Gaceta medica de Mexico最新文献

Background: Protein interactions participate in many molecular mechanisms involved in cellular processes. The human TATA box binding protein (hTBP) interacts with Antennapedia (Antp) through its N-terminal region, specifically via its glutamine homopeptides. This PolyQ region acts as a binding site for other transcription factors under normal conditions, but when it expands, it generates spinocerebellar ataxia 17 (SCA17), whose protein aggregates in the brain prevent its correct functioning.

Objective: To determine whether the hTBP glutamine-rich region is involved in its interaction with homeoproteins and the role it plays in the formation of protein aggregates in SCA17.

Material and methods: We characterized hTBP interaction with other homeoproteins using BiFC, and modeled SCA17 in Drosophila melanogaster by targeting hTBPQ80 to the fly brain using UAS/GAL4.

Results: There was hTBP interaction with homeoproteins through its glutamine-rich region, and hTBP protein aggregates with expanded glutamines were found to affect the locomotor capacity of flies.

Conclusions: The study of hTBP interactions opens the possibility for the search for new therapeutic strategies in neurodegenerative pathologies such as SCA17.

Background: Suicidal behavior in adolescents is a growing public health problem. Knowing its risk factors is key for reducing it.

Objective: To identify the relationship between two suicidal behaviors (ideation and attempt) and eight mental health problems (MHPs) in Mexican adolescents.

Material and methods: Through an online survey of adolescent students from 20 states, the following information was screened: symptomatology of six MHPs (affective problems/depression, behavioral problems, somatic problems, inattention and hyperactivity problems, oppositional defiant problems and anxiety problems) and suicidal behavior (suicidal ideation and suicide attempts). MHP and suicidal behavior frequencies and percentages were analyzed, and associations were sought using binary logistic regression.

Results: Six-thousand seven hundred sixty-six adolescents completed the survey, out of whom 61.02% were females, with ages ranging between 11 and 19 years (16.38 ± 1.33); 10% reported suicidal behavior, and between 3 and 5%, MHPs. The predictors (χ²₍₈₎ = 387.13, p < 0.001) of suicidal behavior were affective problems/depression, behavioral problems, somatic problems, oppositional defiant problems and anxiety problems.

Conclusion: Five mental health problems increased the risk of reporting suicidal behaviors.

Background: Specific dietary compounds are essential for cognitive health.

Objective: To examine differences in the consumption of macronutrients and inorganic nutrients between people with a higher and lower risk of cognitive impairment.

Material and methods: Cross-sectional analysis of the 3Ollin study. Minimal Mental State Examination determined cognitive status. Two groups were obtained from the median of the score: higher and lower risk of cognitive deterioration. Diet was assessed using two 24-hour recalls. Descriptive statistics and comparison analysis of medians using Mann-Whitney U and Spearman correlation analysis were performed between nutrients and MMSE scores. The results were considered statistically significant when p ≤ 0.05.

Results: Data from 425 people were analyzed; the median age was 71 years (P25-P75 = 65-77). In the group with a lower risk of cognitive impairment, a higher consumption of calories, protein, carbohydrates, fiber, folate, phosphorus, ascorbic acid, vitamin E, alpha-tocopherol, vitamin B₆, vitamin B₁₂, zinc, selenium, and lycopene were observed. Also, a greater consumption of fruits and vegetables (p < 0.005).

Conclusions: There are significant differences in diet between groups at risk for cognitive impairment.

Background: Frailty has been related to adverse outcomes, but evidence on its association with the use of health services is still scarce.

Objective: The purpose of this work was to determine the association of frailty with the use of health services in Mexican adults older than 60 years.

Material and methods: Analysis of the Mexican Health and Aging Study for the years 2015 (baseline) and 2018 (follow-up). Frailty was defined with the frailty index. The following outcomes were included: hospitalization, medical visits, major surgery, minor surgical procedures, and dental visits. Competing risk and count analyses (negative binomial regression) were performed.

Results: A total of 8,526 individuals were included, whose average age was 70.8%; 55.8% corresponded to the female gender. According to the results, hospitalization days and the number of minor procedures were associated with frailty.

Conclusions: Frailty could be useful in the planning of health services for older adults. On the other hand, its evaluation would allow prioritizing care for those who are at higher risk of adverse outcomes.

Introduction: Dysphagia and cognitive impairment are common in older people. It is linked to alterations in brain areas related to swallowing.

Objective: To explore the characteristics of dysphagia using fluoroscopy in patients with mild cognitive impairment (MCI) and dementia.

Material and methods: 158 participants from a memory clinic. Specific criteria for MCI and dementia were used. Dysphagia was assessed with EAT-10 (≥ 3). Those who accepted completed a fluoroscopy study with a barium swallow to evaluate the phases of swallowing; the presence of bronchoaspiration supported the diagnosis of dysphagia. A logistic regression analysis was performed to test the probability between dysphagia and MCI.

Results: According to EAT-10, 86 (54.4 %) were at risk of dysphagia, confirmed in 84 by fluoroscopy, 53.8 % MCI group and 46.2 % dementia. An inverse association was observed in the MCI oral phase group (OR 0.23, p < 0.025), and a positive association; in protection phase against regurgitation (OR 3.76, p < 0.056) and laryngeal muscle contraction (OR 3.22, p < 0.045) versus dementia group.

Conclusions: The study showed a high frequency of dysphagia in patients with MCI, this highlights the importance of its early detection to improve complications associated with dysphagia.

Humans are exposed every day to innumerable external stimuli, both environmental and microbial. Immunological memory recalls each specific stimulus and mounts a secondary response that is faster and of a larger magnitude than the primary response; this process constitutes the basis for vaccine development. The COVID-19 pandemic offers a unique opportunity to study the development of immune memory against an emergent microorganism. Memory T cells have an important role in the resolution of COVID-19, and they are key pillars of immunological memory. In this review, we summarize the main findings regarding anti-SARS-CoV-2 memory T cells after infection, after vaccination, and after the combination of these two events ("hybrid immunity"), and analyze how these cells can contribute to long-term protection against the infection with SARS-CoV-2 variants.

Background: The proportion of older people living with HIV (PLWH) has increased. Non-communicable diseases occur earlier in PLWH than in the general population.

Objective: The goal of this study was to estimate the prevalence of comorbidities in PLWH and cancer in a tertiary referral center in Mexico City.

Material and methods: In this retrospective study, we included PLWH > 40 years with a history of cancer, coming to Instituto Nacional de Cancerologia from 2010 through 2019. All patients needed to be on antiretrovirals for at least six months. Data collected included cancer type, comorbidities, frequency of polypharmacy, FRAX score and 10-year cardiovascular risk. Patients were evaluated for depression with the Beck Inventory Depression-II Scale. Variables associated to multimorbidity (2 or more comorbidities) were evaluated.

Results: Of 125 patients, 69% had at least one comorbidity; 32% had ≥ 2. Common comorbidities were dyslipidemia (54%), hypertension (19%), obesity (14%) and Diabetes (12%). In patients ≥ 50 years, 29 (62%) already undergone a densitometry and 9 (31%) had osteoporosis; 56 depression questionnaires were used: 30% had mild-to-severe depression. Being ≥ 50 years was associated with multimorbidity (aOR 2.57 (1.18-5.58), p = 0.017).

Conclusions: A high prevalence of multimorbidity and poor screening of bone disease and mental health is reported in patients with PLWH and cancer. A holistic approach to the PLWH in the Infectious Diseases consultation is needed to improve the detection and management of non-communicable diseases, to go beyond viral suppression and towards an improved quality of life.

Introduction: Percutaneous nephrostomy tubes (PNT), which are used in some cancer hospitals, are associated with an increase in urinary tract infections (UTI).

Objective: To determine the impact of a standardized care program on the incidence of UTIs requiring hospitalization (UTI-RH).

Material and methods: Retrospective study that included patients with a first PNT inserted. The incidence, relative risk (RR), costs and outcomes of patients with UTI-RH were compared during the period before (P0) vs. after the intervention (P1).

Results: 113 PNTs were inserted during P0, and 74 at P1. During P0, 61 patients (53.9%) experienced 64 UTI-RH events in 22,557 PNT days. At P1, four patients (5.4%) had a UTI-RH in 6,548 PNT days (IRR: 0.21, 95% CI: 0.05-0.57). The RR was 0.09 (95% CI: 0.03-0.25). Monthly cost per day/bed was USD 3,823 at P0 and USD 1,076 at P1, and for antibiotics, it was USD 790 at P0 and USD 123.5 at P1.

Conclusions: This study highlights the importance of a standardized care program for permanent percutaneous devices, since this reduces antibiotic use, hospitalization, and the cost of care.