Direccion de Investigacion

Dolores Hidalgo Cuna de la Independencia Nacional, Mexico

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Dolores Hidalgo Cuna de la Independencia Nacional, Mexico
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Cantu-De Leon D.,Direccion de Investigacion | Herrera Montalvo L.,National Autonomous University of Mexico
Annals of Diagnostic Pathology | Year: 2015

Primary mucinous adenocarcinomas of the ovary are a diagnostic challenge because their histologic and immunohistochemical features usually overlap with metastatic tumors. SATB2 is a recently identified protein with restricted expression in the glandular cells lining the lower gastrointestinal tract. The aim of this study is to examine the differential expression of SATB2 in primary and metastatic tumors of the ovary. Mucinous ovarian tumors of intestinal type were retrieved from the pathology files of the Instituto Nacional de Cancerología de México. A double reading of the hematoxylin and eosin-stained slides was performed to confirm the diagnosis, and a detailed review of the clinical chart was performed to define the primary origin of the tumor (ovarian vs metastatic). Immunohistochemical staining for CK20, CDX2, and SATB2 was performed and evaluated by 2 gynecopathologists. A total of 106 mucinous tumors were identified, 26 of which were considered to be metastatic, and 80 of which were primary ovarian tumors. All of the primary tumors that were not associated with cystic teratomas were negative for SATB2, and the 4 that were associated with a teratoma were positive for SATB2. All 20 of the metastatic tumors of the colon and appendix were positive for CK20, and 4 were positive for CK7. In addition, all 20 of these tumors were positive for SATB2, and 19 were positive for CDX2. SATB2 appears to be a useful marker for the diagnosis of primary vs metastatic mucinous intestinal-type neoplasms and is highly sensitive in detecting lower gastrointestinal tract metastasis. © 2015 Elsevier Inc.

PubMed | Direccion de Investigacion
Type: Journal Article | Journal: Artificial organs | Year: 2016

Hemodialysis (HD) is usually performed with the gradually decreasing ultrafiltration rate (UFR) profile (dUFR). The aim of the present study was to compare the hemodynamic response to HD with the dUFR to that of HD with the gradually increasing UFR profile (iUFR). The study population included 10 patients (three women, mean age: 288 years) undergoing maintenance HD who had reached dry weight without taking antihypertensive medications. Each patient received (in random order) one HD session with the dUFR and another with the iUFR (both with 3h total UFR=2200mL). Hemodynamic response was evaluated with a brachial blood pressure (BP) monitor, echocardiogram and Portapres to measure digital BP, heart rate, cardiac output, stroke volume, and peripheral resistance. Mean values were compared at each HD hour during the first 3h of a 4-h HD session. The HD characteristics, including Kt/V, were similar for both UFR profiles. Relative blood volume decreased more gradually and linearly with the iUFR. Hemodynamic variables were not significantly different between the two profiles, but brachial BP was more stable with the iUFR. Digital diastolic BP increased with both profiles. Peripheral resistance increased with both profiles, and tended to increase more with the iUFR. Echocardiographic variables changed similarly during the HD session with both profiles. In conclusion, these two UFR profiles are similar in most hemodynamic variables. The statistical equivalence of both profiles suggests that either could be prescribed based on the clinical characteristics of the patient.

PubMed | Direccion de Investigacion, Metropolitan Autonomous University and National Autonomous University of Mexico
Type: | Journal: Geriatrics & gerontology international | Year: 2016

Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders.Household survey in 655 persons 70years old and over residing in one county in Mexico City.Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted.Mean age was 79.27.1years; 54.2% were women. Mean OHIP-14-Sp score was 6.88.7, median was 4. The final model showed that men (RR=1.30); persons with xerostomia (RR=1.41); no utilization of removable prostheses (RR=1.55); utilization of non-functional removable prostheses (RR=1.69); fair self-perception of general health (RR=1.34); equal (RR=1.43) or worse (RR=2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR=1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association.Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2016; : -.

PubMed | Laboratorio Of Ultrasonido Musculoesqueletico Y Articular, Direccion de Investigacion and National Research Center y Atencion en Medicina del Deporte
Type: | Journal: Gaceta medica de Mexico | Year: 2015

Taekwondo is associated with an increased incidence of musculoskeletal injuries such as tendinopathy, synovitis, chondropathy, and ligament and meniscus injuries that may have an asymptomatic course in their initial stages, especially those located in the knee.To describe the presence of morphostructural abnormalities in asymptomatic taekwondo athletes (TKD) knees through the use of diagnostic ultrasound (US).A cross-sectional, descriptive and comparative study. We evaluated 32 knees of 16 subjects (8 TKD and 8 recreational athletes). All subjects underwent sport-medical history and knee US.A variety of intra- and extra-articular morphostructural abnormalities were observed; the most frequent were synovitis, meniscal extrusion, and enthesopathy.The practice of Taekwondo abnormalities associated with an increased risk of knee injuries that may go unnoticed in the early stages. The use of US as an auxiliary tool in the diagnosis of these injuries and/or advisable since it can define in detail the anatomical structures subject to overuse, biomechanical stress, or repetitive trauma, and contribute to early detection of asymptomatic morphostructural alterations that may ensure timely preventive and therapeutic interventions.

PubMed | Servico Of Reumatologia Do Centro Hospitalar Of Lisbon Ocidental, Hospital Universitario La Paz, Hospital Marino Molina Scippa ESSALUD, Hospital Edgardo Rebagliati Martins and 14 more.
Type: Journal Article | Journal: Clinical rheumatology | Year: 2016

The objective of this study is to evaluate inter-reader entheses ultrasound (US) reliability and the influence of the type of image or degree of sonographer experience on US reliability in patients with spondyloarthritis (SpA). Eighteen Latin American ultrasonographers with different experience took part in an US reading exercise evaluating 60 entheseal images (50% static images and 50% videos) from healthy controls and SpA patients. The following sonographic lesions were assessed: structure, thickness, bone proliferation/tendon calcification, erosions, bursitis, and Doppler signal. Another group of three experts with significant experience in entheses US read all images too. Inter-reader reliability among participants and experts was calculated by the Cohens kappa coefficient. Thresholds for kappa values were <0.2 poor, 0.21-0.4 fair, 0.41-0.6 moderate, 0.61-0.8 good, and 0.81-1 excellent. Furthermore, the results for the expert group were stratified based on the type of image. Kappa correlation coefficients among participants, showed variability depending on the type of lesion, being fair for structure and thickness, moderate for calcifications, erosions, and bursitis, and excellent for Doppler signal. Inter-reader reliability among experts was higher, being moderate for structure and thickness, good for calcifications and bursitis, and excellent for erosions and Doppler. Inter-reader reliability for assessing calcification and structure using static images was significantly higher than for videos. Overall inter-reader reliability for assessing entheses by US in SpA is moderate to excellent for most of the lesions. However, special training seems fundamental to achieve better inter-reader reliability. Moreover, the type of image influenced these results, where evaluation of entheses by videos was more difficult than by static images.

Pacheco-Tena C.,Autonomous University of Chihuahua | Perez-Tamayo R.,National Autonomous University of Mexico | Pineda C.,Direccion de Investigacion | Gonzalez-Chavez S.A.,University of Toronto | And 6 more authors.
Journal of Rheumatology | Year: 2015

Objective. Patients with juvenile-onset spondyloarthritis (SpA) may develop ankylosis of the midfoot resembling the spinal changes seen in patients with ankylosing spondylitis (AS). The study of the histopathology of the feet of patients with tarsitis could help us understand the pathogenesis of bone formation in affected structures in the SpA. The objective of our study was to describe the histopathologic characteristics of the midfoot in patients with tarsitis associated with SpA. Methods.We obtained synovial sheaths, entheses, and bone samples from 20 patients with SpA with midfoot pain/tenderness and swelling. Tissue samples underwent HandE staining; immunohistochemistry for CD3, CD4, CD8, CD68, and CD20 cell identification; and immunofluorescence for bone lineage proteins, including osteocalcin, osteopontin, parathyroid hormone-related protein, bone sialoprotein, and alkaline phosphatase. Results. Slight edema and hyalinization were found in some tendon sheaths, and few inflammatory cells were detected in the entheses. In bones, we found some changes suggesting osteoproliferation, including endochondral and intramembranous ossification, but no inflammatory cells. In entheses showing bone proliferation, we detected osteocalcin and osteopontin in cells with a fibroblastmesenchymal phenotype, suggesting the induction of entheseal cells toward an osteoblast phenotype. Conclusion. Osteoproliferation and abnormal expression of bone lineage proteins, but no inflammatory infiltration, characterize midfoot involvement in patients with SpA. In this sense, tarsitis (or ankylosing tarsitis) resembles the involvement of the spine in patients with AS. Ossification may be in part explained by the differentiation of mesenchymal entheseal cells toward the osteoblastic lineage.

Matta N.E.,National University of Colombia | Lotta I.A.,National University of Colombia | Valkiunas G.,Institute of Ecology | Gonzalez A.D.,National University of Colombia | And 4 more authors.
Parasitology Research | Year: 2014

We describe Leucocytozoon quynzae sp. nov. (Haemosporida, Leucocytozoidae), which is the first Leucocytozoon parasite identified to species level in hummingbirds. It was found in the Amethyst-throated Sunangel (Heliangelus amethysticollis, Trochilidae, Apodiformes) captured in the Palacio Forest, which belongs to the damping zone of Chingaza National Natural Park, Cundinamarca, Colombia, at 2,900 m above sea level where the transmission occurs; the new species were found both in the high Andean forest and Paramo ecosystem. This parasite is described based on the morphology of its blood stages, a fragment of the mitochondrial cytochrome b gene, and the complete mitochondrial genome. Illustrations of blood stages of the new species are given, and the phylogenetic analysis places this lineage in a well-supported clade with other lineages of unidentified to species level leucocytozoids reported in the Trochilidae birds elsewhere. The new species possess gametocytes in roundish host cells; it can be readily distinguished from other similar leucocytozoids, primarily due to (1) a comma-like shape of the host cell nucleus, which extended one half or less of the circumference of the gametocyte and (2) a large number of prominent volutin granules in the cytoplasm. Identical mitochondrial cytochrome b sequence of Leucocytozoon quynzae was found in different hummingbird species at the type locality and also was reported in one passerine bird at the highlands of Peru. Leucocytozoon quynzae is the first leucocytozoid parasite described from South American birds; its transmission occurs both at low temperatures and high elevations. We discuss some patterns of distribution of avian leucocytozoids in South America and the role of Gigantodax spp. (Diptera, Simuliidae) as potential vectors of Leucocytozoon parasites in the Andean Region. © 2013 Springer-Verlag Berlin Heidelberg.

PubMed | University of Toronto, Instituto Mexicano del Seguro Social, Hospital Infantil Of Mexico Federico Gomez, Direccion de Investigacion and University of Guadalajara
Type: Journal Article | Journal: PloS one | Year: 2016

We conducted a cost-effectiveness analysis of seven hepatitis C virus (HCV) testing strategies in blood donors.Three of the seven strategies were based on HCV diagnosis and reporting guidelines in Mexico and four were from previous and current recommendations outlined by the CDC. The strategies that were evaluated determine antibody levels according to the signal-to-cut-off (S/CO) ratio and use reflex Immunoblot (IMB) or HCV RNA tests to confirm true positive (TP) cases of chronic HCV infection. Costs were calculated from the perspective of the Mexican Institute of Social Security (IMSS). A decision tree model was developed to estimate the expected number of true positive cases and costs for the base-case scenarios and for the sensitivity analyses.Base-case findings indicate an extended dominance of the CDC-USA2 and CDC-USA4 options by the IMSS Mexico3 and IMSS-Mexico1 alternatives. The probabilistic sensitivity analyses results suggest that for a willingness-to-pay (WTP) range of $0-9,000 USD the IMSS-Mexico1 strategy is the most cost-effective of all strategies ($5,000 USD per TP). The IMSS-Mexico3, IMSS-Mexico2, and CDC-USA3 strategies are also cost-effective strategies that cost between $7,800 and $8,800 USD per TP case detected. The CDC-USA1 strategy was very expensive and not cost-effective.HCV antibody testing strategies based on the classification of two or three levels of the S/CO are cost-effective procedures to identify patients who require reflex IMB or HCV RNA testing to confirm chronic HCV infection.

PubMed | Division de Investigacion Basica, National Autonomous University of Mexico, Instituto Nacional Of Neurologia Y Neurocirugia and Direccion de Investigacion
Type: | Journal: The Journal of steroid biochemistry and molecular biology | Year: 2016

Intracellular progesterone receptors (PRs) and protein kinases C (PKCs) are known regulators of cancer cell proliferation and metastasis. Both PRs and PKCs are found overexpressed in grade IV human astrocytomas, also known as glioblastomas, which are the most frequent and aggressive brain tumors. In the present study, we investigated whether PR activation by PKC induces the migration and invasion of glioblastoma derived cell lines and if PKC and isoforms are involved in PR activation. We observed that PKC activation with tetradecanoylphorbol acetate (TPA) increases the migration and invasion capacity of two human glioblastoma derived human cell lines (U251 MG and U87) and that the treatment with the PR receptor antagonist RU486 blocks these processes. Interestingly, the pharmacological inhibition of the isoenzymes PKC and PKC also resulted in a blocked PR transcriptional activity. Also, TPA-dependent PR activation increases the expression of progesterone-induced blocking factor (PIBF), a known PR target gene. These results hint to an existing cross-talk between PKCs and PRs in regulating the infiltration process of human glioblastomas.

PubMed | Direccion de Investigacion and National University of Colombia
Type: Case Reports | Journal: Biomedica : revista del Instituto Nacional de Salud | Year: 2016

Approximately 2 million people die each year from tuberculosis. One third of the worlds population is estimated to be infected with the tuberculosis bacillus, although only 5-10% will develop the disease in their lifetime. The disease progression risk depends on endogenous and exogenous factors. Indigenous communities are a high-risk group for infection and development of tuberculosis. In addition to factors such as geographical isolation, social and cultural neglect and malnutrition, susceptibility to genetic polymorphisms has been identified in them. Spinal tuberculosis is the most destructive form of the disease, which represents approximately half of all cases of skeletal tuberculosis. The case of an HIV negative, indigenous Colombian man is presented. His diagnosis was done based on clinical and image findings, and it was confirmed with the rapid molecular assay Genotype MTBDRplus and IS6110 PCR.The culture in solid media was negative after 16 weeks. We briefly discuss the pathogenesis, diagnosis and treatment. Finally, we comment on some aspects of the situation of tuberculosis among indigenous Colombian communities.

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