Percepción y Realidad del Secuestro en Nuevo León: Una Visión Multidisciplinaria en el Diagnóstico de Rutas, Perfiles y Zonas Detectadas Para su Prevención y Tratamiento

Durante el año 2012, un total de 18 académicos y profesionales procedentes de distintas disciplinas y apoyados por la UANL, Waldos y Asociados, la Procuraduría General de Justicia del Gobierno de Nuevo León y el Instituto Dipev, trabajaron específicamente en diversas técnicas metodológicas para analizar el fenómeno del secuestro en la entidad

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Prevalencia de trastornos temporomandibulares en un grupo de adultos mayores mexicanos

Aim: To determine frequency and distribution of temporomandibular disorders (TMD) by age and sex in a group of elderly adults in Mexico City.  Material and methods: One hundred and fifty-four older adults in Mexico City were examined in a cross-sectional study. Subjects who had big edentulous gaps (absence of two or more teeth) or those who were fully edentulous, as well as those who refused to participate, were excluded from the study.  For the epidemiological survey, diagnostic criteria for Temporomandibular Disorders (DC/TMD), after standardization by a dentist (kappa=0.892), were considered. Results. A 33.1% had some type of TMD, being more common in people between 60 and 69 years old, variable with which it was related (Likelihood Ratio=21.553, p=0.006, X2MH=08.389, p=0.021). A 14.3% reported some type of facial trauma history, behavior that also was statistically significant (X2MH=13.566, p= 0.0001). Disorders that occurred most frequently were: disc displacement with reduction (62.8%) and disc displacement without reduction (9.8%). Conclusions. TMD occurred in one of every three subjects surveyed, showing a relationship with age and trauma history.Objetivo. Determinar la frecuencia y distribución de los trastornos temporomandibulares (TTM) por edad y sexo en un grupo de adultos mayores de la Ciudad de México. Material y métodos. Estudio de corte transversal. Se examinaron 154 adultos mayores de la Ciudad de México. Fueron excluidos del estudio a todos aquellos que presentaron brechas edéntulas amplias (ausencia de dos ó más dientes) o edentulismo total, así como aquellos que no aceptaron participar en el estudio. Para la encuesta epidemiológica se tomaron en cuenta los Criterios Diagnósticos de los Trastornos Temporomandibulares (CD/TTM), previa estandarización de una Cirujana Dentista (kappa=0.892). Resultados. El 33.1% presentó algún tipo de TTM, siendo más frecuente en personas entre 60 y 69 años variable con la cual estuvo relacionada (Razón de verosimilitud=21.553, p=0.006, X2MH=08.389, p=0.021). El 14.3% refirió algún tipo de antecedente traumático facial, comportamiento que también resultó ser estadísticamente significativo (X2MH=13.566, p=0.0001). Los trastornos que se presentaron con mayor frecuencia fueron: el desplazamiento del disco con reducción (62.8%) y el desplazamiento del disco sin reducción (9.8%). Conclusiones. Los TTM se presentaron en uno de cada tres adultos mayores examinados, existiendo una relación con la edad y los antecedentes traumáticos

Prevalence of temporomandibular joint disorders in a Mexican elderly group

Aim: To determine frequency and distribution of temporomandibular disorders (TMD) by age and sex in a group of elderly adults in Mexico City.  Material and methods: One hundred and fifty-four older adults in Mexico City were examined in a cross-sectional study. Subjects who had big edentulous gaps (absence of two or more teeth) or those who were fully edentulous, as well as those who refused to participate, were excluded from the study.  For the epidemiological survey, diagnostic criteria for Temporomandibular Disorders (DC/TMD), after standardization by a dentist (kappa=0.892), were considered. Results. A 33.1% had some type of TMD, being more common in people between 60 and 69 years old, variable with which it was related (Likelihood Ratio=21.553, p=0.006, X2MH=08.389, p=0.021). A 14.3% reported some type of facial trauma history, behavior that also was statistically significant (X2MH=13.566, p= 0.0001). Disorders that occurred most frequently were: disc displacement with reduction (62.8%) and disc displacement without reduction (9.8%). Conclusions. TMD occurred in one of every three subjects surveyed, showing a relationship with age and trauma history.Objetivo. Determinar la frecuencia y distribución de los trastornos temporomandibulares (TTM) por edad y sexo en un grupo de adultos mayores de la Ciudad de México. Material y métodos. Estudio de corte transversal. Se examinaron 154 adultos mayores de la Ciudad de México. Fueron excluidos del estudio a todos aquellos que presentaron brechas edéntulas amplias (ausencia de dos ó más dientes) o edentulismo total, así como aquellos que no aceptaron participar en el estudio. Para la encuesta epidemiológica se tomaron en cuenta los Criterios Diagnósticos de los Trastornos Temporomandibulares (CD/TTM), previa estandarización de una Cirujana Dentista (kappa=0.892). Resultados. El 33.1% presentó algún tipo de TTM, siendo más frecuente en personas entre 60 y 69 años variable con la cual estuvo relacionada (Razón de verosimilitud=21.553, p=0.006, X2MH=08.389, p=0.021). El 14.3% refirió algún tipo de antecedente traumático facial, comportamiento que también resultó ser estadísticamente significativo (X2MH=13.566, p=0.0001). Los trastornos que se presentaron con mayor frecuencia fueron: el desplazamiento del disco con reducción (62.8%) y el desplazamiento del disco sin reducción (9.8%). Conclusiones. Los TTM se presentaron en uno de cada tres adultos mayores examinados, existiendo una relación con la edad y los antecedentes traumáticos

Modulation of the immune microenvironment of high-risk ductal carcinoma in situ by intralesional pembrolizumab injection.

Ductal carcinoma in situ (DCIS) is a risk factor for the subsequent development of invasive breast cancer. High-risk features include age &lt;45 years, size &gt;5 cm, high-grade, palpable mass, hormone receptor negativity, and HER2 positivity. We have previously shown that immune infiltrates are positively associated with these high-risk features, suggesting that manipulating the immune microenvironment in high-risk DCIS could potentially alter disease progression. Patients with high-risk DCIS were enrolled in this 3 × 3 phase 1 dose-escalation pilot study of 2, 4, and 8 mg intralesional injections of the PD-1 immune checkpoint inhibitor, pembrolizumab. Study participants received two intralesional injections, three weeks apart, prior to surgery. Tissue from pre-treatment biopsies and post-treatment surgical resections was analyzed using multiplex immunofluorescence (mIF) staining for various immune cell populations. The intralesional injections were easily administered and well-tolerated. mIF analyses demonstrated significant increases in total T cell and CD8+ T cell percentages in most patients after receiving pembrolizumab, even at the 2 mg dose. T cell expansion was confined primarily to the stroma rather than within DCIS-containing ducts. Neither cleaved caspase 3 (CC3) staining, a marker for apoptosis, nor DCIS volume (as measured by MRI) changed significantly following treatment. Intralesional injection of pembrolizumab is safe and feasible in patients with DCIS. Nearly all patients experienced robust total and CD8+ T cell responses. However, we did not observe evidence of cell death or tumor volume decrease by MRI, suggesting that additional strategies may be needed to elicit stronger anti-tumor immunity

Whistle repertoire and structure reflect ecotype distinction of pantropical spotted dolphins in the Eastern Tropical Pacific

Abstract The pantropical spotted dolphin in the Eastern Tropical Pacific (ETP) is found in two genetically and phenotypically diverged ecotypes, coastal and offshore. These habitats have distinct acoustic characteristics, which can lead to the evolution of distinct acoustic communication. Whistles are sounds widely used by dolphins to mediate species and individual recognition and social interactions. Here, we study the whistle acoustic structure and repertoire diversity of offshore and coastal pantropical spotted dolphins. Our results show that there is significantly more within- and across-group variation in whistle fundamental frequency between ecotypes than between offshore groups and between coastal groups. A Random Forest classification analysis performed with an accuracy of 83.99% and identified duration, peak and minimum frequency as the most informative variables for distinguishing between ecotypes. Overall, coastal spotted dolphins produced significantly shorter whistles that were significantly lower in frequency (peak, minimum and maximum, and start and end) than offshore dolphins. Ecotypes produced whistle repertoires that were similar in diversity, but different in contour composition, with the coastal ecotype producing more upsweep whistles than offshore dolphins. The results of this study suggest that acoustic adaptations to coastal and offshore environments could be important contributors to intraspecific variation of dolphin whistle repertoires

Bond Strength of Adhesive Systems to Calcium Silicate-Based Materials: A Systematic Review and Meta-Analysis of In Vitro Studies

Since the adhesion of resin composites to calcium silicate-based cement is considered challenging. Therefore, the best adhesion strategy should be indicated. This review aimed to assess the effect of different adhesive systems on the bond strength of resin composite to calcium silicate-based cement through a systematic review and meta-analysis. The subsequent PICOS framework used was: population, calcium silicate-based cement; intervention, use of self-etch adhesive systems; control, use of total-etch adhesive systems; outcome, bond strength; study design, in vitro studies. The literature search was conducted independently by two reviewers up to 18 February 2021. Electronic databases (PubMed, ISI Web of Science, SciELO, Scopus, and Embase) were searched for applicable articles. In vitro manuscripts studying the effect of adhesive systems on the bond strength of calcium silicate-based cement were considered. The meta-analyses were performed using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Bond strength comparisons were made considering the type of calcium silicate-based cement (Mineral Trioxide Aggregate (MTA), Biodentine&trade;, or TheraCal LC&reg;). A p-value &lt; 0.05 was considered statistically significant. A total of 7321 studies were retrieved in databases searched. After full-text evaluation, 37 eligible papers were assessed for qualitative analysis, leaving a total of 22 papers for the quantitative analysis. According to the meta-analysis, the bond strength values of resin composite materials to MTA and TheraCal LC&reg; cement were favored when a total-etch adhesive system was used (p &le; 0.02). On the other hand, the meta-analysis of the bond strength of resin-based materials to Biodentine&trade; calcium silicate-based cement was similar between both approaches (p = 0.12). The in vitro evidence suggests that the bond strength of resin-based materials to both MTA and TheraCal LC&reg; cement was preferred by using the total-etch adhesive strategy. However, when bonding to Biodentine&trade;, the use of self-etch or total-etch strategies displayed promising results. Given the lack of evidence related to the chemical interaction of self-etch adhesive materials with the bioceramics, if self-etch adhesives are used for bonding resin-based restorations to calcium silicate-based cement, a pretreatment with phosphoric acid could be recommended

. 24 (1990) abril-septiembre. Historias. Revista de la Dirección de Estudios Históricos

- Una revista, sesenta años después. Los Annales por María Teresa Solana. - Para una historia de la lectura Henri-Jean Martin. - Entre el soliloquio y el diálogo por Emilio Uranga. - San Rafael: Un pueblo y una empresa. Imágenes de su historia en el proceso de trabajo, 1890-1940 por Laura Espejel López. - La historiografía mexicana y lo contemporáneo por Hira de Gortari Rabiela. - Las apariciones de Cihuacóatl por Rodrigo Martínez. - La urbanización moderna del pueblo de Tiquicheo a fines de la época colonial por Marta Teran. - Raíz colonial de la tradición otomiana en la región. Guanajuato-Querétaro por Ana Maria Crespo y Beatriz Cervantes J. - Apoyo y antagonismo en torno al establecimiento del consulado de Veracruz por Matilde Souto Mantecon. - Comercio y Estado en el México colonial e independiente por Inés Herrera y Armando Alvarado. - La visión de los salvados. Los retablos de la revolución y la guerra cristera por Patricia Arias y Jorge Durand. - Una ventana a la ciudad. Bibliografía de orientación en la Puebla de los Angeles, siglos XIX y XX por Leticia Gamboa Ojeda y Carlos Contreras Cruz. - De la tradición a su leyenda por Antonio Saborit. - Ocharte, sucesor de Juan Pablos por Emma Rivas. - Asuntos de familia por Guillermo Turner. - Imágenes de la imagen por Julia Tuñón. – Crestomanía por José Mariano Leyva