Mexican Medical Students Protest During COVID-19 Pandemic

During February  2021, a protest was organized by Mexican medical students through social media. About 200 interns, social service physicians and physicians protested peacefully in front of the city hall of Monterrey, Nuevo Leon, the capital of Mexico's second largest metropolitan area. Due to the current contingency situation, it was requested to attend with face shield and masks. The reason for the protest was to raise their voice due to the precarious situation where social service physicians are sent to rural areas of the country in which they have all the obligations of workers but without belonging to the working class - lacking the the benefits of this same as a living wage or fair working hours. The protesters were in limbo between student and worker. The protest also demanded justice for the sensitive death of young doctors due to malpractice situations of the Mexican authorities. We believe that a total reform of the social service in medicine is necessary. It is the responsibility of the authorities to cover the rural areas with permanently trained doctors without depending on recently graduated doctors. It is always important to assert our fundamental rights, including the right to protest in a peaceful manner

Percepción de los estudiantes de Medicina hacia la enseñanza entre pares en una universidad de México

Introduction: peer teaching is common in universities and allows students to teach their peers from the early academic years. During the COVID-19 pandemic, medical students have had to learn through online classes, but peer teaching has helped them overcome these educational challenges. Objective: to describe the experiences and perceptions of Medicine students about the peer teaching model. Method: an observational, descriptive and cross-sectional study was carried out. A self-conducted survey was applied integrating sociodemographic variables and personal experiences. It was shared among the medical students and the model was evaluated, the number of 366 students between 1-12 semester of the Autonomous University of Nuevo León was found as the minimum necessary sample. Results: 258 (61 %) women were identified, it was considered by 334 (79 %) that the instructors taught in a good or excellent way, it was referred by 333 (78.7 %) that they had a good or excellent clarity of the explanations. In addition, 295 (69.7 %) stated that the instructors explained better than the teachers almost always or always and 359 (84.9 %) explained that they felt satisfied with the instructors. The best rated departments were radiology (72.3 %) rating it as good, pathology (69 %) and embryology (68.7 %). Conclusions: It was found that the students' perception of the peer teaching model is positive, that it can serve to complement the teaching of teachers and can be very useful in the current pandemic situation.Introducción: la enseñanza entre pares es común en universidades y permite a los estudiantes enseñar a sus compañeros desde los primeros años académicos. Durante la pandemia de COVID-19 los estudiantes de Medicina han tenido que aprender mediante clases online, pero la enseñanza entre iguales les ha ayudado a superar estos retos educativos.Objetivo: describir las experiencias y percepciones del alumnado de Medicina sobre el modelo de enseñanza entre pares.Método: se realizó un estudio observacional, descriptivo y transversal. Se aplicó una encuesta de realización propia integrando variables sociodemográficas y experiencias personales. Se compartió entre los estudiantes de Medicina y se evaluó el modelo, se encontró como muestra mínima necesaria la cantidad de 366 estudiantes entre 1-12 semestre de la Universidad Autónoma de Nuevo León.Resultados: se identificaron 258 (61 %) mujeres, se consideró por 334 (79 %) que los instructores enseñaban de una manera buena o excelente, se refirió por 333 (78,7%) que se tenía una claridad buena o excelente de las explicaciones. Además, 295 (69,7 %) nombró que los instructores explicaban mejor que los profesores casi siempre o siempre y 359 (84,9 %) explicó sentirse satisfechos con los instructores. Los departamentos mejor valorados fueron radiología (72,3 %) calificándola como buena, patología (69 %) y embriología (68,7%).Conclusiones: se encontró que la percepción de los estudiantes al modelo de enseñanza de pares es positiva, que puede servir para complementar la enseñanza de profesores y puede ser de gran utilidad ante la situación actual de pandemia

Medical Students’ Perception Towards the COVID-19 Pandemic in Mexico: Distance Learning, Assisting Hospitals, and Vaccination

Background: Mexico has been one of the most affected countries by the COVID-19 pandemic. Its health workers are playing a substantial role, but they are suffering from a high mortality rate, which highlights the need of vaccinating them before any other population. Medical interns have reduced their practices, some continue to assist clinical rotations without the protective equipment, and they are not being considered for vaccination. We wanted to determine the attitude of medical students and interns towards distance learning, assisting hospitals, and vaccination. Methods: We conducted a paired survey of a cohort of medical students who were evaluated twice, in June 2020 and in December 2020, using an online survey (32-online questions) to assess their perception of the pandemic. Results: We collected the response of 384 students in the summer period and 331 in the winter period; the majority were women from non-clinical semesters, and the median age of response was 21 years old (IQR 19 – 22). We found that the percentage of acceptance for vaccination was 95.6% in the summer and 93.7% in the winter, a remarkable acceptance in both periods. The percentage of students who manifested having someone close to them with symptoms suggestive of COVID-19 was 38.5% in the summer, showing an increase to 77.6% in the winter. Conclusion: We observed that medical students had a positive attitude towards vaccination and that the probable COVID-19 cases among them have increased in just a few months

Valor del índice de resistencia arterial medido por Doppler en la función del injerto renal a mediano y largo plazos

Objective: To evaluate the association between the value of the arterial resistance index (RI) measured by Doppler at the month after transplantation, and the loss of graft. Secondary outcomes of loss greater than or equal to 50% of renal function, eath with functioning graft, biopsy findings (inflammation, hyalinosis, rejection, interstitial fibrosis - tubular atrophy, IFTA) are reported. Methods: A cohort study of 66 patients, who underwent renal transplantation at San José Hospital of Bogotá between October 2007 and April 2011. The RI of the hilar artery was measured by Doppler ultrasound at the month post-transplant. Most patients had follow-up until the second year. We describe the cumulative incidence of renal graft loss, loss greater than or equal to 50% of the glomerular filtration rate. At the second year after transplantation, rejection, IFTA, hyalinosis and documented inflammation were reported in protocol biopsies. Association analysis was performed on the histological outcomes. Results: only 2 cases of renal graft loss were reported, belonging to the group with normal RI (3.8%). At 3 years of follow-up, 5 patients had lost more than 50% of GFR compared to baseline, 4 occurred in patients with RI <0.8, 2 of them (3.7%) ocurred in the first year and only one patient with RI> 0.8 ocurred at 3 years. The median GFR at 3 years of follow-up in both groups is greater than 60 ml / min. In the first year of follow-up 22 (47%) patients with normal RI had IFTA, and 7 (54%) with RI> 0.8 had IFTA. Hyalinosis was reported for 23% with RI> 0.8 and 25.5% with RI <0.8. Conclusion: the outcome of the grafts depends not only on RI, but also on factors such as cold ischemia, induction and maintenance immunosuppressive treatment, degree of incompatibility between donor and recipient. Histopathological changes such as IFTA, inflammation, hyalinosis, were observed in both groups, suggesting that there are other factors stronger than the RI, which correlates with the occurrence of these findings.Objetivo: evaluar la asociación entre el valor del índice de resistencia arterial (IR) medido por doppler al mes postrasplante y la pérdida de injerto. Se reportan los desenlaces secundarios de pérdida mayor o igual al 50% de la función renal, muerte con injerto funcionante, hallazgos de la biopsia (inflamación, hialinosis, rechazo, fibrosis intersticial - atrofia tubular, IFTA, por sus siglas en inglés). Métodos: se realizó un estudio de cohorte de 66 pacientes, que recibieron trasplante renal, del Hospital San José de Bogotá, entre octubre de 2007 y abril de 2011; se midió el IR de la arteria hilar por ecografía doppler al mes postrasplante. La mayoría de los pacientes fueron seguidos hasta el segundo año. Se describe la incidencia acumulada de pérdida del injerto renal, pérdida mayor o igual al 50% de la tasa filtración glomerular; al segundo año postrasplante se reporta el rechazo, IFTA, hialinosis e inflamación documentada en las biopsias de protocolo. Se realizó análisis de asociación en los desenlaces histológicos. Resultados: solo se reportaron 2 casos de pérdida del injerto renal, pertenecientes al grupo con IR normal (3.8%). A los 3 años de seguimiento 5 pacientes habían perdido más del 50% de la TFG respecto a la basal, 4 ocurrieron en los pacientes con IR <0.8, 2 de ellos (3.7%) fueron al primer año y solo un paciente con IR >0.8 a los 3 años. La mediana de la TFG a los 3 años de seguimiento en ambos grupos es mayor de 60 ml/ min. En el primer año de seguimiento 22 (47%) pacientes con IR normal presentaron IFTA y 7 (54%) con IR >0.8 presentaron IFTA; la hialinosis con un 23% para IR >0.8 y 25.5% para IR <0.8. Conclusión: los desenlaces de los injertos no solo dependen del IR, hay otros factores que pueden influir como es el tiempo de isquemia fría, esquema de tratamiento inmunosupresor de inducción y mantenimiento, grado de incompatibilidades entre donante, receptor. Cambios histopatológicos como IFTA, inflamación, hialinosis, se observaron en cualquiera de los 2 grupos, lo que sugiere que hay otros factores más fuertes que el IR, que se correlaciona con la aparición de estos hallazgos

Predictors of Cerebral Arteriovenous Malformation Mortality: A Single-center, Five-year Retrospective Study

Background: Arteriovenous Malformations (AVMs) are abnormalities in intracranial vessels between the arterial and venous systems. This study aimed to identify the predictors of mortality in patients that presented to our hospital with AVMs, ruptured or unruptured, and correlate them to those available in the literature. Methods: An analytical, observational, retrospective study was performed to review data of patients with cerebral AVMs in the University Hospital “Dr José Eleuterio González” from January 2016 to December 2020. Clinical files were reviewed based on AVMs diagnosis according to the  International Classification of Diseases 10th Revision, ICD-10. Variables were subjected to a univariate analysis and those found significant (p-value < 0.05) were subjected to a logistic regression. Results: A total of 80 patients were included in our study. Most of the participants were females (56.3%) and three were pregnant. The most common presenting symptom was holocranial headache (34 cases) occurring between the hours of 22:00 to 7:00. The most significant predictors of mortality were a total bleeding volume greater than 9.18 cm3 (p = 0.010), the presence of more than one symptom (p = 0.041), and a history of previous cerebral intraparenchymal hemorrhage (p = 0.014). Conclusion: Results demonstrated an important association between intracranial bleeding and mortality. Ultimately, more prospective studies are needed to determine predictor factors for mortality in AVMs patients

Congenital medulloblastoma presented in the neonatal period

Congenital medulloblastoma is a rare brain tumor that appears in less than 1% of pediatric patients. Congenital medulloblastoma has a poor prognosis and should be suspected in patients with clinical manifestations of hyporeactivity, slow suction reflexes, and the presence of hydrocephalus. Herein we present the case of a 12-day-old female newborn who developed non-communicative hydrocephalus, hyporeactivity, and hyporeflexia. Magnetic resonance imaging of her brain showed a heterogeneous and cystic mass on the posterior cranial fossa. A suboccipital craniotomy was performed. The histopathologic analysis reported a congenital medulloblastoma. She remained in hospital until her death at 112 days old. This is one of the first case reports with clinical-radiological and pathological documentation. Awareness of this diagnosis can allow prenatal intervention, rendering a better prognosis. This case report exemplifies the importance of good prenatal follow-up

Inclusión de la harina de caña proteica en la alimentación de alevines de tilapia roja (Oreochromis spp.)

The biological effect of protein sugar cane meal inclusion in all isocaloric and isoprotein diets for red tilapia (Oreochromis spp.) alevins was evaluated. Four complete diets including 0 %, 10 %, 15 %, and 20 % of sugar cane meal protein were prepared. A total of 500 red tilapia alevins (Oreochromis spp.) weighing 1,55 ± 0,01 g were randomly distributed into 5 treatment reservoirs. Weight gain and food consumption were registered during 50 days to calculate daily weight gain, specific growth rate, food conversion rate, protein efficiency rate, and net protein utility. None of the inclusion levels showed significant differences compared to the control group. Findings support the inclusion of protein sugar cane meal in complete diets up to 20 % without affecting growth indexes, food supply and survival indicators.Se evaluó el efecto de la inclusión de harina de caña proteica en dietas isocalóricas e isoproteicas para alevines de tilapia roja (Oreochromis spp.) Se elaboraron cuatro dietas completas con 0; 10; 15 y 20 % de dicho alimento, elaborado a partir de caña de azúcar y ensilado de pescado. Un total de 500 alevines de 1,55 ± 0,01 g fueron distribuidos aleatoriamente en cinco piscinas por tratamiento. Durante 50 días se registró el crecimiento en peso y consumo de alimento para calcular el incremento de peso diario, tasa de crecimiento específico, factor de conversión alimentaria, tasa de eficiencia proteica y utilidad proteica neta. Ninguno de los niveles de inclusión mostró diferencias significativas con respecto al control; así, se concluye que la harina de caña proteica puede formar parte de dietas completas hasta en un 20 % de inclusión, sin que se afecten los indicadores de crecimiento, utilización de alimentos y supervivencia

Maternal dietary patterns and acute leukemia in infants: results from a case control study in Mexico

BackgroundChildhood cancer is the leading cause of disease-related mortality among children aged 5–14 years in Mexico, with acute leukemia being the most common cancer among infants. Examining the overall dietary patterns allows for a comprehensive assessment of food and nutrient consumption, providing a more predictive measure of disease risk than individual foods or nutrients. This study aims to evaluate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in Mexican infants.MethodsA hospital-based case–control study was conducted, comparing 109 confirmed acute leukemia cases with 152 age-matched controls. All participants (≤24 months) were identified at hospitals in Mexico City between 2010 and 2019. Data on a posteriori dietary patterns and other relevant variables were collected through structured interviews and dietary questionnaires. Multivariate logistic regression was employed to estimate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in infants.ResultsThe “Balanced & Vegetable-Rich” pattern, characterized by a balanced consumption of various food groups and higher vegetable intake, exhibited a negative association with acute leukemia when compared to the “High Dairy & Cereals” Pattern (adjusted odds ratio [OR] = 0.51; 95% confidence interval [CI]: 0.29, 0.90). We observed that mothers who gave birth to girls and adhered to a healthy dietary pattern during pregnancy exhibited significantly lower odds of their children developing AL compared to those who gave birth to boys [OR = 0.32 (95% CI 0.11, 0.97)]. Our results underscore the significance of maternal nutrition as a modifiable factor in disease prevention and the importance of prenatal health education

Correlation between arterial resistance índex by doppler in renal graft function

Objetivo: evaluar la asociación entre el valor del índice de resistencia arterial (IR) medido por doppler al mes postrasplante y la pérdida de injerto. Se reportan los desenlaces secundarios de pérdida mayor o igual al 50% de la función renal, muerte con injerto funcionante, hallazgos de la biopsia (inflamación, hialinosis, rechazo, fibrosis intersticial - atrofia tubular, IFTA, por sus siglas en inglés). Métodos: se realizó un estudio de cohorte de 66 pacientes, que recibieron trasplante renal, del Hospital San José de Bogotá, entre octubre de 2007 y abril de 2011; se midió el IR de la arteria hilar por ecografía doppler al mes postrasplante. La mayoría de los pacientes fueron seguidos hasta el segundo año. Se describe la incidencia acumulada de pérdida del injerto renal, pérdida mayor o igual al 50% de la tasa filtración glomerular; al segundo año postrasplante se reporta el rechazo, IFTA, hialinosis e inflamación documentada en las biopsias de protocolo. Se realizó análisis de asociación en los desenlaces histológicos. Resultados: solo se reportaron 2 casos de pérdida del injerto renal, pertenecientes al grupo con IR normal (3.8%). A los 3 años de seguimiento 5 pacientes habían perdido más del 50% de la TFG respecto a la basal, 4 ocurrieron en los pacientes con IR <0.8, 2 de ellos (3.7%) fueron al primer año y solo un paciente con IR >0.8 a los 3 años. La mediana de la TFG a los 3 años de seguimiento en ambos grupos es mayor de 60 ml/ min. En el primer año de seguimiento 22 (47%) pacientes con IR normal presentaron IFTA y 7 (54%) con IR >0.8 presentaron IFTA; la hialinosis con un 23% para IR >0.8 y 25.5% para IR <0.8. Conclusión: los desenlaces de los injertos no solo dependen del IR, hay otros factores que pueden influir como es el tiempo de isquemia fría, esquema de tratamiento inmunosupresor de inducción y mantenimiento, grado de incompatibilidades entre donante, receptor. Cambios histopatológicos como IFTA, inflamación, hialinosis, se observaron en cualquiera de los 2 grupos, lo que sugiere que hay otros factores más fuertes que el IR, que se correlaciona con la aparición de estos hallazgos.Abstract Objective: To assess the association between the value of arterial resistance index (RI) measured by Doppler month post transplant and graft loss. Secondary outcomes of greater than or equal to 50% loss of renal function, death with a functioning graft biopsy findings (inflammation, hyalinosis, rejection, IFTA) are reported. Methods: A cohort study of 66 patients who received a kidney transplant at the Hospital San José de Bogotá, between October 2007 and April 2011 was performed; arterial resistance index hilar artery doppler ultrasound month post-transplant was measured. Most patients were followed until the second year. The cumulative incidence of graft loss is described, lost greater than or equal to 50% of glomerular filtration rate; tubular atrophy (IFTA), hyalinosis and documented inflammation in protocol biopsies - the second year transplant rejection, interstitial fibrosis is reported. Association analysis was performed in histological outcomes. Results: Two cases of graft loss was reported and all belonging to the group with normal (3.8%) IR. At 3-year follow-up five patients had lost more than 50% of GFR from baseline, where four occurred in patients with RI 0.8 resistance to 3 years. Median GFR at 3 years follow-up in both groups was greater than 60 ml / min. In the first year of follow-up 22 (47%) patients with normal IR presented interstitial fibrosis and tubular atrophy (IFTA), and seven (54%) with IR> 0.8 presented IFTA; hyalinosis with 23% for IR> 0.8, and 25.5% for IR <0.8. Conclusion: The outcome of the grafts not only depend on the index of arterial resistance, other factors that may influence such as cold ischemia time, immunosuppressive treatment scheme for induction and maintenance, grade mismatches between donor, recipient. Histopathological changes as IFTA, inflammation, hyalinosis was observed in either group, which suggests that other factors strongest IR, which correlates with the appearance of these findings

Memoria del primer encuentro internacional sobre el poder en el pasado y el presente de América Latina.

Esta memoria reúne 27 trabajos que dan cuenta, en la media de lo posible, de la notable complejidad de las manifestaciones del poder en el pasado y el presente de América Latina, al abarcar tanto las de carácter democrático como las de naturaleza autoritaria, tanto las que prevalecieron en los ámbitos de mayor amplitud, imperiales o nacionales, como las que se hicieron presentes en ámbitos locales, organizacionales más reducidos, tanto en pasados más o menos remotos como en la coyuntura más actual