Hospital Civil De Guadalajara Research Articles

Is there gender discrimination in full breastfeeding in Mexico?

Objective: differences have been shown between males and females in terms of the prevalence of malnutrition in different parts of the world, which point to discrimination against females, including with respect to full breastfeeding. Therefore, the objective was to show that exclusive breastfeeding is less common for females in a population of medium-low and low socioeconomic strata. Methods: this was a cross-sectional analysis of a sample of 170 mother-infant dyads according to type of feeding (74 full breastfeeding, 57 partial breastfeeding and 39 human milk substitutes) at the Nuevo Hospital Civil de Guadalajara. Dependent variables according to type of feeding: full breastfeeding (exclusive and/or predominant), partial breastfeeding, and human milk substitutes. Independent variables: demographic data, schooling, occupation of mothers and/or parents, and family income. Kruskal-Wallis, Mann-Whitney U and Chi-square tests and odds ratio were used. Results: the probability of full breastfeeding was 3.8 times lower in females than in males. In a non-significant way, the likelihood of full breastfeeding was lower than that of partial breastfeeding, and full breastfeeding was lower than the combination of partial breastfeeding and human milk substitutes in females. Full breastfeeding and partial breastfeeding were lower than human milk substitutes, and partial breastfeeding was lower than human milk substitutes in females. Conclusion: there is a differentiated character in the privilege of full breastfeeding; it is four times lower in females than in males.

Pediatric Langerhans Cell Histiocytosis (LCH) Clinical Outcome in Hospital Civil De Guadalajara, México

Pediatric Langerhans cell histiocytosis (LCH) clinical outcome in Hospital Civil de Guadalajara, México.Introduction: LCH results from clonal proliferation of functionally and immunophenotyped inmature round Langerhans cells along with eosinophiles, machrophages, lymphocytes and ocasionally multinucleated giant cells (1). Its incidence is 2-10 cases by million of children below 15 yr in US (2). Our objective was to describe the clinical characteristics and treatment outcome of patients with LCH at Departement of Hematology-Oncology of Hospital Civil de Guadalajara México.Methods: It was a retrospective design and 41 pediatric patients below 18 yr were included. The diagnosis was corroborated by pathology and immunohistochemistry. Variables as age, gender, localised vs systemic disease, risk organ commitment, global survival (GS) and event free survival (EFS) were analysed. We used descriptive and inferencial statistics with SPSS program.Results: There were included 41 patients from January 1st 2012 to December 31st 2017. Relation male:female was 1.1:1. Mean presentation was localised disease (58%). Bone was the principal affected structure (34%) and it was 71% to be combined with lung, lymph node and CNS compromise. Risk organ commitment was presented in 32%, being more frecquent bone marrow and liver in 22% each one. Time induction treatment was equal or below 12 weeks in 66% of patients. The 25% of patients had reactivation of LCH, with similar lesions to the beggining in 19.5%. We found statistically significant differences between dead patients (DP) (14.6%) and not dead patients (NDP) (85.4%) in clinical presentation: localised (0% in DP vs 69% in NDP) and systemic disease (100% vs 31%) (p=0,003) and risk organ commitment (100% in DP vs 20% in NDP) (p=0,000). Median age of 13 vs 24 months was for DP and NDP respectively.Conclusion: Dead patients were younger than 13 months old, with systemic disease, and risk organ commitment. We found a later asking of medical advice in DP (6 months) vs NDP (2 months).Keys words: langerhans cell histiocytosis, multisystem disease, risk organ DisclosuresNo relevant conflicts of interest to declare.

Etiological identification of viral agents in acute encephalitis in Guadalajara, México, 2011-2015

Introduction: Viral encephalitis is a well-known inflammatory process associated with neurological dysfunction that might derive into severe brain damage or a fatal outcome. In México there is no epidemiological data that describes the prevalence of viral agents responsible for acute encephalitis. Objective: To identify the main viral agents by real time PCR involved in acute encephalitis in Mexico. Materials and methods: We obtained cerebral spinal fluid (CSF) samples from all patients with suspected viral encephalitis admitted to the emergency service of the Hospital Civil de Guadalajara “Fray Antonio Alcalde”. To identify pathogens, we performed nucleic acid extraction using real-time PCR and RT-PCR. Results: Sixty-six patients were diagnosed with acute encephalitis from 2011 to 2014. A definitive viral etiological diagnosis was established in 16 patients (24%); the main causative agents were enteroviruses in 50% of the 16 positive samples, followed by herpes simplex virus (37%) and cytomegaloviruses (12.5%). Patients with encephalitis were predominantly male (63.3%) and a seasonal predominance was observed during autumn (37.5%). The main clinical characteristics in the acute encephalitis phase were fever (48.45) and cephalea (36.3), followed by seizures, disorientation, and muscular weakness (30.3%). Kerning sign was present in two cases (3%) and other two cases presented Brudzinski’s sign (3%). Conclusions: CSF PCR is a suitable diagnostic technique for the identification of viral encephalitis caused by viral infections that allows an appropriate antiviral therapeutic treatment.

Symmetrical and bilateral basal ganglia calcification. Case series and literature review.

Symmetric, bilateral basal ganglia calcification is rare finding that sometimes occurs asymptomatically. Its prevalence increases with age, and the most affected site is the globus pallidus. A series of seven cases with clinical and imaging diagnosis of basal ganglia calcification, recorded during the 2012 to 2016 period at the Department of Internal Medicine of the Hospital Civil de Guadalajara "Fray Antonio Alcalde, is presented. Most common clinical presentation was with altered alertness, headache and seizures. There was one case with movement disorders; there were no cases identified with dementia or tetany. Ganglia calcification can be associated with age-related neurodegenerative changes, but it can be an initial manifestation of a variety of systemic pathologies, including disorders of the calcium metabolism, intoxication by different agents, and autoimmune and genetic diseases. Correlation of typical imaging findings with clinical manifestations and laboratory results should be established to reach a definitive judgment.

Neonatal mortality and associated factors in newborn infants admitted to a Neonatal Care Unit.

The increasing survival rate of preterm infants has altered the epidemiology of neonatal diseases; however, neonatal mortality is still the main component of child mortality. The objective of this study was to evaluate neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit. Prospective cohort study conducted between January 2016 and January 2017 at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca." The incidence of deaths and associated conditions was evaluated using a multivariate logistic regression analysis. A total of 9366 live births were registered; 15% (n: 1410) of these were admitted to the neonatal care unit. The mortality rate was 125.5 per 1000 hospitalized newborn infants (95% confidence interval [CI]: 109-144); the main reasons for admission were congenital malformations or genetic disorders (28.2%), infections (24.9%), and respiratory distress (20.9%). The conditions associated with death were gestational age < 37 weeks (OR: 2.41, 95% CI: 1.49-3.93), birth weight < 1500 grams (OR: 6.30, 95% CI: 4.15-9.55), moderate/severe respiratory distress at 10 minutes (OR: 1.89, 95% CI: 1.24-2.86), Apgar score < 7 at 5 minutes (OR: 9.40, 95% CI: 5.76-15.31), congenital malformations (OR: 5.52, 95% CI: 3.12-9.78), and less than 5 antenatal care visits (OR: 1.51, 95% CI: 1.09-2.08). Preterm birth, low birth weight, respiratory distress, Apgar score < 7, congenital malformations, and a history of < 5 antenatal care visits were associated with a higher risk for death.

Incidence and risk factors for bacteremia on pediatric patients with burns in a specialized care center in Mexico

Bacteremia events are frequent cause of mortality in burn patients and may originate from infected wounds, by bacterial translocation of endogenous microorganisms, from invasive devices or contaminated intravenous solutions. To quantify the incidence of bacteremia in pediatric patients with burns and to identify risk factors. A prospective cohort study was performed in pediatric patients with burns of Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Bacteremia was diagnosed by blood cultures in patients with clinical manifestations of sepsis. Risk factors were investigated by multivariate analysis with Cox regression. Were included in the cohort 260 patients, median age 3 years. The incidence of bacteremia was 9.6 events per 1,000 days patient. The most frequently isolated bacteria were Enterobacteriaceae (41.9%), Staphylococcus aureus (22.6%) and Pseudomonas aeruginosa (22.6%). Factors associated with bacteremia were: bums ≥ 20% TBSA (HR 11.06; 95% CI 4.8-25.4), deep second degree bums or higher (HR 6.9; 95% CI 2.0-23.3) and have had two or less debridement (HR 26.4; 95% CI 8.0-87.7). Patients with more extensive and deep burns with fewer debridement are at increased risk of bacteremia.

Association of metabolic syndrome with low birth weight, intake of high-calorie diets and acanthosis nigricans in children and adolescents with overweight and obesity

ObjectiveThe theory of fetal programming suggests that low birth weight (LBW) predisposes to greater food intake and increases the chance of overweight and obesity, which are in turn associated to conditions such as metabolic syndrome (MS) and acanthosis nigricans. The study objective was to ascertain whether an association exists between MS, LBW, intake of high-calorie diets, and acanthosis nigricans in children and adolescents with overweight or obesity. Material and methodsA case-control was conducted on 100 children who attended the overweight and obesity outpatient clinic of the OPD Hospital Civil de Guadalajara “Fray Antonio Alcalde”. Subjects were stratified in groups with and without MS based on the criteria of the International Diabetes Federation for children aged less than 16 years. Data on LBW, intake of high-calorie diets for 24-h dietary recalls (average 2 days a week), and acanthosis nigricans (Simone criteria) were obtained by questioning the parents. Frequencies and logistic regression were calculated using SPSS version 22. ResultsThe results show that 82% of children and adolescents were obese and 18% overweight, and 73% had MS. MS was associated to LBW (OR: 4.83 [95% CI: 1.9–12.47]), high-calorie diets (OR: 136.8 [95% CI: 7.7–2434]), and acanthosis nigricans (OR: 1872 [95% CI: 112.9–31028]). ConclusionsIn children and adolescents with overweight and obesity, LBW, high-calorie diets, and acanthosis nigricans are associated to a higher probability of MS.

Asociación del síndrome metabólico con bajo peso al nacimiento, consumo de dietas hipercalóricas y acantosis nigricans en escolares y adolescentes con sobrepeso y obesidad

ObjectiveThe theory of fetal programming suggests that low birth weight (LBW) predisposes to greater food intake and increases the chance of overweight and obesity, which are in turn associated to conditions such as metabolic syndrome (MS) and acanthosis nigricans. The study objective was to ascertain whether an association exists between MS, LBW, intake of high-calorie diets, and acanthosis nigricans in children and adolescents with overweight or obesity. Material and methodsA case-control was conducted on 100 children who attended the overweight and obesity outpatient clinic of the OPD Hospital Civil de Guadalajara “Fray Antonio Alcalde”. Subjects were stratified in groups with and without MS based on the criteria of the International Diabetes Federation for children aged less than 16 years. Data on LBW, intake of high-calorie diets for 24-hour dietary recalls (average 2 days a week), and acanthosis nigricans (Simone criteria) were obtained by questioning the parents. Frequencies and logistic regression were calculated using SPSS version 22. ResultsThe results show that 82% of children and adolescents were obese and 18% overweight, and 73% had MS. MS was associated to LBW (OR: 4.83 [95% CI: 1.9-12.47]), high-calorie diets (OR:136.8 [95% CI: 7.7-2434]), and acanthosis nigricans (OR: 1872 [95% CI: 112.9-31028]). ConclusionsIn children and adolescents with overweight and obesity, LBW, high-calorie diets, and acanthosis nigricans are associated to a higher probability of MS.

Oxygen Monitoring Reduces the Risk for Retinopathy of Prematurity in a Mexican Population

Background: Retinopathy of prematurity (ROP), a potentially blinding disease, affects preterm infants. High levels of oxygen saturation are a well-known risk factor for ROP. Objectives: To assess the frequency of ROP type 1 needing treatment after improved oxygen monitoring (2011) in a Mexican preterm population selected for WINROP analyses and to retrospectively revalidate WINROP, an online surveillance system identifying infants at risk of developing ROP type 1. Methods: Preterm infants born with birth weight (BW) <1,750 g and/or at gestational age (GA) ≤34 weeks, screened for ROP in 2012-2014 at the Hospital Civil de Guadalajara, Mexico were included (n = 151). Eighty-five infants with GA <32 weeks qualified for WINROP analyses. GA, BW, maximal ROP stage, ROP treatment and weekly weights were recorded. The results in the present study were compared to those of a previous WINROP study in the same hospital (2005-2010; n = 352). Results: In the present WINROP cohort, 11.8% of the infants born at GA <32 weeks received treatment compared to 51.0% of the infants in the previous WINROP cohort. One infant (3%) born at GA ≥32 weeks received treatment during the present study period compared to 35.6% during the previous period. WINROP displayed 80.0% sensitivity in infants born at GA <32 weeks in the present study compared to 84.7% in the previous study. Conclusions: Uncontrolled oxygen supplementation is the major risk factor for severe ROP in infants born at GA ≥32 weeks. After improved oxygen monitoring, the frequency of ROP treatment was dramatically reduced at the Hospital Civil de Guadalajara, Mexico.

Early neonatal sepsis, incidence and associated risk factors in a public hospital in western Mexico

Early neonatal sepsis (EOS) is the second leading cause of death in the first week of life. Epidemiology differs in developed and developing countries. To describe the epidemiology of EOS among newborn patients in a public hospital in western Mexico. A prospective cohort study was performed in newborns of Nuevo Hospital Civil de Guadalajara "Dr. Juan I Menchaca". EOS was diagnosed with blood cultures or cultures of cerebrospinal fluid within the first 72 h of life. We analyzed risk factors (RF) by multivariate analysis with logistic regression. We identified an EOS incidence of 4.7 events per 1,000 live births. Seventy two percent of the isolated bacteria were gram negative bacilli. Factors associated with EOS were maternal age≤15 years (OR 3.50; 95% CI 1.56-7.85), rupture of membranes>18 h (OR 2.65; 95% CI 1.18-5.92), maternal fever (OR 6.04; 95% CI 1.54-23.6), birth weight≤2,500 g (OR 4.82; 95% CI 2.38-9.75) and gestational age<37 weeks (OR 3.14; 95% CI 1.58-6.22). In addition to the RF known for EOS an independent association was observed with maternal age≤15 years.

Prevalence and risk factors for gastroschisis in a public hospital from west México.

Mexico is recognized as a country with a high prevalence of gastroschisis, although the cause of this remains unclear. We define the prevalence and potential risk factors for gastroschisis in a public hospital from west México. A case-control study was conducted among 270 newborns, including 90 patients with nonsyndromic gastroschisis (cases) and 180 infants without birth defects (controls), born all during the period 2009 to 2013 at the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" (Guadalajara, Mexico), from a total of 51,145 live births. Potential maternal risk factors for gastroschisis were compared using multivariate logistic regression analysis to evaluate the deviance explained by different variables of interest. The overall prevalence of gastroschisis in live births was 17.6 per 10,000 births (95% confidence interval [CI] 14.0-21.2), whereas in offspring of women ≤ 19 years old was 29.9 per 10,000 births (95% CI 21.9-38.0). Mothers ≤ 19 years (adjusted odds ratio [aOR] 2.8: 95% CI 1.5-5.1), anemia during pregnancy (aOR 10.7; 95% CI 2.0-56.9), first-trimester exposure to hormonal contraceptives (aOR 3.7; 95% CI 1.0-13.0), and first-trimester alcohol consumption (aOR 3.4; 95% CI 1.6-7.3), were associated with gastroschisis. Contrarily, adjusted OR for pre-pregnancy body mass index ≥ 25 kg/m(2) has protective odds (aOR 0.2; 95% CI 0.1-0.5). Our results suggest an increased risk for gastroschisis among mothers under the age of 20, with anemia during pregnancy, and those who used hormonal contraceptives or consumed alcohol during early pregnancy, whereas, pre-pregnancy overweight has a protective OR, and they are discussed as clues in its pathogenesis.

Minor phenotypic variants in patients with acute lymphoblastic leukaemia from west Mexico

Abstract Introduction Acute lymphoblastic leukaemia (ALL) has been associated with an excess of minor phenotypic variants (MPV), including common variants and minor anomalies, indicative of an altered phenogenesis. The objective of the study was to determine the association between MPV and ALL. Patients and methods In a hospital based case–control study, we studied 120 children with ALL (including standard and high risk) and 120 healthy children as a control group, matched for age and sex, seen in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca (Guadalajara, Mexico). In both groups, 28 anthropometric measurements were made, as well as a systematic search for 405 MPV, through a physical examination. Adjusted odds ratio was estimated (aOR) with its intervening variables by logistic regression. The confidence interval was 95% (95%CI). Results Anthropometric signs associated with ALL were: long upper segment (aOR = 2.19, 95%CI: 1.01–4.76), broad jaw (aOR = 2.62, 95%CI: 1.29–5.30), narrow ears (aOR = 6.22, 95%CI: 2.60–14.85), and increase in internipple distance (aOR = 2.53, 95%CI: 1.07–5.98). The hypoplasia mesofacial, broad forehead, small nose, short columella, narrow ears, telethelia, Sydney crease (SC), Greek type feet and cafe-au-lait spots (CALS), had a 3–17 times higher frequency in children with ALL. By number, an association was found from ≥4 MPV (aOR = 2.14, 95%CI: 1.25–3.66, P = .004). Conclusions From ≥4 MPV, an association was found with ALL, suggesting prenatal factors in phenogenesis and leukemogenesis. CALS and SC were confirmed as MPV in children with ALL.

ASSOCIATION OF VARIABLE NUMBER TANDEM REPEAT POLYMORPHISM (VNTR 86 BP) AT RECEPTOR ANTAGONIST INTERLEUKIN-1 (IL-1RA) WITH CLINICAL VARIABLES IN RHEUMATOID ARTHRITIS

Event Abstract Back to Event ASSOCIATION OF VARIABLE NUMBER TANDEM REPEAT POLYMORPHISM (VNTR 86 BP) AT RECEPTOR ANTAGONIST INTERLEUKIN-1 (IL-1RA) WITH CLINICAL VARIABLES IN RHEUMATOID ARTHRITIS Sergio J. Ramírez-Pérez1, Samuel García-Arellano1, Ulises De La Cruz-Mosso1, Sergio Cerpa-Cruz2, Yeminia Valle1, Jorge R. Padilla-Gutiérrez1, Edith Oregon-Romero1 and José F. Muñoz-Valle1* 1 Universidad de Guadalajara, Mexico 2 O.P.D. Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Servicio de Reumatología, Mexico BACKGROUND: rheumatoid arthritis (RA) is a chronic systemic-inflammatory disease of unknown etiology characterized by autoantibodies production and cytokines desregulation. There are many factors such as environmental, hormonal, immunological and genetics associated with its susceptibility. Preliminary studies have associated the 86 bp VNTR polymorphism in intron 2 of the IL-1RA gene (rs2234663) to development and susceptibility of rheumatoid arthritis. Based on this knowledge, the aim of this study was to associate the 86 bp VNTR with clinical variables in RA patients from Western Mexico. PATIENTS AND METHODS: we performed an observational case-control study, 183 patients with RA classified according to the ACR/EULAR 2010 criteria and 180 Control Subjects (CS) were analyzed. The identification of IL-1RA VNTR polymorphism was performed by Polymerase Chain Reaction (PCR) technique and visualizated in polyacrylamide gel 6% stained with AgNO3 0.2%. RESULTS: not significant differences in genotype frequencies between cases and controls (p>0.05) were observed. Regarding IL-1RA VNTR alleles, the 2 repeats A2 allele (IL-1RN*2) was associated with protection for RA (OR=0.64, CI 0.44-0.93; p=0.01) in comparisson with A1, A3, and A4 alleles. The genotype frequencies were found in Hardy-Weinberg equilibrium (p=0.35). Subjects carrying of the A1/A2 heterozygous genotype showed a higher disease activity assessed by DAS28 index (5.59; p=0.02), whereas the subjects with genotype A1/A4 showed a significant increase in C-Reactive Protein (CRP) in comparison with other genotypes (31.27 mg/dL vs ; p<0.001). CONCLUSION: the allele A2 is a protector allele for RA in patients from Western Mexico. Moreover, the genotype A1/A2 was associated with increased disease activity, whereas the genotype A1/A4 was associated with a significant increase in CRP. Keywords: Association, polymorphism, IL-1ra, Rheumatoid arthritis, VNTR Conference: IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología, Medellin, Colombia, 13 Oct - 16 Oct, 2015. Presentation Type: Poster Presentation Topic: Immunogenetics Citation: Ramírez-Pérez SJ, García-Arellano S, De La Cruz-Mosso U, Cerpa-Cruz S, Valle Y, Padilla-Gutiérrez JR, Oregon-Romero E and Muñoz-Valle JF (2015). ASSOCIATION OF VARIABLE NUMBER TANDEM REPEAT POLYMORPHISM (VNTR 86 BP) AT RECEPTOR ANTAGONIST INTERLEUKIN-1 (IL-1RA) WITH CLINICAL VARIABLES IN RHEUMATOID ARTHRITIS. Front. Immunol. Conference Abstract: IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología. doi: 10.3389/conf.fimmu.2015.05.00112 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 14 May 2015; Published Online: 14 Sep 2015. * Correspondence: PhD. José F Muñoz-Valle, Universidad de Guadalajara, Guadalajara, Jalisco, 44340, Mexico, biologiamolecular@hotmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Sergio J Ramírez-Pérez Samuel García-Arellano Ulises De La Cruz-Mosso Sergio Cerpa-Cruz Yeminia Valle Jorge R Padilla-Gutiérrez Edith Oregon-Romero José F Muñoz-Valle Google Sergio J Ramírez-Pérez Samuel García-Arellano Ulises De La Cruz-Mosso Sergio Cerpa-Cruz Yeminia Valle Jorge R Padilla-Gutiérrez Edith Oregon-Romero José F Muñoz-Valle Google Scholar Sergio J Ramírez-Pérez Samuel García-Arellano Ulises De La Cruz-Mosso Sergio Cerpa-Cruz Yeminia Valle Jorge R Padilla-Gutiérrez Edith Oregon-Romero José F Muñoz-Valle PubMed Sergio J Ramírez-Pérez Samuel García-Arellano Ulises De La Cruz-Mosso Sergio Cerpa-Cruz Yeminia Valle Jorge R Padilla-Gutiérrez Edith Oregon-Romero José F Muñoz-Valle Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Effect of pentoxifillyine in the expression of apoptotic genes in leukemic cells of pediatric patients with acute lymphoblastic leukemia during steroid window phase

Effect of pentoxifillyine in the expression of apoptotic genes in leukemic cells of pediatric patients with acute lymphoblastic leukemia during steroid window phase

Alterations in neutrophil extracellular traps release is associated with the degree of decompensation of liver cirrhosis

Event Abstract Back to Event Alterations in neutrophil extracellular traps release is associated with the degree of decompensation of liver cirrhosis Juan M. Agraz Cibrian1, Jorge E. Segura-Ortega2, Vidal Delgado-Rizo1, Karla S. Bustos-Lopez2 and Mary Fafutis-Morris1* 1 Universidad de Guadalajara, Mexico 2 Antiguo hospital Civil de Guadalajara "Fray Antonio Alcalde", Gastroenterology, Mexico Background: Patients with liver cirrhosis present high susceptibility to bacterial infections. The neutrophils of these patients possess defects in the production of oxygen radicals, which are essential for the elimination of bacteria through the activation of diverse microbicidal mechanisms, such as neutrophil extracellular traps (NETs) release. Aim: Determination of NETs and neutrophil activation markers in patients with LC. Methods: We carried out neutrophil purification with Ficoll Histopaque from a sample of the peripheral blood of patients with compensated and decompensated liver cirrhosis. The neutrophils were activated with Phorbol 12-Myristate 13-Acetate to evaluate NETs release by means of fluorescence microscopy and fluorometry, while the expression of activation markers (CD69, CD80, Perforin, and CAP-18) was evaluated by flow cytometry. Results: We observed a significant diminution in NETs release capacity in terms of the degree of complication of the disease in patients with liver cirrhosis. We found no significant differences on comparing the different neutrophil activation markers; however, we observed a correlation between diminution of CD69 and CD80 expression and patients’ decompensation. Contrariwise, we observed an increase in the intracellular expression of CAP-18 and perforin. Conclusions: In this work, we demonstrated that patients with liver cirrhosis present neutrophil extracellular traps release deficiencies, which increase the risk of the establishment of complications. Keywords: Neutrophils, NETs, Liver Cirrhosis, CD69, LL37 Conference: IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología, Medellin, Colombia, 13 Oct - 16 Oct, 2015. Presentation Type: Poster Presentation Topic: Innate Immunity Citation: Agraz Cibrian JM, Segura-Ortega JE, Delgado-Rizo V, Bustos-Lopez KS and Fafutis-Morris M (2015). Alterations in neutrophil extracellular traps release is associated with the degree of decompensation of liver cirrhosis . Front. Immunol. Conference Abstract: IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología. doi: 10.3389/conf.fimmu.2015.05.00002 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 28 Apr 2015; Published Online: 14 Sep 2015. * Correspondence: PhD. Mary Fafutis-Morris, Universidad de Guadalajara, Guadalajara, jalisco, 45116, Mexico, mfafutis@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Juan M Agraz Cibrian Jorge E Segura-Ortega Vidal Delgado-Rizo Karla S Bustos-Lopez Mary Fafutis-Morris Google Juan M Agraz Cibrian Jorge E Segura-Ortega Vidal Delgado-Rizo Karla S Bustos-Lopez Mary Fafutis-Morris Google Scholar Juan M Agraz Cibrian Jorge E Segura-Ortega Vidal Delgado-Rizo Karla S Bustos-Lopez Mary Fafutis-Morris PubMed Juan M Agraz Cibrian Jorge E Segura-Ortega Vidal Delgado-Rizo Karla S Bustos-Lopez Mary Fafutis-Morris Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Case series of infants presenting with end stage retinopathy of prematurity to two tertiary eye care facilities in Mexico: underlying reasons for late presentation.

To describe the characteristics of infants with bilateral Stage 4b or 5 ROP (i.e. with subtotal or total retinal detachment) who presented to eye departments in two major cities in Mexico, to identify reasons why they may have become blind in order to recommend how programs could be improved. A large case-series of infants with Stage 4b or 5 ROP in both eyes confirmed by ultrasound who attended the ROP Clinic, Hospital Civil de Guadalajara from September 2010 to November 2012, and the Department of Ophthalmology, Hospital Infantil de Mexico Federico Gomez from December 2011 to December 2012 were identified from the diagnostic databases of each hospital. Mothers of infants in Guadalajara had a telephone interview. 89/94 eligible infants were included in the study, 48 in Guadalajara and 41 in Mexico City. Cases came from 22 of the 32 states in Mexico. Half of the infants attending Guadalajara 24/48 (50 %) had been cared for in NICUs without ROP screening programs and were not examined. Among the 24 infants cared for in NICUs with ROP programs, 7/24 (29.1 %) mothers reported that their infant had not been examined while in the NICU, and a further 9/24 (37.5 %) were either not referred for screening after discharge or they did not attend. Two infants had failed laser treatment. Strategies and resources to prevent end stage ROP have not been firmly established in Mexico. There is an urgent need to expand the coverage and quality of ROP programs, to ensure that existing screening guidelines are better adhered to, and to improve communication with parents.

Molecular Mechanisms Associated with Nosocomial Carbapenem-resistant Acinetobacter baumannii in Mexico

Acinetobacter baumannii is an emerging pathogen worldwide that is most commonly associated with nosocomial infections and multi-drug resistance. In the present study we determined the mechanisms of carbapenem resistance and clonal diversity of A. baumannii nosocomial isolates in Hospital Civil de Guadalajara, Mexico. A total of 303 clinical isolates of A. baumannii identified during a period expanding from 2004-2011 were analyzed for carbapenem resistance using several microbiological and molecular methods. Clonal relatedness of these isolates was determined using pulsed-field gel electrophoresis. Of the 303 isolates, 84% were resistant to meropenem, 71.3% to imipenem and 78.3% the resistant isolates were positive for metallo-β-lactamases as determined by the phenotypic assay. In addition, 49.6% of carbapenem-intermediate or -resistant isolates carried the blaOXA-72 gene and 1.2% carried the blaVIM-1 gene. Efflux pump phenotype was responsible for reduced susceptibility to meropenem in 14.5% and to imipenem in 31.6% of the resistant isolates, respectively in the presence of the efflux pump inhibitor, carbonyl cyanide 3-chlorophenylhydrazone. Strains representing different carbapenem-resistant patterns exhibited reduced expression of 22, 29, 33, and 43 kDa OMPs. Among the bacterial collection studied, 48 different clones were identified, two of which were predominant and persistently transmitted. Carbapenemase production in combination with efflux pump expression, reduction in OMPs expression and the cross-transmission of clones appear to be major contributors to the high frequency of carbapenem-resistance observed in A. baumannii. To our knowledge, this is the first study to define the molecular mechanisms associated with carbapenem-resistance in A. baumannii in Mexico.

Variantes fenotípicas menores en pacientes con leucemia linfoblástica aguda del occidente de México

IntroductionAcute lymphoblastic leukemia (ALL) has been associated with an excess of minor phenotypic variants (MPV), including common variants and minor anomalies, indicative of an altered phenogenesis. The objective of the study was to determine the association between MPV and ALL. Patients and methodsIn a hospital based case-control study, we studied 120 children with ALL (including standard and high risk) and 120 healthy children as a control group, matched for age and sex, seen in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca (Guadalajara, Mexico). In both groups, 28 anthropometric measurements were made, as well as a systematic search for 405 MPV, through a physical examination. Adjusted odds ratio was estimated (aOR) with its intervening variables by logistic regression. The confidence interval was 95% (95%CI). ResultsAnthropometric signs associated with ALL were: long upper segment (aOR= 2.19, 95%CI: 1.01-4.76), broad jaw (aOR= 2.62, 95%CI: 1.29-5.30), narrow ears (aOR= 6.22, 95%CI: 2.60-14.85), and increase in internipple distance (aOR= 2.53, 95%CI: 1.07-5.98). The hypoplasia mesofacial, broad forehead, small nose, short columella, narrow ears, telethelia, Sydney crease (SC), Greek type feet and café-au-lait spots (CALS), had a 3 to 17 times higher frequency in children with ALL. By number, an association was found from ≥4 MPV (aOR= 2.14, 95%CI: 1.25-3.66, P=.004). ConclusionsFrom ≥4 MPV, an association was found with ALL, suggesting prenatal factors in phenogenesis and leukemogenesis. CALS and SC were confirmed as MPV in children with ALL.

Acinetobacter baumannii Infections in a Tertiary Care Hospital in Mexico over the Past 13 Years

Background:Acinetobacter baumannii has evolved from an opportunistic pathogen into a common and persistent nosocomial bacterium capable of causing severe infections during endemic and epidemic periods. Methods: The study period extended from January 1999 to December 2011 and involved patients hospitalized at the Hospital Civil de Guadalajara, Fray Antonio Alcalde, Jalisco, Mexico. From each patient, a single isolate was obtained, and a total of 3,680 unique isolates were collected. Susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. Results:A. baumannii has disseminated throughout the Hospital Civil de Guadalajara, Fray Antonio Alcalde, since 1999. A. baumannii isolates obtained from patients treated in the adult intensive care unit represent the majority of the isolates that have been collected. In addition, A. baumannii was isolated from the adult neurosurgical ward and the adult internal medicine ward, and these isolates were frequently obtained from secretions. A persistent decrease in the susceptibility of A. baumannii isolates to meropenem (92% in 1999 to 12% in 2011), imipenem and amikacin has been observed. Conclusions:A. baumannii became an endemic nosocomial pathogen during the study period at the Hospital Civil de Guadalajara, Fray Antonio Alcalde, and has exhibited a persistent decrease in susceptibility to all categories of antimicrobial agents over the past 13 years.

Factors associated with adherence to the dietary management of children and adolescents with type 1 diabetes mellitus

ObjectiveTo identify factors associated with adherence to the dietary management of children and adolescents with type 1 diabetes mellitus (DM1) attending the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”.MethodsCross‐sectional study in 57 patients with DM1. Adherence to dietary management was assessed through two 24‐ hour recall dietary surveys and the instrument “Diabetes self care activities measure”; glycosylated hemoglobin A1c (HbA1c) was measured. We compared the characteristics of those with better vs poorer adherence in the consumption of energy recommendations, servings of carbohydrate (CH) and number of meal times during the day, with the chi square and student T tests. The protocol was approved by the Hospital Ethics Committee.ResultsMean age 12 ± 2.9 years. The average HbA1c was above 9%; 23% reported attending a diabetes education group. 24% reported adequate energy intake and 60% omitted one or more meal times during the day, collations were those more often omitted. Consumption of CH servings was poor in 70% of patients and in no case was excessive. An association was found between those who meet the prescribed servings of CH and do not omit meal times with a better match of energy recommendations.ConclusionsThe dietary adherence was poor, qualified through the fulfillment of the prescribed eating plan, self perception of compliance, and HbA1c levels.