Abstract There are more than 1 billion people with disabilities worldwide, with 16% of children having some type of neurodevelopmental disorder (ND). In Mexico, 6% of the population presented some disability; however, there is a lack of data on ND in children under 5 years of age. Objective: The objective of this study was to determine the prevalence of neurodevelopmental alterations in children under 5 years of age in urban, suburban, and rural populations from two states of Mexico. Methods: This was an observational and cross-sectional design study. We included 501 clinically healthy children from 0 to 60 months of age, from urban, suburban, and rural populations from the state of Queretaro (201) and from the State of Mexico (300). Neurodevelopmental alterations were detected through the electronic N-PED system, exploring areas of neurological development of language, psychomotor, and sensory (auditory and visual). The positive subjects were clinically assessed to confirm the diagnosis. Results: A 14.7% prevalence of ND was found, with a significant difference between Queretaro (8.9%) and the State of Mexico (18.7%). Language alterations were significantly different for both states (4.9% and 16% for Queretaro and the State of Mexico, respectively). Conclusions: The prevalence of ND and language alterations presented significant differences between the two evaluated states.

Resumen Hay más de mil millones de personas con discapacidad en todo el mundo, el 16% de los niños tiene algún tipo de trastorno del desarrollo neurológico (DN). En México, 6% de la población presenta alguna discapacidad; sin embargo, faltan datos en niños menores de 5 años. Objetivo: Determinar la prevalencia de alteraciones del neurodesarrollo en menores de 5 años, en poblaciones urbanas, suburbanas y rurales, de 2 estados de México. Métodos: Estudio observacional, de diseño transversal. Se incluyeron 501 niños, clínicamente sanos, de 0 a 60 meses de edad, de poblaciones urbanas, suburbanas y rurales de Querétaro (201) y del Estado de México (300). Se detectaron alteraciones del neurodesarrollo a través del sistema electrónico N-PED, explorando áreas del lenguaje, psicomotor y sensorial (auditivo y visual). Los sujetos positivos fueron evaluados clínicamente para confirmar el diagnóstico. Resultados: Se encontró una prevalencia de trastornos del DN de 14.7%, con una diferencia significativa entre Querétaro (8.9%) y el Estado de México (18.7%). Las alteraciones del lenguaje fueron significativamente diferentes para ambos estados (4.9% y 16% para Querétaro y el Estado de México, respectivamente). Conclusiones: La prevalencia de trastornos del DN y del lenguaje, presentaron diferencias significativas entre los dos estados evaluados.

Resumen Objetivo: Profundizar en las relaciones electro- clínica y el análisis de fuentes de las crisis de ausencia en la infancia. Métodos: Se estudiaron 33 sujestos con el diagnóstico clínico y electrofisiológico de crisis de ausencia sin medicación antiepiléptica, se realizó Video-EEG. Se recogieron los comportamientos clínicos y variables electrofisiológicas durante las crisis y se aplicó un Modelo General Lineal, con p < 0.05. El análisis de las fuentes se realizó con el método VARETA. Resultados: Se evaluaron 174 crisis El 75,75% mostró descargas epileptiformes interictales (DEI) y el 12,12% mostró actividad delta posterior. Existió un comportamiento desigual en relación con el total de crisis electroclínicas y la presencia o no de DEI (p = 0.02) y entre los sujetos sin DEI y DEI multifocales (p = 0.008). El número de crisis registradas durante la HPV tuvo un comportamiento diferente entre sujetos sin DEI y EEG con DEI multifocales (p = 0.03) y entre EEG focal y multifocal (p = 0.04). El análisis de las fuentes evidenció el inicio frontal de las crisis en el 57,47%, con la participación de las regiones mesial y dorsolateral en el 43% y 57% respectivamente. Conclusiones: Los datos sugieren que las crisis de ausencia no son ¨generalizadas¨ si se considera la activación cortical global, sino que involucran descargas localizadas en regiones corticales específicas, principalmente del lóbulo frontal.

Abstract Purpose: This study was to deepen into the electro-clinical relationship and source analysis of absence seizures in childhood. Methods: Thirty-three subjects were studied with clinical and electrophysiological diagnosis of absence seizures without antiepileptic medication, video-electroencephalogram was applied. We obtained clinical behavior and electrophysiological variables during seizures and General Linear Model was applied, with p < 0.05. Source analysis was carried out with VARETA method. Results: 174 seizures were evaluated. 75.75% showed interictal epileptiform discharges (IED) and 12.12% showed posterior delta activity. There was an unequal behavior in relation with total electro-clinical seizures and presence or no of IED (p = 0.02), namely between subjects without IED in EEG and multifocal EEG (p = 0.008). Quantity of seizures recorded during HPV had a different behavior between subjects without IED in EEG and multifocal EEG (p = 0.03) and between focal and multifocal EEG (p = 0.04). Source analysis (VARETA) evidence the onset frontal of seizures in 57.47%, mesial and dorsolateral regions in 43% and 57%, respectively. Conclusion: These data suggest that absence seizures are not “generalized” if we considered global cortical activation but rather involve localized discharges from specific cortical regions, mainly frontal lobe.

Objective: Current treatment for borderline personality disorder (BPD) involves psychological and pharmacological interventions. However, neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) may positively affect BPD symptomatology. The objective of this study was to evaluate the clinical and neuropsychological effects of rTMS on the dorsomedial prefrontal cortex (DMPFC) in BPD patients. Methods: Fourteen patients with BPD were randomized into two groups (active vs. sham) for 15 sessions of rTMS on the DMPFC. Clinical effects were measured using the Borderline Symptoms List (BSL), Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity over Time (BEST), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Barratt’s Impulsiveness Scale (BIS). Neuropsychological effects were determined by a Stop-Signal Task (SST), the Wisconsin Card-Sorting Test (WCST), and the Iowa Gambling Test (IGT). Results: Within-group comparison showed significant differences (p < 0.05) in CGI-BPD (total score and six of nine psychopathologic domains), BEST, HDRS, HARS, and IGT scores for active modality. Conclusion: The 5 Hz-DMPFC rTMS technique was well tolerated and lessened the severity of BPD symptomatology, especially abandonment, affective issues, interpersonal relationships, suicidal behavior, anger, and paranoid ideation. Cognitive improvement was seen in decision-making. Additional studies are needed to fully evaluate the effects of rTMS on BPD symptomatology. Clinical Trial Registration: NCT03832777.

Immunological diagnostic methods for Trypanosoma cruzi depend specifically on the presence of antibodies and parasitological methods lack sensitivity during the chronic and “indeterminate” stages of the disease. This study performed a serological survey of 1,033 subjects from 52 rural communities in 12 of the 18 municipalities in the state of Querétaro, Mexico. We detected anti-T. cruzi antibodies using the following tests: indirect haemagglutination assay (IHA), indirect immunofluorescence assay (IFA), ELISA and recombinant ELISA (rELISA). We also performed Western blot (WB) analysis using iron superoxide dismutase (FeSOD), a detoxifying enzyme excreted by the parasite, as the antigen. Positive test results were distributed as follows: ELISA 8%, rELISA 6.2%, IFA and IHA 5.4% in both cases and FeSOD 8%. A comparative study of the five tests was undertaken. Sensitivity levels, specificity, positive and negative predictive values, concordance percentage and kappa index were considered. Living with animals, trips to other communities, gender, age, type of housing and symptomatology at the time of the survey were statistically analysed using SPSS software v.11.5. Detection of the FeSOD enzyme that was secreted by the parasite and used as an antigenic fraction in WBs showed a 100% correlation with traditional ELISA tests.

OBJETIVO E MÉTODOS: Estimar a concentração de iodo urinário (CIU) mediana e correlacioná-la com os indicadores de nutrição geral e com o índice de desigualdade social (IDS) de 50 escolas estaduais de ensino fundamental de 10 municípios do estado de Querétaro, no México. RESULTADOS: Utilizou-se um total de 1.544 crianças e encontrou-se uma ingestão acima das necessidades de iodo (CIU mediana de 297 µg/L). O nível de iodo determinado foi deficiente, adequado, mais do que adequado e excessivo em 2, 4, 19 e 25 escolas, respectivamente. Setenta e sete por cento de amostras de sal de mesa mostraram uma quantidade de iodo adequada (20-40 ppm), enquanto 9,6% das amostras tinham um teor de iodo baixo (< 15 ppm). As medianas de CIU por escola foram correlacionadas positivamente com as medianas do índice de massa corporal (IMC) usando o desvio-padrão da contagem (DP) (r = 0,47; p < 0.005), o DP da altura (r = 0,41; p < 0.05) e a prevalência de sobrepeso e de obesidade (r = 0,41; p < 0,05). As medianas de CUI por escola foram correlacionadas negativamente com a prevalência de desnutrição (r = -0.39; p = 005) e com o índice de desigualdade social (r = -0.36; p < 0,05). Os melhores modelos de regressão múltipla mostraram que a DP do IMC e a altura foram relacionados significativamente com a CIU (p < 0,05). CONCLUSÃO: Existe uma convivência entre os dois extremos de ingestão de iodo (insuficiente e excessiva). Em nosso conhecimento, a correlação positiva entre a CIU, o excesso de peso e a obesidade não foi descrita anteriormente e poderia ser explicada pela disponibilidade e consumo de alimentos ou refeições ricos(as) em energia e sal iodado.

OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

Importancia del yodo en la gestación. El yodo es un nutrimento constituyente indispensable de las hormonas tiroideas (HT). Las HT participan activamente en periodos críticos del desarrollo cerebral durante las etapas embrionaria, fetal y posnatal. Por lo tanto la ausencia o deficiencia de las HT o de yodo en estas etapas del desarrollo produce un daño cerebral irreversible. De hecho, se sabe que la deficiencia de yodo es la principal causa de daño cerebral prevenible en el mundo. Debido a los ajustes fisiológicos propios de la gestación los requerimientos de yodo se incrementan notablemente, pasando de 150 μg al día en la mujer adulta no gestante a 250 μg al día durante el embarazo. Por otra parte, estudios epidemiológicos recientes hechos en todo el mundo muestran que el consumo de yodo durante la gestación es insuficiente en varios países; incluso en países desarrollados como Australia y España e Italia. En la presente revisión se da un panorama general de la importancia del consumo adecuado de yodo durante la gestación.

Iodine is an essential constituent of thyroid hormones (TH). TH actively take part in critical periods of brain development during embryonic, fetal and postnatal stages. Therefore the absence of TH or iodine in these critical periods produces an irreversible brain damage. In fact, it is known that iodine deficiency is the leading cause of preventable brain damage worldwide. Because of the physiological adjustments during pregnancy iodine requirements increase significantly from 150 μg per day in non-pregnant adult women to 250 μg per day. Moreover, recent epidemiological studies around the world show that iodine intake during pregnancy is insufficient in many countries, even in developed countries like Australia, Spain and Italy. In the present work an overview of the importance of iodine nutrition during pregnancy is given.

Diabetes mellitus type 1 is a multifactorial metabolic disease in which immunological mechanisms play an essential role. Once the disease is fully established, affected individuals are dependent upon exogenous insulin administration. Current research has identified a pancreatic population resembling stem cells features. This population of nestin-positive cells is activated under specific circumstances and opens the possibility of developing procedures for obtaining new β cells for the regeneration of the pancreatic islets. In this work we review the embryonic development of pancreas, pancreatic stem cells, the current models for the induction of stem cells in adult pancreas, the role of free radicals on the induction of new stem cells, and the current therapeutic procedures to improve the expression of these cells.

La diabetes mellitus tipo 1 es una enfermedad metabólica multifactorial en la que los mecanismos inmunológicos juegan un papel fundamental. Una vez desarrollada la enfermedad, los pacientes son dependientes de la administración exógena de insulina. Actualmente, el campo de la investigación experimental ha identificado una población pancreática con características de células madre. Esta población de células positivas a nestina, se expresa bajo ciertas condiciones especiales y abre la posibilidad de desarrollar técnicas para la obtención de nuevas células β que pudieran regenerar el tejido dañado. Este trabajo es una revisión acerca del desarrollo embrionario del páncreas, las células madre pancreáticas embrionarias, los modelos actuales de lesión para la inducción de la expresión de células madre en páncreas adultos, el papel de los radicales libres sobre la expresión de nuevas células madre y las terapias experimentales actuales para mejorar la expresión de estas células.

Background: Placental choriangioma is the most frequent non trophoblastic tumor of the placenta. Its real incidence is unknown, and is frequently unnoticed. However, giant tumors cause important maternal-fetal complications. Objectives: To report two cases of giant placental chorioangioma, the diagnostic method and the evolution of pregnancy. Results: In both cases the outcome was fatal for the fetus: an immature newborn weighing 670 grams and a still born weighing 1300 grams, obtained through emergency C-section due to vaginal bleeding. The histopathological report confirmed the suspected diagnosis. Conclusion:Jhe prognosis of a pregnancy with giant placental choriangioma depends mainly on the size of the fetus and how opportunely the diagnosis is made. The ultrasonography is recommended for its opportune detection

Antecedentes: El corioangioma placentario es el tumor no trofoblástico más frecuente de la placenta, su incidencia real es desconocida, frecuentemente pasan desapercibidos, los tumores grandes causan complicaciones materno fetales importantes. Objetivos: Reportar dos casos de corioangioma gigante de placenta, el método diagnóstico y la evolución del embarazo. Resultados: En ambos casos el resultado fue fatal para el feto, con un producto inmaduro de 670 gramos y un óbito de 1300 gramos, obtenidos por operación cesárea urgente por sangrado transvaginal. El reporte histopatológico corroboró el diagnóstico de sospecha. Conclusión: El pronóstico de un embarazo con corioangioma gigante de placenta, depende fundamentalmente del tamaño y de la oportunidad con que se hace el diagnóstico. Se resalta la utilidad del examen ultrasonogrático para su detección oportuna