Biología del virus del papiloma humano y técnicas de diagnóstico

El virus del papiloma humano (VPH) pertenece al grupo de virus con tropismo por los epitelios; infectan predominantemente la piel y las membranas mucosas y producen proliferaciones benignas o papilomas, que bajo ciertas circunstancias pueden experimentar transformación maligna. El VPH es considerado el agente causal más importante del carcinoma del cérvix uterino y el conocimiento de su biología es fundamental para el entendimiento de la carcinogénesis cervical. Existe evidencia epidemiológica y molecular sobre la estrecha relación del VPH en el desarrollo del carcinoma cervical y sus precursores. La infección por el virus del papiloma humano es un importante problema de salud pública en nuestro país, para lo cual se ha identificado a la población con claros factores de riesgo, tales como: inicio temprano de vida sexual activa y múltiples parejas sexuales, hacia quienes se dirigen todos los esfuerzos de prevención y diagnóstico temprano, donde ya se incluyen estudios avanzados y cada vez más sensibles y específicos, con el fin de detectar más oportunamente esta mortal enfermedad

Epidemiología de la infección y detección de tipos oncogénicos del VPH por captura de híbridos en mujeres sin factores de riesgo aparentes

Objective. To determine prevalence of infection by human papilloma virus (HPV),in female population, with no apparent risk factors, who spontaneously undergo the Papanicolaou test at the Hospital Universitario Dr. José E. González during the 2006-2010 period. Materials and methods. An observational, cross-sectional, prospective, analytic, comparative study in 361 patients who spontaneously requested a vaginal cytology test. Results. A total of 361 women were studied from which 18 (5%) were taken out since their sample was not enough, thereby resulting in a final significant sample of 343 patients. The study showed infection by HPV in 51 patients (14,9%); there was higher prevalence in the positive divorced group (11,8%); with respect to the negative divorced group 3,1% (p=0.0152). It was established a significant correlation (p=0,001) between the number of sexual partners and the test positivity (Rho=0,175), as well as a significant association between being divorced and being positive (p=0,0152, X2=5,888). Discussion. Normal gynecological examination does not rule out the presence of VPH. Likewise, a normal vaginal cytology report or with non-specific inflammatory changes does not allow to conclude the absence of HPV, so that early detection of infection by HPV, calls for molecular methods of diagnosis. It can be concluded that by using traditional methods of diagnosis it is not possible to detect all HPV-infected patients and it would be desirable to perform molecular tests for infection diagnosis.Objetivo. Determinar la prevalencia de infección por el virus del papiloma humano (VPH) en la población femenina, sin aparentes factores de riesgo, que espontáneamente acude a realizarse la prueba de Papanicolaou en el Hospital Universitario Dr. José E. González durante el periodo 2006 - 2010. Material y métodos. Se realizó un estudio observacional, transversal, prospectivo, analítico comparativo en 361 pacientes, las cuales espontáneamente solicitaron una prueba de citología vaginal. Resultados: Se estudiaron un total de 361 mujeres, de las cuales se eliminaron 18 (5%) por no haberse obtenido muestra suficiente, quedando una muestra final significativa de 343 pacientes, demostrando infección por VPH de cualquier tipo en 51 pacientes (14,9%), se observó mayor prevalencia en el grupo de divorciadas positivas (11,8%), con respecto al de divorciadas negativas del 3,1%, (p=0,0152), se estableció una correlación significativa (p=0,001) entre el número de parejas sexuales y la positividad de la prueba (Rho=0,175), así como una asociación significativa entre la característica de ser divorciada y ser positiva (p=0,0152, X2=5,888). Discusión. La exploración ginecológica normal no descarta la presencia de VPH e igualmente, una citología normal o con cambios inflamatorios inespecíficos, tampoco permite concluir la ausencia de VPH, de tal manera que la detección temprana de infección por VPH requiere métodos moleculares de diagnóstico. Podemos concluir que con los métodos tradicionales de diagnóstico, no es posible detectar todas las pacientes infectadas con VPH, por lo cual sería deseable practicar pruebas moleculares para diagnóstico de la infección

Burnout Among First-Year Medical Students During COVID-19 Pandemic in Mexico: A Cross-Sectional Study

Background: The coronavirus pandemic is an international public health emergency without precedence in modern history. It represents a challenge to students’ academic and psychological stability due to the changes it caused in daily life. This study aimed to evaluate the prevalence and level of burnout in medical students caused by the academic and psychological instability that the pandemic represents. Methods: A prospective cross-sectional study was designed using the Maslach Burnout Inventory-Student Survey (MBI-SS). This evaluated the emotional exhaustion due to study demands, cynicism, and negative self-academic efficacy. This study was based in the school of medicine of the Universidad Autonoma de Nuevo Leon (UANL) in Monterrey, Mexico, during the Spring semester of 2020. Results: A total of 154 (93 women and 61 men) first-year medical students participated (response rate of 36.4%). Burnout was identified in 14.9% (n=23), and high emotional exhaustion in 53.9% (n=83). Burnout was almost 4 times more likely to develop in men than in women (aOR = 4.8; 95% Confidence Interval=1.7-13.3) when considering age as a covariable in the multivariable model. Conclusion: Further epidemiological studies of burnout syndrome in medical students are needed, and schools should consider promoting mental health and making programs available for their students to help overcome the emotional and social challenges during the pandemic

Morphological Analysis of Major Segments of Coronary Artery Occlusion: Importance in Myocardial Revascularization Surgery

Revascularization surgery should ensure morphological similarity between the coronary artery and the graft. This is an important factor for its duration and permeability. The aim of this study was to analyze the morphological characteristics and morphometrics of the coronary artery segments with greater occlusion. This was an observational, cross-sectional descriptive study that consisted of two phases. A macroscopic phase in which 11 cadaveric hearts were extracted and coronary dominance and length of the anterior interventricular artery (AIA), the right coronary artery (RCA) and the circumflex artery (CXA) were determined. In the microscopic phase a total of 77 segments of these arteries were obtained and the luminal diameter, wall thickness, and amount of elastic fibers and the presence and size of the atheroma were determined. Right coronary dominance was the most frequent. Total vessel length was 15.65±1.17 cm for the AIA, 12.67±2.02 cm for the RCA and 8.79±2.5 cm for the CXA. Diameters ranged from 2.3 mm in the proximal segments and between 1.1 mm to 1.8 mm in the distal segments. Wall thickness in the proximal segments was between 354 µm and 396 µm and in the distal segments it ranged from 120 µm to 305 µm. The amount of elastic fibers showed that they were muscular arteries. Atheromas were present in 35% in the CXA, and in 32.5% in the AIA and the RCA. The largest ones were found in the proximal segments. This study examined the morphology and morphometry of the segments of the coronary arteries that are more frequently occluded. It provides information on the most significant parameters to be considered for election of the vascular graft in myocardial revascularization surgery

ANTI-GIARDIA ACTIVITY OF HEXANE EXTRACT OF CITRUS AURANTIFOLIA (CHRISTIM) SWINGLE AND SOME OF ITS CONSTITUENTS

Giardia lamblia is a parasite that causes giardiasis in humans and other mammals. The common treatment includes different classes of drugs, which were described to produce unpleasant side effects. Citrus aurantifolia, popularly known as lima, is a plant used in the traditional medicine to treat gastrointestinal symptoms. The aim of the present study was to evaluate the anti-Giardia activity of 10 pure compounds obtained from a hexanic extract of Mexican lime, on the basis of trophozoite growth inhibition. 4-hexen-3-one, citral and geraniol showed IC50 values of 34.2, 64.5 and 229.49 µg/ml in axenic cultures after 24 h of incubation, respectively. The obtained results lead us to propose that these compounds from C. aurantifolia have potential for use as therapeutic agents against giardiasis

ANTIMICROBIAL EFFECT OF VANCOMYCIN ELECTRO-TRANSFERRED WATER AGAINST METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS VARIANT

Background: There is a number of alternative and complementary therapeutics that are unproven or have not been properly tested. For past twenty years, the transfer of bio-energetic information has been recognized as a novel scientific approach capable of contributing to improved therapy in the management of several diseases through the so-called bio-resonance therapy (BRT). Although BRT was discovered in the late 1980s, it is still poorly studied. The aim of this study was to evaluate the antibacterial effect of water samples transferred with electronic information of vancomycin, a well known drug against methicillin-resistant Staphylococcus aureus (MRSA), by using a BRT device on bacterial cultures. Material and Methods: MRSA cultures were treated with vancomycin electro-transferred water samples, vancomycin (4.0 and 8.0 µg/mL), sham electro-transferred (water to water) and non-transferred water samples (medium alone). Growth inhibition was evaluated in liquid and solid culture medium, spectrophotometrically and by CFU determination respectively. Results: The obtained data showed that by transferring vancomycin (4.0 and 8.0 µg/mL) information to water samples, the growth of cultured MRSA was significantly (p< 0.05) inhibited (up to 35%), compared with those cultures treated with electro-transferred water to water or cultured in medium alone (0% growth inhibition). Conclusion: This in vitro study suggests that water samples that are electronically transferred with vibration sustained information of vancomycin are capable of inhibiting growth of axenically cultured methicillin resistant S. aureus

Pelvimetry by Reformatted Computed Tomography in 290 Female Pelvis: Morphometric Variations Regarding Age

The Mexican government passed a new reform of article 11 of the General Law in 2014 regarding Women's Access to a Life Free of Violence, which states that a cesarean section may not be performed if a vaginal birth is viable. Cesarean sections are excessively indicated in Northen Mexico, using the diagnosis of cephalopelvic disproportion due to a narrow pelvis. Currently, there is no standardized morphometry of the female pelvis in a Mexican population to establish adequate diagnostic parameter. Our study measures the pelvic diameters of the birth canal using abdominopelvic computed tomography (CT). Two hundred and ninety CT from Mexican women between the ages of 18 and 50 were collected and 3D reformatted in order to morphologically measure the pelvic diameters of clinical relevance. Measurements were conducted by two diagnostic imaging specialists. The mean and standard deviation of the measured diameters were: anatomical conjugate diameter (ACD) 11.65±0.99 cm, the obstetric conjugate diameter (OCD) 11.73±0.98 cm, diagonal conjugate diameter (DCD) 12.49±0.98 cm and Interspinous distance (ISD) 10.41±0.78 cm. Significant differences were found in all four mean diameters in between the 20–29 age groups versus the >40, as well as between the 30–39 groups versus the >40. Our study shows that as Mexican women get older, the mean pelvic diameters become narrower

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Epidemiología de la infección y detección de tipos oncogenéticos del VPH por tecnología de captura de híbridos en mujeres sin aparentes factores de riesgo

Introducción: El virus del papiloma humano (VPH) pertenece al grupo de virus con tropismo por los epitelios, infecta predominantemente la piel y las membranas mucosas produciendo proliferaciones epiteliales benignas o papilomas, que bajo ciertas circunstancias (las cuales si bien aún no han sido definidas a satisfacción, se estima que se relacionan con el estado inmunológico de la paciente, su carga genética, la presencia de ciertos receptores, así como la continua infección por diversos tipos de virus) pueden experimentar transformación maligna. El virus del papiloma humano (VPH) es considerado el agente causal más importante del carcinoma del cérvix uterino y el conocimiento de su biología es fundamental para el entendimiento de la carcinogénesis cervical. Existen evidencias epidemiológicas y moleculares de la estrecha relación del VPH con el desarrollo del carcinoma cervical y sus precursores. La infección por el virus del papiloma humano es un importante problema de salud pública en nuestro país; por ello, se ha identificado a la población con claros factores de riesgo y hacia ella se dirigen todos los esfuerzos de prevención y diagnóstico temprano. Sin embargo, existe una gran cantidad de mujeres, la mayoría de ellas amas de casa, a las que no se les reconoce el riesgo, por lo que se desconoce su vulnerabilidad a la infección y quedan, por tanto, desprotegidas de los programas preventivos. Material y Métodos: Se incluyeron un total de 343 pacientes de sexo femenino, mayores de 13 años de edad, con vida sexual activa, pero con un historial máximo de 2 parejas sexuales, y sin historia de infección previa por VPH. Se tomaron muestras de la zona de transición del cérvix uterino, con el fin de identificar el VPH por medio de captura de híbridos; a través de este método, se identificaron los tipos oncogénicos y no oncogénicos. Resultados: En la población estudiada (n=343) se observó una prevalencia de VPH del 14,9%. De este subgrupo, se encontró que el 88% tenían infección por tipos de VPH de alto riesgo, el 12 %, con VPH de bajo riesgo, y el 41% tenían infección mixta, por subtipos tanto oncogénicos como no oncogénicos de VPH. En 14,9 mujeres de cada 100, sin aparentes factores de riesgo, se demostró infección por VPH, prevalencia que es equiparable a la publicada en una población de jóvenes universitarias mexicanas, pero inferior a lo descrito en estudios americanos que van del 26,8% en la población general de 14 a 59 años, hasta el 44,8% en el grupo de 20 a 24 años de edad; lo cual se puede explicar por la diferente cultura con respecto de la sexualidad, entre ambas poblaciones. Conclusiones: La mayoría de los casos de infección por VPH detectadas por captura de híbridos HC2® no mostraron alteraciones en la exploración ginecológic