DIAGNÓSTICO DE LA SITUACIÓN DEL AGAVE-MEZCAL Y OPCIONES DE DESARROLLO LOCAL EN COMUNIDADES INDÍGENAS DE OAXACA

La situación de crisis económica y ambiental que impera en todo el mundo se ha reflejado en la sobreexplotación de los recursos naturales, ocasionando con ello la pérdida de biodiversidad, contaminación y agotamiento de los mismos; además de, un mayor empobrecimiento de comunidades, debilitamiento cultural y ahondamiento de las brechas regionales. Por ello cobra gran importancia la búsqueda de alternativas que permitan la conservación in-situ de cultivos de especies nativas que ayuden a mitigar la pérdida de la diversidad genética, como es el Agave spp. utilizado para la producción de mezcal artesanal en el estado de Oaxaca. Las condiciones de desigualdad y pobreza que imperan en el estado de Oaxaca son muy notables y de manera particular en la región mixteca donde las condiciones geográficas y de los suelos, que no son aptos para la agricultura, ocasionan los bajos niveles de productividad de la actividad agrícola, en la cual se ocupa gran parte de la población económicamente activa. Aunado a esto se presentan altos índices de marginación, migración y pobreza, donde los programas de apoyo social para la comunidad han sido deficientes, razón por la cual es necesaria la búsqueda de alternativas que les permita contar con una mejor productividad y desarrollo económico y laboral

Escala Hospitalaria de Ansiedad y Depresión (HADS) en cuidadores primarios informales de pacientes con cáncer: propiedades psicométricas.

Introduction: Symptoms of anxiety and depression are some of the major mental health problems in caregivers affecting quality of life. Valid and reliable screening instruments such as the Hospital Anxiety and Depression Scale (HADS) has made possible the detection of possible cases of depression and anxiety. However, the psychometric properties of this instrument have not been documented in caregivers in the Mexican population. Objetives: Determine the psychometric properties of the HADS in a sample of caregivers in the Mexican population. Materials and Methods: 200 caregivers from the National Cancer Institute participated, of which 65.5% were women and 34.5% men, with a mean age of 47.4 ± 14.1 years. Participants completed concurrently the HADS and Zarit Burden Interview. Results: A factor analysis to two factors explained 42.05% of the variance with 14 items on two factors. The internal consistency of the overall scale was satisfactory (α=0.83). Cronbach’s alphas for each subscale were .78 and .82. The concurrent validity assessed by way of correlations with concurrent measures showed significant associations (Pearson r=0.41-0.64, p<0.05). Conclusions: The HADS has adequate cons­truct validity, internal consistency and concu­rrent validity for use in caregivers of cancer patients from the Mexican population. The relevance of the results is that this is a popu­lation that can require mental health care in stages of care for patients with cancer.Introducción: la sintomatología ansiosa y depresiva son parte de los principales problemas de salud mental en cuidadores primarios informales afectando su calidad de vida. A través de instrumentos de tamizaje válidos y confiables como la Escala Hospitalaria de Ansiedad y Depresión (HADS) ha sido posible detectar posibles casos. Sin embargo, hasta ahora no se habían caracterizado las propiedades psicométricas en cuidadores primarios informales de pacientes con cáncer en población mexicana. Objetivo: determinar las propiedades psicométricas de la HADS en una muestra de cuidadores primarios informales. Material y Método: Participaron 200 pacientes del Instituto Nacional de Cancerología, de los cuales 65,5% eran mujeres y 34,5% hombres; la edad promedio fue de 47,4 ± 14,1 años. Los participantes contestaron además del HADS la escala de carga de Zarit. Resultados: El análisis factorial presentó dos factores con los 14 reactivos originales. La consistencia interna de la escala global mostró un índice satisfactorio (α=0,83). Los alfas de Cronbach de cada subescala tuvieron un valor de 0,82 y 0,78 que explican el 42,58% de la varianza. La validez por medio de correlación con las medidas concurrentes mostraron resul­tados significativos (r de Pearson de 0,41-0,64, p<0,05). Conclusiones: La HADS en cuidadores pri­marios de pacientes con cáncer en población mexicana presentó adecuadas características psicométricas. La relevancia de los resultados obtenidos radica en que se trata de una po­blación que puede llegar a requerir atención oportuna en salud mental en diferentes etapas del cuidado de pacientes con cáncer

Effects of weight loss after bariatric surgery on pulmonary function tests and aobtructive sleep apnea in morbidly obese women

Introducción: la obesidad afecta a la función respiratoria e incrementa el riesgo de síndrome de apneas-hipopneas del sueño (SAHS). Objetivo: evaluar el efecto de la cirugía bariátrica, en mujeres con obesidad mórbida, sobre la función respiratoria y sobre el índice de apneas-hipopneas (IAH) tras dos años de seguimiento. Métodos: se incluyeron 15 mujeres (índice de masa corporal [IMC] medio 50,52 ± 12,71 kg.m-2, edad media 40,13 ± 10,06 años). Los enfermos fueron analizados en dos fases: previo a la cirugía bariátrica y tras dos años de la misma. En cada visita se valoraron las medidas antropométricas y se realizaron pruebas de función respiratoria consistentes en espirometría, pletismografía, medida de la presión inspiratoria máxima y del índice de tensión-tiempo de los músculos inspiratorios, así como análisis de gases arteriales. Por último, también se efectuó una poligrafía cardiorrespiratoria durante el sueño. Resultados: tras la cirugía bariátrica el IMC disminuyó en 44,07 kg.m-2 (IC 95% 38,32 – 49,81). De igual forma, se observaron incrementos significativos en el volumen espiratorio forzado al primer segundo (FEV1) (p < 0,01), la capacidad vital forzada (FVC) (p < 0,01), el volumen de reserva espiratorio (ERV) (p = 0,040), la capacidad funcional residual (FRC) (p = 0,009) y la resistencia de las vías aéreas (Raw) (p = 0,018). Por otra parte, el IAH (p = 0,001) y el índice de desaturación de oxígeno (p = 0,001) disminuyeron tras la cirugía. Se observó una correlación significativa entre el grado de pérdida de peso y el incremento del ERV (0,774, p = 0,024). Conclusiones: tras dos años desde la cirugía bariátrica se siguen observando mejorías significativas en la función respiratoria y en la gravedad del SAHS. La mejoría del ERV estaría en relación directa con los niveles de peso perdidoIntroduction: obesity impacts on respiratory function and also it acts as a risk factor for obstructive sleep apnea (OSA). Aims: to study the effects of bariatric surgery on pulmonary function tests and on OSA in morbidly obese women over 4 years. Methods: fifteen morbidly obese women (mean body mass index [BMI] 50.52 ± 12.71 kg.m-2, mean age 40.13 ± 10.06 years) underwent pulmonary function tests (PFT) in two opportunities (before and after weight loss surgery). PFT included spirometry, body plethysmography and measure of maximal inspiratory mouth pressure (PImax) and of tension-time index for inspiratory muscles. Also, in both opportunities, resting arterial blood gas tensions were evaluated and a full night sleep register was performed. Results: BMI significantly decreased after bariatric surgery (-44.07 kg.m-2 [CI 95% -38.32 – -49.81]). Also, there was a significantly increase in forced expiratory volume in 1 second (FEV1) (p < 0.01), forced vital capacity (FVC) (p < 0.01), expiratory reserve volume (ERV) (p = 0.040), functional residual capacity (FRC) (p = 0.009) and a decline in airways resistance (Raw) (p = 0.018). Concerning sleep registers, apnea hypopnea index (p = 0.001) and desaturation index (p = 0.001) were also reduced after weight loss. Improve in ERV had a significant correlation with weight loss (r = 0.774, p = 0.024). Conclussions: pulmonary function tests and apnea hypopnea index improve after bariatric surgery in mor- bidly obese women. Improvement of ERV is well correlated with weight los

Hospital anxiety and depression scale (HADS) in informal primary caregivers of cancer patients: psychometric properties

Introduction: Symptoms of anxiety and depression are some of the major mental health problems in caregivers affecting quality of life. Valid and reliable screening instruments such as the Hospital Anxiety and Depression Scale (HADS) has made possible the detection of possible cases of depression and anxiety. However, the psychometric properties of this instrument have not been documented in caregivers in the Mexican population. Objetives: Determine the psychometric properties of the HADS in a sample of caregivers in the Mexican population. Materials and Methods: 200 caregivers from the National Cancer Institute participated, of which 65.5% were women and 34.5% men, with a mean age of 47.4 ± 14.1 years. Participants completed concurrently the HADS and Zarit Burden Interview. Results: A factor analysis to two factors explained 42.05% of the variance with 14 items on two factors. The internal consistency of the overall scale was satisfactory (α=0.83). Cronbach’s alphas for each subscale were .78 and .82. The concurrent validity assessed by way of correlations with concurrent measures showed significant associations (Pearson r=0.41-0.64, p&lt;0.05). Conclusions: The HADS has adequate cons­truct validity, internal consistency and concu­rrent validity for use in caregivers of cancer patients from the Mexican population. The relevance of the results is that this is a popu­lation that can require mental health care in stages of care for patients with cancer.</p

Recommendations for the Clinical Approach to Immune Thrombocytopenia: Spanish ITP Working Group (GEPTI)

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Primary immune thrombocytopenia (ITP) is a complex autoimmune disease whose hallmark is a deregulation of cellular and humoral immunity leading to increased destruction and reduced production of platelets. The heterogeneity of presentation and clinical course hampers personalized approaches for diagnosis and management. In 2021, the Spanish ITP Group (GEPTI) of the Spanish Society of Hematology and Hemotherapy (SEHH) updated a consensus document that had been launched in 2011. The updated guidelines have been the reference for the diagnosis and management of primary ITP in Spain ever since. Nevertheless, the emergence of new tools and strategies makes it advisable to review them again. For this reason, we have updated the main recommendations appropriately. Our aim is to provide a practical tool to facilitate the integral management of all aspects of primary ITP management.Peer reviewe

The number of tumor infiltrating T-cell subsets in lymph nodes from patients with Hodgkin lymphoma is associated with the outcome after first line ABVD therapy

Prognostic factors in Hodgkin lymphoma (HL) still fail to accurately identify high-risk patients. Tumor microenvironment in HL is a current focus of research for risk definition but few studies have focused on infiltrating lymphocytes. Here, we analyzed the number of tumor infiltrating lymphocytes by flow cytometry in diagnostic biopsies from 96 HL homogeneously treated patients with ABVD with or without radiotherapy. Most lymph node cells were lymphocytes (90 ± 17), with a median T/B/NK distribution of 74%/26%/0.7%, and CD4 T-cell predominance. The amount of CD19 B cells, and NK cells did not show association with disease features. However, high numbers of CD8 and CD4 cells were associated with better and poorer outcomes, respectively. Patients with ≥15% cytotoxic CD8 cells among the total cell population had a longer 10-year freedom from treatment failure (FFTF) (93% vs. 73%, p=.04). In turn, cases with ≥75% of CD4 infiltrating cells showed a significantly decreased FFTF (73% vs. 96%, p=.021). Consequently, CD4/CD8 ratio ≥5 associated with a poorer 10-year FFTF (69.5% vs. 94%, p=.02). This deleterious effect was particularly prominent in advanced disease (n = 58, p=.01). In multivariate analysis, a CD4/CD8 ratio ≥5 was the only independent variable to predict for treatment failure (HR = 4.5, 95% confidence interval, 1.2–16.8). In conclusion, our study shows that high CD4 and low CD8 T-cells infiltrates of tumor specimens associate with poor prognosis in HL patients, and CD4/CD8 ratio might be potentially useful for tailoring therapy.Peer Reviewe

Methylation is an inactivating mechanism of the p16 gene in multiple myeloma associated with high plasma cell proliferation and short survival

[EN]In order to gain further insights into the role of the p16 gene in cell cycle regulation and the prognostic implications of its inactivation, we investigated the methylation status of the p16 gene in 98 untreated patients using a polymerase chain reaction assay based on the inability of some restriction enzymes to digest methylated sequences. Forty-one patients showed a p16 methylated gene (42%). The percentage of S-phase plasma cells (PC) in these patients was almost three times higher than in those with an unmethylated p16 gene (4Æ16% ± 3Æ37% vs 1Æ5% ± 1Æ41%, P < 0Æ001). The presence of p16 methylation also correlated with both elevated b2-microglobulin serum levels and high C-reactive protein values. Patients with a p16 methylated gene had shorter overall and progression-free survival than those patients without p16 methylation. However, this feature did not retain independent prognostic influence on multivariate analysis, probably due to its association with the S-phase PC, which had more potent statistical significance in the Cox model. These findings showed methylation of the p16 gene was a frequent event in MM patients at diagnosis, and was associated with an increased proliferative rate of plasma cells and a poor prognosis, indicating an important role for p16 gene in the cell cycle regulation of multiple myeloma tumour cells, and thus in the clinical outcome of the disease