The Mexican Institute of Social Security (Spanish: Instituto Mexicano del Seguro Social, IMSS) is a governmental organization that assists public health, pensions and social security in Mexico operating under the Secretariat of Health. It also forms an integral part of the Mexican healthcare system.
ABSTRACT Background: Early chronic kidney disease (CKD) is frequently asymptomatic and remains underdiagnosed in high-risk populations. Urinary extracellular vesicles (uEVs) provide a non-invasive source of kidney-related biomolecules and may improve early detection strategies. We evaluated uEV-associated interleukin-6 (IL-6), cathepsin D (CTD), and transforming growth factor-β (TGF-β) as candidate biomarkers for early CKD, including sex-stratified patterns. Methods: In this cross-sectional study, 230 adults at high risk (type 2 diabetes mellitus and/or systemic arterial hypertension) were classified as having normal kidney function (NKF) or CKD stages G1–G4. uEVs were isolated using a standardized protocol and characterized by scanning electron microscopy, Raman spectroscopy, dynamic light scattering, and Western blot for Alix and flotillin-1. Total uEV-associated protein was quantified, and CTD, IL-6, and TGF-β were measured in uEV preparations. Results: uEVs displayed expected morphology and marker expression. Particle size distributions differed by sex and CKD status. Total uEV protein content did not significantly differ across CKD stages. uEV-associated IL-6 was significantly higher in G1 compared with NKF (p ≤ 0.05). CTD showed a decreasing trend from G1 to G4 with stage- and sexspecific differences, most evident in women at G1. uEV-associated TGF-β did not differ significantly across stages. Conclusions: uEV-derived IL-6 and CTD show potential as non-invasive indicators of early CKD, with clinically relevant sex-dependent patterns, while TGF-β may provide complementary information. Standardized uEV isolation and measurement workflows are essential for biomarker reproducibility and future clinical translation.
RESUMO Introdução: A doença renal crônica (DRC) em fase inicial é frequentemente assintomática e permanece subdiagnosticada em populações de alto risco. As vesículas extracelulares urinárias (uEVs) constituem uma fonte não invasiva de biomoléculas relacionadas ao rim e podem aprimorar as estratégias de detecção precoce. Avaliamos a interleucina-6 (IL-6), a catepsina D (CTD) e o fator de crescimento transformador-β (TGF-β) associados às uEVs como biomarcadores candidatos para a DRC em fase inicial, incluindo padrões estratificados por sexo. Métodos: Neste estudo transversal, 230 adultos de alto risco (diabetes mellitus tipo 2 e/ou hipertensão arterial sistêmica) foram classificados como tendo função renal normal (FRN) ou DRC nos estágios G1–G4. As uEVs foram isoladas por meio de um protocolo padronizado e caracterizadas por microscopia eletrônica de varredura, espectroscopia Raman, espalhamento dinâmico de luz e Western blot para Alix e flotilina-1. A proteína total associada às uEVs foi quantificada, e a CTD, a IL-6 e o TGF-β foram mensurados nas preparações de uEVs. Resultados: As uEVs apresentaram a morfologia e a expressão de marcadores esperadas. As distribuições de tamanho das partículas diferiram conforme o sexo e o estado da DRC. O conteúdo total de proteína das uEVs não diferiu significativamente entre os estágios da DRC. A IL-6 associada às uEVs foi significativamente mais elevada em G1 em comparação com a FRN (p ≤ 0,05). A CTD apresentou uma tendência decrescente de G1 a G4, com diferenças específicas de estágio e sexo, mais evidentes em mulheres no estágio G1. O TGF-β associado às uEVs não diferiu significativamente entre os estágios. Conclusões: A IL-6 e a CTD derivadas das uEVs mostram potencial como indicadores não invasivos de DRC em fase inicial, com padrões dependentes do sexo clinicamente relevantes, enquanto o TGF-β pode fornecer informação complementar. Fluxos de trabalho padronizados de isolamento e mensuração de uEVs são essenciais para a reprodutibilidade dos biomarcadores e para a futura translação clínica.
Onychomycosis is hard to eradicate because the nail unit limits transungual drug delivery. A recalcitrant phenotype involves compact subungual fungal masses (dermatophytoma or fungal conglomerate), reported with dermatophytes and non-dermatophyte molds. We systematically reviewed treatment outcomes, emphasizing debulking and combination therapy. Evidence is mainly case reports and small cohorts with heterogeneous diagnostics, regimens, and outcome definitions. Debulking was commonly used via chemical keratolysis (e.g., urea) and/or physical methods (e.g., debridement, curettage, drilling, partial avulsion). Debulking may improve response by reducing compact fungal burden and facilitating antifungal access. However, comparative studies with standardized definitions, mycologic confirmation, and meaningful endpoints are needed to define optimal debulking strategies and therapeutic combinations.
En este ensayo se hace una interpretación filosófica del reciente movimiento #YoSoy132. Se argumenta que el hashtag es un ejemplo significativo de la “veridicción” política contemporánea, lo cual supone comprender el proceso constitutivo de las movilizaciones sociales en México. Mediante un análisis pragmático del discurso se defiende que la singularidad de #YoSoy132 no reside exclusivamente en su crítica de los medios de comunicación, sino en sus actos civiles que realizan performativamente una problematización de la democracia contemporánea. Estos actos, se defenderá, extienden el significado de la democracia. El ensayo analiza las condiciones globales de emergencia de este movimiento civil, para finalmente argumentar que el hashtag debe entenderse como un ejercicio de la parrhesía, cuya genealogía antigua fue estudiada por Michel Foucault en sus cursos de 1982-1984. En estas páginas también se discute, además del citado filósofo francés, con la filosofía política de Arendt, Butler y Derrida, entre otros.
This study applied statistical shape modeling to 284 DXA hip scans from Mexican women, identifying proximal femur morphotypes characterized by long, narrow necks and valgus orientation. These shape patterns showed directionally lower regional BMD in vulnerable areas, although associations were modest. The findings describe femoral configurations that resemble those previously associated with fracture risk in international cohorts, supporting the potential role of morphometric analysis as a complementary, population-specific approach to skeletal fragility assessment.PurposeHip fractures are a major cause of disability and mortality in older adults, particularly among women with osteoporosis. Bone mineral density (BMD) is a cornerstone of fracture risk assessment but does not fully capture biomechanical and structural vulnerability. This study is aimed at characterizing proximal femur morphology in Mexican women using statistical shape modeling and at examining its relationship with regional BMD.MethodsIn this exploratory cross-sectional analysis, 284 dual-energy X-ray absorptiometry (DXA) hip scans were processed with BoneFinder software to generate morphometric profiles. Active Shape Models (ASM) identified the main modes of shape variation, which were analyzed in relation to site-specific BMD.ResultsSeventeen femoral configurations were identified, with three representative morphotypes: long, narrow necks with valgus alignment, short and wide necks, and intermediate morphologies. Shape patterns characterized by long, narrow, valgus-oriented femoral necks showed directionally lower regional BMD in the superior neck and Ward's triangle-sites critical for fracture initiation-although associations were modest in regression analyses. Automated morphometry identified structural traits linked to mechanical disadvantage beyond traditional cortical indices.ConclusionThis is the first study to apply statistical shape modeling to Latin American women, identifying recurring femoral shape patterns that resemble morphologies previously associated with fracture risk in international cohorts. While prospective validation with fracture outcomes is needed, this exploratory study provides foundational evidence for anatomically informed, population-specific approaches to skeletal fragility assessment.
