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The goal of this work is to report a novel assay that preserves antigenicity of extracts with high protease content without using enzymatic inhibitors. A great reduction of proteolytic activity in the insoluble chloroform/methanol and heated amoebic fraction (IC[ratio ]MC) was obtained by this method, even in the presence of sodium dodecyl sulphate and 2-mercaptoethanol. The substrates azo-casein and the hide powder azure were used to determine the reduction of proteolytic activity of IC[ratio ]MC compared with the activity of crude extract and crude extract with iodoacetamide. The IC[ratio ]MC SDS-PAGE pattern shows a higher quantity of bands than extract with the inhibitor iodoacetamide or than crude extract. In addition, anti-Entamoeba histolyticaantibodies from amoebic liver abscess patients recognized a richer antigenic Western blot pattern in the IC[ratio ]MC fraction than in crude extract alone or with inhibitor. The described method has proved to be suitable to preserve amoebic antigens for its use in diagnostic tests and it can be used for immunological response studies againstE. histolyticaantigens. Furthermore we propose that this method to obtain the IC[ratio ]MC fraction can be applied for the study of other microorganisms or cells with high enzymatic content.

Diabetes in pregnant women is associated with an increased risk for maternal and neonatal morbidities and remains a significant medical challenge. Fortunately, the prognosis has changed dramatically, related to an increased clinical awareness of the potential risks for the mother and the infant, better health care and intensive treatment strategies to maintain the closest to normal metabolic milieu. Diabetes and pregnancy may be divided into pregestational diabetes (women previously diagnosed with type 1 or type 2 diabetes) and gestational diabetes defined as any glucose intolerance detected during pregnancy that has evolved from a diagnosis associated with the metabolic risk of type 2 diabetes to a clinical condition associated with higher risks for maternal and perinatal morbidity. Early diagnosis of gestational diabetes is an important step to improve outcomes and systematic or selective screening with the OGTT should be established. Associated with the global epidemic in diabetes, pregnancy associated with diabetes is saturating high-risk obstetric clinics and neonatal intensive care units, becoming a heavy burden to the health care systems around the world.

Dystrophic epidermolysis bullosa (DEB) is an inherited blistering skin disorder caused by mutations in the type VII collagen gene (COL7A1). In this study, we determined the molecular basis of autosomal recessive DEB in a 19-year-old Hispanic Mexican woman by PCR amplification of genomic DNA, heteroduplex analysis, and automated sequencing of heteroduplex bandshifts. This approach revealed a homozygous frameshift mutation, 2470insG, in exon 19 of COL7A1 and resulted in attenuated basement membrane zone expression of type VII collagen, a reduced number of anchoring fibrils at the dermal-epidermal junction, and a sub-lamina densa level of blister formation. Clinically, the patient had widespread trauma-induced skin fragility and complete loss of the nails, but had less pseudosyndactyly of the fingers and toes and milder mucosal involvement compared to most patients with the generalized form of this genodermatosis. We also screened 7 other Hispanic-Mexican patients with recessive DEB, none of whom were known to be related to this individual, for the mutation 2470insG using heteroduplex analysis and direct sequencing and detected this mutation on 7/14 alleles. Haplotype analysis using intragenic COL7A1 and flanking polymorphisms and microsatellite markers revealed that all the mutant alleles had arisen on similar allelic backgrounds, consistent with propagation of a common Hispanic Mexican ancestral haplotype. In view of the high allelic frequency of the mutation 2470insG in the patients studied, we recommend initial screening for this mutation when attempting to identify the molecular pathology of recessive DEB in Hispanic Mexican patients.

A thyroid nodule (TN) is a discrete lesion in the thyroid gland radiologically distinct from the adjacent parenchyma, with a prevalence variable depending on the diagnostic method used and the study population. Thyroid disorders have been identified in more than 50% of patients with systemic lupus erythematosus (SLE); however, the prevalence of TN has not been frequently studied. We identified a prevalence of 27% TN in 55 SLE patients > 16 years of age. One-third of TN were >1 cm with radiological features of malignancy. The mean age of patients with TN was 39 ± 11 years, 93% women, and SLE duration 10 ± 6 years. Among patients, we reported family history of cancer in three cases (20%), thyroid disease in one (7%), and autoimmune disease in six (40%). Regarding treatment, 50% of patients with TN were treated with azathioprine vs. 23% of patients without TN ( p = 0.02), with an OR of 3.94 (95% CI 1.12–13.84, p = 0.03). As a conclusion a high prevalence of TN in SLE patients was found. Prevalence of TN correlated only with history of azathioprine use. We don’t know the long-term implications of our findings; however, a functional and morphological evaluation of the thyroid gland is warranted in all patients with SLE.

The weight is an anthropometric parameter routinely used in ambulatory and hospital settings, and takes its importance, because often there are clinical conditions that impede it´s taking in a traditional scale. There are equations to estimate weight. However, they have not been designed for Mexican ambulatory patients.To develop an equation to estimate weight in Mexican ambulatory patients from the Study of Health, Well Being and Aging, corresponding to Mexico city an surrounded area.The database of the Study of Health, Well Being and Aging of Mexico City was used, and adults of 60 years and older, who completed the anthropometric measures were included. Two groups of datasets were crated though random numbers, one for the design and the other for the validation of the equation. The equation was obtained from the first database and cross-validated in the second.The equations obtained were: (0.67)* (Knee height)+(0.46)* (Mid-arm circumference)+(0.60)* (waist circumference)+(0.38)* (hip circumference)+(0.53)* (calf circumference)-(0.17)* (Age in years)-80.01 and (0.69)* (Knee height)+(0.61)* (Mid-arm circumference)+(0.17)* (waist circumference)+(0.45)* (hip circumference)+(0.58)* (calf circumference)-(0.24)* (Age in years)-55.9 in men and women respectively. The correlation coefficients were 0.94 y 0.92 (p0.001 for both). The differences between the real and estimated values were not significant.The equations developed in our analysis were confident and can be employed to estimate weight in ambulatory elderly. It is needed to test its validity in clinical scenarios were it is not possible to weight patients directly in the rest of the Mexican republic and adjust to specific populations.

Management of macroprolactinomas in women who plan to get pregnant is controversial and when this happen there is a risk of pituitary enlargement, if this happens bromocriptine has a safe profile to be used during pregnancy, but if it is not tolerated cabergoline is a good alternative.We describe two patients with macroprolactinomas who intended to get pregnant. One of them had been previously treated surgically and the second one was treated with bromocriptine and got pregnant before the tomographic studies were checked. Both patients developed during pregnancy symptoms of macroprolactinoma enlargement and were initially treated with bromocriptine but this was not tolerated and were switched to cabergoline. Both pregnancies ended with a normal full term newborn.Pregnant women with symptoms of pituitary enlargement must be treated with bromocriptine, but if it is not tolerated cabergoline is a good choice.

the abnormalities in liver function tests (LFTs) and liver complications (LC) from parenteral nutrition (PN) are common and usually multifactorial. These factors have not yet been assessed in the adult Mexican population.To determine whether the dose prescribed1 g/kg is a risk factor for the abnormalities in liver function tests (LFTs) from PN.Cohort study including patients older than 15 years and excluding those managed at the intensive car unit or with abnormalities in liver enzymes before the start of PN. The exposed and non-exposed groups were those receiving1 g of lipids per kg of body weight or1 g/kg, respectively. LFTs were defined as an increase higher than 50% of the normal range for AST, ALT, AF or total bilirrubin.the incidence of LFTs abnormalities was 20 (47.6%) and 15 (41.6%) in the exposed and non-exposed groups, respectively (RR 1.14 95% IC: 0.69-1.88; p = 0.59). The most frequent liver damage pattern was cholestatic, followed by the mixed pattern and then hepatocellular. The dose of prescribed lipids1 g/kg was not associated with the development of LC from LFTs abnormalities. The higher the dose of proteins the lower the frequency of LFTs abnormalities.The dose of lipids prescribed1 g/kg was not associated with the development of LFTs abnormalities from PN in our sample population. These findings should be confirmed in clinical trials.

women with gestational diabetes have an increase risk for maternal and neonatal metabolic complications.to evaluate detection, treatment and close surveillance.we recruited all women with gestational diabetes whose pregnancies ended in this hospital between September to November of 2005. All newborns were examined by a neonatologist and initiated early feeding with infant formula or glucose solution.a total of 74 patients with gestational diabetes were included. The age was 31.03 +/- 4.79 years, and the body mass index before pregnancy was 32.31 +/- 6.41. Eighteen patients developed third-trimester complications, in fourteen of them it was hypertensive disease of pregnancy. All were single pregnancies that ended in 71 term and 3 preterm newborns. There were not fetal or perinatal deaths. There were four small newborns for gestational age, 18 large for gestational age and 52 normal weight newborns. Eleven neonates had metabolic complications, eight of them had idiopathic respiratory distress syndrome, four had hypoglycaemia and one large for gestational age had obstetric trauma. Also two neonates with cardiovascular malformations were diagnosed. Thirty-six mothers returned for revaluation, eight had type 2 diabetes, six glucose intolerance.this group of patients shows the maternal and neonatal morbidity associated to gestational diabetes in patients under close surveillance. Systematic early screening in women at risk and close surveillance are required to obtain healthy newborns.

Neonatal hypoglycemia is a frequent event in the first hours of life of newborns from mothers with diabetes mellitus. We studied a group of diabetic mothers newborns during the first day of life, taking venous blood samples at6 h, 6-12 h and 12-24 h of life for glucose analysis (n = 85), defining hypoglycaemia as a glucose level35 mg/dL. Calcium serum levels were also determined in the first venous sample in 19 neonates and 7 mEq/L was the criteria for hypocalcemia. The mothers age (mean +/- standard deviation) was 30.5 +/- 5.5 years (range 16-41 years), 43 (50.6%) of them with gestational diabetes, 40 (47.1%) with type 2 diabetes and 2 (2.4%) with type 1 diabetes. Pregnancies ended by caesarean section in 78 (91.8%) and by partum in seven (8.2%) women. There were 20 (23.5%) preterm newborns. In relation to neonates weight, 27 (31.7%) were macrosomic and 7 (8.2%) were premature, two of them with very low weight. A total of 55 (64.77%) newborns had hypoglycaemia, but only one of them had a convulsive episode, the rest were asymptomatic. In relation to the newborns weight, 18 (66.6%) of the macrosomic, 33 (64.7%) of the normal weight and four (57.1%) of the premature groups had hypoglycaemia. The comparisons between the newborns weight groups showed non significant differences, but the prevalence of neonatal hypoglycaemia was significantly higher in the group of gestational diabetes than in the type 2 diabetes group (p0.05). Calcium analysis also disclosed asymptomatic hypocalcemia in five (7.25%) newborns. These results show an elevated prevalence of asymptomatic neonatal hypoglycaemia in the offspring of women with diabetes mellitus in their early hours of life, and stress the importance of systematic glucose monitoring and early treatment in the first hours of life of these neonates.

This study was aimed to identify the prevalence of gestational diabetes (GD) defined as any glucose intolerance detected in a pregnant women using the oral glucose tolerance test (OGTT) protocol, proposed by the World Health Organization (WHO) and to explore the effect of late pregnancy on the glucose tolerance test. Two groups of pregnant women20 years of age were evaluated with an OGTT, one group at the beginning, and the other one at the end of the third trimester, newborns weight and gestational age were recorded at the end of pregnancy.Group A (n = 152), was studied at 24-28 weeks and group B (n = 214) was studied at 32-36 weeks, after an overnight fasting a 75 g glucose load was provided and a blood sample was taken after 2 h. Glucose levels140 mg/dL were diagnostic of GD, women with glucose levels in the range of 140-199 mg/dL were prescribed dietary recommendations, but women with glucose levels200 mg/dL were treated with insulin. Newborns were considered macrosomic if weighted4,000 g and large for gestational age if exceeded the 97th percentile or the Lubchenko scale, both conditions are described as macrosomia in the text. Comparisons were done using the Chi-square and Fisher exact tests.In group A GD was diagnosed in 27 women (17.76%), but only three of them (1.97%) had glucose levels200 mg/dL and in group B-GD was diagnosed in 62 women (28.97%), but only eight of them (3.73%) had glucose levels200 mg/dL. The difference in rates between groups A and B was significant (p0.01). In group A, normal women had 19 (15.2%) macrosomic newborns and women with GD had nine (33.33%) macrosomic newborns, this difference was significant (p0.05); however, in group B women with GD vs. normal, had 10 (16.12%) and 19 (12.5%) macrosomic newborns, respectively (p = ns).The new criteria for GD diagnosis increases notoriously its prevalence in our population to 17.76% at the beginning of the third trimester, comparing with 1.97% of women with glucose levels200 mg/dL applying the WHO criteria for diabetes in nonpregnant adults, however, comparing the newborns weight of normal women vs. GD women the prevalence of macrosomia was almost the double, reflecting the importance of this diagnosis in perinatal health. Women screened at the end of pregnancy had a significant increase in GD prevalence, but macrosomia was not different of the normal women of this group suggesting that GD at this stage of pregnancy may help to detect women with a higher risk to develop diabetes, but have no impact on perinatal health.

Natural radionuclides and physicochemical parameters have been evaluated in groundwater samples from boreholes belonging to the drinking water supply system of the Toluca City, Mexico. The results obtained for radon and radium, together with the physicochemical parameters of the studied samples, indicate a fast and efficient recharge pattern. The presence of a local and a regional groundwater flows was also observed. The local flow belongs to shallower water, recognized by its low radon content and dissolved ions, as compared with the regional, deeper groundwater flow with a longer residence time.

Primary pigmented nodular adrenocortical disease is a rare cause of Cushing's syndrome in children and young adults. It is characterized by hypercorticolism resistant to dexamethasone suppression and at microscopic examination by multiple small black cortical nodules containing large cells with eosinophilic cytoplasm and lipofuscin with internodular cortical atrophy. Its pathogenesis is unknown. Bilateral adrenalectomy is the treatment of choice. We report a case of Cushing's syndrome due to primary pigmented nodular adrenocortical disease in a 32 year old female and review the literature.

To evaluate the prevalence of silent myocardial ischemia in patients with non-insulin dependent diabetes mellitus with no symptoms of cardiac disease.Tertiary care center.60 patients with non-insulin dependent diabetes mellitus; mean age 58 +/- 12 years, who had no symptoms of angina or any other clinical evidence of coronary artery disease and normal resting electrocardiogram. A control group of 57 healthy volunteers, matched for age and sex were included.All patients underwent a 24 hour electrocardiographic Holter monitoring test. An ischemic episode was defined as depression of the ST segmentor = 1 mm foror = 1 min.10 of the 60 diabetic (17%) were found to have silent myocardial ischemia and only 3/57 (5%) was detected in the controls. In a two years follow up, four diabetics developed symptomatic angina pectoris.Silent myocardial ischemia in asymptomatic diabetics occurs frequently; a lack of symptoms does not discard a myocardial ischemia, and the Holter recordings may help in its detection.

To determine the prevalence of gestational diabetes (GD) in an outpatient clinic in northeastern Mexico.732 consecutive pregnant women referred for prenatal care during a two-year period. INTERVENTION AND OUTCOME MEASURE: A 100 g glucose tolerance test was performed in the patients with sampling at 1, 2 and 3 hours postchallenge. The patients were classified according to the criteria of the American Diabetes Association as normal, abnormal, and a third category of those showing a single abnormal value in the tolerance test.Six percent of the women (44/732) had GD and 1.4% (10/732) had one abnormal value. A comparison group was made with a subset of 44 of the 678 women who showed a normal tolerance test. No group differences were seen in parity, and age, nor in body weight gain or changes in body mass index, the latter measured in the initial and final weeks of pregnancy. Significant differences versus the normal women were seen in the GD group for cesarean births (43% vs 30%) and in macrosomy (25% vs 7%). The group with one abnormal test showed high values in cesareans (50%) and macrosomy (10%) but did not reach significant difference with the other groups.GD was higher in our study than in the only paper on GD prevalence reported in Mexico (3.9%). The higher incidence of cesareans and macrosomy in GD makes it necessary to consider therapeutic interventions in these cases.

Considering pancreatic reserve recognition a more rational basis for starting insulin therapy in NIDDM, during 1988 we studied fasting and post-breakfast plasma C-peptide levels in 31 patients (21 w, 10 m, mean age 48.2 +/- 17.7 yr), referred to our department for insulin therapy evaluation because of primary or secondary failure to other measures. Major features were obesity and chronically uncontrolled illness. Our patients were categorized as follows: group A, considered non responders which included four patients; group B, taken as responders consisting in seven; and a remaining of 20 hyperresponsive patients which formed group C; these with patients of group B, embodied an 87.1% of patients. Among nonresponders there was no any case of total B cell loss of function, and plasma C-peptide activity surpassed through those limits considered for ketoacidosis. We believe that these patients should be eligible candidates for insulin therapy. We failed to found out correlation of plasma C-peptide activity with either age or duration of illness. Our observation supports that fasting plasma C-peptide evaluation would suffice for pancreatic reserve evaluation. We conclude that our patients mainly presented an insulin resistant state associated with obesity thus enhancing the commonplace call for reinforcing nonpharmacologic treatment modalities such as caloric restriction, weight loss and exertion to achieve a better control in NIDDM patients.