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Impact of payment source, referral site, and place of residence on outcomes after allogeneic transplantation in mexico

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World Journal of Transplantation 2024年第2期14卷 76-87页

作者： Andrés Gómez-De León Yesica A López-Mora Valeria García-Zárate Ana Varela-Constantino Sergio U Villegas-De Leon Xitlaly J González-Leal Raúl del Toro-Mijares Anna C Rodríguez-Zúñiga Juan F Barrios-Ruiz Victor Mingura-Ledezma Perla R Colunga-Pedraza Olga G Cantú-Rodríguez César H Gutiérrez-Aguirre Luz Tarín-Arzaga Elías E González-López David Gómez-Almaguer Hematology service Universidad Autónoma de Nuevo LeónFacultad de Medicina y Hospital Universitario Dr.JoséEleuterio GonzálezMonterrey 64460Nuevo LeónMexico Hemato-logy service Clínica Gómez AlmaguerMonterrey 64710Nuevo LeónMexico Hematology service Instituto Tecnológico de Estudios Superiores de MonterreyTec SaludEscuela de Medicina Ignacio SantosMonterrey 64710Nuevo LeónMexico

BACKGROUND The impact of social determinants of health in allogeneic transplant recipients in low-and middle-income countries is poorly described.This observational study analyzes the impact of place of residence,referring institution,and transplant cost coverage(out-of-pocket vs government-funded vs private insurance)on outcomes after allogeneic hematopoietic stem cell transplantation(alloHSCT)in two of mexico's largest public and private institutions.AIM To evaluate the impact of social determinants of health and their relationship with outcomes among allogeneic transplant recipients in mexico.METHODS In this retrospective cohort study,we included adolescents and adults≥16 years who received a matched sibling or haploidentical transplant from 2015-2022.Participants were selected without regard to their diagnosis and were sourced from both a private clinic and a public University Hospital in mexico.Three payment groups were compared:Out-of-pocket(OOP),private insurance,and a federal Universal healthcare program“Seguro Popular”.Outcomes were compared between referred and institution-diagnosed patients,and between residents of Nuevo Leon and out-of-state.Primary outcomes included overall survival(OS),categorized by residence,referral,and payment source.Secondary outcomes encompassed early mortality,event-free-survival,graft-versus-host-relapse-free survival,and non-relapse-mortality(NRM).Statistical analyses employed appropriate tests,Kaplan-Meier method,and Cox proportional hazard regression modeling.Statistical software included SPSS and R with tidycmprsk library.RESULTS Our primary outcome was overall survival.We included 287 patients,n=164 who lived out of state(57.1%),and n=129 referred from another institution(44.9%).The most frequent payment source was OOP(n=139,48.4%),followed by private insurance(n=75,26.1%)and universal coverage(n=73,25.4%).No differences in OS,event-free-survival,NRM,or graft-versus-host-relapse-free survival were observed for patients diagnosed locally vs in another institution,nor pat

关键词： Hematopoietic cell transplant Social determinants of health Geography Haploidentical Out-of-pocket Financial toxicity Survival Health services and outcomes Hematopoietic malignancy Aplastic anemia

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Limited impacts of occasional tillage on dry aggregate size distribution and soil carbon and nitrogen fractions in semi-arid drylands

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International Soil and Water Conservation Research 2024年第1期12卷 96-106页

作者： Wooiklee S.Paye Vesh R.Thapa Rajan Ghimire New mexico State University Agricultural Science CenterClovisNM88101USA New mexico State University Department of Plant and Environmental SciencesLas CrucesNM88003USA

Tillage management that minimizes the frequency and intensity of soil disturbance can increase soil carbon(C)and nitrogen(N)sequestration and improve the resilience of dryland cropping systems,yet the impact of occasional disturbance on soil aggregate formation and the soil organic carbon(SOC)storage within aggregates has not been studied well.We evaluated the effect of four tillage management practices on soil dry aggregate size distribution,aggregate-protected C and N,mineral-associated organic matter carbon(MAOM-C),particulate organic matter carbon(POM-C),and corn(Zea mays L.)and sorghum(Sorghum bicolor(L.)Moench)yields in a semi-arid dryland cropping system.Treatments included conventional tillage(CT),strip-tillage(ST),no-tillage(NT),and occasional tillage(OT)management in a corn-sorghum rotation.Soil macro-aggregates were 51-54%greater under ST,NT,and OT,while small and micro-aggregates were greater in CT.Conventional tillage reduced soil aggregate-associated C by 28-31%in macro-aggregates and 47-53%in small aggregates at 26 months(M)sampling compared to ST,NT,and OT.In clay+silt fraction,CT had 14-16%,21-26%,and 36-43%less SOC at 7,14,and 26M samplings,respectively,than ST,NT,and OT.Aggregate associated N was generally similar under ST,NT,and OT,which was greater on average than CT.Soil MOAM-C and POM-C under ST,NT,and OT were generally greater than respective SOC fractions under CT at 19 and 26 M after OT implementation.Corn and sorghum yields were similar among tillage systems in 2020,but greater under ST,NT,and OT than CT in 2021.Our results suggest that while frequent intensive tillage can lower SOC and N storage,a single stubble mulch occasional tillage after several years of NT does not lead to soil C and N losses and soil structural instability in semi-arid drylands.

关键词： Conventional tillage Occasional tillage Aggregate associated carbon Mineral associated organic matter carbon(MAOM-C) Particulate organic matter carbon(POM-C)

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Ductal carcinoma in situ within a fibroadenoma:A case report and review of literature

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World Journal of Radiology 2024年第3期16卷 58-68页

作者： Yazmin Olivares-Antúnez Yesika Janett Dávila-Zablah JoséRaúl Vázquez-Ávila Gabriela Sofía Gómez-Macías María Teresa Mireles-Aguilar Margarita Lilia Garza-Montemayor Department of Diagnostic Breast Imaging Center Hospital Zambrano HellionTecnológico de MonterreyNuevo León 66260Mexico Department of Patology service Hospital San JoséTecnológico de MonterreyNuevo León 64710Mexico Department of Faculty of Medicine Hospital Universitario de la UANLNuevo León 64710Mexico. Department of Breast Surgery Center Hospital Zambrano HellionTecnológico de MonterreyNuevo León 66260Mexico

BACKGROUND Fibroadenoma(FA)is the most common tumor found in young women,although it can occur in any age group.Ductal carcinoma in situ(DCIS)that is confined in a FA is rare;it is most frequently reported as an incidental finding.CASE SUMMARY We report a case of DCIS within a FA in a 46-year-old female without cancerrelated personal and family histories.The patient was diagnosed with a breast conglomerate of nodules and was followed for 1 year.In the current control image study,we found suspicious microcalcification,as a new finding,within one of the nodules.Consequently,a core biopsy of the tumor,which appeared hypoechoic,oval,and circumscribed,was performed.The pathological diagnosis was ductal carcinoma in situ within a fibroepithelial lesion.The patient underwent breastconserving surgery and received radiotherapy as well as endocrine therapy(tamoxifen).CONCLUSION We recommend a multidisciplinary approach for adequate treatment and followup.

关键词： Carcinoma in situ Fibroadenoma Mammography Ultrasound Magnetic resonance imaging Radiology Case report

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Forecasting tropical cyclone rainfall and flooding hazards and impacts

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Tropical Cyclone Research and Review 2023年第2期12卷 100-112页

作者： Alex Lamers Sunitha Devi.S Monica Sharma Robbie Berg Jose Manuel Galvez Zifeng Yu Tarik Kriat Sareti Cardos David Grant Lorenzo A.Moron NOAA/NWS Weather Prediction Center USA India meteorological Department India Shanghai Typhoon Institute CMAChina LaReunion RSMC Meteo-FranceFrance mexico meteorological service USA Bureau of Meteorology Australia PAGASA Philippines

This review summarizes the rapporteur report on advances in monitoring and forecasting of rainfall associated with tropical cyclones(TCs)and its impact during 2014–18,as presented to the 10th International Workshop on TCs(IWTC-10)held in Bali,Indonesia during 5th–9th December 2022.Major physical processes that can modulate TC rainfall distribution,including topography,storm motion,vertical wind shear,and intensity,along with the fundamental physics of rain bands and clouds as simulated by numerical models,diurnal variation of rainfall,and various synoptic and mesoscale features controlling the rainfall distribution are briefly discussed.Improvements to the dynamic core and physical processes in global models are providing useable forecasts nearly up to 7 days.This report also summarizes,some tools that have been developed to predict TC rainfall.Lately there is a tendency for operational forecasting centers to utilize multi-model ensemble systems for rainfall forecasting that demonstrate superior performance than individual models,ensemble members,or even single model ensembles.Major impacts include pluvial and fluvial floods,and landslides.The techniques developed by various forecasting centers to assist in predicting and communicating the impacts associated with these events are also presented in this report.

关键词： Rainfall Flooding Storm size Topography

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Fulminant Hepatitis Associated with Chronic Consumption of 3,4-Methylenedioxy-Methamphetamine;Case Report

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Open Journal of Gastroenterology 2024年第5期14卷 161-166页

作者： Ulises Solis Gomez Gustavo Adolfo Hernández Valdez Juan Antonio Contreras Escamilla Ivan Alejandro Medina Jimenez Jorge Morales Rojas Jocelyn Nataly Quintero Melendez Marco Antonio González Villar Department of Internal Medicine ISSSTE APP General Hospital of Tepic Tepic Nayarit Mexico

The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).

关键词： Fulminant Hepatitis Acute Liver Failure Methamphetamine Severe Acute Liver Failure in a User of Drugs of Abuse Hepatology

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Assessment of diagnostic capacity and decision-making based on the 2015 American Thyroid Association ultrasound classification system

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World Journal of Methodology 2022年第3期12卷 148-163页

作者： Luis-Mauricio Hurtado-Lopez Alfredo Carrillo-Muñoz Felipe-Rafael Zaldivar-Ramirez Erich Otto Paul Basurto-Kuba Blanca-Estela Monroy-Lozano Department of Surgery Thyroid ClinicHospital General de MexicoMexico City 06720Mexico Thyroid Clinic General Surgery ServiceHospital General de MexicoMexico 06726Mexico

BACKGROUND This study evaluates the American Thyroid Association(ATA)ultrasound(US)classification system for the initial assessment of thyroid nodules to determine if it indeed facilitates clinical decision-making.AIM To perform a systematic review and meta-analysis of the diagnostic value of the ATA US classification system for the initial assessment of thyroid nodules.METHODS In accordance with the PRISMA statement for diagnostic test accuracy,we selected articles that evaluated the 2015 ATA US pattern guidelines using a diagnostic gold standard.We analyzed these cases using traditional diagnostic parameters,as well as the threshold approach to clinical decision-making and decision curve analysis.RESULTS We reviewed 13 articles with 8445 thyroid nodules,which were classified according to 2015 ATA patterns.Of these,46.62%were malignant.No cancer was found in any of the ATA benign pattern nodules.The Bayesian analysis post-test probability for cancer in each classification was:(1)Very-low suspicion,0.85%;(2)Low,2.6%;(3)Intermediate,6.7%;and(4)High,40.9%.The net benefit(NB),expressed as avoided interventions,indicated that the highest capacity to avoid unnecessary fine needle aspiration biopsy(FNAB)in the patterns that we studied was 42,31,35,and 43 of every 100 FNABs.The NB calculation for a probability threshold of 11%for each of the ATA suspicion patterns studied is less than that of performing FNAB on all nodules.CONCLUSION These three types of analysis have shown that only the ATA high-suspicion diagnostic pattern is clinically useful,in which case,FNAB should be performed.However,the curve decision analysis has demonstrated that using the ATA US risk patterns to decide which patients need FNAB does not provide a greater benefit than performing FNAB on all thyroid nodules.Therefore,it is likely that a better way to approach the assessment of thyroid nodules would be to perform FNAB on all non-cystic nodules,as the present analysis has shown the ATA risk patterns do not provide an adequate clinical decision-ma

关键词： Thyroid nodule Thyroid cancer Ultrasound Bayesian analysis Systematic review Metaanalysis

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Safety of intravitreal quinupristin/dalfopristin in an animal model

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International Journal of Ophthalmology(English edition) 2016年第3期9卷 373-378页

作者： Veronica E.Giordano Sergio E.Hernandez-Da Mota Tania N.A dabache-Guel Armando Castillejos-Cheve Sonia Corredor-Casas Samantha M.Salinas-Longoria Rafael Romero-Vera Juan M.Jimenez-Sierra Jose L.Guerrero-Naranjo Virgilio Morales-Canton Department of Ophthalmology Retina and Vitreous Service Asociacion para Evitar la Ceguera en Mexico Vicente Garcia Torres 46 Coyoacan Barrio San Lucas Mexico City 04030 Mexico Ophthalmology service Clinica David Boulevard Garcia de Leon 598 Nueva Chapultepec Morelia Michoacan 58280Mexico Department of Ophthalmology Glaucoma Service Asociacion para Evitar la Ceguera en Mexico Vicente Garcia Torres 46 Coyoacan Barrio San Lucas Mexico City 04030 Mexico Department of Ophthalmology Pathology Service Asociacion para Evitar la Ceguera en Mexico Vicente Garcia Tortes 46 Coyoacan Barrio San Lucas Mexico City 04030 Mexico

AIM： To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS： Eighteen New Zealand white rabbits were divided into three treatment groups （groups 1 to 3） and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection （baseline） and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS： Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 （Kruskall-Wallis test, P=0.000）. By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealedno significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION： Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/O.1 mL in this rabbit model.

关键词： endophthalmitis quinupristin/dalfopristin retinal toxicity

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Pharmacokinetics of sildenafil in children with pulmonary arterial hypertension

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World Journal of Pediatrics 2017年第6期13卷 588-592页

作者： Hugo Juárez Olguín Hector Osnaya Martínez Carmen Flores Pérez Blanca Ramírez Mendiola Liliana Rivera Espinosa Juan Luis Chávez Pacheco Janett Flores Pérez Ignacio Mora Maga(n)a Laboratory of Pharmacology National Institute of PediatricsMexico CityMexico Department of Pharmacology Faculty of MedicineNational Autonomous University of MexicoMexico CityMexico service of Cardiology National Institute of PediatricsMexico CityMexico Laboratory of Pharmacology National Institute of PediatricsMexico CityMexico Subdirection of Teaching and Educational Programming National Institute of PediatricsMexico CityMexico

Background:Recently,sildenafil was introduced to treat pulmonary arterial hypertension (PAH);however,there are currently few studies on the pharmacokinetics of sildenalfil in children.Therefore,we aimed to carry out a pharmacokinetic study of sildenafil in children with PAH using a single dose.Methods:Twelve children diagnosed with PAH,consisting of with ten males and two females,were recruited for the study after obtaining written consent from their parents or guardians.Blood samples were obtained predose and at 0.25,0.5,1,2,4,8 and 12 hours after the oral administration of 1 mg/kg of sildenafil using an extemporal pediatric formulation developed in our laboratory.The samples were analyzed using a previously validated high performance liquid chromatography method.Results:A pharmacokinetic analysis using the WinNonlin 3.1 program that considered the Akaike information criterion (AIC) for sdecting a more adjustable model was performed.The following pharmacokinetic parameters were obtained:maximal concentration (Cmax):366+179 ng/mL,time to maximal concentration:0.92±0.30 hours,elimination half-life (t1/2):2.41±1.18 hours,total clearance (CLto/F):5.85±2.81 L/hour,volume of distribution (Vd/F):20.13±14.5 L,absorption rate constants (Ka):0.343 hour-1,elimination rate (Ke):0.35 hour-1,area under curve from zero to infinity:2061±618 ng/mL/hour.The data of all patients adjusted to the model of one compartment were corroborated using AIC.Conclusions:The parameters Ka,Ke and t1/2 were found to be similar to those reported in adults;however,the values of Cmax and Vd/F were significantly higher.Based on these findings,we propose that treatment regimen of sildenafil be adjusted in children with PAH.

关键词： pharmacokinetics pulmonary arterial hypertension sildenafil

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Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson’s disease

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World Journal of Gastroenterology 2011年第46期17卷 5035-5048页

作者： Richard A Awad Experimental Medicine and Motility Unit Gastroenterology Service U-107Mexico City General Hospital

Exciting new features have been described concerning neurogenic bowel dysfunction,including interactions between the central nervous system,the enteric nervous system,axonal injury,neuronal loss,neurotransmission of noxious and non-noxious stimuli,and the fields of gastroenterology and neurology.Patients with spinal cord injury,myelomeningocele,multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation,incontinence,gastrointestinal motor dysfunction and altered visceral sensitivity.Spinal cord injury is associated with severe autonomic dysfunction,and bowel dysfunction is a major physical and psychological burden for these patients.An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease.Multiple sclerosis is a neurodegenerative disorder in which axonal injury,neuronal loss,and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability.Parkinson's disease is a multisystem disorder involving dopaminergic,noradrenergic,serotoninergic and cholinergic systems,characterizedby motor and non-motor symptoms.Parkinson's disease affects several neuronal structures outside the substantia nigra,among which is the enteric nervous system.Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease,even before the involvement of the central nervous system.This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease,as it could represent the point of entry for a putative environmental factor to initiate the pathological process.This review covers the data related to the etiology,epidemiology,clinical expression,pathophysiology,genetic aspects,gastrointestinal motor dysfunction,visceral sensitivity,management,prevention and prognosis of neurogenic bowel dysfunction patients with these neurological diseases.Embryological,morphological and ex

关键词：中枢神经系统帕金森氏症多发性硬化脊髓损伤胃肠病学功能紊乱患者神经退行性疾病

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Visual rating and the use of image analysis for assessing canopy density in a pecan provenance collection during leaf fall

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林业研究:英文版 2023年第6期34卷 1843-1854页

作者： Cristina Pisani Clive H.Bock Jennifer Randall United States Department of Agriculture−Agricultural Research service (USDA-ARS)Southeastern Fruit and Tree Nut Research Station(SEFTNRS)ByronGA 31008USA Department of Entomology Plant Pathology and Weed ScienceNew Mexico State UniversityLas CrucesNM 88003USA

A collection representing the native range of pecan was planted at the US DA-ARS Southeastern Fruit and Tree Nut Research Station,Byron,GA.The collection(867 trees)is a valuable genetic resource for characterizing important horticultural traits.Canopy density during leaf fall is important as the seasonal canopy dynamics provides insights to environmental cues and breeding potential of germplasm.The ability of visual raters to estimate canopy density on a subset of the provenance collection(76 trees)as an indicator of leaf shed during autumn along with image analysis values was explored.Mean canopy density using the image analysis software was less compared to visual estimates(11.9%vs 18.4%,respectively).At higher canopy densities,the raters overestimated foliage density,but overall agreement between raters and measured values was good(ρc=0.849 to 0.915),and inter-rater reliability was high(R^(2)=0.910 to 0.953).The provenance from Missouri(MOL),the northernmost provenance,had the lowest canopy density in November,and results show that the higher the latitude of the provenance,the lower the canopy density.Based on regression,the source provenance latitude explained 0.609 of the variation using image analysis,and0.551 to 0.640 when based on the rater estimates of canopy density.Visual assessment of pecan canopy density due to late season leaf fall for comparing pecan genotypes provides accurate and reliable estimates and could be used in future studies of the whole provenance collection.

关键词： Carya illinoinensis Accuracy Reliability Canopy Foliage density Leaf area density Leaf area index

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