Intervenções nutricionais para o tratamento da diabetes mellitus gestacional

Introducción: la diabetes mellitus gestacional (DMG) es una alteración del metabolismo de los hidratos de carbono (HC), de severidad variable, que se inicia o se reconoce por primera vez durante la gesta- ción; su frecuencia se ha duplicado en la última década en mujeres con factores de riesgo fácilmente identificables. La terapia de nutrición es una parte integral de la gestión de la dmg. Antiguamente, se utilizaba la restricción de HC; actualmente, se utiliza control de calidad y cantidad de HC, y se está evaluando la eficacia de distintas intervenciones nutricionales. Materiales y métodos: se realizó una búsqueda de artículos originales mediante Pubmed y bases académicas, principalmente ensayos clínicos en los que se demuestra el efecto de la intervención con distintos tipos de dietas en mujeres con DMG. Resultados: se obtuvieron mejores resultados en cuanto a los niveles de glucosa en las dietas altas en HC complejos, grasas saturadas y la utilización de proteína de soja, siendo estas una mejor opción para el control glucémico y evitar repercusiones en el estado nutrición de la madre y del bebé. Conclusión: la terapia nutricional basada en el control de la cantidad, calidad y distribución de hc es el tratamiento inicial para la DMG, pero existe la necesidad de ensayos controlados aleatorios que comparen diferentes intervenciones dietéticas y que evalúen modificaciones en porcentajes de macronutrimentos, valor calórico total, tipo y calidad de nutrimentos que demuestren el papel que cumple la intervención nu- tricional en los resultados de embarazos afectados con DMG.Introduction: Gestational diabetes mellitus (GDM) is an alteration of carbohydrate metabolism, of variable severity, that is initiated or is recognized for the first time during gestation. Its frequency has doubled in the last decade, in women with easily identifiable risk factors. Nutrition therapy is an integral part of the management of gdm. Most women are treated only for nutritional management. The low carbohydrate diet is the most used. Material and methods: We searched original articles using pubmed, sci-hub and academic groups, mainly articles of clinical trials demonstrating the efficacy of different types of diet applied to women with gestational diabetes and their impact on glucose. Results: Better glucose levels were obtained in the high diets in complex carbohydrates, unsaturated lipids and the use of soy protein, being these a better option for glicemic control and to avoid repercussions in the nutritional state of the mother and baby. Conclusion: Nutritional therapy based on quantity control and carbohydrate distribution is the initial treatment for gestational diabetes mellitus, but there is a need for randomized controlled trials comparing different dietary interventions modified in macronutrient percentages of total caloric value. Demonstrating the role they play in addition, Lipids and Proteins.Introdução: a DMG é uma alteração do metabolismo dos hidratos de carbono (HC), de severidade variável, que se inicia ou se reconhece por primeira vez durante a gestação; sua frequência se tem duplicado naúltima década, em mulheres com fatores de risco facilmente identificáveis. A terapia de nutrição é umaparte integral da gestão da DMG. Antigamente utilizava-se a restrição de hc; atualmente se utiliza controle de qualidade e quantidade de HC, e está-se avaliando a eficácia de distintas intervenções nutricionais. Materiais e métodos: realizou-se uma busca de artigos originais mediante pubmed e bases acadêmicas, principalmente ensaios clínicos nos que se demostra o efeito da intervenção com diferentes tipos de dietas em mulheres com DMG. Resultados: obtiveram-se melhores resultados em quanto aos níveis de glicose nas dietas altas em HC complexos, gorduras saturadas e a utilização de proteína de soja, sendoestas uma melhor opção para o controle glicêmico e evitar repercussões no estado nutricional da mãe e do bebê. Conclusão: a terapia de nutrição baseada no controle da quantidade, qualidade e distribuição de HC é o tratamento inicial para a DMG, mas existe a necessidade de ensaios controlados aleatóriosque comparem diferentes intervenções dietéticas que avaliem modificações em porcentagens de ma- cronutrientes, valor calórico total, tipo e qualidade de nutrientes que demostrem o papel que tem a intervenção nutricional nos resultados de gravidezes afetadas com DMG

Metabolic Syndrome, depression and patient safety culture in Mexican resident physicians

Background: Medical residence can affect the well-being and health of resident physicians (rp), which are directly related to the quality of medical care and patient safety. El objective was to identify the prevalence of metabolic syndrome (MetS), depressive symptoms, and evaluate the culture of patient safety in resident physicians. Methods: Cross-sectional analytical survey of 106 physicians residing in 13 medical specialties of a public hospital in Mexico. MetS was defined according to who criteria and depressive symptoms using the cesd-r scale; the culture of patient safety was evaluated with the Spanish version of the Hospital Survey on Patient safety. Results: 53.7% had a combined prevalence of overweight/obesity and insulin resistance was found in 33%. 8.5% of rp had prediabetes and 2.5% diabetes. 23.6% of the sample presented two MetS components. The prevalence of MetS was 8.5% and depressive symptoms were found in 21.7% of rp. The evaluation of the culture of patient safety showed strength in the dimensions of teamwork in the unit-service, organizational learning- continuous improvement, expectations and actions of the direction and frequency of reported events, perception of patient safety culture was found in 8/10 rp. Conclusions: A high prevalence of cardiometabolic alterations and depressive symptoms was found in Mexican rp. It is necessary to promote self-care for health and to strengthen the concept of patient safety culture among resident physicians

Metabolic Syndrome, depression and patient safety culture in Mexican resident physicians

Background: Medical residence can affect the well-being and health of resident physicians (rp), which are directly related to the quality of medical care and patient safety. El objective was to identify the prevalence of metabolic syndrome (MetS), depressive symptoms, and evaluate the culture of patient safety in resident physicians. Methods: Cross-sectional analytical survey of 106 physicians residing in 13 medical specialties of a public hospital in Mexico. MetS was defined according to who criteria and depressive symptoms using the cesd-r scale; the culture of patient safety was evaluated with the Spanish version of the Hospital Survey on Patient safety. Results: 53.7% had a combined prevalence of overweight/obesity and insulin resistance was found in 33%. 8.5% of rp had prediabetes and 2.5% diabetes. 23.6% of the sample presented two MetS components. The prevalence of MetS was 8.5% and depressive symptoms were found in 21.7% of rp. The evaluation of the culture of patient safety showed strength in the dimensions of teamwork in the unit-service, organizational learning- continuous improvement, expectations and actions of the direction and frequency of reported events, perception of patient safety culture was found in 8/10 rp. Conclusions: A high prevalence of cardiometabolic alterations and depressive symptoms was found in Mexican rp. It is necessary to promote self-care for health and to strengthen the concept of patient safety culture among resident physicians

Intervenções nutricionais para o tratamento da diabetes mellitus gestacional

Introducción: la diabetes mellitus gestacional (DMG) es una alteración del metabolismo de los hidratos de carbono (HC), de severidad variable, que se inicia o se reconoce por primera vez durante la gesta- ción; su frecuencia se ha duplicado en la última década en mujeres con factores de riesgo fácilmente identificables. La terapia de nutrición es una parte integral de la gestión de la dmg. Antiguamente, se utilizaba la restricción de HC; actualmente, se utiliza control de calidad y cantidad de HC, y se está evaluando la eficacia de distintas intervenciones nutricionales. Materiales y métodos: se realizó una búsqueda de artículos originales mediante Pubmed y bases académicas, principalmente ensayos clínicos en los que se demuestra el efecto de la intervención con distintos tipos de dietas en mujeres con DMG. Resultados: se obtuvieron mejores resultados en cuanto a los niveles de glucosa en las dietas altas en HC complejos, grasas saturadas y la utilización de proteína de soja, siendo estas una mejor opción para el control glucémico y evitar repercusiones en el estado nutrición de la madre y del bebé. Conclusión: la terapia nutricional basada en el control de la cantidad, calidad y distribución de hc es el tratamiento inicial para la DMG, pero existe la necesidad de ensayos controlados aleatorios que comparen diferentes intervenciones dietéticas y que evalúen modificaciones en porcentajes de macronutrimentos, valor calórico total, tipo y calidad de nutrimentos que demuestren el papel que cumple la intervención nu- tricional en los resultados de embarazos afectados con DMG.Introduction: Gestational diabetes mellitus (GDM) is an alteration of carbohydrate metabolism, of variable severity, that is initiated or is recognized for the first time during gestation. Its frequency has doubled in the last decade, in women with easily identifiable risk factors. Nutrition therapy is an integral part of the management of gdm. Most women are treated only for nutritional management. The low carbohydrate diet is the most used. Material and methods: We searched original articles using pubmed, sci-hub and academic groups, mainly articles of clinical trials demonstrating the efficacy of different types of diet applied to women with gestational diabetes and their impact on glucose. Results: Better glucose levels were obtained in the high diets in complex carbohydrates, unsaturated lipids and the use of soy protein, being these a better option for glicemic control and to avoid repercussions in the nutritional state of the mother and baby. Conclusion: Nutritional therapy based on quantity control and carbohydrate distribution is the initial treatment for gestational diabetes mellitus, but there is a need for randomized controlled trials comparing different dietary interventions modified in macronutrient percentages of total caloric value. Demonstrating the role they play in addition, Lipids and Proteins

Phenotypic characteristics of isolates of Aspergillus section Fumigati from different geographic origins and their relationships with genotypic characteristics

BACKGROUND: Epidemiological studies worldwide have shown that A. fumigatus exhibits important phenotypic and genotypic diversity, and these findings have been of great importance in improving the diagnosis and treatment of diseases caused by this fungus. However, few studies have been carried out related to the epidemiology of this fungus in Latin America. This study's aim is to report on the epidemiology of the fungus by analyzing the phenotypic variability of Aspergillus section Fumigati isolates from different Latin American countries and the relationship between this variability, the geographical origin and genotypic characteristics. METHODS: We analyzed the phenotypic characteristics (macro- and micromorphology, conidial size, vesicles size, antifungal susceptibility and thermotolerance at 28, 37 and 48°C) of A. section Fumigati isolates from Mexico (MX), Argentina (AR), Peru (PE) and France (FR). The results were analyzed using analysis of variance (ANOVA) and Tukey's multiple comparison test to detect significant differences. Two dendrograms among isolates were obtained with UPGMA using the Euclidean distance index. One was drawn for phenotypic data, and the other for phenotypic and genotypic data. A PCoA was done for shown isolates in a space of reduced dimensionality. In order to determine the degree of association between the phenotypic and genotypic characteristics AFLP, we calculated the correlation between parwise Euclidean distance matrices of both data sets with the nonparametric Mantel test. RESULTS: No variability was found in the macromorphology of the studied isolates; however, the micromorphology and growth rate showed that the PE isolates grew at a faster rate and exhibited the widest vesicles in comparison to the isolates from MX, AR and FR. The dendrogram constructed with phenotypic data showed three distinct groups. The group I and II were formed with isolates from PE and FR, respectively, while group III was formed with isolates from MX and AR. The dendrogram with phenotypic and genotypic data showed the same cluster, except for an isolate from FR that formed a separate cluster. This cluster was confirmed using PCoA. The correlation between the phenotypic and genotypic data of the isolates revealed a statistically significant association between these characteristics. CONCLUSIONS: The PE isolates showed specific phenotypic characteristics that clearly differentiate them from the rest of the isolates, which matches the genotypic data. The correlation between the phenotypic and genotypic characteristics showed a statistically significant association. In conclusion, phenotypic and genotypic methods together increase the power of correlation between isolates.The data presented here are part of the doctoral thesis of MGFDL (Programa de Posgrado en Ciencias Biológicas, Facultad de Ciencias, UNAM) who has a fellowship from CONACyT (Grant 172552). This research was supported by Instituto de Ciencia y Tecnología del Distrito Federal (ICyTDF). PIFUTP08-122 and Dirección General de Asuntos del Personal Académico (DGAPA) DGAPA-UNAM-IN224706-3.S

Metabolic Syndrome, depression and patient safety culture in Mexican resident physicians

Background: Medical residence can affect the well-being and health of resident physicians (rp), which are directly related to the quality of medical care and patient safety. El objective was to identify the prevalence of metabolic syndrome (MetS), depressive symptoms, and evaluate the culture of patient safety in resident physicians. Methods: Cross-sectional analytical survey of 106 physicians residing in 13 medical specialties of a public hospital in Mexico. MetS was defined according to who criteria and depressive symptoms using the cesd-r scale; the culture of patient safety was evaluated with the Spanish version of the Hospital Survey on Patient safety. Results: 53.7% had a combined prevalence of overweight/obesity and insulin resistance was found in 33%. 8.5% of rp had prediabetes and 2.5% diabetes. 23.6% of the sample presented two MetS components. The prevalence of MetS was 8.5% and depressive symptoms were found in 21.7% of rp. The evaluation of the culture of patient safety showed strength in the dimensions of teamwork in the unit-service, organizational learning- continuous improvement, expectations and actions of the direction and frequency of reported events, perception of patient safety culture was found in 8/10 rp. Conclusions: A high prevalence of cardiometabolic alterations and depressive symptoms was found in Mexican rp. It is necessary to promote self-care for health and to strengthen the concept of patient safety culture among resident physicians

The AMS technique as an important tool for the measurement of astrophysical cross sections

Accelerator Mass Spectrometry is a technique commonly used to approach low concentrations of certain long half-life radioisotopes. The most important contribution of the technique is the accurate measure of organic sample ages, by separating masses 12,13 and 14 in the case of carbon allocated in such samples. However, the reach of AMS could cover many other scientific scopes, since it can give us a precise measure of a very small concentration of a radioisotope. On this direction, AMS can be used to approach reactions of interest for astrophysics, if we spot an specific radioisotope which concentration can be measure with AMS. Starting with this, we have selected specific reactions involving 14C, 10Be and 26Al, produced with slow neutrons from a reactor and positive ions at an accelerator. The main idea is to produce a particular reaction and later to measure the radioisotopic concentration using AMS. In this study our first results for 14C and 10Be nuclei produced with neutrons, and the preliminary results for 26Al nuclei produced with deuterium are shown