Abstract Introduction The average life expectancy, as well as the prevalence of Type 2 diabetes (T2D), is increasing worldwide. Population-based studies have demonstrated that the duration of T2D has been associated with cognitive impairment. However, despite the high prevalence of T2D and cognitive impairment in Chile, the association between years with T2D and suspicion of cognitive impairment has not yet been investigated. The objective of this study was to investigate the association between duration of T2D and suspicion of cognitive impairment in Chilean older adults. Material and Methods 1,040 older adults aged ≥60 years from the Chilean National Health Survey (2009-2010) were included. Suspicion of cognitive impairment was assessed by the abbreviated Mini-Mental State Examination (MMSE). The number of years with T2D was self-reported and categorised into four groups. Poisson Regression analysis was used to assess the association between altered MMSE and the number of years with DM2, adjusted by potential confounders including socio-demographic, lifestyle, adiposity and health-related factors. Results When the analyses were adjusted for socio-demographic factors, people who had T2D for 15 to 24 and ≥25 years had 2.2-times (95%CI: 1.07; 3.33) and 5.8-times (95%CI: 3.81; 11.0) higher relative risk (RR) of cognitive impairment, compared to those without T2D. When the analyses were additionally adjusted for lifestyle and health-related covariates, the RR for cognitive impairment was 1.76-times (95%CI: 1.02; 2.50) and 4.54-times (95%CI: 2.70; 6.38) higher for those who had T2D for 14-24 years and ≥25 years, respectively. Conclusions Number of years with T2D was associated with suspicion of cognitive impairment. A longer duration of T2D was associated with a higher likelihood of cognitive impairment in the Chilean older population, independently of confounder factors included in the study.

RESUMEN Introducción: La esperanza de vida está aumentando en todo el mundo, así como la diabetes tipo 2 (DM2). Estudios poblacionales han demostrado que la duración de la DM2 se ha asociado con el deterioro cognitivo. Sin embargo, a pesar de la alta prevalencia de DM2 y deterioro cognitivo en Chile, aún no se ha investigado la asociación entre años con DM2 y la sospecha de deterioro cognitivo. El objetivo del estudio fue investigar la asociación entre la duración de la DM2 y la sospecha de deterioro cognitivo en personas mayores chilenas. Material y Métodos Participaron 1.040 personas ≥60 años de la Encuesta Nacional de Salud de Chile (2009-2010). El deterioro cognitivo se evaluó mediante el Mini Examen del Estado Mental abreviado (MMSE). El número de años con DM2 fue categorizado en cuatro grupos. Para valorar la asociación entre MMSE alterado y el número de años con DM2, se utilizó una regresión de Poisson, ajustados a posibles factores de confusión sociodemograficos, de estilos de vida, adiposidad y salud. Resultados Cuando se ajustaron los análisis por factores sociodemográficos, las personas con 15 a 24 y ≥25 años con DM2 presentaron 2,2 veces (IC95%: 1,07; 3,33) y 5,8 veces (IC95%: 3,81; 11,0) riesgo relativo (RR) de deterioro cognitivo, en comparación con aquellas sin DM2. Luego de ajustar adicionalmente los análisis para las covariables relacionadas con el estilo de vida y la salud, el RR para deterioro cognitivo fue 1,76 veces (IC95%: 1,02; 2,50) y 4,54 veces (IC95%: 2,70; 6,38) más alto para aquellas personas con 14-24 y ≥25 años de DM2. Conclusiones Se asoció el número de años con DM2 con la sospecha de deterioro cognitivo. Una mayor duración de la DM2 se asoció con una mayor probabilidad de deterioro cognitivo en la población mayor chilena.

ABSTRACT The objective of this research was to simulate the genetic gains expected comparing random mating strategies and mate selection by optimum contribution with different penalty levels in the inbreeding rate of Santa Inês sheep. The optimum contribution theory was thus applied to optimize genetic gain in the long term in twelve selection groups by selectively mating 500 females with the respective males, increasingly penalizing the increase in inbreeding in the objective function. Genetic algorithms were used to find the optimum contribution. Optimization was achieved via EVA software. Selection candidates had their contribution defined into four treatments, using different values to weigh the genetic merit and penalize increases in inbreeding. This made it possible to measure the degree of control over those parameters that can be obtained with this methodology. This selection offers different levels of genetic gain, which are achievable from restrictions on the coancestry. The number of males selected and their distribution into selection groups varied according to the penalty attributed to inbreeding in the objective function. Mate selection using optimum contribution should be adopted when aiming to limit the increase in inbreeding. Increasing the exchange of genetic material between groups is recommended to elevate genetic gain and maintain control over inbreeding.

RESUMO A hemorragia cerebral é definida como um sangramento no parênquima cerebral e representa um importante problema de saúde pública. Ela corresponde a 10 a 15% das causas de AVC e está associada a altas taxas de morbimortalidade. Apesar dos avanços no campo do AVC e dos cuidados neurocríticos, os princípios do manejo agudo permaneceram fundamentalmente os mesmos por muitos anos. As principais estratégias de tratamento incluem controle agressivo da pressão arterial, hemostasia precoce, reversão de coagulopatias, evacuação do coágulo por meio de técnicas cirúrgicas abertas ou cirúrgicas minimamente invasivas e gerenciamento da pressão intracraniana elevada.

ABSTRACT Intracerebral hemorrhage (ICH), defined as bleeding into the brain parenchyma, is a significant public health issue. Although it accounts for only 10 to 15% of strokes, it is associated with the highest morbidity and mortality rates. Despite advances in the field of stroke and neurocritical care, the principles of acute management have fundamentally remained the same over many years. The main treatment strategies include aggressive blood pressure control, early hemostasis, reversal of coagulopathies, clot evacuation through open surgical or minimally invasive surgical techniques, and the management of raised intracranial pressure.

Resumen Los estudios multicéntricos sobre cáncer mamario requieren colaboración interinstitucional, recursos y personal especializado. En México, muchas instituciones prestan estos servicios, con información poco accesible; para mitigarlo, la Sociedad Mexicana de Oncología conformó el Grupo Cooperativo de Investigación de México en Oncología. Objetivo: Describir la infraestructura, personal y actividades de hospitales con atención de pacientes con cáncer mamario en México. Métodos: Se realizó una encuesta a 30 especialistas en cáncer mamario sobre recursos y servicios de sus instituciones. Resultados: Trece (43.3%) especialistas respondieron la encuesta, siendo el 38.5% de Instituciones con Seguro Popular, 23.1% del Instituto Mexicano del Seguro Social y el 38.4% de otras afiliaciones, con una mediana de 300 (50-950) casos nuevos por año. Todas cuentan con cirugía oncológica, radiología mamaria, cuidados paliativos, patología, nutrición y sesiones multidisciplinarias. Todas tienen ultrasonido con transductor para mama, el 92.3% mastografía digital y el 53.8% tomosíntesis y/o resonancia magnética. La detección de ganglio centinela se realiza en el 92.3% de los casos con colorante y el 61.5% con radionúclido. El 92.3% dispone de tamoxifeno, inhibidores de la aromatasa y trastuzumab, y < 40% otras terapias blanco. En el 21.3% existen firmas genéticas y en el 61.5% análisis de cáncer hereditario. Conclusiones: La capacidad institucional para participar en estudios multicéntricos es heterogénea; los pocos recursos en varias instituciones limitan su inclusión en estudios de cáncer mamario.

Abstract Multicenter studies on breast cancer require inter-institutional collaboration, resources and specialized personnel. In Mexico, many institutions provide these services, but their information is not accessible; to mitigate it, the Mexican Society of Oncology formed the Mexican Cooperative Research Groups in Oncology. Objective: To describe the infrastructure, personnel and activities of hospitals with care of patients with breast cancer in Mexico. Methods: A survey was conducted to 30 breast cancer specialists about resources and services of their institutions. Results: 13 (43.3%) specialists answered the survey, 38.5% of Seguro Popular, 23.1% of Instituto Mexicano del Seguro Social, and 38.4% of other institutions, with a median of 300 (50-950) new cases per year. All the institutions have oncological surgery, breast radiology, palliative care, pathology, nutrition and multidisciplinary sessions. All have ultrasound with breast transducer, 92.3% digital mammography, and 53.8% tomosynthesis and/or magnetic resonance. They do sentinel lymph node detection with dye (92.3%) or radionuclide (61.5%). Tamoxifen, aromatase inhibitors and trastuzumab are available in 92.3%, and other target therapies in < 40%. Genetic signatures are done in 21.3% and 61.5% analysis of hereditary cancer. Conclusions: The institutional capacity to participate in multicenter studies is heterogeneous; the few resources in several institutions limit their inclusion to studies of breast cancer.