Estructura y variabilidad genética del bisonte americano (Bison bison) en México

Controlling for genetic variables to managing conservation populations. Single nucleotide polymorphism (SNP) genetic markers were used to analyze genetic structure and variability in an American bison population in the state of Chihuahua, Mexico. A total of 174 individuals were sampled and analysis done of 42,366 SNP distributed in 29 chromosomes. Estimates were done of expected (He) and observed (Ho) heterozygosity, polymorphic information content (PIC), the fixation index (FST), the Shannon index (SI), linkage disequilibrium (LD), kinship relationships (Rij; %), and effective population size (Ne). A genetic structure analysis was run to infer how many lines or genomes (k) define the studied population. A panel with 2,135 polymorphic SNPs was identified and selected, with an average of 74 SNP per chromosome. In the exclusion process, 84.5 % were monomorphic, 8.5 % had a usable percentage less than 90 %, 6.3 % had a minor allele frequency less than 0.01 and 0.70 % exhibited Hardy-Weinberg disequilibrium (P<0.05). Estimated values were 0.30 for the SI, 0.187 for Ho, 0.182 for He, -0.029 for the FST, and 0.152 for PIC. Of the 15,051 Rij estimates generated, the average value was 7.6 %, and 45.1 % were equal to zero. The Ne was 12.5, indicating a possible increase of 4 % in consanguinity per generation. Three genetic lines were identified (proportions = 0.730, 0.157 and 0.113), and, given the study population’s origin, are probably associated with natural selection or genetic drift. Genetic variability, as well as Rij levels, must be considered in conservation schemes.Los objetivos fueron analizar la estructura y variabilidad genética del bisonte americano con marcadores genéticos de tipo SNP. Se muestrearon 174 bisontes y se analizaron 42,366 SNP distribuidos en los 29 cromosomas. Se estimó la heterocigosis esperada (He) y observada (Ho), contenido de información polimórfica (CIP), índice de fijación (FIS), índice de Shannon (IS), desequilibrio de ligamiento y relación de parentesco (Rij; %), así como el tamaño efectivo de población (Ne). Se realizó un análisis de estructura genética para inferir cuántas líneas o genomas (k) definen la población. Se identificó y seleccionó un panel con 2,135 SNP polimórficos, con un promedio de 74 SNP por cromosoma. En el proceso de exclusión,  84.5 % fueron monomórficos,  8.5 % con porcentaje de usables menor a 90 %, 6.3 % con frecuencia del alelo menor inferior a 0.01 y 0.70 % por desequilibrio Hardy-Weinberg (P<0.05). Las estimaciones de IS, Ho, He, FIS y CIP fueron de 0.30, 0.187, 0.182, -0.029 y 0.152, respectivamente. Se generaron 15,051 estimaciones de Rij, el valor promedio de éstas fue 7.6 %, y el 45.1 % de ellas fue igual a cero. El Ne fue de 12.5, señalando un posible incremento de consanguinidad por generación de 4 %. Se identificaron tres líneas genéticas, con proporciones de 0.730, 0.157 y 0.113; dado el origen de la población, se asocian a selección natural o deriva genética. La variabilidad genética, así como los niveles de la Rij, se deben de considerar en esquemas de conservación

Ética profesional en educación superior : finalidades, estrategias y desafíos de la formación

Todo proyecto educativo que no responde a su época se expone a problemas de legitimidad y al duro escrutinio y sanción de los usuarios. Las instituciones de educación superior no son la excepción de esta premisa clásica, incluso más validada por eldinamismos, la versatilidad y ojo crítico en el mundo contemporáneo. La ética se ha convertido en el baremo principal para someter a juicio a las instituciones y a las personas que ahí actuan, como a las finalidades que se pretenden en sus acciones. En esta perspectiva, debe examinarse la función de las instituciones de educación superior.Este libro es el esfuerzo colectivo por acercarnos a esa problemática, en especial a las finalidades, estrategias y relaciones en juego para cumplir la tarea de la formación y sus nexos inevitables con la ética profesional

Effectiveness of subcutaneous low-dose alemtuzumab and rituximab combination therapy for steroid-resistant chronic graft-versus-host disease

Background Chronic graft-versus-host disease is a common late complication of allogeneic hematopoietic stem cell transplantation. Corticosteroids are the standard initial treatment. Second-line treatment has not been well defined. We evaluated the effectiveness and safety of low doses of alemtuzumab plus low doses of rituximab in the treatment of steroid-refractory chronic graftversus-host disease. Design and Methods Ten men and 5 women were prospectively included in the study. All patients received one cycle of subcutaneous alemtuzumab 10 mg/day/3 days and intravenous rituximab 100 mg on Days +4, +11, +18 and +25. The therapeutic response was measured on Days +30, +90 and +365 of the protocol. Results Median age was 41 years. The main site involved was the oral mucosa (86.7%) followed by the eyes (66.7%), liver (60%), skin (53%), lungs (13.3%) and intestinal tract (6.7%). The overall response was 100% at Day +30 evaluation: 10 patients (67%) had partial remission, 5 (33%) had complete remission. At Day +90 evaluation, 7 (50%) patients had partial remission, 4 (28%) had complete remission; 3 (21%) had relapsed chronic graft-versus-host disease and one patient did not reach the evaluation time point. So far, 5 patients have reached the Day +365 follow-up evaluation; 2 (40%) had partial remission, 2 had complete remission and one experienced chronic graft-versus-host disease progression. Adverse effects were mainly infections in 67% of patients; these were all quickly solved, except for one patient who died from pneumonia. Conclusions This combination therapy appears to be an efficacious and safe treatment for steroid-refractory chronic graft-versus-host disease. Longer follow up to determine the durability of response and survival is required (ClinicalTrials.gov: NCT01042509)

Gender differences and management of stroke risk of nonvalvular atrial fibrillation in an upper middle-income country: Insights from the CARMEN-AF registry

Background: Atrial Fibrillation (AF) is associated with an increased risk of stroke and systemic embolism. Several studies have suggested that female AF patients could have a greater risk for stroke. There is scarce information about clinical characteristics and use of antithrombotic therapies in Latin American patients with nonvalvular AF. Objective: To describe the gender differences in clinical characteristics, thromboembolic risk, and antithrombotic therapy of patients with nonvalvular AF recruited in Mexico, an upper middle-income country, into the prospective national CARMEN-AF Registry. Methods: A total of 1423 consecutive patients, with at least one thromboembolic risk factor were enrolled in CARMEN-AF Registry during a three-year period (2014–2017). They were categorized according to Gender. Results: Overall, 48.6% were women, mean age 70 ± 12 years. Diabetes, smoking, alcoholism, non-ischemic cardiomyopathy, coronary artery disease, and obstructive sleep apnea were higher in men. Most women were found with paroxysmal AF (40.6%), and most men with permanent AF (44.0%). No gender differences were found in the use of vitamin K antagonists (VKA) (30.5% in women vs. 28.0% in men). No gender differences were found in the use of direct oral anticoagulants (DOAC) (33.8% women vs 35.4% men). Conclusions: CARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC. Keywords: Atrial fibrillation, Gender, Thromboembolic risk, Antithrombotic therapy, Stroke, Mexic

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk

Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes)

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