Prevalencia de insuficiencia suprarrenal en pacientes con infección por el virus de inmunodeficiencia humana : Evaluación con la prueba de Cosyntropin en dosis baja (10 ug.)

Tesis (Doctorado en Medicina) UANLUANLhttp://www.uanl.mx

Muestreo estratificado

Para muchos investigadores, el diseño de investigación es uno de los procesos claves para el éxito de su proyecto. El diseño de un método cuantitativo implica el diseño del muestreo. En este capítulo se presentan los fundamentos teó- ricos y el procedimiento del diseño del muestreo estratificado para su aplicación en estudios cuantitativos. Se describe la coherencia de los conceptos: tamaño óptimo de la muestra, representatividad y aleatoriedad, que caracterizan al muestreo proba- bilístico. En relación a estos conceptos y procedimientos y a manera de ejemplo, se presenta un estudio aplicado en 3 universidades con poblaciones significativamente diferentes, y se determinan la población, la unidad de análisis, el tamaño óptimo de la muestra y los respectivos estratos o subpoblaciones del estudio para asegurar la representatividad de la muestra con el fin de procesar posteriormente los datos por medio de herramientas estadísticas y realizar inferencias válidas sobre la población objeto de estudio

Análisis ambiental por contaminación en trece localidades aledañas a la laguna de Coyuca de Benítez, Guerrero

Se realizó un análisis geoespacial de puntos de contaminación de residuos sólidos y descarga de aguas residuales donde se encontraron 60 puntos rojos de los cuales 5 son de descarga de aguas negras y 55 de residuos sólidos, la única localidad donde no se encontraron puntos rojos fue en la localidad del Macahuite, además se realizaron encuestas a los ciudadanos de trece localidades aledañas a la Laguna de Coyuca de Benítez donde de acuerdo a los resultados las localidades Bajos del ejido, El Conchero, Kilometro diecisiete, Luces en el Mar y San Nicolás de las Playas tienen un servicio de recolección deficiente y en las demás localidades el servicio de recolección es inexistente a lo que se traduce en quema de basura y en tiraderos que son arrastrados a la Laguna por las corrientes de agua que se forman en épocas de lluvia. Todas las localidades cuentan con fosa séptica, sólo Bajos del Ejido cuenta con drenaje pero no funciona porque aún no está concluido. Se recomienda que las instituciones como los tomadores de decisiones elaboren un plan de manejo de residuos sólidos que considere un relleno sanitario, equipamiento como vehículos especiales para pasar por las calles angostas de las localidades y dotar de servicios como el drenaje

Educating in History: thinking historically through historical reenactment

This paper aimed to identify trends in the scientific literature that relate the link between two concepts: historical thinking and historical reenactment. The definition of both concepts and their commonalities were examined. Convinced that History instruction and Heritage education could improve new methods and techniques, and aware of the benefits of reenactments in active learning and participation in and outside the classroom, we came to the obvious conclusion that merging both aspects is a must and should be disseminated. We also analyzed the presence of second-order concepts in reenactment practices and how they are addressed by actors and spectators. Reenactments foster the acquisition of critical thinking by citizens through education; their quality, however, must be improved through research and didactics—didactics based on reenactment that help us value the past and the traces still present in local areas. Local and global identity and heritage, emotions, reproduction of objects, the use of sources, relevance, empathy, multiperspectives, causation, communication, the relationship between past and present, and the sustainable economy proposed by the 2030 Agenda, are all aspects that should take center stage in turning this phenomenon into a living and lasting history as an experience

El estado y las relaciones internacionales

El Estado-Nación y La Soberanía son conceptos claves en las relaciones internacionales. Ambos conceptos están íntimamente vinculados con la ciencia política y las relaciones internacionales contemporáneas. En el presente capítulo se abordara la importancia del Estado-Nación en el sistema internacional y la participación de México a través del tiempo en la esfera global, para inalizar con las conclusiones, actividades y la bibliografí

Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management

Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, *382 million individuals live with diabetes, and 40–50% of the global population is labeled at ‘‘high risk’’ (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted. In both diabetes and obesity, genetic, epigenetic, and environmental factors overlap and are inclusive rather than exclusive

A Novel Method Based on Headspace-Ion Mobility Spectrometry for the Detection and Discrimination of Different Petroleum Derived Products in Seawater

The objective of the present study is to develop an optimized method where headspace-ion mobility spectrometry is applied for the detection and discrimination between four petroleum-derived products (PDPs) in water. A Box-Behnken design with a response surface methodology was used, and five variables (incubation temperature, incubation time, agitation, sample volume, and injection volume) with influences on the ion mobility spectrometry (IMS) response were optimized. An IMS detector was used as a multiple sensor device, in which, each drift time acts as a specific sensor. In this way, the total intensity at each drift time is equivalent to multiple sensor signals. According to our results, 2.5 mL of sample incubated for 5 min at 31 degrees C, agitated at 750 rpm, and with an injection volume of 0.91 mL were the optimal conditions for successful detection and discrimination of the PDPs. The developed method has exhibited good intermediate precision and repeatability with a coefficient of variation lower than 5%, (RSD (Relative Standard Deviation): 2.35% and 3.09%, respectively). Subsequently, the method was applied in the context of the detection and discrimination of petroleum-derived products added to water samples at low concentration levels (2 mu L center dot L-1). Finally, the new method was applied to determine the presence of petroleum-derived products in seawater samples.This work has been co-financed by the 2014-2020 ERDF Operational Program and by the Department of Economy, Knowledge, Business and University of the Regional Government of Andalusia. Project reference: "FEDER-UCA18-107214"

Clinical Study Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism

Adrenal function might be impaired in patients with primary hypothyroidism. The objective was to evaluate adrenocortical function using the low-dose cosyntropin test in patients with primary hypothyroidism. Consequently a prospective, longitudinal, controlled study of sixty adult patients with primary hypothyroidism was carried out. Patients naïve to L-T4 treatment were compared with control participants. A low-dose cosyntropin test was done before and after L-T4 therapy. Thirty and sixty minutes after the lowdose cosyntropin, the mean cortisol values were lower in the cases group (612.6 ± 133.1 and 603.4 ± 153.7 nmol/L) when compared to the control group (677.0 ± 82.4 and 669.9 ± 83.7 nmol/L) ( = 0.001 and 0.003), respectively. After L-T4 therapy, this difference was lost. Four out of 60 cases (6.7%) taking a cortisol cutoff value of 500 mmol/L and 11 out of 60 (18.3%) having 550 mmol/L as the cutoff had adrenal insufficiency before L-T4 therapy. After L-T4 therapy, 50% and 81% of the cases had normal cortisol response. In conclusion, patients with different degrees of intensity of primary hypothyroidism had improved cortisol response after reaching euthyroidism. The incidence of adrenal insufficiency was 6.7-18.3% and more than 50% of the cases had a normal cortisol response after L-T4 therapy

Characterization of Biodegraded Ignitable Liquids by Headspace-Ion Mobility Spectrometry

The detection of ignitable liquids (ILs) can be crucial when it comes to determining arson cases. Such identification of ILs is a challenging task that may be affected by a number of factors. Microbial degradation is considered one of three major processes that can alter the composition of IL residues. Since biodegradation is a time related phenomenon, it should be studied at different stages of development. This article presents a method based on ion mobility spectroscopy (IMS) which has been used as an electronic nose. In particular, ion mobility sum spectrum (IMSS) in combination with chemometric techniques (hierarchical cluster analysis (HCA) and linear discriminant analysis (LDA)) has been applied for the characterization of different biodegraded ILs. This method intends to use IMSS to identify a range of ILs regardless of their degree of biodegradation. Three ILs (diesel, gasoline and kerosene) from three different commercial brands were evaluated after remaining in a soil substrate for several lengths of time (0, 2, 5, 13 and 38 days). The HCA results showed the samples' trend to fall into categories characterized by ILs type and biodegradation time. The LDAs allowed a 99% successful classification of the samples according to the IL type. This is the first time that an HS-IMS technique has been used to detect ILs that have undergone biodegradation processes. The results show that IMS may be a promising alternative to the current standard method based on gas-chromatography for the analysis of biodegraded ILs. Furthermore, no pretreatment of the samples nor the use of a solvent is required