Ten Years of Experience Support Pharmacogenetic Testing to Guide Individualized Drug Therapy

[EN]Precision medicine utilizing the genetic information of genes involved in the metabolism and disposition of drugs can not only improve drug efficacy but also prevent or minimize adverse events. Polypharmacy is common among multimorbid patients and is associated with increased adverse events. One of the main objectives in health care is safe and efficacious drug therapy, which is directly correlated to the individual response to treatment. Precision medicine can increase drug safety in many scenarios, including polypharmacy. In this report, we share our experience utilizing precision medicine over the past ten years. Based on our experience using pharmacogenetic (PGx)-informed prescribing, we implemented a five-step precision medicine protocol (5SPM) that includes the assessment of the biological-clinical characteristics of the patient, current and past prescription history, and the patient's PGx test results. To illustrate our approach, we present cases highlighting the clinical relevance of precision medicine with a focus on patients with a complex history and polypharmacy.Instituto de Salud Carlos III; European Regional Development Fun

Niveles de sustentabilidad en la reserva de la biosfera Ría Lagartos, Yucatán

 In Mexico, one of the strategies for the management and conservation of natural ecosystems is the formation of biosphere reserves, which are managed by the National Commission of Natural Protected Areas (Comisión Nacional de Áreas Naturales Protegidas, CONANP), government agency in charge of protecting and regulating the management and sustainable exploitation of natural resources. This contribution has the objective of analyzing the levels of sustainability present in the Ría Lagartos Biosphere Reserve, Yucatán, based on the evaluation of attributes (Productivity, Adaptability, Stability, Resilience, Equity and Self-management). These attributes are established by the Framework for the Evaluation of Natural Resource Management Systems Incorporating Sustainability Indicators (Marco de Evaluación de Sistemas de Manejo de Recursos Naturales Incorporando Indicadores de Sustentabilidad, MESMIS). The formulation of indicators that integrate the ecologic, economic and social axes in four key populations settled within the area is the basis of the study. The results obtained determine that the reserve presents a Low Level of sustainability, where the lack of budget for its management, conservation and research constitutes the unavoidable component that favors the gradual development of factors that dislocate the efficiency of government actions. This shows the fragility and short-term vision in the formulation of operative instruments destined to the maintenance and conduction of this type of areas.  En México una de las estrategias para el manejo y conservación de los ecosistemas naturales es la formación de reservas de la biosfera, mismas que se encuentran administradas por la Comisión Nacional de Áreas Naturales Protegidas (CONANP), instancia gubernamental encargada de proteger y regular el manejo y aprovechamiento sustentable de los recursos naturales. Esta contribución tiene como objetivo analizar los niveles de sustentabilidad presentes en la reserva de la biosfera Ría Lagartos, Yucatán, a partir de la evaluación de los atributos (Productividad, Adaptabilidad, Estabilidad, Resiliencia, Equidad y Autogestión) establecidos por el Marco de Evaluación de Sistemas de Manejo de Recursos Naturales Incorporando Indicadores de Sustentabilidad (MESMIS). Base del trabajo lo fue la formulación de indicadores que integran los ejes ecológico, económico y social en cuatro poblaciones clave asentadas dentro del área. Los resultados obtenidos determinan que la reserva presenta un Nivel Malo de sustentabilidad, donde la falta de presupuesto para su manejo, conservación e investigación constituye el componente ineludible, que favorece el desarrollo paulatino de factores que dislocan la eficiencia de las acciones gubernamentales. Lo anterior demuestra la fragilidad y visión de corto plazo en la formulación de instrumentos operativos destinados al sostenimiento y conducción de este tipo de áreas

Cellular effects mediated by pathogenic LRRK2: homing in on Rab-mediated processes

Leucine-rich repeat kinase 2 (LRRK2) is a key player in the pathogenesis of Parkinson's disease. Mutations in LRRK2 are associated with increased kinase activity that correlates with cytotoxicity, indicating that kinase inhibitors may comprise promising diseasemodifying compounds. However, before embarking on such strategies, detailed knowledge of the cellular deficits mediated by pathogenic LRRK2 in the context of defined and pathologically relevant kinase substrates is essential. LRRK2 has been consistently shown to impair various intracellular vesicular trafficking events, and recent studies have shown that LRRK2 can phosphorylate a subset of proteins that are intricately implicated in those processes. In light of these findings, we here review the link between cellular deficits in intracellular trafficking pathways and the LRRK2-mediated phosphorylation of those newly identified substrates

Performing masculinity, influencing health: A qualitative mixed-methods study of young Spanish men

Background: The literature shows how gender mandates contribute to differences in exposure and vulnerability to certain health risk factors. This paper presents the results of a study developed in the south of Spain, where research aimed at understanding men from a gender perspective is still limited.Objective: The aim of this paper is to explore the lay perceptions and meanings ascribed to the idea of masculinity, identifying ways in which gender displays are related to health.Design: The study is based on a mixed-methods data collection strategy typical of qualitative research. We performed a qualitative content analysis focused on manifest and latent content.Results: Our analysis showed that the relationship between masculinity and health was mainly defined with regard to behavioural explanations with an evident performative meaning. With regard to issues such as driving, the use of recreational drugs, aggressive behaviour, sexuality, and body image, important connections were established between manhood acts and health outcomes. Different ways of understanding and performing the male identity also emerged from the results. The findings revealed the implications of these aspects in the processes of change in the identity codes of men and women.Conclusions: The study provides insights into how the category ‘man’ is highly dependent on collective practices and performative acts. Consideration of how males perform manhood acts might be required in guidance on the development of programmes and policies aimed at addressing gender inequalities in health in a particular local context.This research received no specific grant from any funding agency in the public, commercial, or not- for-profit sectors. However, we had the opportunity to write this paper with the financial support from the European Regional Development Fund (FEDER) and the Andalusian Government’s Economy, Innovation and Science Department (Exp P08-CTS-4321)

Kwapa: Gente del río. Estrategias transmedia de impacto social

El PAP Alter Código, período Primavera 2023, trabajó con los dos proyectos que se han venido trabajando en semestres anteriores: el videojuego A Orillas del río y el documental Déjennos pescar. Ambos proyectos parten de la metodología interdisciplinaria y colaborativa con miembros de la comunidad Cucapá para crear representaciones audiovisuales no estigmatizantes, que detonen el sentido de comunidad y refuercen su acervo cultural. El videojuego A Orillas del río es del género point and click, de vista isométrica, el cual está inspirado en el cuento oral tradicional El zorro y el coyote, que busca ser una herramienta lúdica de aprendizaje para reforzar el aprendizaje de la lengua Cucapá en los niños. Los resultados obtenidos fueron el demo del nivel uno (escenas uno y dos); colorimetría, arcos de personajes principales; programación de minijuegos. Dentro del documental ‘Déjennos pescar’ los resultados fueron un montaje, una clasificación del material grabado con transcripciones de audio, mientras que en la parte de estrategia de impacto se creó un manual de uso de redes sociales con colorimetría, tipografía, estilo de voz, tipo de contenido según la red social, para los futuros integrantes del equipo.ITESO, A.C