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ContextType 2 diabetes (DM2) is an emerging disease in the pediatric population. DM2 is associated with metabolic-associated fatty liver disease (MAFLD). High-density lipoproteins (HDLs) are lipoproteins that are believed to have atheroprotective properties that reduce the risk of cardiovascular disease (CVD). Current evidence suggests that the physicochemical and functional features of HDLs may play a key role in the pathogenesis of atherosclerosis.ObjectiveWe aimed to assess the impact of MAFLD on cholesterol efflux capacity (CEC) in adolescents with DM2.DesignA cross-sectional study.SettingAttention clinic for Children with Diabetes of the Hospital Infantil de México Federico Gómez.Patients or other participantsThis study included a total of 70 adolescents, 47 of which had DM2 and 23 were healthy individuals.InterventionsThe presence of MAFLD was determined by MR spectroscopy with proton density fat fraction. We compared the distribution of HDL subtypes (HDL2b, HDL2a, HDL3a, HDL3b, and HDL3c) and the chemical composition of HDLs (total protein, triglycerides, phospholipids, cholesteryl esters, and free cholesterol). HDL functionality was determined by the CEC, measuring the fluorescent cholesterol efflux from J774 macrophage cells.Main outcome measuresWe were expecting to observe a decrease in HDL efflux capacity in adolescents with type 2 diabetes and MAFLD.ResultsIn our study, we observed a prevalence of MAFLD in 66% of adolescents with DM2, similar to that reported in other international studies (60%–80%). In the population with DM2 and MAFLD, we did not observe a decrease in CEC. Initially we found a slight elevation of CEC in adolescents with DM2, however, with the increase in liver fat, a little decrease is observed, which could explain a probable metabolic phenomenon, since the physicochemical composition and distribution of the particles is associated with the percentage of liver fat. A positive correlation between the percentage of liver fat and the concentration of HDL2b (p = 0.011), HDL2a (p = 0.014) and average particle size (p = 0.011) and the proportion of triglycerides inside the particles (p = 0.007). Likewise, negative correlation were found with the percentage of liver fat, cholesterol esters (p = 0.010) and free cholesterol of the particles (p

Background: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD. Methods: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed. Results: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD. Conclusion: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence.

Abstract Background High-density lipoproteins (HDLs) have antiatherogenic properties related to their chemical structure. Adipose tissue (AT) influences HDL reverse cholesterol transport and plasma HDL cholesterol levels. However, whether AT dysfunction affects HDL subpopulations and their glycation in early type 2 diabetes (T2D) is still unknown. Objective To investigate the association of inflammation and AT dysfunction serum markers with the size and glycation of HDLs in normoglycemic, prediabetes, and T2D subjects. Methods We assessed HDL particle size and advanced glycation end-product (AGE) content in HDLs isolated from normoglycemic (n = 17), prediabetes (n = 17), and recently T2D-diagnosed (n = 18) subjects. Insulin, adiponectin, and plasminogen activator inhibitor 1 (PAI-1) were determined using the Bio-Rad Multiplex Platform, and free fatty acids (FFAs) and high sensitivity C-reactive protein (hs-CRP) were determined by standard procedures. The AT insulin resistance (ATIR) index and ATIR/adiponectin and adiponectin/leptin ratios were calculated. Results HDL was progressively smaller (nm) and enriched with AGE (mg-BSA-AGE/mg protein) according to the glucose categories: 8.49 and 7.5 in normoglycemic subjects, 8.44 and 12.4 in prediabetic subjects, and 8.32 and 14.3 in T2D subjects (P = 0.033 and P = 0.009 for size and AGE, respectively). In multivariable regression analysis, the ATIR/adiponectin ratio was inversely associated with HDL size (β = -0.257, P = 0.046), and the ATIR ratio was directly associated with HDL glycation (β = 0.387, P = 0.036). In contrast, adiponectin and the adiponectin/leptin ratio were not associated with alterations in HDL particles. Furthermore, HDL size was associated with resistin (β = -0.348, P = 0.007) and PAI-1 (β = -0.324, P = 0.004). HDL and AGE were related to insulin concentrations (β = 0.458, P = 0.015). Analyses were adjusted for age, sex, body mass index, triglycerides, and HDL-cholesterol. Conclusion HDL size was significantly associated with the ATIR/adiponectin ratio and inflammation, whereas glycation was more strongly related to the ATIR index. These findings have important implications for the management and prevention of cardiovascular disease in T2D patients.

Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide and is highly prevalent in Mexico, as 10.2% of the adult population harbors this condition. T2DM is usually associated with cardiovascular comorbidities, including arrhythmias. Metabolic impairment is one of the mechanisms that contribute to tissue remodeling that affects atrial structure, and concomitant, the cardiac conduction system, both could result in atrial fibrillation (AF). AF is estimated to affect more than a half million Mexicans, and its incidence is expected to keep rising. According to national registries, T2DM is present in 28.4% of Mexican patients with AF and the coexistence of both diseases is associated with a higher risk of stroke. In clinical practice, the CHA2DS2-VASc risk score is useful for stroke risk stratification in patients with AF to facilitate the adequate use of anticoagulation therapy. T2DM is among the items of the CHA2DS2-VASc score because it correlates with an intrinsic prothrombotic state. In this narrative review, we present information that highlights the need for optimal glucose control and adequate anticoagulation in subjects with T2DM and AF.

Background Plasminogen activator inhibitor 1 (PAI-1) and resistin are associated with dysfunctional adipose tissue (AT)-related metabolic complications. The role of dietary eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids in this relationship is unknown. Aim To investigate the association of EPA and DHA with PAI-1 and resistin, as well as the role of this association on the glucose metabolism of apparently healthy subjects. Subjects and methods Thirty-six healthy individuals were included. Validated food frequency questionnaires were used to analyse dietary habits. Inflammatory and glucose metabolism markers were quantified. Subcutaneous AT samples were obtained, and adipocyte number, area, and macrophage content were assessed. Results In 36 subjects aged 56 ± 8 years and with a body mass index of 26 ± 4 kg/m2, logEPA, and logDHA showed significant association with logresistin and a marginal association with PAI-1. Adipocyte number, area, and lognumber of macrophages per adipocyte significantly correlated with PAI-1 but not with logresistin. Although logEPA and logDHA were independently associated with loginsulin, loginsulin resistance, and C-Peptide, the addition of logresistin, but not of PAI-1, into the multivariable model, abolished the associations. Conclusions EPA and DHA could modulate glucose metabolism across AT functional states. Our data indicate that this association is independent of other metabolic risk factors.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.

Introducción: Los pacientes con psoriasis tienen prevalencia incrementada de factores de riesgo y enfermedad cardiovascular. Objetivo: Determinar si los pacientes con psoriasis y síndrome metabólico (SM) tienen mayor frecuencia de ateroesclerosis subclínica comparados con pacientes con psoriasis y sin SM. Material y Métodos: Estudio transversal, en pacientes con psoriasis; SM fue definido con base en criterios ATP III. Se obtuvieron datos demográficos, clínicos y antropométricos. Se realizó química sanguínea, proteína C reactiva de alta sensibilidad (PCR-hs) e insulina. Ateroesclerosis subclínica fue definida como grosor de íntima-media carotídeo (GIMC) elevado, medido por ultrasonido tipo B. Resultados: Se incluyeron 92 pacientes con psoriasis, 67 (72.8 %) con SM y 25 (27.2 %) sin SM. Los sujetos con psoriasis y SM tuvieron valores significativamente más elevados de peso, índice de masa corporal, circunferencia de cintura, tensión arterial sistólica, glucosa, insulina, triglicéridos, resistencia a insulina, PCR-hs y menores niveles de colesterol de alta densidad, comparados con sujetos sin SM. El GIMC fue mayor en pacientes con psoriasis y SM. La edad y el SM fueron predictores independientes de mayor GIMC después de realizar múltiples análisis de regresión lineal. Conclusiones: Síndrome metabólico está asociado con mayor inflamación y ateroesclerosis subclínica en pacientes con psoriasis.

Compared to body mass index, waist circumference (WC), and adiposity measurements, adipose tissue (AT) morpho-functionality evaluations are better predictors of cardiometabolic abnormalities (CA). The present study establishes a dysfunctional adiposity index (DAI) as an early marker of CA based on adipocytes morpho-functional abnormalities. DAI was established in 340 subjects without cardiovascular risk factors selected from a cross-sectional study (n=1600). Then, DAI was calculated in 36 healthy subjects who underwent subcutaneous AT biopsy. The correlation of DAI with adipocyte morphology (size/number) and functionality (adiponectin/leptin ratio) was analyzed. The DAI cut-off point was identified and its independent association with CA was determined in 1418 subjects from the cross-sectional study. The constant parameters to calculate the DAI were [WC/[22.79+[2.68*BMI]]]*[triglycerides (TG, mmol/L)/1.37]*[1.19/high density lipoprotein-cholesterol (HDL-C, mmol/L)] for males, and [WC/[24.02+[2.37*BMI]]]*[TG(mmol/L)/1.32]*[1.43/HDL-C(mmol/L)] for females. DAI correlated with adipocytes mean area, adipocyte number and adiponectin/leptin ratio. DAI ≥1.065 was independently associated with diabetes, non-alcoholic fatty liver disease, subclinical atherosclerosis, and hypertension. The present study highlights that DAI is associated with early CA independently of adiposity and other risk factors. Since DAI is obtained using accessible parameters, it can be easily incorporated into clinical practice for early identification of AT abnormalities in apparently healthy subjects.

Background: Acute kidney injury (AKI) occurs frequently after cardiac surgery for congenital heart disease and it has a great impact on patient´s prognosis. Objective: The aims of this study were to determine the incidence and risk factors for AKI in children undergoing cardiac surgery and its impact on mortality, duration of mechanical ventilation, ICU and total hospital length of stay. Methods: This was a historical cohort study of children 0 - 18 years of age who underwent cardiac surgery between 2012 and 2014. We used the Risk Adjustment for Congenital Heart Surgery-1 (RACHS) scale to evaluate risk of the surgery. AKI was defined in accordance to the Acute Kidney Injury Network (AKIN) criteria. Results: A total of 485 patients were included. AKI occurred in 89 (18.3%) patients during the study period. Risk factors for AKI were age < 2 years, cardiopulmonary bypass (CPB) time > 120 min and RACHS score > 3. AKI increased the mortality risk (OR: 5.82, 95% CI: 2.24-15.10) and the time in mechanical ventilation and ICU stay from 1 to 5 days and 6 to 12 days, respectively. Conclusions: Risk factors for AKI are younger age, higher RACHS score, and time of CPB greater than 120 minutes. AKI increases mortality, days on MV and ICU stay. In the present study AKIN scale allowed us to classify the severity of AKI and it correlated with prognosis after cardiac surgery.

Introducción: Los gramnegativos continúan siendo los causantes de infecciones asociadas a la atención a la salud (IAAS). Material y métodos: Analizamos la resistencia antimicrobiana de patógenos durante el 2013 vs. 2018 y lo comparamos con lo publicado en 2006 vs. 2012. Resultados: Identificamos nueve patógenos gramnegativos, de un total de 404 aislamientos, con una prevalencia en 2013 (N = 227 [0.22]) vs. 2018 (N = 177 [0.17]) y una incidencia por egresos (6,607 en el 2013 y 7,778 en el 2018) del 3.4 y 2.2% respectivamente. Destacaron tres patógenos: Klebsiella pneumoniae (129 [31.93%]), Pseudomonas aeruginosa (85 [21.03%]) y Escherichia coli (80 [19.80%]). Estos, llamados patógenos ESKAPE-E, prevalecieron como causantes de IAAS. Identificamos un aumento en los patrones de resistencia para muchos patógenos en 2018. Conclusión: La multirresistencia a patógenos ESKAPE-E es un serio problema de salud pública, por carecer de alternativas terapéuticas para enfrentar este reto. Los mapas de resistencia bacteriana ayudan en la prescripción antibiótica.

Recent multidrug resistance in Pseudomonas aeruginosa has favoured the adaptation and dissemination of worldwide high-risk strains. In June 2018, 15 P. aeruginosa strains isolated from patients and a contaminated multi-dose meropenem vial were characterized to assess their association to an outbreak in a Mexican paediatric hospital. The strains were characterized by antibiotic susceptibility profiling, virulence factors’ production, and biofilm formation. The clonal relationship among isolates was determined with pulse-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) sequencing. Repressor genes for the MexAB-OprM efflux pump were sequenced for haplotype identification. Of the strains, 60% were profiled as extensively drug-resistant (XDR), 33% as multidrug-resistant (MDR), and 6.6% were classified as sensitive (S). All strains presented intermediate resistance to colistin, and 80% were sensitive to aztreonam. Pyoverdine was the most produced virulence factor. The PFGE technique was performed for the identification of the outbreak, revealing eight strains with the same electrophoretic pattern. ST235 and ten new sequence types (STs) were identified, all closely related to ST233. ST3241 predominated in 26.66% of the strains. Twenty-five synonymous and seventeen nonsynonymous substitutions were identified in the regulatory genes of the MexAB-OprM efflux pump, and nalC was the most variable gene. Six different haplotypes were identified. Strains from the outbreak were metallo-β-lactamases and phylogenetically related to the high-risk clone ST233.

Objectives To compare the effectiveness of oral versus intramuscular (IM) vitamin B12 (VB12) in patients aged ≥65 years with VB12 deficiency.Design Pragmatic, randomised, non-inferiority, multicentre trial in 22 primary healthcare centres in Madrid (Spain).Participants 283 patients ≥65 years with VB12 deficiency were randomly assigned to oral (n=140) or IM (n=143) treatment arm.Interventions The IM arm received 1 mg VB12 on alternate days in weeks 1–2, 1 mg/week in weeks 3–8 and 1 mg/month in weeks 9–52. The oral arm received 1 mg/day in weeks 1–8 and 1 mg/week in weeks 9–52.Main outcomes Serum VB12 concentration normalisation (≥211 pg/mL) at 8, 26 and 52 weeks. Non-inferiority would be declared if the difference between arms is 10% or less. Secondary outcomes included symptoms, adverse events, adherence to treatment, quality of life, patient preferences and satisfaction.Results The follow-up period (52 weeks) was completed by 229 patients (80.9%). At week 8, the percentage of patients in each arm who achieved normal B12 levels was well above 90%; the differences in this percentage between the oral and IM arm were −0.7% (133 out of 135 vs 129 out of 130; 95% CI: −3.2 to 1.8; p>0.999) by per-protocol (PPT) analysis and 4.8% (133 out of 140 vs 129 out of 143; 95% CI: −1.3 to 10.9; p=0.124) by intention-to-treat (ITT) analysis. At week 52, the percentage of patients who achieved normal B12 levels was 73.6% in the oral arm and 80.4% in the IM arm; these differences were −6.3% (103 out of 112 vs 115 out of 117; 95% CI: −11.9 to −0.1; p=0.025) and −6.8% (103 out of 140 vs 115 out of 143; 95% CI: −16.6 to 2.9; p=0.171), respectively. Factors affecting the success rate at week 52 were age, OR=0.95 (95% CI: 0.91 to 0.99) and having reached VB12 levels ≥281 pg/mL at week 8, OR=8.1 (95% CI: 2.4 to 27.3). Under a Bayesian framework, non-inferiority probabilities (Δ>−10%) at week 52 were 0.036 (PPT) and 0.060 (ITT). Quality of life and adverse effects were comparable across groups. 83.4% of patients preferred the oral route.Conclusions Oral administration was no less effective than IM administration at 8 weeks. Although differences were found between administration routes at week 52, the probability that the differences were below the non-inferiority threshold was very low.Trial registration numbers NCT 01476007; EUDRACT (2010-024129-20).

Behavioral and cognitive tests in individuals who were malnourished as children have revealed malnutrition-related deficits that persist throughout the lifespan. These findings have motivated recent neuroimaging investigations that use highly portable functional near-infrared spectroscopy (fNIRS) instruments to meet the demands of brain imaging experiments in low-resource environments and enable longitudinal investigations of brain function in the context of long-term malnutrition. However, recent studies in healthy subjects have demonstrated that high-density diffuse optical tomography (HD-DOT) can significantly improve image quality over that obtained with sparse fNIRS imaging arrays. In studies of both task activations and resting state functional connectivity, HD-DOT is beginning to approach the data quality of fMRI for superficial cortical regions. In this work, we developed a customized HD-DOT system for use in malnutrition studies in Cali, Colombia. Our results evaluate the performance of the HD-DOT instrument for assessing brain function in a cohort of malnourished children. In addition to demonstrating portability and wearability, we show the HD-DOT instrument’s sensitivity to distributed brain responses using a sensory processing task and measurements of homotopic functional connectivity. Task-evoked responses to the passive word listening task produce activations localized to bilateral superior temporal gyrus, replicating previously published work using this paradigm. Evaluating this localization performance across sparse and dense reconstruction schemes indicates that greater localization consistency is associated with a dense array of overlapping optical measurements. These results provide a foundation for additional avenues of investigation, including identifying and characterizing a child’s individual malnutrition burden and eventually contributing to intervention development.

La diabetes mellitus es una enfermedad crónica, compleja, multifactorial, que se caracteriza por alteración en el metabolismo de la glucosa, las grasas y las proteínas. Los pacientes que la padecen con frecuencia cursan con hiperglucemia y la enfermedad arterial coronaria es la principal causa de muerte. Las comorbilidades que se asocian a la diabetes son: sobrepeso y obesidad, hipertensión arterial sistémica, dislipidemia aterogénica y en algunos pacientes enfermedad vascular periférica, daño renal, neuropatía y retinopatía. El descontrol crónico de la enfermedad se asocia a mayor susceptibilidad a infecciones, las cuales generalmente cursan con pocos síntomas, pero generalmente se magnifica la hiperglucemia, lo cual empeora el curso de las infecciones. Desde diciembre de 2019, cuando se identificó la enfermedad producida por uno de los coronavirus (coronavirus 2 del síndrome respiratorio agudo grave, SARS-CoV-2) y que ha sido llamada enfermedad por coronavirus 2019 (COVID-19), ha habido algunos reportes que asocian la presencia de diabetes con un mayor riesgo de mortalidad. En este artículo de revisión nos hemos enfocado en cuatro puntos específicos: 1) epidemiología de la prevalencia y de la mortalidad de COVID 19 en la población general y en la población con diabetes mellitus tipo 2; 2) fisiopatología relacionada con la unión del SARS-CoV-2 a los receptores en sujetos con diabetes; 3) la respuesta inmunológica inducida por el SARS-CoV-2, y 4) el tratamiento ambulatorio y hospitalario que se recomienda en los pacientes con diabetes que se infectan con SARS-CoV-2.

Introduction: Healthcare-associated infections are an important cause of morbidity and mortality, are among the most common adverse events in healthcare, and of them, pneumonia is the most commonly reported. Our objective was to evaluate the incidence and clinical outcome of respiratory viruses in hospital-acquired pneumonia (HAP).Methods: This was a prospective cohort study, include patients aged between 0 and 18 who fulfilled Centers for Diseases Control and Prevention (CDC) criteria for HAP. Demographic and clinical data were obtained, and a nasopharyngeal swab specimen was taken for the detection of respiratory viruses. All included patients were monitored until discharge to collect data on the need for mechanical ventilation, intensive care unit (ICU) admission, and mortality. All-cause 30-day mortality was also ascertained.Results: Four thousand three hundred twenty-seven patients were followed for 42,658 patient-days and 5,150 ventilator-days. Eighty-eight patients (2.03%) met the CDC criteria for HAP, 63 patients were included, and clinical and epidemiological characteristics showed no statistically significant differences between patients with virus associated healthcare-associated pneumonia (VAHAP) and those with non-viral healthcare-associated pneumonia (NVHAP). At least one respiratory virus was detected in 65% [95% CI (53–77)] of episodes of HAP, with a single viral pathogen observed in 53.9% and coinfection with 2 viruses in 11.1% of cases. The outcome in terms of ICU admission, mechanical ventilation and the 30-day mortality did not show a significant difference between groups.Conclusions: In two-thirds of the patients a respiratory virus was identified. There was no difference in mortality or the rest of the clinical outcome variables. About half of the patients required mechanical ventilation and 10% died, which emphasizes the importance of considering these pathogens in nosocomial infections, since their identification can influence the decrease in hospital costs and be taken into account in infection control policies.

Abstract Background To evaluate the role of adipose tissue function on the association of fatty liver (FL) with impaired fasting glucose (IFG) or newly diagnosed type 2 diabetes mellitus (nT2D). Methods In 1264 subjects, computed tomography was used to evaluate FL and elevated visceral adipose tissue (VAT). Fasting plasma glucose,

Purpose: Determine if anterior stromal puncture (ASP) has a more effective decrease in symptomatology (pain, photophobia, and foreign body sensation) compared to annular keratotomy (AK) in the treatment of painful bullous keratopathy (PBK) in patients with poor visual prognosis. Methods: Patients with PBK, refractory to combined medical treatment and poor visual prognosis were randomly assigned to one of two surgical procedures. Symptomatology, central corneal thickness (CCT), visual acuity (VA), and best corrected (BCVA) were evaluated with a 7-month follow up. Results: From 78 patients with PBK, 13 fulfilled inclusion criteria; ASP was performed to 7 and AK to 6 of them. There was improvement in the magnitude of symptoms in both groups; however, there was no difference when groups were compared. CCT showed a significant reduction from the basal, of 10.4% in the ASP group compared with a 9.6% increase in the AQ group (p=0.05). VA and BCVA in both groups were not modified. None of the groups presented complications related to the surgical procedures. Conclusions: In this clinical trial, we documented that ASP and AQ produce a similar improvement in the symptomatology of patients with PBK refractory to combined medical treatment and poor VA potential. The ASP group additionally presented a significant decrease in CCT. A longer follow-up period would be required to evaluate if this CCT reduction is able to modify the frequency of bullae development and symptoms relapse. Furthermore, the material used for ASP has a lower cost than the one used for AQ, which could represent an economic advantage for patients that attend our Hospital.

Objetivo principal: determinar la influencia de la edad en los cambios dietéticos en una población de Almería. Metodología: muestreo por conglomerados, con un total de 150 personas, divididos en menores de 40 años, entre 41 y 64 años y mayores de 65 años, se les administró un cuestionario validado de 14 preguntas, con dos opciones de respuesta. Resultados principales: el 68.7% obtuvieron como resultado una adherencia óptima, siendo el 31.34% mayores de 65 años. El 29.3% obtuvieron un nivel de adherencia media, un 1,99% pertenecientes al grupo de edad más longevo y el 2% adherencia baja, perteneciendo un 0% al grupo de edad mayores. La edad relacionada con la puntuación final de la encuesta obtuvo una correlación positiva moderada (Correlación de Pearson p 0.000

We used in vivo and in vitro phosphorus-31 nuclear magnetic resonance (31P-NMR) spectroscopy to follow the change in transport, compartmentation and metabolism of phosphate in the ectomycorrhizal fungus Hebeloma cylindrosporum in response to root signals originating from host (Pinus pinaster) or non-host (Zea mays) plants. A device was developed for the in vivo studies allowing the circulation of a continuously oxygenated mineral solution in an NMR tube containing the mycelia. The in vitro studies were performed on fungal material after several consecutive treatment steps (freezing in liquid nitrogen; crushing with perchloric acid; elimination of perchloric acid; freeze-drying; dissolution in an appropriate liquid medium).

In ectomycorrhizal plants, the fungal cells colonize the roots of their host plant to create new organs called ectomycorrhizae. In these new organs, the fungal cells colonize the walls of the cortical cells, bathing in the same apoplasm as the plant cells in a space named the ‘Hartig net’, where exchanges between the two partners take place. Finally, the efficiency of ectomycorrhizal fungi to improve the phosphorus nutrition of their host plants will depend on the regulation of phosphate transfer from the fungal cells to plant cells in the Hartig net through as yet unknown mechanisms. In order to investigate these mechanisms, we developed an in vitro experimental device mimicking the common apoplasm of the ectomycorrhizae (the Hartig net) to study the phosphorus metabolism in the ectomycorrhizal fungus Hebeloma cylindrosporum when the fungal cells are associated or not with the plant cells of the host plant Pinus pinaster. This device can be used to monitor 32Phosphate efflux from the fungus previously incubated with 32P-orthophosphate.

In order to quantify P accumulation and P efflux in the ectomycorrhizal basidiomycete fungus Hebeloma cylindrosporum, we supplied 32P to mycelia previously grown in vitro in liquid medium. The culture had four main steps that are 1) growing the mycelium on complete medium with P, 2) transfer the mycelia into new culture solution with or without P, 3) adding a solution containing 32P and 4) rinsing the mycelia before incubation with or without plant. The main point is to rinse very carefully the mycelia after 32P supply in order to avoid overestimation of 32P efflux into the medium.

Un alto porcentaje de mortalidad se presenta en plántulas de pinos que son trasplantados de vivero a campo, debido a que no poseen hongos ectomicorrízicos los cuales forman simbiosis obligada con las plantas de forma natural en los bosques. Estos hongos facilitan la absorción de nutrientes y agua, además de estimular su crecimiento. Debido a la importancia ecológica y fisiológica de los hongos ectomicorrízicos, el presente trabajo evaluó el efecto en crecimiento, peso seco, porcentaje de colonización y contenido de nutrientes de la inoculación de seis especies ectomicorrízicas comestibles de los géneros Lacearía y Hebeloma en Pinus patula Schiede ex Schltdl. & Cham. y P. pseudostrobus Lindl., en condiciones de invernadero. Después de 397 días de la siembra se observó un efecto benéfico en el crecimiento de ambos pinos como resultado de la inoculación en términos de peso seco en parte aérea y radical, así como un mayor contenido de N, P y K. El porcentaje de micorrización en plantas inoculadas con las especies fúngicas varió de 57 % a 90 %. Cuando se efectuó inoculación combinada de especies ectomicorrízicas, se registró dominancia de una de las especies inoculadas, en términos de colonización radical. En estos tratamientos con inoculación simultánea, los efectos benéficos registrados en los hospederos fueron comparables a los observados cuando se inoculó de manera individual a las especies fúngicas dominantes. En función de los resultados encontrados se recomienda en el establecimiento de plantaciones forestales la inoculación de ambas especies de pinos con especies de hongos de los géneros Laccaria y Hebeloma.A high percentage of mortality appears in pine seedlings transplanted from nursery to field, due to the fact that they lack ectomycorrhizal fungi which form obligated symbiosis with plants in natural conditions in the forests. These fungi facilitate the absorption of nutrients and water, and therefore stimulate their growth. Due to the ecological and physiological importance of the ectomycorrhizal fungi, this work evaluated the effect in terms of growth, dry weight, percentage of colonization and nutrient content as a result of the inoculation with six edible ectomycorrhizal fungi within the genera Laccaria and Hebeloma on Pinus patula Schiede ex Schltdl. & Cham. and P.pseudostrobus Lindl. under greenhouse conditions. 397 days after sowing, it was observed a beneficial effect in terms of growth and dry weight of aerial and radical parts, as well as a higher contents of N, P and K of both pines as a result of the inoculation. The percentage of mycorrhization in plants inoculated with the fungi species ranged from 57 % to 90 %. When combined inoculation of ectomycorrhizal species was carried out, dominance of one of the inoculated species, in terms of root colonization, was observed. In these treatments with simultaneous inoculation, the beneficial effects reported in the hosts were comparable with those observed in plants inoculated exclusively with the dominant fungal species. According to the results, the inoculation of P. patula and P. pseudostrobus with fungal species of the genera Laccaria and Hebeloma is recommended in the establishment of forest plantations.

Individuals with type 2 diabetes mellitus (DM) characteristically have elevated fasting and postprandial (PP) plasma triglycerides (TG). Previous case-control studies indicated that PPTG levels predict the presence of coronary artery disease (CAD) in people without DM; however, the data for patients with DM are conflicting. Therefore, we conducted a case-control study in DM individuals, 84 with (+) and 80 without (−) CAD. Our hypothesis was that DM individuals with or without CAD would have similar PPTG levels, but CAD+ individuals would have more small d

De manera generalizada del conocimiento de nuestra historia patria se circunscribe a los textos oficiales en donde se transmiten datos acerca de hechos y fechas importantes, personajes relevantes, guerras y gestas heroicas, con un determinado enfoque ideológico que ha invisibilizado ciertas regiones y zonas del país, asi como ciertos sectores y personajes. Es por eso que presentamos este artículo con el abordaje del cultivo del café en Tilarán.

La diabetes mellitus tipo 2 (DM2) es considerada un problema de salud pública global. Es la primera causa de morbilidad-mortalidad en el país. Representa una enfermedad de alto costo para los sistemas de salud, con un gasto de 370 billones de dólares al año, que se estima alcanzará los 490 billones de dólares para 2030...

Cuando Costa Rica entró en estado de guerra contra Japón, Alemania e Italia se procedió a tomar medidas para preservar el orden interno e impedir cualquier acto que beneficiara a los países enemigos, incluyendo a todas las actividades de los súbditos de esas naciones. Además, se fundó la Junta de Custodia de la Propiedad Enemiga para administrar los bienes de aquellos, bajo la Ley de Bloqueo Económico en 1942, que absorbió la antigua Oficina de Coordinación. Se crearon listados de personas o empresas que podrían representar un peligro para las seguridades nacionales e internacionales, diseñadas por Gran Bretaña, los Estados Unidos y el gobierno costarricense. A continuación se presentan las listas más relevantes de la investigación; ellas han sido construidas por el proyecto "Cambio en la propiedad agrícola durante la Segunda Guerra Mundial en Costa Rica", por medio de los Archivos de la Junta de Custodia, que se encuentran en el Archivo Nacional de Costa Rica.

Nació en Escazú en el año 1921 y desde muy corta edad se traslado a la ciudad de Heredia, donde ha radicado hasta la fecha. La enseñanza primaria la curso en la escuela Braulio Morales y la secundaria en el Liceo de Heredia, donde obtuvo su bachillerato en Ciencias y Letras. Realizo sus estudios pedagógicos en la Universidad de Costa Rica, graduándose como profesora de enseñanza primaria, pero sus inclinaciones hacia la historia loa llevaron a continuar su formación en la Escuela de Filosofía y Letras de la misma universidad, donde recibió los títulos de licenciada en Historia y Geografía y profesora de enseñanza media en esta especialidad.

Analiza el impacto que tuvo la construcción del proyecto hidroeléctrico del Arenal y con base en historia oral recuperar la opinión de los campesinos cuyas tierras fueron inundadas por el embalse.

Entre las medidas más importantes que algunos gobiernos latinoamericanos tomaron para apoyar sus compromisos con la política de defensa del Hemisferio durante la Segunda Guerra Mundial, están el control, fiscalización y expropiación de bienes y negocios pertenecientes a ciudadanos o descendientes de alemanes, italianos y japoneses. El gobierno de Costa Rica no fue la excepción. En este artículo se estudia la rápida expropiación de la finca La Caja que pertenecía a la firma Otto Hübbe e hijos, situada en el cantón central de San José, y procura explicar históricamente la razón estratégica para expropiar dicha finca, a pesar de que beneficiaba y exportaba menos del uno por ciento de la cosecha nacional de café. También, se expone la reacción de sus propietarios, enmarcada en la jurisprudencia, al imponer apelaciones al gobierno costarricense y, se explican cuáles fueron los resultados de éstas. Metodológicamente se triangularon, diversas fuentes escritas: series Junta de Custodia y Relaciones Exteriores del Archivo Nacional de Costa Rica y en la sección periódicos de la Biblioteca Nacional de Costa Rica, lo que permitió adehentrarse en un contexto que permite develar la practicidad de las políticas imperialistas y del control estratégico llevado a cabo hacia los enemigos políticos de los países en guerra.

Este artículo analiza el proceso de privatización de las tierras comunales del Valle Central, en general, y de la provincia de Heredia, en particular, para el período 1830-1890. Se delimitó geográficamente así porque la región poseía, en ese entonces, parte de sus terrenos todavía en manos municipales, y temporalmente, porque es en esa época cuando se genera la presión por legalizar e individualizar los terrenos poseídos de otra forma.

La información de las planillas semanales de la empresa González Flores para 1946 y 1961 sirve de base para un estudio de los ciclos laborales y sistemas de trabajo en varias plantaciones de café pertenecientes a ella. Junto con otros datos tomados del archivo de la empresa, de informantes y de fuentes secundarias, ello permite formular algunas conclusiones iniciales sobre los intentos de intensificar la producción mediante aplicación de más abonos e insumos laborales.

Este documento presenta el marco legal de las relaciones con los ciudadanos de países enemigos residentes en Costa Rica durante la Segunda Guerra Mundial, cuando el país le declaró la guerra a Japón, Alemania e Italia. Antes de ese momento, las relaciones diplomáticas se habían modificado conforme a la aparición de nuevos acontecimientos. De esta manera, el país, bajo el contexto de la política de Defensa Hemisférica de los Estados Unidos de América, inició un período de promulgación, eliminación y reforma de leyes, decretos y acuerdos en el entorno nacional e internacional.

Estudio la estructura socio ocupacional en las labores agropecuarias de San Rafael de Heredia y en los migrantes al noroeste del Valle Central, a la luz del censo poblacional de 1927.

Este documento presenta el marco legal de las relaciones con los ciudadanos de países enemigos residentes en Costa Rica durante la Segunda Guerra Mundial, cuando el país le declaró la guerra a Japón, Alemania e Italia. Antes de ese momento, las relaciones diplomáticas se habían modificado conforme a la aparición de nuevos acontecimientos. De esta manera, el país, bajo el contexto de la política de Defensa Hemisférica de los Estados Unidos de América, inició un período de promulgación, eliminación y reforma de leyes, decretos y acuerdos en el entorno nacional e internacional.

Abstract Polymorphisms in the LPA gene have been associated with aortic valve calcification (AVC). There are widely differences in the allelic frequencies, Lp(a) levels, and the association with AVC among ethnic groups. The aim of this study was to determine the association of the LPA gene polymorphisms with Lp(a) levels and risk of developing AVC, in Mexican-Mestizos population. Six LPA polymorphisms (rs10455872, rs7765803, rs6907156, rs1321195, rs12212807 and rs6919346) were genotyped by TaqMan assays in 1265 individuals without premature coronary artery disease. The presence of AVC was determined by computed tomography. The association of the LPA polymorphisms with AVC, Lp(a) and other cardiovascular risk factors (CVRF) was evaluated using logistic regression analysis. Compared to AA genotype, subjects with AG+GG genotypes had high prevalence of Lp(a) ≥30 mg/dL (7.1% vs. 23.7%, p