest number of lesions was located in the middle zone. Deficient oral hygiene, prosthetic and continuous use of the prosthesis, played a fundamental role in the onset of the disease. Conclusions: poor oral and prosthetic hygiene continuous use of the appliance, as well as the presence of unbalanced prostheses, constituted the main risk factors which predisposed to the appearance and worsening of the sub-prosthesis stomatitis.
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Childhood obesity is associated with a number of metabolic abnormalities leading to increased cardiovascular risk. Metabolites can be useful as early biomarkers and new targets to promote early intervention beginning in school age. Thus, we aimed to identify metabolomic profiles associated with obesity and obesity-related metabolic traits. We used data from the Obesity Research Study for Mexican children (ORSMEC) in Mexico City and included a case control (n = 1120), cross-sectional (n = 554) and a longitudinal study (n = 301) of 6-12-year-old children. Forty-two metabolites were measured using electrospray MS/MS and multivariate regression models were used to test associations of metabolomic profiles with anthropometric, clinical and biochemical parameters. Principal component analysis showed a serum amino acid signature composed of arginine, leucine/isoleucine, phenylalanine, tyrosine, valine and proline significantly associated with obesity (OR = 1.57; 95%CI 1.45-1.69, P = 3.84 × 10-31) and serum triglycerides (TG) (ß = 0.067, P = 4.5 × 10-21). These associations were validated in the cross-sectional study (P < 0.0001). In the longitudinal cohort, the amino acid signature was associated with serum TG and with the risk of hypertriglyceridemia after 2 years (OR = 1.19; 95%CI 1.03-1.39, P = 0.016). This study shows that an amino acid signature significantly associated with childhood obesity, is an independent risk factor of future hypertriglyceridemia in children.
Assuntos
Aminoácidos/metabolismo , Biomarcadores/metabolismo , Hipertrigliceridemia/diagnóstico , Metaboloma , Obesidade Infantil/complicações , Aminoácidos/análise , Antropometria , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Humanos , Hipertrigliceridemia/epidemiologia , Hipertrigliceridemia/etiologia , Hipertrigliceridemia/metabolismo , Estudos Longitudinais , Masculino , México/epidemiologia , Fatores de RiscoRESUMO
La retinitis es la manifestación más común de la infección por CMV en inmunocomprometidos. Es una infección oportunista representando el 90% de las retinitis infecciosas, y la principal causa de ceguera en este grupo de pacientes. La retinitis por Citomegalovirus (CMV) puede desarrollarse en pacientes no HIV con deterioro de la inmunidad secundario a medicación inmunodepresora o enfermedades malignas que originen por ser estados de inmunodepresión. Se presentan dos estudios de casos. A continuación una síntesis de la evidencia que incluye información del diagnóstico, tratamiento tanto con Ganciclovir, como con Foscarnet.
Retinitis is the most common manifestation of CMV infection in immunocompromised patients. It is an opportunistic infection that accounts for 90% of infectious retinitis andthe main cause of blindness in this group of patients. Cytomegalovirus (CMV) retinitis can develop in non-HIV patients with impaired immunity due to immunosuppressive medication or malignant disease resulting from the status of immunosuppression. Two case studies are presented. Below, there is a synthesis of the evidence, including information on the diagnosis and treatment with both Ganciclovir and Foscarnet.