ABSTRACT The present study aimed to evaluate the ecology considering distribution, abundance, population structure, and fecundity of the marine diplostraceans Penilia avirostris and Pseudevadne tergestina in the Veracruz Reef System National Park, southwest Gulf of Mexico. Surface samples were collected with a 300 μm mesh plankton net at 26 sampling sites in June, August, October (2011), May (2012) and June (2013). Temperature, salinity, and dissolved oxygen were measured in situ. The temperature range was 26.53 ± 0.41 and 29.29 ± 0.27°C, salinity between 33.43 ± 0.49 and 35.91 ± 0.09, and dissolved oxygen between 2.92 ± 0.08 and 6.56 ± 0.08 mg L-1. P. avirostris and P. tergestina presented the highest density, with 2200 ind 100 m-3 in June and 5980 ind 100 m-3 in October, respectively. Four stages were determined in P. avirostris. In P. tergestina, there were five instars, with males in August and October. The size of parthenogenic females of P. avirostris was 773.4 ± 20.08 μm. In P. tergestina, it was 637.6 ± 49.28 μm. The number of embryos in P. avirostris was 2 to 7, and in P. tergestina, 2 to 8 embryos. The correlations between body length and the number of embryos in both species were statistically significant under the potential model (r > 0.68 for both species, P < 0.001). The transects with the highest abundance were the northern and the southern zones because they are far from the influence of the Jamapa River. The density of these crustaceans is related to optimal temperature, salinity, and dissolved oxygen values. The low proportions obtained from gamogenic individuals of P. avirostris and P. tergestina suggest that in tropical and subtropical regions, gamogenesis is not crucial for the life cycle of these organisms.

Resumen: México ocupa el primer lugar en obesidad infantil en el mundo, por lo que resulta importante identificar variables asociadas al consumo alimentario. El objetivo del presente trabajo fue establecer si la forma en que el consumo de alimentos se modifica en función de las normas sociales alimentarias y la publicidad alimentaria que recibe la población infantil escolar. Se diseñó un estudio multivariado predictivo utilizando sistemas de lógica difusa tipo dos de intervalo (IT2 FLS), y comparando su ajuste con modelos convencionales, como la regresión lineal múltiple (RLM). Se trabajó con las respuestas emitidas por 196 niños en un estudio previo y almacenadas en una base de datos, seleccionando solo las que correspondieron a las variables de interés para el estudio. Las normas sociales a evitar, el número de comidas y la compra de alimentos por la publicidad alimentaria permitieron predecir el consumo alimentario de los niños mediante IT2 FLS. En RLM las horas de comidas tuvo mayor capacidad predictiva que el número de comidas. El IT2 FLS proporcionó un mayor coeficiente de determinación (R2 = 0.649), que el de la RLM (R2 = 0.370). El consumo alimentario, al ser un fenómeno multicausal y complejo, puede ser mejor predicho al utilizar métodos de análisis que manejen de forma más flexible la incertidumbre, como lo hace la IT2 FLS.

Abstract: Mexico ranks first in childhood obesity in the world, so it is important to identify variables associated with food consumption. The objective of this work was to establish whether the way in which food consumption is modified depending on social food norms and food advertising received by school children. A predictive multivariate study was designed using interval type two fuzzy logic systems (IT2 FLS), and comparing its fit with conventional models, such as multiple linear regression (RLM). We worked with the responses issued by 196 children in a previous study and stored in a database, selecting only those that corresponded to the variables of interest for the study. The social norms to avoid, the number of meals and the purchase of food through food advertising made it possible to predict children’s food consumption through IT2 FLS. In RLM, mealtimes had a greater predictive capacity than the number of meals. The IT2 FLS provided a higher coefficient of determination (R2 = 0.649) than that of the RLM (R2 = 0.370). Food consumption, being a multicausal and complex phenomenon, can be better predicted by using analysis methods that manage uncertainty more flexibly, as the IT2 FLS does.

Abstract Introduction: Pediatric extreme hydrocephalus (PEH) is a complex condition with uncertain prognostic outcomes. Objectives: In this study, we analyze the long-term change in cerebral parenchymal thickness of pediatric patients with extreme hydrocephalus after shunting. Methods: A retrospective observational study was conducted on patients with PEH treated at the General Hospital of Mexico from 2009 to 2016. Cerebral parenchymal thickness was measured in computed tomography studies before surgical intervention, at 5 months, and 4 years post-surgery. The average change in thickness in millimeters was analyzed, and its normalized value was assessed using the Wilcoxon test and the R2 of a linear function. Results: Twelve patients, including 5 females and 7 males, were studied. Nine cases were congenital, while the remaining 3 cases were 6 months, 7, and 10-years-old. At 5.2 months PostOp., patients showed an average increase of 160% in cerebral parenchymal thickness, which increased to 270% at 4.3 years. However, 4 cases (33.3%) had an increase of < 10% from the original thickness. One patient at 4.3 years exhibited a 594% increase compared to the baseline. In the congenital cases, pre-operative thickness had a good correlation (R2 = 0.70) with post-operative thickness, but pre-operative age of patients did not correlate with post-operative thickness (R2 = 0.03). Conclusions: In this study, 3 out of 12 cases of PEH showed a long-term increase of > 200% compared to preoperative thickness. Even in cases of extreme hydrocephalus, significant long-term improvement can occur. Rapid treatment of these cases is crucial to increase the likelihood of improvement.

Resumen Introducción: Actualmente la obesidad se ha convertido en un problema de salud pública emergente y complejo, cuyo mecanismo es etiopatogénico y multifactorial. Ha sido estudiada desde el enfoque biomolecular, genético y mediante intervenciones para mejorar los estilos de vida; sin embargo, no se han incluido estudios que relacionen la autoeficacia y resiliencia en este problema. Objetivo: Evaluar la relación de autoeficacia para el control de peso con la resiliencia, en mujeres mexicanas. Metodología: Estudio correlacional transversal, en 174 mujeres, con o sin obesidad, inscritas en un centro de capacitación para el trabajo en Puebla y San Luis Potosí, México, se empleó muestreo no probabilistico. Se aplicó el instrumento validado en población mexicana: Inventario de Autoeficacia para el control de peso y Escala de Resiliencia Mexicana; con alfa de Cronbach .945 y .950 respectivamente; estudio realizado con apego a la Ley General de Salud en materia de investigación. El análisis de los resultados fue con estadística descriptiva, pruebas de normalidad y correlación r de Spearman. Resultados: El promedio de edad fue 34.6 ± 14.7, media de IMC 26.4 ± 4.5, un 49.7 % y un 81.7 % obtuvo niveles de autoeficacia y resiliencia altos respectivamente. La relación fue positiva, tamaño de efecto medio y estadísticamente significativo p=.001, con una varianza explicada del 22.6%. Conclusiones: Las mujeres mexicanas mostraron que a mayor resiliencia mayor autoeficacia para el control de peso. Se sugiere integrar la resiliencia en el manejo de la obesidad, que permita el desarrollo de mecanismos para la adquisición de estilos de vida saludables más sustentables.

Abstract Introduction: Currently, obesity has become an emerging and complex public health problem whose mechanism is etiopathogenetic and multifactorial. Obesity has been studied from the biomolecular and genetic approach as well as through interventions to improve lifestyles. However, studies linking the concepts of self-efficacy and resilience have not been included in this issue. Objective: Evaluate the relationship between self-efficacy for weight control and resilience in Mexican women. Methodology: Correlational-cross-sectional study in 174 women, with or without obesity, enrolled in a job-training center of Puebla and San Luis Potosi, Mexico; non-probabilistic sampling was used. These two instruments Self-Efficacy Inventory for Weight Control and Mexican Resilience Scale, validated in the Mexican population were applied: with Cronbach's alpha .945 and .950, respectively. This study carried out in accordance with the General Health Act for Research. The results were analyzed using descriptive statistics, normality tests, and Spearman's r correlation. Results: The mean age was 34.6±14.7, mean BMI 26.4±4.5, 49.7% and 81.7% were high levels of self-efficacy and resilience, respectively. The relationship was positive, medium effect size and statistically significant p=.001, with an explained variance of 22.6%. Conclusions: The Mexican women shown that the greater the resilience, the greater the self-efficacy for weight control. We suggest integrating resilience in managing obesity, which allows the development of mechanisms for the acquisition of more sustainable healthy lifestyles.

Abstrato Introdução: Atualmente, a obesidade tornou-se um problema de saúde pública emergente e complexo, cujo mecanismo é etiopatogênico e multifatorial. Tem sido estudado a partir da abordagem biomolecular e genética e através de intervenções para melhorar os estilos de vida, no entanto, não foram incluídos estudos que relacionem autoeficácia e resiliência neste problema. Objetivo: Avaliar a relação entre autoeficácia para controle de peso e resiliência em mulheres mexicanas. Método: Estudo correlacional e transversal, em 174 mulheres, com ou sem obesidade, matriculadas em um centro de treinamento para o trabalho em Puebla e San Luis Potosí, México, amostra de conveniência. Foram aplicados os instrumentos validados na população mexicana: Inventário de Autoeficácia para o controle de peso e Escala de Resiliência Mexicana, com alfa de Cronbach 0,945 e 9,50 respectivamente, o estudo foi realizado de acordo com a lei geral de saúde sobre pesquisa. A análise dos resultados foi realizada com estatística descritiva, testes de normalidade e correlação r de Spearman. Resultados: A média de idade foi de 34,6±14,7, a média de IMC 26,4±4,5, 49.7% e 81.7% obtiveram níveis altos de autoeficácia e resiliência respectivamente. A relação foi positiva, de tamanho médio do efeito e estatisticamente significativo (p=.001), com uma variância explicada de 22,6%. Conclusão: Mulheres mexicanas mostraram que, quanto maior a resiliência, maior a autoeficácia para o controle do peso. Sugere-se integrar a resiliência na gestão da obesidade, o que permite o desenvolvimento de mecanismos para a aquisição de estilos de vida saudáveis mais sustentáveis.

Resumo Objetivo: Avaliar as alterações do eixo hipotálamo-hipófise-gonadal (HHG) em 1 e 12 meses após transplante renal (TR) e sua associação com a resistência à insulina. Métodos: Foi realizado um estudo clínico retrospectivo em um centro de cuidados terciários em receptores de transplante renal (RTR) com idade entre 18-50 anos com doença renal primária e função do enxerto renal estável. LH, FSH, E2/T e HOMA-IR foram avaliados em 1 e 12 meses após o TR. Resultados: foram incluídos 25 RTR; 53% eram homens e a média de idade foi de 30,6±7,7 anos. O IMC foi de 22,3 (20,4-24,6) kg/m2 e 36% apresentaram hipogonadismo em 1 mês vs 8% aos 12 meses (p=0,001). A remissão do hipogonadismo foi observada em todos os homens, enquanto nas mulheres, o hipogonadismo hipogonadotrófico persistiu em dois RTR aos 12 meses. Ficou evidente uma correlação positiva entre gonadotrofinas e idade em 1 e 12 meses. Cinquenta e seis por cento dos pacientes apresentaram resistência à insulina (RI) em 1 mês e 36% aos 12 meses (p=0,256). O HOMA-IR mostrou uma correlação negativa com E2 (r=-0,60; p=0,050) e T (r=-0,709; p=0,049) em 1 mês, sem correlação em 12 meses. O HOMA-IR aos 12 meses após TR correlacionou-se positivamente com o IMC (r=0,52; p=0,011) e a dose de tacrolimus (r=0,53; p=0,016). Conclusão: O TR bem-sucedido restaura o eixo HHG no primeiro ano. O hipogonadismo apresentou uma correlação negativa com a RI no período inicial após o TR, mas essa correlação não foi significativa aos 12 meses. Objetivo hipotálamohipófisegonadal hipotálamo hipófise gonadal (HHG (TR Métodos (RTR 1850 18 50 18-5 estável LH FSH E2T ET E HOMAIR HOMA IR Resultados 2 53 30677 30 6 7 30,6±7, 223 22 3 22, 20,424,6 204246 20,4 24,6 20 4 24 (20,4-24,6 kgm2 kgm kg m2 m kg/m 36 8 p=0,001. p0001 p p=0,001 . 0 001 (p=0,001) mulheres (RI p=0,256. p0256 p=0,256 256 (p=0,256) r=0,60 r060 r r= 0,60 60 (r=-0,60 p=0,050 p0050 050 r=0,709 r0709 0,709 709 (r=-0,709 p=0,049 p0049 049 correlacionouse correlacionou se r=0,52 r052 52 (r=0,52 p=0,011 p0011 011 r=0,53 r053 (r=0,53 p=0,016. p0016 p=0,016 016 p=0,016) Conclusão bemsucedido bem sucedido ano 185 5 18- 3067 30,6±7 424 20,424, 20424 204 20, 246 24, (20,4-24, p000 p=0,00 00 (p=0,001 p025 p=0,25 (p=0,256 r=0,6 r06 060 0,6 (r=-0,6 p=0,05 p005 05 r=0,70 r070 0709 0,70 70 (r=-0,70 p=0,04 p004 04 r=0,5 r05 (r=0,5 p=0,01 p001 01 306 30,6± 42 20,424 2042 (20,4-24 p00 p=0,0 (p=0,00 p02 p=0,2 (p=0,25 r=0, r0 06 0, (r=-0, r=0,7 r07 070 0,7 (r=-0,7 (r=0, 30,6 20,42 (20,4-2 p0 p=0, (p=0,0 (p=0,2 r=0 (r=-0 07 (r=0 30, (20,4- p=0 (p=0, (r=- (r= (20,4 p= (p=0 (r (20, (p= (20 (p (2 (

Abstract Objective: To evaluate hypothalamic-pi- tuitary-gonadal (HPG) axis alterations at 1 and 12 months after kidney transplan- tation (KT) and their association with in- sulin resistance. Methods: A retrospective clinical study was conducted in a tertiary care center in kidney transplantation recipients (KTRs) aged 18- 50 years with primary kidney disease and stable renal graft function. LH, FSH, E2/T, and HOMA-IR were assessed at 1 and 12 months after KT. Results: Twenty-five KTRs were included; 53% were men, and the mean age was 30.6±7.7 years. BMI was 22.3 (20.4-24.6) kg/m2, and 36% had hypogonadism at 1 month vs 8% at 12 months (p=0.001). Re- mission of hypogonadism was observed in all men, while in women, hypogonadotropic hypogonadism persisted in two KTRs at 12 months. A positive correlation between go- nadotrophins and age at 1 and 12 months was evident. Fifty-six percent of patients had insulin resistance (IR) at 1 month and 36% at 12 months (p=0.256). HOMA-IR showed a negative correlation with E2 (r=- 0.60; p=0.050) and T (r=-0.709; p=0.049) at 1 month, with no correlation at 12 months. HOMA-IR at 12 months after KT correlated positively with BMI (r=0.52; p=0.011) and tacrolimus dose (r=0.53; p=0.016). Conclusion: Successful KT restores the HPG axis in the first year. Hypogonadism had a negative correlation with IR in the early pe- riod after KT, but it was not significant at 12 months. Objective hypothalamicpi hypothalamic pi hypothalamic-pi tuitarygonadal tuitary gonadal (HPG transplan (KT Methods (KTRs 18 5 function LH FSH E2T ET E E2/T HOMAIR HOMA Results Twentyfive Twenty five included 53 men 30677 30 6 7 30.6±7. 223 22 3 22. 20.424.6 204246 20.4 24.6 20 4 24 (20.4-24.6 kgm2 kgm kg m2 m kg/m2 36 8 p=0.001. p0001 p p=0.001 . 0 001 (p=0.001) Re women go evident Fiftysix Fifty six (IR p=0.256. p0256 p=0.256 256 (p=0.256) r= r (r= 0.60 060 60 p=0.050 p0050 050 r=0.709 r0709 0.709 709 (r=-0.709 p=0.049 p0049 049 r=0.52 r052 52 (r=0.52 p=0.011 p0011 011 r=0.53 r053 (r=0.53 p=0.016. p0016 p=0.016 016 p=0.016) Conclusion year pe 3067 30.6±7 2 424 20.424. 20424 204 20. 246 24. (20.4-24. kg/m p000 p=0.00 00 (p=0.001 p025 p=0.25 25 (p=0.256 (r 0.6 06 p=0.05 p005 05 r=0.70 r070 0709 0.70 70 (r=-0.70 p=0.04 p004 04 r=0.5 r05 (r=0.5 p=0.01 p001 01 306 30.6± 42 20.424 2042 (20.4-24 p00 p=0.0 (p=0.00 p02 p=0.2 (p=0.25 0. r=0.7 r07 070 0.7 (r=-0.7 r=0. r0 (r=0. 30.6 20.42 (20.4-2 p0 p=0. (p=0.0 (p=0.2 07 (r=-0. r=0 (r=0 30. (20.4- p=0 (p=0. (r=-0 (20.4 p= (p=0 (20. (p= (20 (p (2 (

Abstract Objective: In this paper we study, from the seller’s perspective, how to auction a finite set of identical items when the buyer who obtains the whole set of goods (if any) gets a bonus, such that the seller maximizes his expected revenue and taking into account the strategic behavior of the bidders. Methodology: We use Bayesian Games for modelling the situation considering a strategy space equal to R + m for each bidder. Results: We show a Symmetric Bayesian Equilibrium for the model as well as the seller’s indifference between several natural ways for offering the bonus to a bidder getting the whole set of items, because he obtains the same expected revenue. Limitations: The model regards only identical items. Originality: We show an equilibrium bid for a n-personal model of m Simultaneous Auctions under first-price close mechanism considering that there is a kind of extra profit. Conclusions: The seller is indifferent between several ways to offer the bonus. It could be interesting to contrast the theoretical results under an experimental framework.

Resumen Objetivo: Estudiar, desde el punto de vista del vendedor, la manera de subastar un conjunto finito de bienes idénticos donde se otorga un cierto premio al postor que obtenga el conjunto completo de bienes, tomando en cuenta el comportamiento estratégico de los postores. Metodología: Se modela la situación como un juego bayesiano considerando el espacio de estrategias de cada jugador como R + m. Resultados: Se muestra un equilibrio bayesiano simétrico y se demuestra que el vendedor es indiferente entre algunas maneras de ofrecer la utilidad extra, al obtener el mismo rendimiento esperado. Limitaciones: El modelo soló considera el caso de bienes idénticos. Originalidad: Se encuentra la puja de equilibrio para un caso de m subastas simultáneas y n postores, bajo el mecanismo del primer precio considerando utilidad extra modeladas mediante juegos bayesianos. Conclusiones: Los cambios en el rendimiento esperado del vendedor no son sensibles ante algunas maneras de otorgar el incentivo.

Abstract A study on the epidemiological Susceptible-Infected-Recovered (SIR) model is presented using free particle dynamics. The study is performed using a computational model consisting of randomly allocated particles in a closed domain which are free to move in random directions with the ability to collide with each other. The transmission rules for the particle-particle interactions are based on the main viral infection mechanisms, resulting in real-time results of the number of susceptible, infected, and recovered particles within a population of N = 200 particles. The results are qualitatively compared with a differential equation SIR model in terms of the transmission rate β, recovery rate γ, and the basic reproductive number R 0, yielding overall good results. The effect of the particle density ρ p on R 0 is also studied to analyze how an infectious disease spreads over different types of populations. The versatility of the proposed free-particle-dynamics SIR model allows to simulate different scenarios, such as social distancing, commonly referred to as quarantine, no social distancing measures, and a mixture of the former and the latter. It is found that by implementing early relaxation of social distancing measures before the number of infected particles reaches zero, could lead to subsequent outbreaks such as the particular events observed in different countries due to the ongoing COVID-19 health crisis.

Abstract: Introduction: Currently the surgical treatment of fractures of extraarticular distal tibia is controversial for the multiple techniques and materials of osteosynthesis, the Minimally Invasive Percutaneous Techniques (MIPO) allow us to preserve the periosteal circulation, crucial point in the natural processes of convalescence of the patient, so this technique takes relevance in our study. Objective: To observe that this approach to fractures of the distal tibia has fewer complications and better functional result than fixation with open technique. Material and methods: A longitudinal, ambispective and analytical study was conducted in the period from July 2018 to September 2019 in patients with closed fracture of the extraarticular distal tibia in patients over 18 years of age without previously diagnosed musculoskeletal comorbidities, the calculation was performed with the WinPEPI program (Programs for Epidemiologists for Windows) version 11.43 based on the study by Paul Toogooda et al (2018) with a confidence interval of 95% a minimum total of 20 patients for each group. Measures of central tendency, correlations between technique and variable were used. Results: Two groups of 20 patients were analyzed comparing MIPO vs conventional technique in a period of 6 months postsurgical evaluating risk of infection, wound dehiscence, radiographic bone consolidation, joint functionality and demographic data; showing positive statistical superiority for MIPO technique. Conclusion: Relevant data were obtained in favor of MIPO with bone consolidation and higher functional score at six months.

Resumen: Introducción: Actualmente el tratamiento quirúrgico de fracturas de tibia distal extraarticular es controversial por las múltiples técnicas y materiales de osteosíntesis, las técnicas Mínimo Invasivo Percutánea (MIPO) nos permiten preservar la circulación perióstica, punto crucial en los procesos naturales de convalecencia del paciente, por ello esta técnica es de gran relevancia en nuestro estudio. Objetivo: Observar que este abordaje de fracturas de tibia distal tiene menos complicaciones y mejor resultado funcional que la fijación con técnica abierta. Material y métodos: Se realizó un estudio de tipo longitudinal, ambispectivo y analítico en el período de Julio de 2018 a Septiembre de 2019 en pacientes adultos con fractura cerrada de tibia distal extraarticular sin comorbilidades, el cálculo se realizó con el programa WinPEPI (Programs for Epidemiologists for Windows) versión 11.43 basado en el estudio de Paul Toogooda, con un intervalo de confianza de 95% se obtuvo un total mínimo de 20 pacientes por cada grupo. Se usaron medidas de tendencia central, correlaciones entre técnica y variable. Resultados: Se analizaron dos grupos de 20 pacientes comparando la técnica MIPO vs. la convencional en un período de seis meses postquirúrgico evaluando riesgo de infección, dehiscencia de herida, consolidación ósea radiográfica, funcionalidad articular y datos demográficos, mostrando superioridad estadística positiva para la técnica MIPO. Conclusiones: Se obtuvieron datos relevantes a favor de MIPO con consolidación ósea y mayor puntaje funcional articular a los seis meses.

Abstract: Introduction: Currently, to manage rotator cuff injury (RCI), there is a tendency to replace mini-open (MO) surgery with arthroscopy, but results and costs are controversial. Objective: To analyze the cost-result of surgical techniques for RCI. Material and methods: A partial economic evaluation of cost-result type was performed on 113 patients with RCI surgically operated by mini-open technique (n = 6), or arthroscopy (n = 91), or both (n = 16). Direct costs included: hospital stay, days of work disability, surgery, implants (anchors), medical assessments, laboratory and imaging. One-year shoulder functionality was evaluated with Constant-Murley scale (EscC-M). Results: The MO technique was the most economical (X = $42,950.60 MXN) and the most expensive was the arthroscopy + MO with anchors (X = $89,594.80 MXN); with a non-significant difference in shoulder functionality (EscC-M = 56.33 ± 7.0 vs. 64.25 ± 9.0 points, respectively) (p > 0.05; Kruskal-Wallis; post hoc Mann-Whitney). Difference of $46,644.1 MXN between techniques corresponded to 7.92 points. There was a mild relationship between the technique and the functionality of shoulder (rs = 0.26; p = 0.005; Spearman). Conclusion: The mini-open technique showed best cost-result, with similar functionality in shoulder to that obtained with the more expensive technique.

Resumen: Introducción: Actualmente, para manejar la ruptura del manguito de los rotadores (LMR), se prefiere la artroscopía sobre técnicas abiertas (mini-open [MO]), con resultados y costos controversiales. Objetivo: Analizar el costo-resultado de las técnicas quirúrgicas para la LMR. Material y métodos: Se realizó una evaluación económica parcial de tipo costo-resultado a 113 pacientes con LMR intervenidos mediante técnica mini-open (n = 6) o artroscopía (n = 91) o ambas (n = 16). Los costos directos incluyeron: estancia, días de incapacidad laboral, cirugía, implantes (anclas), valoraciones médicas, laboratorio e imagen. Se evaluó la funcionalidad del hombro a un año mediante la escala de Constant-Murley (EscC-M). Resultados: La técnica MO fue la más económica (X = $42,950.60 MXN) y la más costosa fue la artroscopía + MO con anclas (X = $89,594.80 MXN); con una diferencia no significativa en la funcionalidad del hombro (EscC-M = 56.33 ± 7 vs 64.25 ± 9 puntos, respectivamente) (p > 0.05; Kruskal-Wallis; post hoc Mann-Whitney). Una diferencia de $46,644.10 MXN entre técnicas correspondió a 7.92 puntos. Hubo relación leve entre la técnica y la funcionalidad del hombro (rs = 0.26; p = 0.005; Spearman). Conclusión: La técnica mini-open mostró mejor costo-resultado, con una ganancia en la funcionalidad de hombro similar a la que se obtiene con la técnica más costosa.

Abstract: OBJECTIVE: To demonstrate if neutrophil/lymphocyte index predicts mortality in patients with influenza-like pneumonia. MATERIAL AND METHOD: A case-control, observational, analytical, cross-sectional, retrospective and retrolective study with patients with influenza like pneumonia who developed severe acute pneumonia from 2009 to 2017. APACHE II, SMART COP and neutrophil lymphocyte index (INL) were calculated. Survival was determined by Kaplan and Meier, for the association between INL and mortality, APACHE II, SMART COP and comorbidities was used χ2 and odds ratio (OR), as well as correlation between APACHE II, SMART COP and INL. RESULTS: There were included 69 patients. OR between the INL and mortality was of 0.174 (p = 0.533, IC95% 0.274-2.08). There was significant association between INL and components of the metabolic syndrome in living patients. There was no difference in survival between INL greater or less than 7. Positive correlation between APACHE II and INL of 0.4295 (p = 0.0002, IC95% 0.00 to 0.063). CONCLUSIONS: There is an association between INL and metabolic syndrome in liv- ing patients, as well as a positive correlation with APACHE II. There is no association between INL and mortality. The cutoff point of the INL shifted 4 points compared to other populations.

Resumen: OBJETIVO: Demostrar si el índice neutrófilo/linfocito predice la mortalidad en pacientes con neumonía tipo influenza. MATERIAL Y MÉTODO: Estudio de casos y controles, observacional, analítico, transversal, retrospectivo y retrolectivo que incluyó pacientes con neumonía por influenza que padecieron neumonía aguda grave de 2009 a 2017. Se calculó APACHE II, SMART COP y el índice neutrófilo/linfocito (INL). Se determinó supervivencia mediante Kaplan y Meier, para la asociación entre INL y mortalidad, APACHE II, SMART COP y comorbilidades se usó χ2 y razón de momios (RM), así como correlación entre APACHE II, SMART COP e INL. RESULTADOS: Se incluyeron 69 pacientes. La RM entre el INL y la mortalidad fue de 0.174 (p = 0.533; IC95% 0.274 a 2.08). Hubo asociación significativa entre el INL y componentes del síndrome metabólico en pacientes vivos. No hubo diferencia en la supervivencia entre INL mayor o menor de 7. Correlación positiva entre APACHE II e INL de 0.4295 (p = 0.0002; IC95% 0.00 a 0.063). CONCLUSIONES: Existe asociación entre el INL y el síndrome metabólico en pacientes vivos, así como correlación positiva con APACHE II. No hay asociación entre el INL y mortalidad. El punto de corte del INL se desplazó cuatro puntos comparado con otras poblaciones.

ABSTRACT Introduction: Trigeminal neuralgia is characterized by paroxysmal attacks of intense pain, lancinating as electric shocks, accompanied by burning sensation and periodic appearance in the distribution of one or more trigeminal branches. The anatomical relationship between the Gasser ganglion and the cavernous sinus could produce an increase in the intraocular tension after the application of the radiofrequency of the trigeminal ganglion when modifying the venous drainage of the eye, a situation that until now has not been studied. The objective was to determine if the application of conventional radiofrequency in the Gasser ganglion produces changes in the intraocular tension in patients with primary trigeminal neuralgia of second and / or third branch. Material and methods: Longitudinal study that included patients diagnosed with trigeminal neuralgia of second and / or third branch; In the operating room and under general anesthesia, radiofrequency procedure was performed in Gasser ganglion, with generator Neurotherm R 500, needles of 100 mm in length and 22 G, with active tip of 5 mm, sensory stimulation at 50 Hertz with 0.3 - 0.5 V applying 80º C for 60 seconds in 2 or 3 phases. Intraocular pressure was measured 24 hours before the procedure, 24 hours after the procedure and seven days after the procedure. The analysis of the intraocular pressure, as well as the EVA scale of pain was determined by an ANOVA analysis of repeated measures. Results: Thirty patients were included of which 26 were women, the average age was 59.6 ± (SD 11.16). Intraocular tension 24 h before, one day after and one week after performing radiofrequency of the Gasser ganglion, did not show significant changes with ANOVA for repeated samples (p 0.916). Conclusions: Intraocular tension was not modified in the short term after radiofrequency of the Gasser ganglion.

RESUMEN Introducción: La neuralgia del trigémino es un cuadro caracterizado por ataques paroxísticos de dolor intenso, lancinante como descargas eléctricas, acompañado de sensación urente y de aparición periódica en la distribución de una o más ramas trigeminales. La relación anatómica entre el ganglio de Gasser y el seno cavernoso pudiera producir un incremento en la tensión intraocular después de la aplicación de la radiofrecuencia del ganglio trigeminal al modificar el drenaje venoso del ojo, situación que hasta el momento no se ha estudiado. El objetivo fue determinar si la aplicación de radiofrecuencia convencional en el ganglio de Gasser produce modificaciones en la tensión intraocular en pacientes con neuralgia trigeminal primaria de segunda y/o tercera rama. Material y métodos: Estudio longitudinal que incluyó a pacientes con diagnóstico de neuralgia del trigémino de segunda y/o tercera rama; en quirófano y bajo anestesia general, se les realizó procedimiento de radiofrecuencia en Ganglio de Gasser, con generador Neurotherm R 500, agujas de 100 mm de longitud y 22 G, con punta activa de 5 mm, estimulación sensitiva a 50 Hertz con 0,3-0,5 V aplicando 80 °C por 60 segundos en dos o tres fases. La presión intraocular se midió 24 horas previas al procedimiento, 24 horas posteriores al procedimiento y siete días después del mismo. El análisis de la presión intraocular, así como la escala EVA de dolor, se determinó mediante un análisis de ANOVA de medidas repetidas. Resultados: Se incluyeron 30 pacientes de los cuales 26 fueron mujeres, la edad promedio fue de 59,6 ± (DE 11,16). La tensión intraocular 24 h antes, un día después y una semana después de la realización de la radiofrecuencia del ganglio de Gasser no mostró modificaciones significativas con ANOVA para muestras repetidas (p = 0,916). Conclusiones: La tensión intraocular no se modificó a corto plazo después de realizar radiofrecuencia del ganglio de Gasser.

Abstract Objective: To evaluate the influence of type 2 diabetes mellitus on the TNM staging classification in patients with renal cell carcinoma treated through nephrectomy. Materials and methods: A retrospective, cross-sectional, descriptive study was conducted. The case records were reviewed of patients with sporadic and unilateral renal cell carcinoma that underwent nephrectomy at the Urology Department of the Hospital Metropolitano Dr. Bernardo Sepúlveda. Demographic and clinical variables: age, sex, pathologic tumor size, and type of surgery (radical or partial). The comorbidities evaluated were high blood pressure, type 2 diabetes mellitus, and dyslipidemia. Staging and tumor size (2009 TNM classification), Fuhrman grade, and histologic type were analyzed. Each TNM classification result was analyzed independently through the χ2 test. Overall survival and recurrence-free survival were evaluated through the Kaplan-Meier test. Results: A total of 18.6% of the 43 study patients presented with type 2 diabetes mellitus. T1b tumors predominated in 32.6% of the cases. No statistically significant differences were found in the comparison of pathologic tumor stage (p = 0.5), lymph node disease (p = 0.7), or metastasis (p = 0.5) between patients with and without diabetes. Median follow-up was 45 months and no differences were found in the comparison of overall survival and recurrence-free survival in the patients with type 2 diabetes mellitus (p = 0.76) and those without the pathology (p = 0.78). Conclusions: Type 2 diabetes mellitus had no significant impact on the pathologic stage of renal cell carcinoma or on overall survival and recurrence-free survival in those patients.

Resumen Objetivo: Analizar la repercusión de la diabetes tipo 2 en la clasificación TNM (estadificación) de pacientes con cáncer renal y nefrectomía. Materiales y métodos: Estudio transversal, retrospectivo y descriptivo, efectuado mediante la revisión de los expedientes de pacientes con carcinoma de células renales esporádico y unilateral, nefrectomía, atendidos entre 2008 y 2014 en el Departamento de Urología del Hospital Metropolitano Dr. Bernardo Sepúlveda. Variables demográficas y clínicas: edad, sexo, tamaño tumoral patológico y tipo de cirugía (radical o parcial); comorbilidades (hipertensión arterial sistémica, diabetes mellitus tipo 2 y dislipidemia); estadificación y tamaño del tumor (clasificación TNM 2009), grado de diferenciación celular y tipo histológico. Las características clínicas y patológicas se analizaron de forma independiente con la prueba c2. Los índices de supervivencia global y libre de recurrencia se analizaron con la prueba de Kaplan-Meier. Resultados: Se estudiaron 43 pacientes, 18.6% de ellos con diabetes tipo 2. Predominaron los tumores T1b en 32.6% de los casos. No se encontraron diferencias estadísticamente significativas al comparar el estadio tumoral patológico (p = 0.5), enfermedad ganglionar (p = 0.7) y metástasis (p = 0.5) en pacientes con y sin diabetes. La mediana de seguimiento fue de 45 meses, diferencias al comparar la supervivencia global y libre de recurrencia en pacientes con y sin diabetes tipo 2 (p = 0.76 y 0.78, respectivamente). Conclusión: La diabetes tipo 2 no repercute de forma significativa en el estadio patológico de pacientes con cáncer renal, ni en la supervivencia global ni libre de recurrencia.

To quantify the effect on genetic diversity of restoring tree populations in an area under the influence of an urban heat island, we evaluated the genetic diversity of 72 Ceiba aesculifolia individuals, from a restoration experiment established from 2170 to 2260 m a.s.l. Reintroduced individuals were compared with the provenance from which the seeds were obtained, and two external provenances, for a total of 123 individuals. Samples were analyzed with three AFLP primer combinations. Polymorphisms of 38.4 to 62.5% were obtained. Genetic diversity estimated with the Simpson index ranged from 0.14 to 0.2. The provenances in the restoration site had higher diversity than the provenance that originated the seeds. Groups formed with provenances with similar genetic diversity (no statistical differences) also shared similar Bayesian mixture proportions. Having higher genetic diversity in restored provenances than in the provenance that originated the seeds can be favorable as the conditions in the site change in the future due to the expected increase in the urban heat island effect as the nearby city expands.

Para cuantificar el efecto en la diversidad genética de restaurar poblaciones arbóreas en un área bajo la influencia de una isla de calor urbano, evaluamos la diversidad genética de 72 individuos de Ceiba aesculifolia en un área de restauración establecida entre los 2170 a los 2260 m s.n.m. Los individuos reintroducidos se compararon con la procedencia de la que se obtuvieron las semillas y dos procedencias externas, alcanzando un total de 123 individuos. Las muestras se analizaron con tres combinaciones de oligonucleótidos para generar AFLP. Se obtuvieron valores de polimorfismo entre 38,4 y 62,5%. La diversidad genética, evaluada con el índice de Simpson, varió entre 0,14 y 0,20. Las procedencias del sitio restaurado tuvieron diversidad mayor que la procedencia de la que se obtuvieron las semillas. Los grupos obtenidos de procedencias con diversidad genética similar (no estadísticamente significativas), también compartieron proporciones similares de las mezclas Bayesianas. Contar con una mayor diversidad genética en las procedencias del sitio de restauración que en la procedencia que originó las semillas puede ser favorable en la medida que las condiciones del sitio cambian en el futuro, en consecuencia del incremento en los efectos de la isla de calor urbano conforme aumenta la ciudad cercana al sitio.

Heat stress (HS) induces the production of oxygen-derived free radicals associated with deleterious effects on the physiology, pathology and productivity of dairy cows. In order to evaluate physiological and productive responses of Holstein cows during summer and winter in an arid area, 40 lactating cows (100 to 150 d in milk) were randomly selected from a representative month per season of the year (n = 20/season). Data were analysed by ANOVA under a completely random experimental design, with season of the year as factor of interest (summer vs. winter), and a level of significance of 5%. During winter time, cows were under their thermoneutral zone, whereas in summer they were under severe HS conditions. The skin temperatures of right side, buttock, udder and head, as well as raw milk were about 10 °C higher in summer (P < 0.05). Respiration rates were twice higher 106.87 ± 0.05 vs. 47.74 ± 0.06 (P < 0.05) in summer when compared with winter, while the rectal temperature increased 1.6 °C in summer. Cholesterol and TAS concentrations, ghecose, TOS and IEO were lower (P < 0.05) in summer, while glucose TOS and IEO were higher (P < 0.05) in summer than in winter. Milk production was reduced by more than half (P < 0.05) in summer, and significant reductions of 42.6% in energy production in milk and 48.4% in the milk production adjusted to 3.5% fat were observed. The percentages of fat and protein in milk were higher (P < 0.05) in summer. In conclusion, the effect of heat stress is evident in summer and has detrimental effects on physiological responses and productivity of lactating Holstein cows. Environmental innovations are needed to reduce the negative impact of high temperatures in this arid region of México.

El estrés por calor (EC) induce la producción de radicales libres derivados del oxígeno que se asocian con efectos negativos en la fisiología, patología y productividad de vacas lecheras. Con el propósito de medir y comparar variables fisiológicas y productivas de vacas Holstein en verano e invierno en una zona árida, se seleccionaron aleatoriamente 40 vacas lactantes (100 a 150 d en leche) en un mes representativo de cada época del año (n = 20/ época). Los datos fueron analizados en un ANOVA bajo un diseño experimental completamente al azar, con época del año como factor de interés (verano vs. invierno), y un nivel de significación del 5%. Las temperaturas de la piel en costado derecho, nalga, ubre y cabeza, así como de la leche, fueron 10 °C más altas (P < 0,05) en verano. La tasa respiratoria fue dos veces mayor (106,87 ± 0,05 vs. 47,74 ± 0,06; P < 0,05) en verano, mientras que la temperatura rectal alcanzó 1,6 °C más (P < 0,05) en verano. Las concentraciones de colesterol y TAS fueron menores (P < 0,05) en verano, mientras que la glucosa, TOS and IEO fueron mayores (P < 0,05) en la misma época. La producción de leche se redujo en más del 50% (P < 0,05) en verano, observándose reducciones de 42,6% en la producción de energía en leche y de 48,4% en la producción de leche ajustada a 3,5% de grasa. Se concluye que el efecto del EC es evidente y tiene un efecto perjudicial en la fisiología y productividad de vacas Holstein en producción, lo que hace necesario utilizar innovaciones ambientales para reducir este impacto negativo de las altas temperaturas.

Introduction: Multiple cervical spine fractures are a relatively infrequent entity and thus the available information on them is scarce worldwide. The cases reported are usually managed conservatively, with a combination of skeletal traction and various braces, with variable results. There are only a few reports of multiple fractures treated surgically. Objective: This is a report of a clinical case of a multiple cervical fracture treated surgically in 2 stages at the Mexico City Center for Patients with Spine and Spinal Cord Injury (Centro de Atención a Lesionados Raquimedulares de la Ciudad de México), located at "La Villa" General Hospital, SSDF. Material and methods: We report the clinical case of a male, 46 year-old patient involved in a motor vehicle accident who sustained spine and spinal cord injuries consisting of ASIA C C2-C6 fractures. It was decided to perform two-stage surgery with posterior and anterior instrumentation. We report the 19-month clinical and radiological follow-up. Results: In the 19-month follow-up visit, the patient was found to be ASIA D according to the neurological assessment, with mild motor deficit of the left thoracic limb. The patient had returned to his usual job and had acceptable cervical spine mobility. Conclusions: The patient's appropriate course from the neurological perspective and his return to his daily activities leads to recommending the surgical management of multiple fractures, customizing it in each case according to the fractures' characteristics. Favorable results may be expected from this approach.

Introducción: Las fracturas múltiples en la columna cervical son una entidad relativamente infrecuente, acerca de la cual la información disponible a nivel mundial es escasa. Existe una tendencia en los casos reportados a manejar dicha entidad de manera conservadora, con combinación de tracciones esqueléticas y diversas órtesis, con resultados variables. Existen pocos reportes de fracturas múltiples manejadas quirúrgicamente. Objetivo: Reportar un caso clínico de fractura múltiple cervical manejado quirúrgicamente en dos tiempos y su seguimiento, en el Centro de Atención a Lesionados Raquimedulares de la Ciudad de México, en el Hospital General "La Villa" de los SSDF. Material y métodos: Se presenta el caso clínico de un paciente masculino de 46 años de edad quien sufre accidente automovilístico con trauma raquimedular con fracturas de C2 a C6, ASIA C. Se decide su tratamiento quirúrgico a dos tiempos con instrumentación posterior y anterior sucesivamente. Se reporta el seguimiento clínico y radiológico a casi dos años de evolución. Resultados: A 19 meses de seguimiento el paciente se encuentra neurológicamente en ASIA D, con un leve déficit motor en el miembro torácico izquierdo. Reincorporado a su trabajo habitual y con movilidad aceptable en la columna cervical. Conclusiones: La evolución satisfactoria presentada por el paciente, tanto en su recuperación neurológica como en la reincorporación a sus labores cotidianas permite recomendar el manejo quirúrgico de fracturas múltiples, individualizando cada caso e interviniendo de acuerdo con la personalidad de cada fractura, con lo cual se puede esperar la obtención de resultados favorables.