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PubMed | Centro Universitario Of Ciencias Economico Administrativas Cucea, CUCEA, UIMEC and Centro Universitario Of Ciencias Of La Salud
Type: Journal Article | Journal: Ostomy/wound management | Year: 2017

Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 12.3 years; mean duration of diabetes, 14.95 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010. Information included demographic data (age, gender, marital status, time elapsed since first diagnosis of diabetes mellitus type 2 [DM2]), and the following clinical records: Wagner classification, bacterium type, antimicrobial resistance, length of hospital stay, and the antibiotic schedule utilized, as well as number and type of laboratory tests, medications, intravenous therapy, surgical and supportive treatment, type and number of specialists, and clinical outcome. Microcosting was used to calculate the unit cost of each medical treatment element. Using the Monte Carlo and Markov predictive simulation economical models, cost reduction associated with early identification of the specific microorganism through bacterial culture in IDFU was estimated. Based on the statistical results, differences between real and estimated costs when including early microbiological culture were identified and the number and type of most common species of infectious bacteria were detected. The total cost observed in the patient cohort was $502 438.04 USD, mean cost per patient was $7177.69 $5043.51 USD, and 72.75% of the total cost was associated with the hospital stay length. The cost of the entire treatment including antibiotics was $359 196.16 USD; based on the simulation of early microbiological culture, the model results showed cost could be reduced by 10% to 25% (in this study, the cost could be as low as $304 624.63 USD). The use of early microbiological cultures on IDFU to determine the appropriate antibiotic can reduce treatment costs by >30% if hospital stay is part of the consideration.

Llamas-Covarrubias M.A.,University of Guadalajara | Valle Y.,Centro Universitario Of Ciencias Of La Salud | Navarro-Hernandez R.E.,Centro Universitario Of Ciencias Of La Salud | Guzman-Guzman I.P.,University of Guadalajara | And 5 more authors.
Rheumatology International | Year: 2012

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease of unknown etiology. Many cytokines have been found to be associated with RA pathogenesis and among them is macrophage migration inhibitory factor (MIF). The aim of this study was to determine whether MIF serum levels are associated with RA course, clinical activity, and clinical biomarkers of the disease. MIF levels were determined in serum samples of 54 RA patients and 78 healthy subjects (HS) by enzyme-linked immunosorbent assay (ELISA). Disease activity was evaluated using the DAS28 score. Patients were subgrouped according to disease activity and years of evolution of disease. Statistical analysis was carried out by SPSS 10.0 and GraphPad Prism 5 software. RA patients presented increased levels of MIF as compared to HS. MIF levels were raised on early stages of RA and tend to decrease according to years of evolution. Moreover, MIF levels positively correlated with rheumatoid factor in RA patients and with C reactive protein in all individuals studied. Our findings suggest that MIF plays a role in early stages of RA. © Springer-Verlag 2011.

Satoh M.,University of Florida | Chan J.Y.F.,University of Florida | Ceribelli A.,Humanitas Clinical and Research Center | Del-Mercado M.V.,Centro Universitario Of Ciencias Of La Salud | Chan E.K.L.,University of Florida
Advances in Experimental Medicine and Biology | Year: 2013

Like many other classical autoantibodies in systemic rheumatic diseases, anti-Su antibodies were originally defined by the double immunodiffusion assay in the early 80s. However, despite its high prevalence, only a few reports on anti-Su were published in the following years and the progress in characterizing the target antigens and clinical significance was slow, probably due to its inconsistent or poor reactivity in other standard immunoassays. In 2006 the target antigen was identified as the microRNA (miRNA)-binding protein Argonaute 2 (Ago2). Ago2 is a key component of the RNA-induced silencing complex enriched in cytoplasmic foci called GW bodies. Due to preferential reactivity of human autoantibodies with native antigens, immunoprecipitation is the only method to reliably detect anti-Su/Ago2 antibodies. Anti-Su/Ago2 does not appear to have disease specificity since it is found in 10-20% of patients with various rheumatic diseases, including systemic lupus erythematosus, scleroderma, polymyositis/dermatomyositis, and Sjögren's syndrome, as well as apparently healthy individuals at lower prevalence. The clinical significance and the mechanism of production of anti-Su/Ago2 remains to be clarified. © Springer Science+Business Media New York 2013.

Gurrola-Diaz C.M.,Centro Universitario Of Ciencias Of La Salud | Garcia-Lopez P.M.,University of Guadalajara | Sanchez-Enriquez S.,Centro Universitario Of Ciencias Of La Salud | Troyo-Sanroman R.,Centro Universitario Of Ciencias Of La Salud | And 2 more authors.
Phytomedicine | Year: 2010

Insulin resistance, obesity, hypertension, and dyslipidemia are strongly associated with metabolic syndrome (MeSy), which is considered to be a reversible clinical stage before its evolution to coronary heart disease and diabetes. Currently, the antihypertensive and hypolipidemic properties of aqueous Hibiscus sabdariffa extracts (HSE) have been demonstrated in clinical trials and in vivo experiments. The aim of the present study was to evaluate the effects of a Hibiscus sabdariffa extract powder (HSEP) and a recognized preventive treatment (diet) on the lipid profiles of individuals with and without MeSy according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. The protocol was a follow-up study carried out in a factorial, randomized design (T1=preventive treatment comprises Diet, T2=HSEP, T3=HSEP+preventive treatment (Diet) X MeSy, non-MeSy individuals). A total daily dose of 100 mg HSEP was orally administered in capsules for one month. The preventive treatment (diet) was selected according to NCEP-ATP III recommendations and adjusted individually. Total cholesterol, LDL-c, HDL-c, VLDL-c, triglycerides, glucose, urea, creatinine, AST, and ALT levels in the blood were determined in all individuals pre- and post-treatment. The MeSy patients treated with HSEP had significantly reduced glucose and total cholesterol levels, increased HDL-c levels, and an improved TAG/HDL-c ratio, a marker of insulin resistance (t-test p<0.05). Additionally, a triglyceride-lowering effect was observed in MeSy patients treated with HSEP plus diet, and in individuals without MeSy treated with HSEP. Significant differences in total cholesterol, HDL-c, and the TAG/HDL-c ratio were found when the means of absolute differences among treatments were compared (ANOVA p<0.02). Therefore, in addition to the well documented hypotensive effects of Hibiscus sabdariffa, we suggest the use of HSEP in individuals with dyslipidemia associated with MeSy. © 2009 Elsevier GmbH. All rights reserved.

Martinez M.B.A.,Centro Universitario Of Ciencias Of La Salud | Lamotte B.V.,Centro Universitario Of Ciencias Of La Salud | Santoncini C.U.,Instituto Nacional Of Psiquiatria
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2011

Objective: Determine the relationship between the variables of self-esteem (SE), body dissatisfaction (BD), and body mass index (BMI) in a continuum of risky eating behaviors (REB) that ranges from normal behavior to the risk of eating disorders (ED), thus facilitating early detection of adolescents with ED symptomatology and the degree to which such variables have an influence. Methods: A total of 1 982 young women aged 15-19 were selected through stratified random sampling. Self-esteem (Pope, McHale, and Craighead scale), body dissatisfaction (Stunkard's Figure Rating Scale), and body mass index were measured. A brief REB questionnaire was administered. Three categories of REB were defined: no risk, moderate risk, and high risk. A multiple regression analysis was performed. Results: A direct relationship was found between risk of REB and BD, with significant differences between the groups (P < 0.001): no risk (83.6% of sample), 54.1% had BD; moderate risk (11.9% of sample), 84.8% had BD; and high risk (4.5% of sample), 89.9% had BD. There were significant differences in SE and BMI only between the group with no risk and each of the risk groups. Self-esteem played a role in predicting REB in all the regression models evaluated, whereas BMI did not. Conclusions: It is essential to identify adolescents at moderate risk of REB who have prodromic features of ED such as low SE and BD. When these features occur simultaneously, they can mediate a negative effect of BMI on REB.

Ortiz-Lazareno P.C.,Instituto Mexicano del Seguro Social IMSS | Bravo-Cuellar A.,Instituto Mexicano del Seguro Social IMSS | Bravo-Cuellar A.,University of Guadalajara | Lerma-Diaz J.M.,Instituto Mexicano del Seguro Social IMSS | And 10 more authors.
Cancer Cell International | Year: 2014

Background: The resistance of cancerous cells to chemotherapy remains the main limitation for cancer treatment at present. Doxorubicin (DOX) is a potent antitumor drug that activates the ubiquitin-proteasome system, but unfortunately it also activates the Nuclear factor kappa B (NF-k{cyrillic}B) pathway leading to the promotion of tumor cell survival. MG132 is a drug that inhibits I kappa B degradation by the proteasome-avoiding activation of NF-k{cyrillic}B. In this work, we studied the sensitizing effect of the MG132 proteasome inhibitor on the antitumor activity of DOX. Methods: U937 human leukemia cells were treated with MG132, DOX, or both drugs. We evaluated proliferation, viability, apoptosis, caspase-3, -8, and -9 activity and cleavage, cytochrome c release, mitochondrial membrane potential, the Bcl-2 and Bcl-XL antiapoptotic proteins, senescence, p65 phosphorylation, and pro- and antiapoptotic genes. Results: The greatest apoptosis percentage in U937 cells was obtained with a combination of MG132 + DOX. Likewise, employing both drugs, we observed a decrease in tumor cell proliferation and important caspase-3 activation, as well as mitochondrial membrane potential loss. Therefore, MG132 decreases senescence, p65 phosphorylation, and the DOX-induced Bcl-2 antiapoptotic protein. The MG132 + DOX treatment induced upregulation of proapoptotic genes BAX, DIABLO, NOXA, DR4, and FAS. It also induced downregulation of the antiapoptotic genes BCL-XL and SURVIVIN. Conclusion: MG132 sensitizes U937 leukemia cells to DOX-induced apoptosis, increasing its anti-leukemic effectiveness. © 2014 Ortiz-Lazareno et al.; licensee BioMed Central Ltd.

Hernandez-Ojeda J.,Centro Universitario Of Ciencias Of La Salud | Roman-Pintos L.M.,Centro Universitario Of Ciencias Of La Salud | Rodriguez-Carrizalez A.D.,Centro Universitario Of Ciencias Of La Salud | Troyo-Sanroman R.,Centro Universitario Of Ciencias Of La Salud | And 3 more authors.
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy | Year: 2014

Background: Diabetic neuropathy affects 50%–66% of patients with diabetes mellitus. Oxidative stress generates nerve dysfunction by causing segmental demyelinization and axonal degeneration. Antioxidants are considered to be the only etiologic management for diabetic polyneuropathy, and statins such as rosuvastatin increase nitric oxide bioavailability and reduce lipid peroxidation. The aim of this study was to evaluate the antioxidant effect of rosuvastatin in diabetic polyneuropathy.Methods: We conducted a randomized, double-blind, placebo-controlled Phase IIa clinical trial in patients with type 2 diabetes and diabetic polyneuropathy (DPN) stage $1b. We allo­cated subjects to two parallel groups (1:1) that received rosuvastatin 20 mg or placebo for 12 weeks. Primary outcomes were neuropathic symptom score, disability score, and nerve conduction studies, and secondary outcomes were glycemic control, lipid and hepatic profile, lipid peroxidation, and nerve growth factor beta (NGF-β) levels.Results: Both groups were of similar age and duration since diagnosis of diabetes and DPN. We observed improvement of DPN in the rosuvastatin group from stage 2a (88.2%) to stage 1b (41.2%), improvement of neuropathic symptom score from 4.5±2 to 2.4±1.8, and significant (P=0.001) reductions of peroneal nerve conduction velocity (from 40.8±2.2 to 42.1±1.6 seconds) and lipid peroxidation (from 25.4±2 to 12.2±4.0 nmol/mL), with no significant change in gly­cemic control or β-NGF.Conclusion: The severity, symptoms, and nerve conduction parameters of DPN improved after 12 weeks of treatment with rosuvastatin. These beneficial effects appear to be attributable to reductions in lipid peroxidation and oxidative stress. © 2014 Hernández-Ojeda et al.

Ramos-Zuniga R.,Centro Universitario Of Ciencias Of La Salud | De La Cruz-Ramirez J.,Hospital V Gomez Farias | Casillas-Espinosa P.M.,Centro Universitario Of Ciencias Of La Salud | Sanchez-Prieto J.A.,Centro Universitario Of Ciencias Of La Salud | Lopez-Hernandez M.D.S.,Centro Universitario Of Ciencias Of La Salud
Minimally Invasive Neurosurgery | Year: 2011

Introduction: Despite improvements in sanitation, diagnosis and treatment, neurocysticercosis is still a public health problem in many countries. In symptomatic patients, there is a broad spectrum of clinical manifestations. When cysticerci are lodged in the ventricles or the subarachnoid space, the flow of cerebrospinal fluid can be obstructed and lead to hydrocephalus and intracranial hypertension. The endoscopic view may be useful as a diagnostic tool. Patients: This report clearly shows a common endoscopic pattern in 4 selected patients with ventricular cysticercosis (2 third ventricle/2 lateral ventricle). The endoscopic view of the cysts in the ventricles resembles a full moon. This analogy helped to identify the features of cysticerci with intact walls and the vesicular stage, malleable due to its cystic content and having an irregular surface, as evidence of the microscopic structure of the cyst wall in a cysticercus. Conclusions: This finding is not seen in other intraventricular cysts or tumors that can actually be considered as an additional diagnostic criterion among the definitive findings to establish the diagnosis of cysticercosis, since it involves direct endoscopic visualization of a cysticercus under histopathological demonstration. Additionally, the endoscopic approach can be used as primary treatment for these cases, following the minimally invasive approach principle. © Georg Thieme Verlag KG Stuttgart - New York.

Villafan-Bernal J.R.,Centro Universitario Of Ciencias Of La Salud | Llamas-Covarrubias M.A.,University of Guadalajara | Munoz-Valle J.F.,University of Guadalajara | Rivera-Leon E.A.,Centro Universitario Of Ciencias Of La Salud | And 5 more authors.
Journal of Investigative Medicine | Year: 2014

Background: The uncarboxylated osteocalcin (ucOC) has been described as a regulator of glucose metabolism in mice, and it is decreased in human type 2 diabetes mellitus (T2D). Although inversely correlated with serum glucose, insulin, and glycated hemoglobin, it is unclear if ucOC decrement is caused by diabetes or plays a role in the pathogen-esis and/or progression of the disease. Whatever the case may be, diabetes affects osteoblast gene expression, and possibly the proportion of ucOC over carboxylated OC (cOC). The association of ucOC/cOC index with glycemic status markers in patients with T2D has not been described before. Objective: The objective of this study was to assess the ucOC/cOC index and its relationship with glycemic status markers in patients with T2D. Methods: The ucOC/cOC index was determined by the quotient of ucOC and cOC serum levels in 80 T2D patients and 160 healthy subjects. The relationship between the ucOC/cOC index and glycemic status markers was evaluated. Results: The ucOC/cOC index was low and negatively correlated to fasting plasma glucose and homeostasis assessment-insulin resistance model in T2D patients. The odds ratio for T2D patients with an ucOC/cOC index below the cut-point obtained by receiver operating characteristic analysis was 12.64 (confidence interval, 5.75-27.77; P < 0.001). Conclusions: A value of ucOC/cOC index less than 0.3 is associated with markers of poor metabolic control in patients with T2D. Copyright © 2013 by The American Federation for Medical Research.

PubMed | University of Colima, Monterrey Institute of Technology, Centro Universitario Of Ciencias Of La Salud and University of Guadalajara
Type: | Journal: Frontiers in cellular neuroscience | Year: 2016

Sleep deprivation (SD) affects spatial memory and proliferation in the dentate gyrus. It is unknown whether these deleterious effects persist in the long run. The aim of this study was to evaluate the proliferation, differentiation and maturation of neural progenitors as well as spatial memory 21 days after suffering SD. Sixty-day old male Balb/C mice were exposed to 72-h REM-SD. Spatial memory, cell fate, apoptosis and expression levels of insulin-like growth factor 1 receptor (IGF-1R) were evaluated in the hippocampus at 0, 14, and 21 days after SD or control conditions. After 21-days recovery period, memory performance was assessed with the Barnes maze, we found a significant memory impairment in SD mice vs. control (94.0 10.2 s vs. 25.2 4.5 s; p < 0.001). The number of BrdU+ cells was significantly decreased in the SD groups at day 14 (controls = 1.6 0.1 vs. SD mice = 1.2 0.1 cells/field; p = 0.001) and at day 21 (controls = 0.2 0.03 vs. SD mice = 0.1 0.02 cells/field; p < 0.001). A statistically significant decrease was observed in neuronal differentiation (1.4 0.1 cells/field vs. 0.9 0.1 cells/field, p = 0.003). Apoptosis was significantly increased at day 14 after SD (0.53 0.06 TUNEL+ cells/field) compared to controls (0.19 0.03 TUNEL+ cells/field p < 0.001) and at 21-days after SD (SD mice 0.53 0.15 TUNEL+ cells/field; p = 0.035). At day 0, IGF-1R expression showed a statistically significant reduction in SD animals (64.6 12.2 units) when compared to the control group (102.0 9.8 units; p = 0.043). However, no statistically significant differences were found at days 14 and 21 after SD. In conclusion, a single exposition to SD for 72-h can induce deleterious effects that persist for at least 3 weeks. These changes are characterized by spatial memory impairment, reduction in the number of hippocampal BrdU+ cells and persistent apoptosis rate. In contrast, changes IGF-1R expression appears to be a transient event. Highlight Sleep deprivation affects spatial memory and proliferation in the dentate gyrus. To date it is unknown whether these deleterious effects are persistent over a long period of time. We analyzed the effects of sleep deprivation in the hippocampus after 21 days of recovery sleep. Our findings indicate that after sleep recovery, the detrimental effects of SD can be observed for at least 2 weeks, as shown by a reduction in memory performance, changes in the hippocampal cellular composition and higher apoptotic rate over a long period of time.

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