Pre- and Postnatal Surgery, Most Common Conditions, Diagnosis and Treatment

The authors make a general but relevant description of the most common surgical problems occurring both in the human being that develops in the uterus and in the one that has already been born

What happened after the initial global spread of pandemic human influenza virus A (H1N1)? A population genetics approach

Viral population evolution dynamics of influenza A is crucial for surveillance and control. In this paper we analyzed viral genetic features during the recent pandemic caused by the new influenza human virus A H1N1, using a conventional population genetics approach based on 4689 hemagglutinin (HA) and neuraminidase (NA) sequences available in GenBank submitted between March and December of 2009. This analysis showed several relevant aspects: a) a scarce initial genetic variability within the viral isolates from some countries that increased along 2009 when influenza was dispersed around the world; b) a worldwide virus polarized behavior identified when comparing paired countries, low differentiation and high gene flow were found in some pairs and high differentiation and moderate or scarce gene flow in others, independently of their geographical closeness, c) lack of positive selection in HA and NA due to increase of the population size of virus variants, d) HA and NA variants spread in a few months all over the world being identified in the same countries in different months along 2009, and e) containment of viral variants in Mexico at the beginning of the outbreak, probably due to the control measures applied by the government

Can the pyruvate: ferredoxin oxidoreductase (PFOR) gene be used as an additional marker to discriminate among Blastocystis strains or subtypes?

Background Blastocystis spp. are the most prevalent intestinal eukaryotes identified in humans, with at least 17 genetic subtypes (ST) based on genes coding for the small-subunit ribosomal RNA (18S). It has been argued that the 18S gene should not be the marker of choice to discriminate between STs of these strains because this marker exhibits high intra-genomic polymorphism. By contrast, pyruvate:ferredoxin oxidoreductase (PFOR) is a relevant enzyme involved in the core energy metabolism of many anaerobic microorganisms such as Blastocystis, which, in other protozoa, shows more polymorphisms than the 18S gene and thus may offer finer discrimination when trying to identify Blastocystis ST. Therefore, the objective of the present study was to assess the suitability of the PFOR gene as an additional marker to discriminate among Blastocystis strains or subtypes from symptomatic carrier children. Methods Faecal samples from 192 children with gastrointestinal symptoms from the State of Mexico were submitted for coprological study. Twenty-one of these samples were positive only for Blastocystis spp.; these samples were analysed by PCR sequencing of regions of the 18S and PFOR genes. The amplicons were purified and sequenced; afterwards, both markers were assessed for genetic diversity. Results The 18S analysis showed the following frequencies of Blastocystis subtypes: ST3 = 43%; ST1 = 38%; ST2 = 14%; and ST7 = 5%. Additionally, using subtype-specific primer sets, two samples showed mixed Blastocystis ST1 and ST2 infection. For PFOR, Bayesian inference revealed the presence of three clades (I-III); two of them grouped different ST samples, and one grouped six samples of ST3 (III). Nucleotide diversity (π) and haplotype polymorphism (θ) for the 18S analysis were similar for ST1 and ST2 (π = ~0.025 and θ = ~0.036); remarkably, ST3 showed almost 10-fold lower values. For PFOR, a similar trend was found: clade I and II had π = ~0.05 and θ = ~0.05, whereas for clade III, the values were almost 6-fold lower. Conclusions Although the fragment of the PFOR gene analysed in the present study did not allow discrimination between Blastocystis STs, this marker grouped the samples in three clades with strengthened support, suggesting that PFOR may be under different selective pressures and evolutionary histories than the 18S gene. Interestingly, the ST3 sequences showed lower variability with probable purifying selection in both markers, meaning that evolutionary forces drive differential processes among Blastocystis STs

Appendicitis in Children: Fundamentals and Particularities

Acute appendicitis in children under 5 years of age is a diagnostic challenge, its delay is usually dramatic and leaves serious sequelae. It is one of the main causes of surgical intervention, it is common for other diseases to be associated with it and to simulate it. Acute appendicitis is of obstructive etiology and its pathophysiology, the bacteriology involved and the evolution of the disease progresses through its phases, from the simple to the complex, is addressed in each case. The typical abdominal pain of appendicitis, in addition to vomiting and fever at a young age, is most often accompanied by an atypical clinical picture such as diarrhea. Integrating the clinical signs at this age requires the full capacity and good sense of the pediatric surgeon. For a correct and timely diagnosis, unfortunately many pediatric patients present in complicated stages of the disease, which implies decision-making regarding the type of surgical intervention and subsequent treatments

Production of food nanomaterials by specialized equipment

In the past decade, there has been a great interest in using nanotechnology by different industries, including food, pharmaceutical, and beauty. Nanotechnology provides many advantages to produce functional compounds which tend to be delivered for desired properties, such as protection from the environment or food matrix, controlled release, and increased bioavailability and bioaccessibility (Muhammad et al., 2019, Sedaghat Doost et al., 2019b, Sedaghat Doost et al., 2018c). There is a variety of methods to prepare food nanomaterials. Specialized equipment is frequently employed for the production of efficient nano-delivery systems, which is the focus of this chapter; the basic principle of conventional and recent techniques, as well as their advantages and disadvantages are described

Estilo de vida e influencia en el desorden alimenticio un estudio de caso en el municipio de Malpaso, Chiapas, México

This article shows the results of a case study about the lifestyle and influence on eating disorder in patients who came during the investigation period to Family Medical Unit (FMU) located in the municipality of Malpaso, Chiapas. Objective: to determine the lifestyle and influence on the alimentary disorder in patients who attended the family medicine consultation at FMU No. 41 of Malpaso, Chiapas. Materials and methods: a questionnaire was applied and later contrasted with the FANTASTIC instrument, both designed to determine lifestyles. Results and discussion: it was determined that, in general, the study subjects have a "bad" lifestyle, which is manifested in chronic degenerative diseases such as: DM1, DM2, HAS, dyslipidemias, hyperuricemia, CA, to name a few. It was also found that 53.1% are overweight, 26.8% have obesity grade I, 8.4% are obesity grade II, 1.4% are obesity grade III and only 11.9% are normal weight. When comparing the results of the questionnaire with the FANTASTIC instrument, it was corroborated that the lifestyle of the respondents is bad and with a high consumption of foods rich in calories. Conclusions: the subjects of the study of this research run a permanent risk of dying prematurely for having a bad lifestyle, and this will be reflected in short and medium term in most cases, with the appearance of chronic degenerative diseases.Este artigo mostra os resultados de um estudo de caso sobre o estilo de vida e a influência sobre o transtorno alimentar em beneficiários que participaram durante o período da investigação para uma Unidade Médica Familiar (UMF) localizada no município de Malpaso, Chiapas. Objetivo: determinar o estilo de vida e a influência sobre o transtorno alimentar nos titulares de direitos que frequentaram a prática familiar no UMF no. 41 de Malpaso, Chiapas. Materiais e métodos: um questionário foi aplicado e, posteriormente, foi contrastado com o instrumento FANTÁSTICO, ambos projetados para determinar estilos de vida. Resultados e discussão: foi determinado que, em geral, os sujeitos do estudo têm um estilo de vida "ruim", que se manifesta em doenças crônico-degenerativas como diabetes mellitus tipo 1 (DM1), diabetes mellitus tipo 2 (DM2), hipertensão arterial (HAS), dislipidemias, hiperuricemia e câncer, para citar alguns. Do mesmo modo, verificou-se que 53,1% estão com sobrepeso, 26,8% têm obesidade grau I, 8,4% obesidade grau II, 1,4% obesidade grau III e apenas 11,9% têm peso normal. Ao contrastar os resultados do questionário com o instrumento FANTÁSTICO, foi corroborado que o estilo de vida dos entrevistados é ruim e com alto consumo de alimentos ricos em calorias. Conclusões: os sujeitos do estudo da presente investigação estão em permanente risco de morrer prematuramente por ter um estilo de vida ruim, que se refletirá no curto e médio prazo na maioria dos casos, com a aparência de doenças crônicas. - degenerativa.Este artículo muestra los resultados de un estudio de caso sobre el estilo de vida e influencia en el desorden alimenticio en derechohabientes que acudieron durante el periodo de la investigación a una Unidad Médica Familiar (UMF) ubicada en el municipio de Malpaso, Chiapas. Objetivo: determinar el estilo de vida e influencia en el desorden alimenticio en derechohabientes que acudieron a la consulta de medicina familiar en la UMF no. 41 de Malpaso, Chiapas. Materiales y métodos: se aplicó un cuestionario y, posteriormente, se contrastó con el instrumento FANTASTIC, ambos diseñados para determinar los estilos de vida. Resultados y discusión: se determinó que, en general, los sujetos de estudio tienen un estilo de vida “malo”, el cual se manifiesta en enfermedades crónico-degenerativas como diabetes mellitus tipo 1 (DM1), diabetes mellitus tipo 2 (DM2), hipertensión arterial sistémica (HAS), dislipidemias, hiperuricemia y cáncer, por citar algunas. Asimismo, se encontró que 53.1% tiene sobrepeso, 26.8% tiene obesidad grado I, 8.4% obesidad grado II, 1.4% obesidad grado III y sólo 11.9% tiene peso normal. Al contrastar los resultados del cuestionario con el instrumento FANTASTIC, se corroboró que el estilo de vida de los encuestados es malo y con un alto consumo de alimentos ricos en calorías. Conclusiones: los sujetos de estudio de la presente investigación están en riesgo permanente de fallecer de manera prematura por tener un estilo de vida malo, que se verá reflejado en el corto y mediano plazo en la mayoría de los casos, con la aparición de enfermedades crónico-degenerativas

A Pilot Genome-Wide Association Study in Postmenopausal Mexican-Mestizo Women Implicates the RMND1/CCDC170 Locus Is Associated with Bone Mineral Density

To identify genetic variants influencing bone mineral density (BMD) in the Mexican-Mestizo population, we performed a GWAS for femoral neck (FN) and lumbar spine (LS) in Mexican-Mestizo postmenopausal women. In the discovery sample, 300,000 SNPs were genotyped in a cohort of 411 postmenopausal women and seven SNPs were analyzed in the replication cohort (n=420). The combined results of a meta-analysis from the discovery and replication samples identified two loci, RMND1 (rs6904364, P=2.77×10−4) and CCDC170 (rs17081341, P=1.62×10−5), associated with FN BMD. We also compared our results with those of the Genetic Factors for Osteoporosis (GEFOS) Consortium meta-analysis. The comparison revealed two loci previously reported in the GEFOS meta-analysis: SOX6 (rs7128738) and PKDCC (rs11887431) associated with FN and LS BMD, respectively, in our study population. Interestingly, rs17081341 rare in Caucasians (minor allele frequency < 0.03) was found in high frequency in our population, which suggests that this association could be specific to non-Caucasian populations. In conclusion, the first pilot Mexican GWA study of BMD confirmed previously identified loci and also demonstrated the importance of studying variability in diverse populations and/or specific populations

Role of Urinary Kidney Stress Biomarkers for Early Recognition of Subclinical Acute Kidney Injury in Critically Ill COVID-19 Patients

A high proportion of critically ill patients with COVID-19 develop acute kidney injury (AKI) and die. The early recognition of subclinical AKI could contribute to AKI prevention. Therefore, this study was aimed at exploring the role of the urinary biomarkers NGAL and [TIMP-2] × [IGFBP7] for the early detection of AKI in this population. This prospective, longitudinal cohort study included critically ill COVID-19 patients without AKI at study entry. Urine samples were collected on admission to critical care areas for determination of NGAL and [TIMP-2] × [IGFBP7] concentrations. The demographic information, comorbidities, clinical, and laboratory data were recorded. The study outcomes were the development of AKI and mortality during hospitalization. Of the 51 individuals that were studied, 25 developed AKI during hospitalization (49%). Of those, 12 had persistent AKI (23.5%). The risk factors for AKI were male gender (HR = 7.57, 95% CI: 1.28–44.8; p = 0.026) and [TIMP-2] × [IGFBP7] ≥ 0.2 (ng/mL)2/1000 (HR = 7.23, 95% CI: 0.99–52.4; p = 0.050). Mortality during hospitalization was significantly higher in the group with AKI than in the group without AKI (p = 0.004). Persistent AKI was a risk factor for mortality (HR = 7.42, 95% CI: 1.04–53.04; p = 0.046). AKI was frequent in critically ill COVID-19 patients. The combination of [TIMP-2] × [IGFBP7] together with clinical information, were useful for the identification of subclinical AKI in critically ill COVID-19 patients. The role of additional biomarkers and their possible combinations for detection of AKI in ritically ill COVID-19 patients remains to be explored in large clinical trials