Opioids: Pharmacology and Epidemiology

Los opioides desde hace muchos años son los analgésicos más utilizados y efectivos para el tratamiento del dolor. Este trabajo da a conocer la clasificación farmacológica, usos terapéuticos, riesgos a la salud y reacciones adversas de los opioides como fármacos, planteando el paradigma del usar este tipo de fármacos para el control del dolor, sin embargo se han convertido en un problema de salud en distintos países ya que en ciertas circunstancias tienen un alto potencial de causar adicción. Además de su uso contra el dolor, los opioides son utilizados como antidiarreicos, antitusivos y para el tratamiento de diversas sintomatologías. A pesar de los efectos adversos, el mal uso y abuso de los opioides; se consideran imprescindibles en la terapia contra el dolor. Actualmente las investigaciones farmacéuticas trabajan en la búsqueda constante de nuevos fármacos con efectos menos severos y con potencia analgésicaOpioids have been used for many years as the most effective analgesics for pain management. This work discloses the pharmacological classification, therapeutic uses, health risks and adverse reactions of opioids as medicines, setting out the paradigm of using this type of drug to control pain. However, they have become a health problem in distinct countries, as they have a high addictive potential under certain circumstances. In addition to their use against pain, opioids are also employed as antidiarrheal, antitussive and for the treatment of diverse symptomatology. Despite the adverse effects, misuse and abuse of opioids, they are still considered as indispensable in pain therapy. Currently pharmaceutical research is working on the constant development for new drugs with less severe effects and a high analgesic potency

A Novel Partial Deletion of Exons 2–10 of the STS Gene in Recessive X-Linked Ichthyosis

X-linked ichthyosis is an inherited disease due to steroid sulfatase deficiency. Onset is at birth or early after birth with dark, regular, and adherent scales of skin. Approximately 85%-90% of X-linked ichthyosis patients have large deletions of the STS gene and flanking sequences. Three patients have been identified with partial deletions of the gene. Two deletions have been found at the 3′ extreme and the other one implicating exons 2–5. This study describes a novel partial deletion of the STS gene in an X-linked ichthyosis patient. The subject was classified through steroid sulfatase assay in leukocytes using 7-[3H]-dehydroepiandrosterone sulfate as a substrate. Exons 1, 2, 5, and 7–10, and 3′ flanking sequences DXS1131, DXS1133, DXS237, DXS1132, DXF22S1, and DXS278 of the STS gene were analyzed through polymerase chain reaction. The DNA analysis showed that exon 1 and 3′ flanking sequences from DXS237 to DXS278 were present. In this study we report the fourth partial deletion of the STS gene and the first spanning exons 2–10 in X-linked ichthyosis patients

Gender-specific differences in clinical and metabolic variables associated with NAFLD in a Mexican pediatric population

Introduction and Objectives: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and it is more prevalent in Hispanic males. The gender differences can be explained by body fat distribution, lifestyle, or sex hormone metabolism. We evaluated anthropometric and metabolic differences by gender in children with and without NAFLD. Methods: We included 194 participants (eutrophic, overweight, and individuals with obesity). The presence of NAFLD was determined using ultrasonography, and we evaluated the association between this disease with metabolic and anthropometric variables by gender. Results: The mean age was 10.64 ± 2.54 years. The frequency of NAFLD in boys was 24.51% and in girls was 11.96% (OR = 2.39; 95%CI = 1.10–5.19; p = 0.025). For girls, NAFLD was significantly associated with triglycerides (p = 0.012), homeostatic model assessment of insulin resistance (HOMA-IR) (p = 0.048), and the visceral adiposity index (VAI) (p = 0.024). The variables related to NAFLD in a gender-specific manner were body mass index (BMI) (p = 0.001), waist circumference (WC) (p < 0.001), HDL cholesterol (p = 0.021), alanine aminotransferase (ALT) (p < 0.001), and aspartate aminotransferase (AST) (p = 0.002). Conclusions: In our study NAFLD is more frequent in boys, only ALT, and no other clinical or metabolic variables, were associated with NAFLD in these patients. HOMA-IR, VAI, triglyceride levels, and ALT were associated with NAFLD only in girls. The ALT cut-off points for the development of NAFLD in our study were 28.5 U/L in females and 27.5 U/L in males. Our findings showed that NAFLD should be intentionally screened in patients with obesity, particularly in boys

Expression of metalloproteinases MMP-2 and MMP-9 is associated to the presence of androgen receptor in epithelial ovarian tumors

Abstract Background The current study evaluated the metalloproteinases MMP-2 and MMP-9 expression in epithelial cells and the surrounding stroma in ovarian tumors and the association of MMPs with the histological subtypes, the clinical stage and the presence of steroid hormone receptors. Tumor samples were obtained from 88 patients undergoing surgical cytoreduction of primary ovarian tumors in Instituto Nacional de Cancerología, from México City. The formalin fixed and paraffin embedded samples were processed in order to demonstrate the presence of androgen receptor,estrogen receptor alpha, progesterone receptor, MMP-2,MMP-9 and collagen IV by immunohistochemistry and/or immunofluorescence. Results MMP-2 and MMP-9 were differentially expressed in the epithelium and the stroma of ovarian tumors associated to histological subtype, clinical stage and sexual steroid hormone receptor expression. Based on Cox proportional hazard regression model we demonstrated that MMP-2 located in the epithelium and the stroma are independent prognostic biomarkers for overall survival in epithelial ovarian tumors. Kaplan Meir analysis of the combination of AR (+) with MMP-2 (+) in epithelium and AR (+) with MMP-2 (−) in stroma displayed a significant reduction of survival. Conclusions The presence of MMP-2 in the stroma of the tumor was a protective factor while the presence of MMP-2 in the epithelium indicated an adverse prognosis. The presence of AR associated with MMP-2 in the tumor cells was a risk factor for overall survival in epithelial ovarian cancer