Determinación de potenciales biomarcadores de preeclampsia en etapas tempranas del embarazo mediante un análisis proteómico

La preeclampsia (PE) es una de las principales causas de morbilidad y mortalidad materna y neonatal asociadas al embarazo. La detección de pacientes en riesgo antes del inicio clínico de la PE es una prioridad. La proteómica se ha convertido en una valiosa herramienta para el descubrimiento de nuevos biomarcadores. El objetivo del presente estudio fue determinar nuevos biomarcadores potenciales para la detección precoz de la PE mediante enfoques proteómicos cuantitativos y cualitativos. Se obtuvieron muestras de sangre de mujeres embarazadas a las 10-12 semanas de gestación. Se analizaron ocho muestras de pacientes que desarrollaron PE y ocho de mujeres no afectadas mediante cromatografía líquida nano 2-D y qTOF-MS. Se consideraron relevantes doce proteínas. Diez proteínas mostraron diferencias cuantitativas: Por arriba de 1.5 veces: PRRC2C (217.02), HEATR5A (179.46), ATP6 (162.38), PRRC2B (83.09), RBM25 (5.36), NUP205 (3.38), HLA-I (2.27), ZCCCH13 (2,15) SREK1 (1,66) y dos por debajo de 0,66: Importina-4 (0,55) y Citocromo b (0,26). Cualitativamente solo LRRK1 se expresó significativamente en PE (p = 0.044), aunque: PRRC2B (p = 0.121), PRRC2C (p =0.134) y NUP205 (p =0.134) mostraron una marcada tendencia a estar presentes en PE estos últimos estuvieron presentes en ambos grupos. Proponemos que las últimas cuatro proteínas podrían actuar como posibles biomarcadores tempranos de PE. Sin embargo, se necesitan más estudios para continuar con la verificación, validación y finalmente la de transferencia a la clínica

Hígado graso agudo del embarazo: comunicación de un caso en el Hospital Universitario de la UANL

El hígado graso agudo del embarazo es un trastorno metabólico, potencialmente fatal, que se manifiesta a partir de la semana 26 de gestación y hasta después del parto, y tiene mayor incidencia entre las semanas 35 y 37 de gestación. El hígado graso agudo del embarazo ocurre aproximadamente en uno de cada 13,000 embarazos, con mortalidad hasta del 20%. Su origen parece ser una alteración en la oxidación intramitocondrial de los ácidos grasos. Las complicaciones más frecuentes son: insuficiencia hepática fulminante, insuficiencia renal, pancreatitis, sangrado uterino, coagulación intravascular diseminada, convulsiones y coma. La muerte materna suele ser por insuficiencia orgánica múltiple, hemorragia posparto, sepsis o ambas. La muerte fetal puede deberse a insuficiencia placentaria o acidosis metabólica con arritmias fetales. Se comunica un caso de hígado graso agudo del embarazo, con deterioro súbito materno y pérdida fetal, cuyo manejo requirió atención en la unidad de cuidados intensivos, y para la recuperación satisfactoria de la paciente fue necesaria la hospitalización durante 19 días

Standardized Classification of Aortic Arch Branching Patterns (SCAABP)

Objectives. To review current anatomical classifications for the aortic branching patterns and propose a method for standardized classification of Aortic Arch Branching Patterns (SCAABP). Methods. Through a three-stage Delphi method, expert vascular anatomists in morphology design SCAABP to report trunks, branches, and laterality of aortic arch branching patterns. Results. SCAABP is a classification that includes 7 parameters (Number of branches, and 6 types of branches [braquiocephalic trunk, common trunk, common carotid, subclavian artery, vertebral artery, and ectopic arteries]). It can integrate all reported branching patterns and allows the classification of new or unreported patterns. The classification allows standardization for future comparison of results, and improvement of evidence-based anatomy. Conclusions. SCAABP is a standardized method for classifying anatomical variants of the aortic arch. It is simple, clear, and contemplates new variants. All reported classifications can be integrated

Burnout Among First-Year Medical Students During COVID-19 Pandemic in Mexico: A Cross-Sectional Study

Background: The coronavirus pandemic is an international public health emergency without precedence in modern history. It represents a challenge to students’ academic and psychological stability due to the changes it caused in daily life. This study aimed to evaluate the prevalence and level of burnout in medical students caused by the academic and psychological instability that the pandemic represents. Methods: A prospective cross-sectional study was designed using the Maslach Burnout Inventory-Student Survey (MBI-SS). This evaluated the emotional exhaustion due to study demands, cynicism, and negative self-academic efficacy. This study was based in the school of medicine of the Universidad Autonoma de Nuevo Leon (UANL) in Monterrey, Mexico, during the Spring semester of 2020. Results: A total of 154 (93 women and 61 men) first-year medical students participated (response rate of 36.4%). Burnout was identified in 14.9% (n=23), and high emotional exhaustion in 53.9% (n=83). Burnout was almost 4 times more likely to develop in men than in women (aOR = 4.8; 95% Confidence Interval=1.7-13.3) when considering age as a covariable in the multivariable model. Conclusion: Further epidemiological studies of burnout syndrome in medical students are needed, and schools should consider promoting mental health and making programs available for their students to help overcome the emotional and social challenges during the pandemic

Modifications to the delivery of a gross anatomy course during the COVID-19 pandemic at a Mexican medical school

The Coronavirus disease was declared a pandemic this year, causing an impact on medical education. Following the World Health Organization’s (WHO) recommendations, Universities around the world implemented social distancing and the use of online platforms. Anatomists lead medical students, most of which are part of Generation Z. Different technological tools have been used in the gross anatomy course in combination with face-toface classes, but now are forced to move exclusively online. The Human Anatomy Department in the Medical School of the Universidad Autonoma de Nuevo León (UANL) implemented asynchronous sessions as a short-term resolution, transformed to synchronous sessions as the pandemic progressed. It is important to consider the adaptability of the student, the near-peer teacher, and academic staff, with the creation of innovative ideas to facilitate the learning for the student and to maintain the quality of the course. Their role in this modality should be assessed, as it may change medical education and the way to teach in the future for the new generation of medical students. Professors’ roles are changing and it is necessary to adapt to new situations

Pelvimetry by Reformatted Computed Tomography in 290 Female Pelvis: Morphometric Variations Regarding Age

The Mexican government passed a new reform of article 11 of the General Law in 2014 regarding Women's Access to a Life Free of Violence, which states that a cesarean section may not be performed if a vaginal birth is viable. Cesarean sections are excessively indicated in Northen Mexico, using the diagnosis of cephalopelvic disproportion due to a narrow pelvis. Currently, there is no standardized morphometry of the female pelvis in a Mexican population to establish adequate diagnostic parameter. Our study measures the pelvic diameters of the birth canal using abdominopelvic computed tomography (CT). Two hundred and ninety CT from Mexican women between the ages of 18 and 50 were collected and 3D reformatted in order to morphologically measure the pelvic diameters of clinical relevance. Measurements were conducted by two diagnostic imaging specialists. The mean and standard deviation of the measured diameters were: anatomical conjugate diameter (ACD) 11.65±0.99 cm, the obstetric conjugate diameter (OCD) 11.73±0.98 cm, diagonal conjugate diameter (DCD) 12.49±0.98 cm and Interspinous distance (ISD) 10.41±0.78 cm. Significant differences were found in all four mean diameters in between the 20–29 age groups versus the >40, as well as between the 30–39 groups versus the >40. Our study shows that as Mexican women get older, the mean pelvic diameters become narrower