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INTRODUCTION AND AIM: Timely detection and diagnosis of hepatitis C virus (HCV) involves identifying the population that is predisposed to treatment and prevention, thus limiting complications and preventing infection. The aim of this study was to analyze and describe risk factors associated with anti-HCV antibody detection in a population with access to public healthcare that participated in a national screening program. MATERIAL AND METHODS: An analytic cross-sectional study was conducted that utilized data related to rapid tests carried out between September 2021 and October 2022 in 26 of the 32 states of Mexico. Anti-HCV reactive tests were selected, according to age and sex, for analyzing and comparing possible risk factors through descriptive and inferential statistics. The geographic distribution and density of the screening program at the state and municipal levels was analyzed. RESULTS: There were 75,185 anti-HCV antibody detections, 2,052 reactive tests, and mean participant age was 44.3 years (±15.1). Occupation: 32.3% were employees, 19% were housewives, and 18.2% were healthcare workers. Five out of every 10 cases had no indication of risk factors, but there was a 1.4 and 5-times greater likelihood of anti-HCV detection in men with a history of sharps injury or intravenous psychoactive substance use, compared with women. Regarding place of residence, 80% of the reactive tests were concentrated in the State of Mexico, Mexico City, and Guanajuato. CONCLUSIONS: The evidence herein helps determine the population and risk factors that should be focused on in carrying out the HCV microelimination strategy of continuous screening, diagnosis, medical treatment access, and epidemiologic surveillance.

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The LysR-type transcriptional regulators (LTTRs) are DNA-binding proteins present in bacteria, archaea, and in algae. Knowledge about their distribution, abundance, evolution, structural organization, transcriptional regulation, fundamental roles in free life, pathogenesis, and bacteria-plant interaction has been generated. This review focuses on these aspects and provides a current picture of LTTR biology.

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Objetivo: Describir resolución quirúrgica de teratoma de mediastino en dos tiempos que debuta en paciente con urgencia vital. Materiales y Métodos: Revisión de caso clínico y descripción retrospectiva del manejo quirúrgico realizado. Resultados: Estudio imagenológico evidenció tumor con contenido quístico que comprometía ambos hemitórax. Dado compromiso vital del paciente, se realiza quistocentesis descompresiva en pabellón, seguido de videotoracoscopía que demuestra origen mediastínico y quistectomía parcial por toracotomía. En un segundo tiempo quirúrgico, se reseca remanente vía esternotomía media. Discusión: Los teratomas mediastínicos son extremadamente infrecuentes, reportándose 44 casos en literatura mundial, sin registros a nivel nacional. Afecta a jóvenes sanos, la mayoría asintomáticos, siendo su hallazgo tardío e incidental. El compromiso de estructuras mediastínicas y de vía aérea pueden ocasionar riesgo vital. Conclusión: La descompresión perioperatoria del contenido quístico del teratoma fue fundamental para mantener fuera de riesgo vital al paciente durante el acto quirúrgico.

Objective: To describe the successful surgical resolution of a giant teratoma of the mediastinum that presents with a vital emergency. Clinical Case: Male patient, 30 years old, with no known history, consulted for a 1-year history of dyspnea on minimal exertion, associated with weight loss without dietary restriction. Imaging study showed tumor with cystic content that compromised both hemithorax. Given the patient's vital commitment, decompressive cystocentesis was performed, followed by video-assisted thoracoscopy that showed mediastinal origin and partial cystectomy by thoracotomy. In a second surgical time, resection of the remnant was performed via median sternotomy. Discussion: Mediastinal teratomas are extremely rare, reporting 44 cases in the world literature, with no national registry. They usually affect healthy young people, most of them asymptomatic and therefore, their discovery is late and incidental. In this case, due to the compression of noble structures, perioperative cystic decompression was essential. Conclusion: Perioperative decompression of the cystic content of the teratoma was essential to maintain stable hemodynamics and subsequent surgical resection.

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In the last 20 years, the prevalence of type 2 diabetes mellitus (T2DM) has tripled in adults aged 20-79 years, affecting more than 25% of people over 50 years of age and especially women during menopause. After the menopause transition, women gain weight, increasing abdominal fat and decreasing lean body mass, with a significant reduction in energy expenditure. Increased insulin resistance and hyperinsulinism characterize this period, aggravated by an increase in plasma proinflammatory cytokines and free fatty acids, and a state of relative hyperandrogenism. Previous recommendations systematically excluded women with T2DM from menopause hormone therapy (MHT); new evidence confirms that MHT significantly reduces the diagnosis of new-onset T2DM and may be beneficial in terms of glycemic control when used for menopause symptom management in patients with pre-existing T2DM. A comprehensive and individualized approach is considered the first line of management for women during this period, especially in T2DM patients or in women at risk of developing the disease. The objectives of this presentation are to review the etiopathogenic factors involved in the increased incidence of new cases of T2DM during menopause, the impact of menopause on T2DM and the role of MHT.

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Bovine herpesvirus (BoAHV) types 1 and 5 are closely-related neurotropic alpha-herpesviruses. BoAHV-1 generally causes respiratory and genital disease but can occasionally cause encephalitis. BoAHV-5 is the causative agent of non suppurative meningoencephalitis in calves. During neuroinvasion, both viruses reach the central and peripheral nervous system. While brain alterations are well-described, the changes that occur in the medulla have not been fully detailed. In this work, we integrated and analyzed the virological findings, the microscopic lesions and the changes that occur in the expression of genes related to the innate immunity, cell cycle and apoptosis in the cervical medulla of calves experimentally-infected with BoAHV-1 and BoAHV-5. This will contribute to the understanding of the differential neuropathogenesis of these alpha-herpesviruses of cattle.

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The zebrafish is an optimal experimental model to study thyroid hormone (TH) involvement in vertebrate development. The use of state-of-the-art zebrafish genetic tools available for the study of the effect of gene silencing, cell fate decisions and cell lineage differentiation have contributed to a more insightful comprehension of molecular, cellular, and tissue-specific TH actions. In contrast to intrauterine development, extrauterine embryogenesis observed in zebrafish has facilitated a more detailed study of the development of the hypothalamic-pituitary-thyroid axis. This model has also enabled a more insightful analysis of TH molecular actions upon the organization and function of the brain, the retina, the heart, and the immune system. Consequently, zebrafish has become a trendy model to address paradigms of TH-related functional and biomedical importance. We here compilate the available knowledge regarding zebrafish developmental events for which specific components of TH signaling are essential.

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INTRODUCTION AND AIMS: Surgical or endoscopic treatments play an essential role in the management of achalasia. The probability of adverse events in the performance of said treatments is a relevant aspect, when establishing the risk-benefit balance. The present study aimed to establish the association between serious adverse events and the performance of those procedures, in adult patients with achalasia. MATERIALS AND METHODS: A systemic search of randomized and nonrandomized clinical trials, retrospective cohorts, and cases series on adult patients with achalasia that underwent laparoscopic Heller myotomy (LHM), peroral endoscopic myotomy (POEM), or endoscopic balloon dilation, that reported serious adverse events, was carried out on the Medline, CENTRAL, and EBSCO databases. Serious adverse events were defined as: death at 30 days, Clavien-Dindo grade III or higher classification, esophageal or gastric perforation, pneumothorax, mucosal tear, leakage, emphysema, pneumonia, and chest pain. The methodology included the PRISMA guidelines for reporting systematic reviews. RESULTS: Thirty-five studies were found that reported information on 1,276 patients that underwent POEM, 5,492 that underwent LHM, and 10,346 that underwent endoscopic balloon dilation. The proportions of adverse events for the three techniques were 3.6, 4.9, and 3.1%, respectively. DISCUSSION AND CONCLUSIONS: The 3 therapeutic interventions evaluated had similar proportions of adverse events. There were few reports of death at 30 days as an outcome and the lack of standardization in reporting adverse events in the studies analyzed was prominent.

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Fishtail projectile points are the earliest widespread projectile type in South America, and share chronology and techno-morphology with Clovis, the oldest North American projectile type. Both were temporally associated with late Pleistocene megafaunal extinctions. Although the elusive direct evidence of human exploitation of megafauna in South America had kept Fishtails out of the extinction debate, a recent paper showed a strong relationship between the temporal density and spatial distribution of megafauna and Fishtail projectile points, and proposed that this weapon was designed and used for megafauna hunting, contributing to their extinction. If so, this technology must be distinctly different from post-FPP technologies (i.e., early Holocene projectile points), used for hunting smaller prey, in terms of distribution and functional properties. In this paper, we explore the changes in projectile point technology, as well as the body mass of potential megafaunal prey, and show that Fishtails were strongly related to the largest extinct megafaunal species.

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Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this second part of the document, the topics related to the treatment of HCC are presented.

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