Relación entre la exposición a contaminantes ambientales y exacerbaciones de asma en pacientes pediatricos

El asma es una enfermedad inflamatoria crónica de la vía respiratoria inferior caracterizada por síntomas como tos, sibilancias, disnea y opresión torácica. Su etiología es multifactorial e involucra la interacción entre factores genéticos y estímulos ambientales. La contaminación atmosférica es uno de estos estímulos ambientales nocivos, es un problema creciente para las grandes ciudades y uno de los probables contribuyentes al empeoramiento agudo de los síntomas de asma. La ciudad de Monterrey ha encabezado en los últimos años las listas de ciudades más contaminadas de México, en particular dos de sus municipios metropolitanos, por lo que consideramos relevante investigar si la contaminación en estos municipios es un factor determinante para el empeoramiento de los síntomas de los niños con asma que habitan en ellos. Material y Métodos Se analizaron los síntomas, uso de medicamentos y flujometrías de pacientes escolares de 5 a 10 años y adolescentes de 11 a 16 años, residentes 2 del municipio de Guadalupe, García y Santa Catarina, Nuevo León que acudieron a la consulta del Centro Regional de Alergia e Inmunología Clínica (CRAIC) con diagnóstico de asma controlada para identificar sus exacerbaciones entre los meses de mayo y octubre de 2017. Por otro lado se obtuvo el nivel promedio horario de los principales contaminantes atmosféricos (CO, NO2, SO2, O3, PM10, PM2.5) de los municipios antes mencionados durante el tiempo del estudio. Objetivos Comparar la cantidad de exacerbaciones de asma en tres poblaciones pediátricas con diferentes grados de exposición a contaminantes ambientales. Resultados Se analizaron los datos de 16 pacientes y se estudiaron 184 días consecutivos. Del total de días estudiados, se presentaron exacerbaciones en 42 días (3%). Se reportaron 15 exacerbaciones en el municipio de Guadalupe (4.09%), 23 exacerbaciones en el municipio de García (3.77%) y 4 exacerbaciones en el municipio de Santa Catarina (1%). 3 Conclusiones El tamaño de la muestra no fue suficiente para elaborar conclusiones que tengan significancia estadística por lo que los resultados obtenidos se deben considerar como observaciones y no tienen validez estadística. De la población de pacientes pediátricos escolares y adolescentes que acudieron al CRAIC con asma controlada de los municipios estudiados, encontramos una prevalencia global de exacerbaciones de 3% durante la duración del estudio. El municipio de Guadalupe presentó proporcionalmente una mayor cantidad de exacerbaciones (n=15, 4.09%) y a diferencia de lo que se pensaba, el municipio de Santa Catarina fue el que presentó menos exacerbaciones (n=4, 1%). Consideramos que por los resultados obtenidos, este estudio solo se puede considerar como un estudio preliminar y valdría la pena extender el estudio a otros municipios del área metropolitana de Monterrey y realizar un seguimiento más prolongado para captar más pacientes, obtener mejores resultados y valorar de manera adecuada la asociación de la contaminación con el asma

Ethos y techné teatrales

This paper aims to explore the ethics of theatrical technique, τεχνη, which extends far beyond the purely technical aspects of the notion, referring instead to the essential quality attached to artistic workmanship. The correct usage of this τεχνη has ethical ramifications that involve the identification of two basic models of interpersonal, social, cultural and economic relationships: domination and collaboration. Unlike other artistic disciplines, theatrical τεχνη has proper ethical implications that stem from the fact that, on stage, the actor does not work directly for the spectator, but for his partner.En este trabajo se indaga sobre la ética de la técnica τεχνη teatral, la cual se entiende más allá de simplemente una técnica, sino como algo imprescindible para la calidad de factura de la obra artística. El uso correcto de esta τεχνη tiene implicaciones éticas en cuanto a la identificación con dos modelos básicos de relaciones interpersonales, sociales, culturales e incluso económicas: la dominación y la colaboración. La τεχνη teatral tiene implicaciones éticas porque en su desarrollo está en que, a diferencia de otras disciplinas artísticas, no se trabaja directamente para el espectador, sino para el compañero

Atopic Dermatitis and Erythrodermia Associated With Systemic Lupus Erythematosus: A Case Report

La eritrodermia es una dermatosis inflamatoria que involucra capas parciales o totales de la piel. La mortalidad es del 16%. Los síntomas sistémicos incluyen fiebre, taquicardia, hinchazón de las extremidades, adenomegalia y hepatomegalia. Las causas infecciosas son las más frecuentes, estando presentes hasta en un 40%, seguidas de ictiosis y dermatitis en el 15% de los casos

Body composition by dual X-ray absorptiometry in Mexican schoolchildren with or without obesity

Objective: Apply dual X-ray absorptiometry (DXA) to determine the amount of fat mass, lean mass, and bone mineral density in Mexican schoolchildren with and without obesity. Material and methods: We performed an observational, analytical, comparative, cross-sectional study of 80 Mexican schoolchildren who attended the Nutrition Clinic of the Pediatric Medical Center in Monterrey, Mexico during the period of January to April 2005. Body mass index (BMI) was determined to classify the participants according to the growth charts of the Centers for Disease Control and Prevention. Two groups of 40 children each (with and without obesity) were formed and DXA was carried out on each individual. Cronbach’s Alpha was used to determine instrument reliability and the Kolmogorov-Smirnov test was used to test the normality of numerical variables. Means were compared using Student´s t test. Results: Statistically signiicant differences were found in fat mass (p≤0.001) and lean mass (p≤0.001), but not in bone mineral content (p=0.051) between both groups. Conclusions: Differences exist in fat mass and lean mass in both groups, but not in bone mineral content between both groups. A signiicant positive correlation was found between fat mass, determined by DXA, and BMI in schoolchildren with and without obesit

Effect of Pluronic P103 Concentration on the Simple Synthesis of Ag and Au Nanoparticles and Their Application in Anatase-TiO₂ Decoration for Its Use in Photocatalysis

Silver and gold nanoparticles were synthesized under environmentally-friendly reaction conditions by using a biodegradable copolymer and water as a solvent. The triblock copolymer Pluronic P103 was utilized as a stabilizing agent or soft template to produce Ag and Au nanoparticles (NPs) of different sizes. Moreover, in the synthesis of Au NPs, the polymer acted as a reducing agent, decreasing the number of reagents used and consequently the residues produced, hence, rendering the procedure less complicated. It was observed that as the concentration of the polymer increased, the size of the metallic NPs augmented as well. However, AgNPs and AuNPs prepared with 1 and 10 wt% Pluronic P103, respectively, showed a significant decrease in particle size due to the presence of polymeric soft templates. The hybrid materials (metal/polymer) were characterized by UV-Vis spectroscopy, DLS, and TEM. The pre-synthesized nanoparticles were employed to decorate anatase-TiO2, and the composites were characterized by DRS, XRD, BET surface area measurements, the TEM technique with the EDS spectrum, and XPS spectroscopy to demonstrate NPs superficial incorporation. Finally, methylene blue was used as a probe molecule to evidence the effect of NPs decoration in its photocatalytic degradation. The results showed that the presence of the NPs positively affected methylene blue degradation, achieving 96% and 97% removal by utilizing TAg0.1 and TAu10, respectively, in comparison to bare anatase-TiO2 (77%)

Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network.

AimThis report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico.Material and methodsA total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes.ResultsAmong blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each).ConclusionOur study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae

A snapshot of antimicrobial resistance in Mexico. Results from 47 centers from 20 states during a six-month period.

AIM:We aimed to assess the resistance rates of antimicrobial-resistant, in bacterial pathogens of epidemiological importance in 47 Mexican centers. MATERIAL AND METHODS:In this retrospective study, we included a stratified sample of 47 centers, covering 20 Mexican states. Selected isolates considered as potential causatives of disease collected over a 6-month period were included. Laboratories employed their usual methods to perform microbiological studies. The results were deposited into a database and analyzed with the WHONET 5.6 software. RESULTS:In this 6-month study, a total of 22,943 strains were included. Regarding Gram-negatives, carbapenem resistance was detected in ≤ 3% in Escherichia coli, 12.5% in Klebsiella sp. and Enterobacter sp., and up to 40% in Pseudomonas aeruginosa; in the latter, the resistance rate for piperacillin-tazobactam (TZP) was as high as 19.1%. In Acinetobacter sp., resistance rates for cefepime, ciprofloxacin, meropenem, and TZP were higher than 50%. Regarding Gram-positives, methicillin resistance in Staphylococcus aureus (MRSA) was as high as 21.4%, and vancomycin (VAN) resistance reached up to 21% in Enterococcus faecium. Acinetobacter sp. presented the highest multidrug resistance (53%) followed by Klebsiella sp. (22.6%) and E. coli (19.4%). CONCLUSION:The multidrug resistance of Acinetobacter sp., Klebsiella sp. and E. coli and the carbapenem resistance in specific groups of enterobacteria deserve special attention in Mexico. Vancomycin-resistant enterococci (VRE) and MRSA are common in our hospitals. Our results present valuable information for the implementation of measures to control drug resistance