Medicina Universitaria最新文献

{"title":"Roles of calcium and Mitochondria-Associated Membranes in the development of obesity and diabetes","authors":"R.E. Cárdenas-Pérez,&nbsp;A. Camacho","doi":"10.1016/j.rmu.2015.10.004","DOIUrl":"10.1016/j.rmu.2015.10.004","url":null,"abstract":"<div><p>Obesity has become a public health problem around the world. According to the Organisation for Economic Co-operation and Development (OECD, 2014 report), more than one in three adults in Mexico are obese. It is known that the hypothalamus, a region of the Central Nervous System (CNS), is actively involved in regulating energy homeostasis during obesity. Anatomically, the hypothalamus is composed of several nuclei coordinating body weight and metabolism, including the arcuate nucleus (ARC), which contains neurons co-expressing orexigenic peptides like Agouti-related protein (AgRP), Neuropeptide Y (NPY) and the anorexigenic peptide Pro-opiomelanocortin (POMC). During obesity, the integration and metabolic response in the ARC is disrupted by three molecular mechanisms: (1) activation of endoplasmic reticulum (ER) stress, (2) mitochondrial dysfunction, and (3) increase of ER and mitochondria contacts, known as Mitochondria-Associated Membranes (MAMs). In this context, it is proposed that MAMs formation induces mitochondrial Ca²⁺ overload and metabolic dysfunction, leading to insulin resistance and diabetes. Recently, MAMs formation has emerged as one of the molecular mechanisms underlying metabolic alterations during obesity. Thus, in this review we will focus on proposing scientific evidence to support the role of the MAMs and their function on calcium regulation during obesity, as an important pathological mechanism in the development of diabetes mellitus type 2.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 23-33"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75616003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and the relation of lactic acid to neonatal mortality in the first week of life","authors":"I. Rodríguez-Balderrama,&nbsp;P.J. Ostia-Garza,&nbsp;R.D. Villarreal-Parra,&nbsp;M. Tijerina-Guajardo","doi":"10.1016/j.rmu.2015.12.001","DOIUrl":"10.1016/j.rmu.2015.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the relationship between lactic acid levels and neonatal mortality in the first week of life, in patients admitted to the Neonatal Intensive Care Unit (NICU) of the “Dr. José E. González” University Hospital.</p></div><div><h3>Material and methods</h3><p>Prospective, observational and diagnostic test performed in the neonatal ward of the “Dr. José Eleuterio González” University Hospital. We included all live preterm infants on mechanical ventilation who were admitted to the NICU from November 1, 2011 to October 31, 2012.</p></div><div><h3>Results</h3><p>One hundred and fifty four patients met the inclusion criteria. At 72<!--> <!-->h, we found that the best sensitivity (95%) was when lactate was less than 1.5<!--> <!-->mmol/l and the best specificity (89%) was present when lactate levels were greater than 2.5<!--> <!-->mmol/l. The pH &lt;7.25 had a sensitivity of 76% and specificity of 96%. At 168<!--> <!-->h (7 days) we found that the best sensitivity (91%) was when lactate levels were less than 1.5<!--> <!-->mmol/l, and that the best specificity (96%) was when lactate levels were greater than 2.5<!--> <!-->mmol/l. We found that the pH &lt;7.25 had a sensitivity of 36% and specificity of 91%.</p></div><div><h3>Conclusion</h3><p>The lactate serum, at 1.5<!--> <!-->mmol/l, has a sensitivity (to be killed) of 95% on the third day and 91% on the seventh day. When the pH is greater than 7.25 there is a specificity (to be alive) of 96% on the third day and 91% on the seventh day. 67% of the dead were under 1500<!--> <!-->g, and were 61% under 28 gestational weeks.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 3-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79429739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternatives for post-operative pain treatment","authors":"T.A. Nava-Obregón ,&nbsp;S. Castillo-Guzmán ,&nbsp;A. Arteaga-García ,&nbsp;C.N. Dávila-Sevilla","doi":"10.1016/j.rmu.2015.10.006","DOIUrl":"10.1016/j.rmu.2015.10.006","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 49-51"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89828766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hairy cell leukemia, an uncommon B-cell lymphoid neoplasia","authors":"M.A. Garza-Ledezma,&nbsp;C.A. Tellez-Hinojosa,&nbsp;E.E. González-López,&nbsp;D. Gómez-Almaguer","doi":"10.1016/j.rmu.2015.12.002","DOIUrl":"10.1016/j.rmu.2015.12.002","url":null,"abstract":"<div><p>Hairy cell leukemia (HCL) is an uncommon B-cell lymphoid neoplasia, representing 2–3% of all leukemias. It is more common in men, with a median age at diagnosis of 52 years. The hair-like projections on its surface are its principal characteristic. Although its etiology has not been established, the recent gene sequencing of HCL identified the presence of the BRAF V600E mutation, absent in other malignant neoplasias of the lymph cells. The clinical course of the disease is usually indolent. The majority of patients initially present weakness and fatigue, pancytopenia and splenomegaly.</p><p>HCL must be distinguished from other indolent lymphoid neoplasias such as prolymphocytic leukemia, splenic marginal zone lymphoma, the variant of HCL (HCLv), and mantle cell lymphoma. Peripheral blood flow cytometer is essential for the detection of CD11c, CD19, CD20, CD22, CD25, and CD10, as well as a bone marrow aspirate to detect immunophenotypes. In addition, a bone biopsy is useful to perform an immunohistochemistry analysis for TRAP, DBA-44 and A1 annexin.</p><p>Purine analogues remain the first line of treatment. However, interferon and rituximab are a valid option, if the ideal treatment is unavailable. New discoveries in the pathophysiology of HCL have brought the creation of pharmaceuticals with distinct therapeutic targets. These pharmaceuticals are currently undergoing testing.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 34-41"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90997272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversies in medicine: Thyroid nodules “head or tails”","authors":"J.F. Ovalle-Berumen","doi":"10.1016/j.rmu.2016.01.003","DOIUrl":"10.1016/j.rmu.2016.01.003","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 55-57"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90273535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Febrile reactions in the 21st century","authors":"R. Cazares-Tamez","doi":"10.1016/j.rmu.2015.12.004","DOIUrl":"10.1016/j.rmu.2015.12.004","url":null,"abstract":"","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 52-54"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73569955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spondylothoracic dysostosis, Jarcho Levin syndrome. Case report","authors":"A.Y. Medina-de la Cruz ,&nbsp;I. Rodríguez-Balderrama ,&nbsp;C.H. Burciaga-Flores ,&nbsp;L.E. Martínez-de Villarreal ,&nbsp;M. Ibarra-Ramírez ,&nbsp;M.E. de la O-Cavazos","doi":"10.1016/j.rmu.2015.10.005","DOIUrl":"10.1016/j.rmu.2015.10.005","url":null,"abstract":"<div><h3>Introduction</h3><p>dysostosis spondylothoracic, or Jarcho Levin syndrome, is characterized by a short neck and thorax, a protruding abdomen, abnormal vertebral segmentation and fusion posterior costal resulting in thoracic restriction or respiratory failure and scoliosis. The prevalence is estimated at 1 in 12,000 live births for the people of Puerto Rico and 1 per 200,000 for the rest of the world. It is inherited in an autosomal recessive manner and the only related gene is MESP2.</p></div><div><h3>Clinical case</h3><p>Newborn male, who during the first hour of life develops perioral cyanosis, thoracoabdominal dissociation and polipnea, requiring endotracheal intubation and mechanical ventilation for respiratory impairment, finding thoracoabdominal costovertebral abnormalities with an x-ray, and a conditioning restrictive pattern like a crab. During the physical examination, we found horizontal eyelid openings, right atrial appendage, straight nasal bridge, short thorax and asymmetry and hypertrichosis, predominantly in the back. A diagnosis of dysostosis spondylothoracic is confirmed, and the patient was discharged at 7 days of age, with follow up neonatal consultation at high risk.</p></div><div><h3>Conclusion</h3><p>In a neonate with respiratory distress syndrome, costovertebral assessment becomes important, with the intention of discarding syndromes associated with defects in the costovertebral segmentation, as Jarcho Levin syndrome, which causes respiratory impairment that can lead to respiratory failure and death.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 16-19"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.10.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76124436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and genetic aspects of Turner's syndrome","authors":"M. Ibarra-Ramírez,&nbsp;L.E. Martínez-de-Villarreal","doi":"10.1016/j.rmu.2016.03.003","DOIUrl":"10.1016/j.rmu.2016.03.003","url":null,"abstract":"<div><p>Turner's syndrome, or monosomy X, is defined as the total or partial loss of the second sex chromosome. The clinical phenotype is highly variable and includes short stature, gonadal dysgenesis, <em>pterygium colli</em>, <em>cubitus valgus</em> and low hairline. The variable expressivity of height and other physical features may be only partially related to the chromosomal formula. Currently, the delay in the diagnosis of Turner's syndrome remains a problem, as only 15–30% of patients are diagnosed during their first year of life. Understanding its complex etiology and learning more about its clinical variability and complications will allow us to advance the therapeutic and management approach of such patients. This review summarizes the clinical characteristics of, and diagnostic tests for, Turner's syndrome and the advances in the study of its underlying genetic factors.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"18 70","pages":"Pages 42-48"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2016.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89789552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Code Stroke: Medical evaluation by a pre-hospital attention service","authors":"J.E. Hernández-Saucedo,&nbsp;R. Cantú-Ríos,&nbsp;M. Fernández,&nbsp;G.C. Palacios-Saucedo,&nbsp;R. Mercado-Longoria,&nbsp;M.B. Clemente-Córdova","doi":"10.1016/j.rmu.2015.09.001","DOIUrl":"https://doi.org/10.1016/j.rmu.2015.09.001","url":null,"abstract":"<div><h3>Introduction</h3><p>In 1996, the NINDS (National Institute of Neurological Disorders and Treatment of Acute Stroke) published targets for the management of patients with acute cerebrovascular events, setting a time of 3<!--> <!-->h or less for administration of thrombolytics, creating the Code Stroke.</p></div><div><h3>Objective</h3><p>Evaluate the time between onset of symptoms and arrival at the emergency department of a hospital as prognostic factors in patients with cerebrovascular events attended by the prehospital emergency medical service in the metropolitan area of Monterrey, Nuevo Leon.</p></div><div><h3>Materials and methods</h3><p>Calls received in the ED (EMME) between January and December 2012 were included in a retrospective cross-sectional study, with symptoms showing within the first 8<!--> <!-->h or with an unknown onset. The Mann–Whitney test and Fisher's exact test were used.</p></div><div><h3>Results</h3><p>Thirty-six patients were included in the study. In 21, the final diagnosis was cerebral infarction, 5 patients were treated with thrombolysis (23.8%). They were divided into two groups: group 1 died or were left with severe neurological sequelae (<em>n</em> <!-->=<!--> <!-->9) and Group 2 survived without sequelae or mild neurological sequelae (<em>n</em> <!-->=<!--> <!-->12). The door hospital arrival time was 67 (29–116)<!--> <!-->min (Group 1) versus 54 (24–86)<!--> <!-->min (Group 2) (<em>p</em> <!-->=<!--> <!-->0.110). The neurological status at the start of the event affected prognosis and mortality (<em>p</em> <!-->=<!--> <!-->0.018).</p></div><div><h3>Conclusions</h3><p>There are few studies analyzing the time between the inception of the symptomatology and the arrival to the emergency room. In our study 23.8% of this series were thrombolyzed, which puts us in the range of international statistics, compared to the series published by Geffner-Sclarsky et al. The population of this study is small so it is not able to show statistical differences, but the few studies that evaluate the Code Stroke in Mexico open the doors to future work with a larger population in Latin American society.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"17 69","pages":"Pages 207-212"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91617461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Models of hepatoprotective activity assessment","authors":"C. Delgado-Montemayor ,&nbsp;P. Cordero-Pérez ,&nbsp;R. Salazar-Aranda ,&nbsp;N. Waksman-Minsky","doi":"10.1016/j.rmu.2015.10.002","DOIUrl":"10.1016/j.rmu.2015.10.002","url":null,"abstract":"<div><p>Liver diseases are a major health problem worldwide, making it necessary to develop new molecules that help counteract or prevent such diseases. On account of this fact, investigations aiming to obtain natural and/or synthetic compounds possessing hepatoprotective activity have been undertaken. The development of new drugs consists of a variety of steps, ranging from the discovery of the pharmacological effects in cellular and animal models, to finally demonstrate their efficacy and safety in humans. Different models for assessment of the hepatoprotective activity <em>in vitro</em>, <em>ex vivo</em> and <em>in vivo</em> can be found in medical literature. The purpose of this review is to show the features, main advantages and disadvantages of each of the models, the hepatotoxic agents most commonly used (CCl₄, acetaminophen, ethanol, <span>d</span>-galactosamine, t-BuOOH, thioacetamide) as well as the biochemical parameters useful to assess liver damage in the different models.</p></div>","PeriodicalId":34640,"journal":{"name":"Medicina Universitaria","volume":"17 69","pages":"Pages 222-228"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmu.2015.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74760742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}