Gaceta medica de Mexico最新文献

Although obesity is an important risk factor for cardiometabolic diseases, not every individual with obesity shows metabolic complications, this phenotype is called metabolically healthy obesity (MHO). Several studies suggest that the distribution of body fat and its accumulation in ectopic depots, rather than overall adiposity, are important factors in defining the metabolic health of individuals with obesity. The identification of genes involved in fat accumulation, particularly in the expansion of subcutaneous adipose tissue, has contributed to better understanding the physiological mechanisms related to metabolic health. Notably, some Latin American populations have an increased susceptibility to the development of metabolic complications. In this review, we discuss the differences in the prevalence of MHO among populations, including Latin Americans, as well as some of the main genetic findings related to healthy and unhealthy metabolic phenotypes of obesity.

Understanding the genetic architecture of complex disease has helped identify at risk individuals, new pathways involved in pathophysiology, and potential pharmacological targets for prevention and/or treatment. Thus, the identification of susceptibility variants of Native American or Mexican origin can potentially benefit any patient, regardless of ethnic origin. The purpose of this review is to provide an overview of the most relevant contributions of Mexican researchers to knowledge on genomics of cardiometabolic disease in the Mexican population, including ethnic-specific variants and population genomics studies, stressing the importance of evolutionary approaches in understanding complex disease. Collaborative efforts and large long-term cohort studies including genomic, multi-omic, fine phenotyping and environmental exposure data are necessary to identify the clinical relevance of these variants and how they interact with the environment, in order to apply this knowledge to personalized medicine.

Background: Both environmental and genetic factors determine metabolic syndrome (MetS) and eventually result in metabolic diseases. MetS is a national health problem in adults and children, with a higher incidence in Indigenous than mestizo individuals.

Objective: Evaluate the association of PPARG/rs1801282, KCNJ11/rs5219, HHEX/rs1111875, HNF4A/rs1800961, ACE-I/D, FTO/rs9939609 and ABCA1/rs9282541 variants with MetS or its components in the Maya children from Yucatan.

Material and methods: A total of 508 Maya children of 9 to 13 years were recruited. We analyze the association of genetic variants with MetS in non-obese Maya children by univariate and multivariate models adjusted by sex, age, and BMI.

Results: Interestingly, the frequency of MetS in non-obese Maya children from rural and urban areas was 35% and 39%, respectively. The genotype-phenotype analysis in rural Maya children revealed that rs9282541-ABCA1 was associated with high glucose (p = 0.011); rs9939609-FTO, with high blood pressure (p = 0.048) and rs1800961-HNF4A, with high insulin and HOMA-IR (p = 0.038, p = 0.043). In urban children, I/D-ECA was associated with high blood pressure (p = 0.022); rs1111875-HHEX, with high triglycerides (p = 0.050) and rs1800961-HNF4A, with low HDL-c (p = 0.048).

Conclusions: These findings provide strong evidence of the role of the studied variants in conferring genetic susceptibility to develop MetS in non-obese Maya children from Mexico.

Artificial intelligence as a generic concept is present in all activities of daily life in contemporary society. In the biomedical scenario has had a particular presence, with the development of systems ranging from the generation of knowledge in medical research to applications in different areas of individual and collective health. Such is the case of new tools based AI in different modalities, in public health, diagnostics, image, medical and surgical clinical processes, as well as rehabilitation, inclusion and functional facilitation strategies. Despite being a relevant advance based on technological innovation and knowledge transfer for management and decision making, it is pertinent to consider some reasonable precautionary measures as recommendations, to evaluate the safety, efficacy and risks in a timely manner.

The medical residency exam is an essential academic filter to access medical residency in Peru. This article examines the factors that influence the performance of applicants, from the quality of the training system to work and emotional conditions. Through a narrative review, deficiencies in supervision, infrastructure and research promotion were identified, in addition to the high prevalence of emotional exhaustion and depersonalization among applicants. Inequalities between regions and the lack of standardization in educational quality also condition the results. Structural reforms and support programs are proposed to improve the system and ensure equitable training.

Background: Non-therapeutic hysterectomy in girls and adolescents with intellectual disability (ID) is an acceptable practice, even when there is a lack of prescriptive ethical reason.

Objectives: To determine the magnitude of the practice of hysterectomy in girls and adolescents with ID, and explore the emic factors associated with this procedure.

Material and methods: Multicenter, intersectoral study with a mixed methods design.

Results: The quantitative results showed that 50 of 234 reported hysterectomies corresponded to females with ID. Average age at the time of surgery was 15 ± 2.9 years. Prophylactic abdominal hysterectomy was the most common procedure, and the justifications for it were "fertility control", "menstrual hygiene management", and "risk of sexual abuse". A qualitative analysis of 15 focus groups revealed that parents' main concern was how to manage their daughters' index disease and reproductive health; they perceived menstruation positively; they expressed their fear of dying and leaving them without support, and emphasized fertility control; none of them approved hysterectomy.

Conclusions: The bodies that define health policies need to create a new philosophy that avoids the reductionist approach of current biomedical model, which separates (in the health-disease process) our interdependence with other humans.