Guía Mexicana de Práctica Clínica de Inmunoterapia 2011

Existen varias guías internacionales para la práctica clínica de in- munoterapia, que aplican solo parcialmente en México. La primera guía mexicana de inmunoterapia data de 1998

Type 2 Diabetes Variants Disrupt Function of SLC16A11 through Two Distinct Mechanisms

Type 2 diabetes (T2D) affects Latinos at twice the rate seen in populations of European descent. We recently identified a risk haplotype spanning SLC16A11 that explains ∼20% of the increased T2D prevalence in Mexico. Here, through genetic fine-mapping, we define a set of tightly linked variants likely to contain the causal allele(s). We show that variants on the T2D-associated haplotype have two distinct effects: (1) decreasing SLC16A11 expression in liver and (2) disrupting a key interaction with basigin, thereby reducing cell-surface localization. Both independent mechanisms reduce SLC16A11 function and suggest SLC16A11 is the causal gene at this locus. To gain insight into how SLC16A11 disruption impacts T2D risk, we demonstrate that SLC16A11 is a proton-coupled monocarboxylate transporter and that genetic perturbation of SLC16A11 induces changes in fatty acid and lipid metabolism that are associated with increased T2D risk. Our findings suggest that increasing SLC16A11 function could be therapeutically beneficial for T2D. Video Abstract [Figure presented] Keywords: type 2 diabetes (T2D); genetics; disease mechanism; SLC16A11; MCT11; solute carrier (SLC); monocarboxylates; fatty acid metabolism; lipid metabolism; precision medicin

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad

A Reorder Buffer Design for High Performance Processors

Abstract. Modern reorder buffers (ROBs) were conceived to improve processor performance by allowing instruction execution out of the original program order and run ahead of sequential instruction code exploiting existing instruction level parallelism (ILP). The ROB is a functional structure of a processor execution engine that supports speculative execution, physical register recycling, and precise exception recovering. Traditionally, the ROB is considered as a monolithic circular buffer with incoming instructions at the tail pointer after the decoding stage and completing instructions at the head pointer after the commitment stage. The latter stage verifies instructions that have been dispatched, issued, executed, and are not completed speculatively. This paper presents a design of distributed reorder buffer microarchitecture by using small structures near building blocks which work together, using the same tail and head pointer values on all structures for synchronization. The reduction of area, and therefore, the reduction of power and delay make this design suitable for both embedded and high performance microprocessors

La degradación ambiental de los paisajes en las cuencas tributarias de la ensenada de Sibarimar (Guanabo e Itabo, Cuba)

The basins of the Guanabo and Itabo rivers are located in the northeaster limit of the La Habana province in Cuba. Meanwhile the urban and touristic uses of the territory are very significant in the coastline, the agriculture and the livestock are predominant in the hinterland. Just a few of natural areas remain in this area. Due to the conflict of uses and changing ecological features, the analysis of the environmental degradation of the landscapes is vital in order to establish a sustainable development of the territory. To reach this aim, we have classified the territory in units attending to the main ecological features that form the different landscapes. After that, we have carried out an integrated diagnosis taking into consideration aspects such as the main uses of the landscape units, its potential and efficiency, environmental dangers, degrading processes and geoecological state.Les bassins hydrographiques des fleuves Itabo et Guanabo sont situés sur la limite nord de la province de La Havane, à Cuba. Alors que l�usages urbains et touristiques sont très importants sur la côte, de l�agriculture et l�élevage sont prédominant dans l�intérieur. Ils ne restent plus quelques zones naturelles résiduelles. En raison des conflits d�usages et de l�évolution des caractéristiques écologiques c�est très important faire d�analyse essentielle de la dégradation de l�environnement du paysage, pour établir un développement durable des terres. Pour ce faire, il faut divisé le territoire en unités suivant les caractéristiques qui ont les différents paysages. Après cela, on fera un diagnostic intégré en train de considérer des aspects tels que les principaux/ dominant utilisations des unités de paysage, le potentiel et l�efficience, les risques et la dégradation sur l�environnement, et aussi l�état géoécologique.Las cuencas de los ríos Guanabo e Itabo se localizan en el límite nororiental de la provincia de La Habana en Cuba. Mientras que los usos urbanos y turísticos son muy importantes en la costa, la agricultura y la ganadería son predominantes en el interior. Solamente quedan unas pocas áreas naturales. Debido al conflicto de usos y a las cambiantes características ecológicas es vital el análisis de la degradación medioambiental de los paisajes para establecer un desarrollo sostenible del territorio. Para alcanzar este objetivo hemos clasificado el territorio en unidades según las principales características que conforman los diferentes paisajes. Después de eso, hemos realizado un diagnóstico integrado teniendo en consideración aspectos como los principales usos de las unidades del paisaje, su potencial y eficiencia, los peligros ambientales, los procesos degradantes y el estado geoecológico

Trimethylamine N-oxide levels are associated with NASH in obese subjects with type 2 diabetes.

AIMS: Trimethylamine N-oxide (TMAO), choline and betaine serum levels have been associated with metabolic diseases including type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD). These associations could be mediated by insulin resistance. However, the relationships among these metabolites, insulin resistance and NAFLD have not been thoroughly investigated. Moreover, it has recently been suggested that TMAO could play a role in NAFLD by altering bile acid metabolism. We examined the association between circulating TMAO, choline and betaine levels and NAFLD in obese subjects. METHODS: Serum TMAO, choline, betaine and bile acid levels were measured in 357 Mexican obese patients with different grades of NAFLD as determined by liver histology. Associations of NAFLD with TMAO, choline and betaine levels were tested. Moreover, association of TMAO levels with non-alcoholic steatohepatitis (NASH) was tested separately in patients with and without T2D. RESULTS: TMAO and choline levels were significantly associated with NAFLD histologic features and NASH risk. While increased serum TMAO levels were significantly associated with NASH in patients with T2D, in non-T2D subjects this association lost significance after adjusting for sex, BMI and HOMA2-IR. Moreover, circulating secondary bile acids were associated both with increased TMAO levels and NASH. CONCLUSIONS: In obese patients, circulating TMAO levels were associated with NASH mainly in the presence of T2D. Functional studies are required to evaluate the role of insulin resistance and T2D in this association, both highly prevalent in NASH patients