Comparison of different treatments used for polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a disease that currently affects many women of reproductive age. In recent years, the incidence of PCOS has increased, affecting 4% of all women worldwide, with a prevalence of 6% in Mexico. PCOS is a condition characterized by different metabolic, reproductive and hormonal disorders such as hyperandrogenism, chronic anovulation, menorrhagia or infertility. Patients commonly develop clinical alterations such as hirsutism, acne and in some cases, they become overweight or obese. Different medications and therapeutic methods from different literatures were evaluated, both pharmacological such as inositol, metformin, resveratrol, simvastatin, dapagliflozin, which showed great improvement, decreasing the levels of hyperandrogenism in patients, as well as non-pharmacological, of which significant improvements were found with a change in lifestyle, such as exercise, ketogenic diet and herbal medications such as chamomile and cinnamon, which showed a positive change in patients. It is important to make a diffusion and early diagnosis of PCOS, since in this way it will be possible to have a timely treatment, which can be individualized according to the characteristics and needs of each patient

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Effect of the preparation method on the gas sensing properties of nanostructured CoAl2O4

We report the effects of varying the oxygen partial pressure (OPP) on the structural and electronic properties of SiO x/Si heterolayers grown by RF reactive sputtering. The produced samples present silicon poly-crystalline characteristics for low values of OPP. The crystallinity decreases as the OPP increases due to oxygen interdiffusion until the silicon crystal structure becomes amorphous. The results of infrared and Raman spectroscopies show higher deviation from stoichiometry and an increment of structural disorder for samples grown with higher values of OPP. Room temperature photoluminescence (PL) is present in all as-grown samples. The PL spectra show two bands, around 1.87 and 2.16 eV, for all the samples, while a third broad band at lower energy shows up and shifts to the red as OPP increases. Our results indicate that silicon-related room temperature PL emission is correlated with the stoichiometry of the SiO x and to the formation of silicon crystals embedded in a silicon dioxide matrix. " 2009 IOP Publishing Ltd.",,,,,,"10.1088/0268-1242/24/10/105028",,,"http://hdl.handle.net/20.500.12104/41032","http://www.scopus.com/inward/record.url?eid=2-s2.0-70350625073&partnerID=40&md5=9a5e700b2cf44a959912dd1afffd8eeb",,,,,,"10",,"Semiconductor Science and Technology",,,,"24",,"Scopu

Photoluminescence of as-grown and thermal annealed SiOx/Si- nanocrystals heterolayers grown by reactive rf sputtering

SiOx/Si -nanocrystals (Si NCs) heterolayers were fabricated employing a rf magnetron sputtering system. The synthesis process, through modification of the oxygen partial pressure of the plasma, promotes the synthesis of stoichiometric SiO2 layers and affect the Si NCs layer giving place to SiOx /Si NCs (1.64<x<2) interfaces. All as-grown samples showed strong photoluminescence (PL) bands in the visible and near-infrared regions; transmission electron microscopy measurements confirmed the presence of Si NCs. Thermal annealing at 1100 �C promoted the SiO 2 stoichiometry in the interface and the crystallization of more Si NCs. The results allow us to clearly identify the origin of the PL bands; indicating that the near-infrared emission is related to the nonstoichiometric oxide while the red and green bands are originated in Si NCs. � 2010 American Institute of Physics

Efficacy and Safety of PCSK9 Inhibition With Evolocumab in Reducing Cardiovascular Events in Patients With Metabolic Syndrome Receiving Statin Therapy: Secondary Analysis From the FOURIER Randomized Clinical Trial.

IMPORTANCE: The PCSK9 inhibitor evolocumab reduced low-density lipoprotein cholesterol and cardiovascular events in the FOURIER randomized clinical trial. Patients with metabolic syndrome (MetS) are at increased cardiovascular risk. OBJECTIVE: To investigate outcomes with evolocumab in patients with and without MetS. DESIGN, SETTING, AND PARTICIPANTS: The FOURIER trial randomized patients worldwide with stable atherosclerotic cardiovascular disease receiving statin to evolocumab vs placebo with follow-up for a median of 2.2 years. Data were collected February 2013 to November 2016. For this prespecified analysis, patients with the requisite data were stratified based on the National Cholesterol Education Program Adult Treatment Panel III MetS criteria; in secondary analyses, patients were further substratified by diabetes at baseline. Analysis was intention to treat. Analysis began March 2018 and ended April 2020. INTERVENTIONS: Patients were randomized to evolocumab or placebo. MAIN OUTCOMES AND MEASURES: The primary end point was cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary end point was cardiovascular death, myocardial infarction, or stroke. RESULTS: Of 27 342 patients (mean [SD] age, 63 [9] years; 20 623 men [75.4%]) included in this analysis, 16 361 (59.8%) with baseline MetS were, when compared with patients without MetS, at higher risk of cardiovascular events (adjusted hazard ratio [95% CI], 1.31 [1.18-1.46]; P < .001 for the primary and 1.38 [1.20-1.57]; P < .001 for the key secondary end point). Evolocumab reduced low-density lipoprotein cholesterol similarly in patients with MetS (median [interquartile range], 92 [79-109] mg/dL vs 30 [19-48] mg/dL; P < .001) and without MetS (median [interquartile range], 92 [81-108] mg/dL vs 29 [18-44] mg/dl; P < .001). For the primary end point, the hazard ratios (95% CI) with evolocumab vs placebo were 0.83 (0.76-0.91) and 0.89 (0.79-1.01) in patients with and without MetS (P for interaction = .39). For the key secondary end point, the corresponding hazard ratios (95% CIs) were 0.76 (0.68-0.86) and 0.86 (0.74-1.01) (P for interaction = .23), respectively. Evolocumab did not increase the risk of new-onset diabetes or other major safety outcomes including worsening glycemic control, compared with placebo in patients with MetS. CONCLUSIONS AND RELEVANCE: Patients with atherosclerotic cardiovascular disease and MetS have substantial residual risk of cardiovascular events despite statin therapy. Evolocumab significantly reduced low-density lipoprotein cholesterol and cardiovascular risk in patients with MetS without increasing new-onset diabetes, worsening glycemic control, or other major safety events. These data suggest the addition of evolocumab to statin therapy in patients with atherosclerotic cardiovascular disease and MetS is safe and efficacious to reduce residual cardiovascular risk. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01764633

Clinical Efficacy And Safety Of Evolocumab In High-Risk Patients Receiving A Statin Secondary Analysis Of Patients With Low Ldl Cholesterol Levels And In Those Already Receiving A Maximal-Potency Statin In A Randomized Clinical Trial

IMPORTANCE Current guidelines for atherosclerotic cardiovascular disease focus on high-intensity statins and targeting or using a threshold low-density lipoprotein cholesterol (LDL-C) level of less than 70 mg/dL for the highest-risk patients. Whether further reduction of LDL-C beyond these boundaries would be beneficial is unknown. OBJECTIVE To compare outcomes of evolocumab vs placebo in patients with stable atherosclerotic cardiovascular disease and a baseline LDL-C of less than 70 mg/dL and in those receiving background treatment with a maximal-potency statin. DESIGN, SETTING, AND PARTICIPANTS This secondary ad hoc analysis of the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial compared randomized treatments in 2 subgroups of patients with stable atherosclerotic cardiovascular disease currently receiving statin. Patients were classified by a baseline LDL-C of less than 70 or at least 70 mg/dL and by statin intensity (maximal: atorvastatin calcium, 80 mg/d, or rosuvastatin, 40 mg/d; submaximal: all other dosages). Patients with baseline LDL of less than 70 mg/dL either had a final screening LDL-C of at least 70 mg/dL or a final screening non-high-density lipoprotein cholesterol level of at least 100 mg/dL. Datawere retrieved from 2013 to 2016 and analyzed in 2017 based on intention to treat. MAIN OUTCOMES AND MEASURES The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The secondary efficacy endpoint was the composite of cardiovascular death, myocardial infarction, or stroke. Safety outcomes included adverse events and events of interest identified in the FOURIER trial. Interaction testing was used to assess the consistency of results in patients who did vs did not satisfy the above criteria. RESULTS A total of 27 564 patients (75.4% men and 24.6% women; mean [SD] age, 62.5 [9.0] years) were included in the analysis. Of 2034 patients (7.4%) who had a baseline LDL-C of less than 70 mg/dL, evolocumab reduced the risk for the primary endpoint (hazard ratio [HR], 0.80; 95% CI, 0.60-1.07) to a similar degree as in the 25 529 patients who had baseline LDL-C of at least 70mg/dL (HR 0.86; 95% CI, 0.79-0.92; P = .65 for interaction; 1 patient was missing baseline LDL-C data). Of 7533 patients (27.3%) receiving maximal-potency statins, evolocumab significantly reduced the primary endpoint (HR, 0.86; 95% CI, 0.75-0.98) to a similar degree as in the 20 031 patients not receiving a maximal-potency statin (HR, 0.85; 95% CI, 0.78-0.93; P = .88 for interaction). The key secondary endpoint was reduced to a similar degree in both analyses. No major safety concerns were identified. CONCLUSIONS AND RELEVANCE Evolocumab was equally effective in reducing cardiovascular events in patients with stable atherosclerotic cardiovascular disease regardless of whether the baseline LDL-C was less than 70 or at least 70 mg/dL and whether the background statin was of maximal or submaximal potency.Wo

Programa de intervención psicopedagógica en la familia

Tesis (Psicopedagogo, Licenciado en Educación)En nuestra sociedad actual, donde todo ocurre tan rápidamente, en la que prima la competitividad, el estrés (tan de moda actualmente), el consumismo y tantos otros fenómenos sociales deshumanizadores, se limitan cada vez más los espacios para compartir con nuestros niños y con nuestras familias. Hemos olvidado que la familia es una de las instituciones más relevantes para la vida de las personas, y es el grupo de origen para todo ser humano. En ésta, se puede estimular el desarrollo sano de sus miembros en los ámbitos biológico, psicológico y social, o puede representar un obstáculo que tendrá repercusiones en los individuos. Todas las familias tienen mecanismos para enfrentar y solucionar los problemas. Pero hay casos en que la magnitud de éstos sobrepasa las fuerzas de la familia, y es aquf en donde ésta requiere de ayuda externa que puede darse en forma de orientación o terapia familiar. En este Seminario de Grado, hemos creído pertinente y necesario abordar el tema de la familia, teniendo como objetivo dar a conocer el rol del psicopedagogo en el ámbito psicoafectivo y teniendo como eje percibir las repercusiones que pueden suscitarse en la familia a ralz de las dificultades de aprendizaje que presentan sus hijos. Para lograr lo planteado, se investigó sobre el concepto de aprendizaje, haciéndose fundamental definir problemas de aprendizaje y necesidades educativas especiales, estableciéndose un paralelo con el fin de comprender las semejanzas y diferencias entre estos dos conceptos. Utilizando una concepción de necesidades educativas especiales, hemos querido intervenir a nivel de padres, involucrándolos y capacitándolos a través de talleres y por medio de una metodologfa activa y participativa, en la labor educativa de la que no están exentos. De esta manera, alcanzaremos una mayor comprensión de las dimensiones de la familia, y el por qué como futuras psicopedagogas encontramos fundamental intervenir en este ámbito

Predicting Benefit From Evolocumab Therapy in Patients With Atherosclerotic Disease Using a Genetic Risk Score Results From the FOURIER Trial

Background: The ability of a genetic risk score to predict risk in established cardiovascular disease and identify individuals who derive greater benefit from PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibition has not been established. Methods: We studied 14 298 patients with atherosclerotic cardiovascular disease from the FOURIER trial (Further Cardiovascular Outcomes Researh With PCSK9 Inhibition in Subjects With Elevated Risk). A 27-single-nucleotide polymorphism genetic risk score defined low (quintile 1), intermediate (quintiles 2-4), and high (quintile 5) genetic risk. Patients were also categorized by major atherosclerotic risk factors including diabetes mellitus, hypertension, low-density lipoprotein cholesterol >= 100 mg/dl, and smoking; multiple (>= 2) risk factors was considered high clinical risk. Outcomes consisted of major coronary events (coronary heart death, myocardial infarction, or coronary revascularization) and major vascular events (major coronary events and ischemic stroke). Median follow-up was 2.3 years. Results: After we adjusted for clinical factors, the genetic risk score was associated with risk for both major vascular events (P-trend=0.005) and major coronary events (P-trend Conclusion: Patients without multiple clinical risk factors or high genetic risk had a low event rate and did not appear to derive benefit from evolocumab over 2.3 years. Conversely, patients with multiple clinical risk factors but without high genetic risk had intermediate risk and intermediate risk reduction. Patients with high genetic risk, regardless of clinical risk, had a high event rate and derived the greatest relative and absolute benefit from evolocumab, which mitigated this risk

Lipoprotein(a), PCSK9 inhibition and cardiovascular risk: Insights from the FOURIER trial

BACKGROUND: Lipoprotein(a) [Lp(a)] may play a causal role in atherosclerosis. Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors have been shown to significantly reduce plasma Lp(a) concentration. However, the relationship between Lp(a) levels, PCSK9 inhibition and cardiovascular (CV) risk reduction remains undefined. METHODS: Lp(a) was measured in 25,096 patients in FOURIER, a randomized trial of evolocumab versus placebo in patients with established atherosclerotic CV disease (median follow-up 2.2 years). Cox models were used to assess the independent prognostic value of Lp(a) and the efficacy of evolocumab for coronary risk reduction by baseline Lp(a) concentration. RESULTS: The median [IQR] baseline Lp(a) concentration was 37[13-165] nmol/L. In the placebo arm, patients with baseline Lp(a) in the highest quartile had a higher risk of coronary heart disease (CHD) death, MI or urgent revascularization (UR) (adjusted HR Q4:Q1 1.22, 95% CI 1.01-1.48) independent of LDL-C. At 48 weeks, evolocumab significantly reduced Lp(a) by a median [IQR] of 26.9% [6.2-46.7%]. The percent change in Lp(a) and LDL-C at 48 weeks in evolocumab patients was moderately positively correlated (r=0.37, 95% CI 0.36-0.39, Pmedian, and by 7% (HR 0.93, 0.80-1.08; P interaction=0.07) in those ≤median. Coupled with the higher baseline risk, the absolute risk reductions and NNT3y were 2.49% and 40 vs. 0.95% and 105, respectively. CONCLUSIONS: Lp(a) is associated with the risk of CV events in patients with established CV disease irrespective of LDL-C. Evolocumab significantly reduced Lp(a) levels, and patients with higher baseline Lp(a) levels experienced greater absolute reductions in Lp(a) and tended to derive greater coronary benefit from PCSK9 inhibition. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov Unique Identifier: NCT01764633