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BACKGROUND: Obesity in Mexico is an alarming problem that has been increasing in recent decades. Dietary factors make this pathology more common at younger ages and closely related to oral health. This study attempts to investigate the association between the oral health status of a Mexican population in the state of Yucatan and their dietary habits. OBJECTIVE: This study explores the relationship between oral health-related quality of life and adherence to the Mediterranean diet in a disadvantaged population in the state of Yucatan, Mexico. METHODS: The research was conducted in July 2023 in Merida, Yucatan (Mexico). The sample consisted of 109 individuals aged between 4 and 72 years old. Data analysis focused on factors such as body mass index (BMI), oral health-related quality of life, and adherence to the Mediterranean diet. RESULTS: A notable presence of caries is observed in individuals with low adherence to the Mediterranean diet (Correlation coefficient 0.040, p=0.682). This underscores the potential interaction between oral health, obesity, and dietary habits. The mean Oral Health-Related Quality of Life (OHIP-14Sp) score was 13.19 ±13.57, median 8.00. CONCLUSIONS: This research adds to the increasing evidence that highlights the significance of a balanced diet in enhancing the oral quality of life for people. More research is necessary to explore preventive measures and treatment to raise awareness about oral health within the community.
ANTECEDENTES: La obesidad en México es un problema alarmante que ha ido en aumento en las últimas décadas. Los factores dietéticos hacen que esta patología sea más común en edades más tempranas y muy relacionada con la salud bucal. Este estudio intenta investigar la asociación entre el estado de salud bucal de una población mexicana en el estado de Yucatán y sus hábitos alimentarios. OBJETIVO: Este estudio explora la relación entre la calidad de vida relacionada con la salud bucal y la adherencia a la dieta mediterránea en una población desfavorecida del estado de Yucatán, México. Métodos: La investigación se realizó en julio de 2023 en Mérida, Yucatán (México). La muestra estuvo compuesta por 109 individuos con edades comprendidas entre 4 y 72 años. El análisis de los datos se centró en factores como el índice de masa corporal (IMC), la calidad de vida relacionada con la salud bucal y la adherencia a la dieta mediterránea. RESULTADOS: Se observa una notable presencia de caries en individuos con baja adherencia a la dieta mediterránea (coeficiente de correlación 0,040, p=0,682). Esto subraya la posible interacción entre la salud bucal, la obesidad y los hábitos alimentarios. La puntuación media de la calidad de vida relacionada con la salud bucal (OHIP-14Sp) fue 13,19 ± 13,57, mediana 8,00. CONCLUSIONES: Esta investigación se suma a la creciente evidencia que resalta la importancia de una dieta equilibrada para mejorar la calidad de vida bucal de las personas. Es necesaria más investigación para explorar medidas preventivas y tratamientos para crear conciencia sobre la salud bucal dentro de la comunidad.
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INTRODUCTION: There is limited information about the coronavirus disease 2019 (COVID-19) disease in Latin-American countries. Our objective was to describe the clinical characteristics and outcomes of COVID-19 patients in Mexico. METHODOLOGY: We conducted a retrospective cohort study with 333 consecutive patients who were admitted to Hospital de Especialidades "Dr. Antonio Fraga Mouret" in Mexico City with COVID-19 between April 1, 2020, and June 30, 2020. Demographic, clinical, laboratory data, treatment details and 30-day outcomes were analyzed. RESULTS: The patients studied included 52% men (172/233) and the median age was 45 years. Up to 75% (250/333) of patients were classified as overweight or obese. There were 185 (56%) inpatients; 85% (158/185) were hospitalized in the general ward, and 15% (27/185) in the Intensive Care Unit (ICU). Laboratory measurements showed significant differences between inpatients and outpatients such as lymphocyte-count (median 0.8 vs 1.2×109/L, p < 0.001), LDH (median 650 vs 294 U/L, p < 0.001), CRP (median 147 vs 5 mg/L, p = 0.007), CK-MB (median, 15 vs 10 U/L, p = 0.008), ferritin (median, 860 vs 392 ng/mL, p = 0.02), and D-dimer (median, 780 vs 600 ng/mL, p = 0.15). These differences were seen between survivor and non-survivor patients as well. The rate of death in mechanically ventilated patients was 94% (67/71). Mortality at 30-day follow-up was 57% (105/185). CONCLUSIONS: We observed that majority of the non-survivors were obese and young. Complications leading to death was observed in majority of the cases.
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COVID-19 , COVID-19/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Obesidad/epidemiología , Pandemias , Derivación y Consulta , Estudios RetrospectivosRESUMEN
BACKGROUND AND AIMS: Chronic heart failure (CHF) represents a significant cause of morbidity and mortality globally. Metabolic maladaptation has proven to be critical in the progression of this condition. Preclinical studies have shown that irisin, an adipomyokine involved in metabolic regulations, can induce positive cardioprotective effects by improving cardiac remodeling, cardiomyocyte viability, calcium delivery, and reducing inflammatory mediators. However, data on clinical studies identifying the associations between irisin levels and functional imaging parameters are scarce in CHF patients. The objective of this study was to determine the association of irisin levels with cardiac imaging measurements through cardiac magnetic resonance, inflammatory markers, and biochemical parameters in patients with CHF compared with control subjects. METHODS AND RESULTS: Thirty-two subjects diagnosed with CHF and thirty-two healthy controls were evaluated in a cross-sectional study. Serum irisin levels were significantly lower in patients with CHF than in controls. This is the first study to report a significant positive correlation between irisin levels and cardiac magnetic resonance parameters such as left ventricular ejection fraction, fraction shortening, and global radial strain. A negative correlation was demonstrated between irisin levels and brain natriuretic peptide, insulin levels, and Homeostatic model assessment for insulin resistance index. We did not observe significant correlations between irisin levels and inflammatory cytokines. CONCLUSIONS: Given the importance of fraction shortening and global radial strain as accurate markers of ventricular wall motion, these results support the hypothesis that irisin may play an essential role in maintaining an adequate myocardial wall architecture, deformation, and thickness.
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Fibronectinas , Insuficiencia Cardíaca , Biomarcadores , Estudios Transversales , Fibronectinas/sangre , Insuficiencia Cardíaca/diagnóstico por imagen , Humanos , Espectroscopía de Resonancia Magnética , Volumen Sistólico , Función Ventricular IzquierdaRESUMEN
Endothelial dysfunction is a crucial physiopathological mechanism for cardiovascular diseases that results from the harmful impact of metabolic disorders. Irisin, a recently discovered adipomyokine, has been shown to exert beneficial metabolic effects by increasing energy consumption, improving insulin sensitivity, and reducing the proinflammatory milieu. Multiple preclinical models have assessed irisin's possible role in the development of endothelial dysfunction, displaying that treatment with exogenous irisin can decrease the production of oxidative stress mediators by up-regulating Akt/mTOR/Nrf2 pathway, promote endothelial-dependent vasodilatation through the activation of AMPK-PI3K-AkteNOS pathway, and increase the endothelial cell viability by activation of ERK proliferation pathway and downregulation of Bad/Bax/Caspase 3 pro-apoptotic pathway. However, there is scarce evidence of these mechanisms in clinical studies, and available results are controversial. Some have shown negative correlations of irisin levels with the burden of coronary atherosclerosis and leukocyte adhesion molecules' expression. Others have demonstrated associations between irisin levels and increased atherosclerosis risk and higher carotid intima-media thickness. Since the role of irisin in endothelial damage remains unclear, in this review, we compare, contrast, and integrate the current knowledge from preclinical and clinical studies to elucidate the potential preventive role and the underlying mechanisms and pathways of irisin in endothelial dysfunction. This review also comprises original figures to illustrate these mechanisms.
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Endotelio/metabolismo , Fibronectinas/metabolismo , Proteínas Quinasas Activadas por AMP/metabolismo , Grosor Intima-Media Carotídeo , Caspasa 3/metabolismo , Endotelio/patología , Humanos , Factor 2 Relacionado con NF-E2 , Fosfatidilinositol 3-Quinasas , Proteínas Proto-Oncogénicas c-akt/metabolismo , Serina-Treonina Quinasas TOR , Proteína X Asociada a bcl-2RESUMEN
INTRODUCTION: Small-bowel involvement in patients with ovarian cancer has been strongly correlated with the possibility of cytoreduction and thus with survival. The main objective of this study was to evaluate the prognostic significance of small-bowel involvement in patients undergoing optimal-complete interval cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). METHODS: We included a series of patients diagnosed with stage IIIC-IVA (pleural effusion) high-grade serous epithelial ovarian cancer and in whom CRS + HIPEC was indicated after neoadjuvant systemic chemotherapy (NACT). The study period extended from January 2008 to January 2020, with a minimum follow-up of 12 months from the inclusion of the last patient. A multivariate analysis using Cox regression allowed us to identify the variables that were independently related to disease-free survival. RESULTS: A total of 144 patients were selected, 13 (9%) of whom were excluded from the analysis, because their disease was considered unresectable. The study included a series of 131 patients with a median age of 62 years (34-79 years) and a median Peritoneal Cancer Index (PCI) calculated during surgery of 9 (1-35). The median PCI of bowel areas 9-12 (SB-PCI) was 3 (1-10). Performance of a CC-1 cytoreduction (HR: 1.93, 95% CI: 1.02-3.64, p = 0.042) and SB-PCI greater than 3 (HR: 2.25, 95%CI: 1.13-4.48, p = 0.21) were independent factors associated with shorter disease-free survival. CONCLUSION: Small-bowel involvement, even in patients with a macroscopically complete resection, showed a correlation with worse prognostic outcomes and could be considered as a variable in the postoperative management of these patients.
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Hipertermia Inducida , Neoplasias Ováricas , Neoplasias Peritoneales , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma Epitelial de Ovario/terapia , Terapia Combinada , Femenino , Humanos , Quimioterapia Intraperitoneal Hipertérmica , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Neoplasias Ováricas/terapia , Neoplasias Peritoneales/terapia , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
BACKGROUND: The follow-up of recovered COVID-19 patients is still limited. We aimed to evaluate the changes in quality-of-life (QOL) and spirometric alterations in the convalescent phase of 115 patients with at least 30 days post-COVID-19. METHODS: We included patients with confirmed COVID-19 infection, available past medical records and at least 30 days after the onset of symptoms. All patients were asked to rate their general health condition before and after COVID-19 using the EQ-5D-5L standardized questionary and perform a spirometry at evaluation. RESULTS: In this study, that included 70%(81/115) of patients with mild or moderate COVID-19; there was a severe decrease in QOL up to 56%(64/115). Alterations in usual activities and anxiety/depression were present in 59% of patients with a severe decrease in QOL. The persistence of symptoms was present in 63%(72/115). Restrictive lung impairment was the most common spirometric alteration in 17%(20/115), of whom 65%(13/20) had mild COVID-19. CONCLUSIONS: Spirometric alterations are presented even in mild COVID-19, and more remarkably, there is a high rate of alterations in quality of life after the recovery of this disease.
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COVID-19/fisiopatología , Pulmón/fisiopatología , Calidad de Vida , Espirometría , Adulto , Ansiedad/etiología , Ansiedad/psicología , COVID-19/complicaciones , COVID-19/rehabilitación , Depresión/etiología , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
BACKGROUND: After 9 years of the ground-breaking social policy Law 1448 of 2011 -Victims Law- and its extension until 2030, the Colombian State and other stakeholders have made several efforts towards granting the right of integral reparation for more than 9 million victims that are recognized in the Colombian transitional context. Psychosocial rehabilitation is a Victims Law's reparation measure whose objective is to re-establish the psychosocial, physical and mental health welfare in the individual, familiar and community levels. This study aims to understand the experiences of psychosocial rehabilitation of women victims of armed conflict in Montes de Maria and the underlying social intervention paradigms that guide the Law's implementation. METHODS: Based on a qualitative design with a phenomenological approach, narrative tools and thematic network analysis permitted to give voice to the women participants. Individual narrative interviews were conducted with 12 women victims and a focus group with eight of them was used as a triangulation strategy. RESULTS: Although the Victims Law is oriented by a sociopolitical intervention paradigm, the stories of the women's victims of Montes de María mainly evidenced non-sociopolitical interventions with humanitarian assistance towards revictimization and State abandonment. As a coping mechanism towards the State negligence encountered, women strive to overcome psychosocial trauma by developing agency and community resources for the resignification of the traumatic experiences and peacebuilding. CONCLUSIONS: For the Victims Law to achieve its integrality aim, the psychosocial approach should be implemented through all its measures but remains absent in Montes de Maria. The diversity of victim's individual and collective initiatives that were found, can contribute towards transformative and participatory psychosocial intervention with community's resources. Women victims can perform as advisors and collaborators in the implementation of individual and collective reparation, which remains as an opportunity for psychosocial rehabilitation and peacebuilding. Further monitoring and evaluation of the law with a territorial and differential perspective is required to respond to the victim's needs.
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The prevalence of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) has increased in the pediatric population. Irisin, an adipomyokine, is involved in white adipose tissue browning, energy expenditure, insulin sensitivity, and anti-inflammatory pathways. Data on the associations among circulating irisin levels, soluble cell adhesion molecules (sCAMs), and inflammatory cytokines is scarce in children and adolescents with MetS and T2DM. Subjects aged 6-16 years were grouped into T2DM, MetS, and healthy controls. Serum irisin levels were significantly lower in the MetS (6.6 [2.8-18.0] ng/mL) and T2DM (6.8 [2.2-23.2] ng/mL) groups compared with controls (30.3 [24.6-57.1] ng/mL). Negative correlations between irisin and the BMI percentile (R = -0.358), WC percentile (R = -0.308), and triglycerides (R = -0.284) were identified, while positive associations with TC (R = 0.287), HDL-c (R = 0.488), and LDL-c (R = 0.414) were observed. Significant negative correlations were found between irisin and sNCAM (R = -0.382), sICAM-2 (R = -0.300), sVCAM-1 (R = -0.292), MCP-1 (R = -0.308), and IFN-α2 (R = -0.406). Of note, lower concentrations of most sCAMs (sICAM-1, sPSGL-1, sP-selectin, sEpCAM, sICAM-2, sALCAM, sPECAM-1, sCD44, sVCAM-1, sICAM-3, sL-selectin, and sNCAM) were shown in T2DM subjects compared with MetS patients. Lower irisin levels induce a lack of inhibition of oxidative stress and inflammation. In T2DM, higher ROS, AGEs, glucotoxicity, and inflammation trigger endothelial cell apoptosis, which downregulates the sCAM expression as a compensatory mechanism to prevent further vascular damage. In opposition, in subjects with MetS that have not yet developed T2DM and its accompanying stressors, the upregulation of the sCAM expression is ensued.
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Diabetes Mellitus Tipo 2/fisiopatología , Endotelio Vascular/fisiopatología , Fibronectinas/sangre , Inflamación/fisiopatología , Síndrome Metabólico/fisiopatología , Adolescente , Niño , Diabetes Mellitus Tipo 2/sangre , Femenino , Humanos , Inflamación/sangre , Masculino , Síndrome Metabólico/sangreRESUMEN
Exercise is an effective strategy for preventing and treating obesity and its related cardiometabolic disorders, resulting in significant loss of body fat mass, white adipose tissue browning, redistribution of energy substrates, optimization of global energy expenditure, enhancement of hypothalamic circuits that control appetite-satiety and energy expenditure, and decreased systemic inflammation and insulin resistance. Novel exercise-inducible soluble factors, including myokines, hepatokines, and osteokines, and immune cytokines and adipokines are hypothesized to play an important role in the body's response to exercise. To our knowledge, no review has provided a comprehensive integrative overview of these novel molecular players and the mechanisms involved in the redistribution of metabolic fuel during and after exercise, the loss of weight and fat mass, and reduced inflammation. In this review, we explain the potential role of these exercise-inducible factors, namely myokines, such as irisin, IL-6, IL-15, METRNL, BAIBA, and myostatin, and hepatokines, in particular selenoprotein P, fetuin A, FGF21, ANGPTL4, and follistatin. We also describe the function of osteokines, specifically osteocalcin, and of adipokines such as leptin, adiponectin, and resistin. We also emphasize an integrative overview of the pleiotropic mechanisms, the metabolic pathways, and the inter-organ crosstalk involved in energy expenditure, fat mass loss, reduced inflammation, and healthy weight induced by exercise.
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Composición Corporal/fisiología , Metabolismo Energético/fisiología , Ejercicio Físico/fisiología , Péptidos/fisiología , Adipoquinas/fisiología , Tejido Adiposo/metabolismo , Animales , Regulación del Apetito/fisiología , Huesos/metabolismo , Humanos , Metabolismo de los Lípidos/fisiología , Hígado/metabolismo , Redes y Vías Metabólicas/fisiología , Músculo Esquelético/metabolismo , Obesidad , Hormonas Peptídicas/fisiología , Pérdida de PesoRESUMEN
Despite numerous demonstrations that the immune system is activated in heart failure, negatively affecting patients' outcomes, no definitive treatment strategy exists directed to modulate the immune system. In this review, we present the evidence that B cells contribute to the development of hypertrophy, inflammation, and maladaptive tissue remodelling. B cells produce antibodies that interfere with cardiomyocyte function, which culminates as the result of recruitment and activation of a variety of innate and structural cell populations, including neutrophils, macrophages, fibroblasts, and T cells. As B cells appear as active players in heart failure, we propose here novel immunomodulatory therapeutic strategies that target B cells and their products.
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Insuficiencia Cardíaca , Linfocitos B , Insuficiencia Cardíaca/terapia , Humanos , Inflamación , Miocitos Cardíacos , NeutrófilosRESUMEN
RESUMEN La enfermedad COVID-19 constituye una amenaza para la salud pública mundial. La realidad observada en los últimos meses evidencia el aumento exponencial de los casos confirmados y la rápida propagación de la enfermedad con una alta letalidad. El objetivo de este trabajo es presentar la secuencia práctica epidemiológica de un caso de COVID-19 en un paciente del Área de salud I del municipio de Cienfuegos, confirmado al SARS-CoV-2, del sexo masculino, con 35 años de edad, de color de piel negra y sin antecedentes de enfermedades concomitantes, quien se encontraba sin sintomatología. El tiempo transcurrido entre el contacto directo y el diagnóstico de positividad fue entre tres y cinco días. Le fueron identificados y aislados 26 contactos directos. Se aislaron además dos casos sintomáticos clasificados como sospechosos y 15 contactos de estos casos. En cada momento se implementaron acciones de aislamiento y control. Las medidas adoptadas en el área de salud I del municipio de Cienfuegos estuvieron encaminadas a detener la transmisión y prevenir el contagio, reduciendo el riesgo de exposición al virus. Se ha demostrado que todas las medidas fueron inmediatas y escalables, en función de la situación epidemiológica concreta.
ABSTRACT COVID-19 disease constitutes a threat to global public health. The reality observed in recent months shows the exponential increase in confirmed cases and the rapid spread of the disease with high lethality. This work is aimed at presenting a case of COVID-19 practical epidemiological sequence, in a patient from Health Area I of the Cienfuegos municipality, confirmed to SARS-CoV-2, male, 35 years old, black and without a history of concomitant diseases, who was asymptomatic. The time elapsed between direct contact and positive diagnosis was between three and five days. A number of 26 direct contacts were identified and isolated. Two symptomatic cases classified as suspicious and 15 contacts of these cases were also isolated. Isolation and control actions were implemented at all times. The measures adopted in health area I of the Cienfuegos municipality were focused at stopping transmission and preventing contagion, reducing the risk of exposure to the virus. All measures have been shown to be immediate and scalable, depending on the specific epidemiological situation.
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INTRODUCTION: In patients with peritoneal carcinomatosis (PC), the incidence of respiratory complications following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is not well established. We aimed to describe the center-specific incidence and patient characteristics associated with respiratory complications following CRS and HIPEC in patients receiving treatment for PC. MATERIALS AND METHODS: We used the University Hospital of Arrixaca study database to identify patients who underwent CRS and HIPEC for PC. Patients who experienced a post-operative respiratory complication were categorized according to the National Cancer Institute-Common Terminology Criteria for Adverse Events. Multivariable regression methods were used to identify independent risk factors for developing a respiratory complication following CRS and HIPEC. RESULTS: Between 2008 and 2017, we identified 247 patients who underwent CRS and HIPEC for PC. A total of eight patients (3.2%) were categorized as having a post-operative respiratory complication. A diaphragmatic peritonectomy and a PC index of > 14 were identified as independent risk factors for developing a respiratory complication. Radiographic evidence of a pleural effusion was identified in 72 patients who had CRS of the diaphragmatic peritoneum; however, only 6 (8.3%) of these patients required pleural drainage. CONCLUSIONS: Only 3.2% of patients developed a symptomatic respiratory complication following CRS and HIPEC. A pleural effusion was identified in almost all patients requiring a diaphragmatic peritonectomy as part of their CRS; however, less than one in ten of these patients required pleural drainage. Prophylactic insertion of a pleural drainage tube is, therefore, not indicated following CRS and HIPEC.
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Quimioterapia del Cáncer por Perfusión Regional/efectos adversos , Procedimientos Quirúrgicos de Citorreducción/efectos adversos , Complicaciones Posoperatorias/epidemiología , Enfermedades Respiratorias/epidemiología , Adulto , Anciano , Femenino , Humanos , Hipertermia Inducida/efectos adversos , Incidencia , Persona de Mediana Edad , Neoplasias Peritoneales/tratamiento farmacológico , Neoplasias Peritoneales/cirugía , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/etiologíaRESUMEN
Determinar el conocimiento de los trabajadores de la salud (TS) sobre diferentes aspectos de la enfermedad COVID-19 en embarazadas. Métodos: Para ello elaboramos una encuesta utilizando la escala de Likert, la cual fue distribuida por las redes sociales durante 8 días, en el mes de abril de 2020. Resultados: La encuesta fue respondida por 617 TS, con edad de predominio en el rango de 51 a 60 años, 33.8 % hombres y mujeres 66.2 %; la mayoría venezolanos 92.2 %; de profesión gineco-obstetras 25.5 %, médicos generales 13.3 %, internistas 7.7 % y perinatólogos 6.1 %, entre otros TS. Más del 70 % de los TS respondió correctamente la pregunta sobre las manifestaciones clínicas del COVID-19 en la gestante, en contraste con la asertividad sobre el aborto, mortalidad materna y prematuridad, la cual fue sólo de 40 % o menos. Este es el primer estudio realizado en Venezuela sobre este tópico(AU)
to determine the knowledge of health care workers (HCW) about different aspects of COVID-19 in pregnant women; Methods: we carried out a survey using the Likert scale, which was distributed by social networks for 8 days in April 2020. Results: The survey was answered by 617 HCW, with a predominant age range of 51 to 60 years with 33.8%, women 66.2%, Venezuelan 92. 2%. Obstetrician-gynecologists 25.5%, general practitioners 13.3%, internists 7.7% and perinatologists 6.1%, More than 70% of the TS answered assertively the question about the clinical manifestations of COVID-19 in the pregnant woman in contrast to the assertiveness about abortion, maternal mortality and prematurity which was 40% or less. This is the first study carried out in Venezuela on this subject(AU)
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Humanos , Masculino , Femenino , Complicaciones del Embarazo/etiología , Personal de Salud , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/prevención & control , Medidas de Seguridad , Salud Pública , TelemedicinaRESUMEN
Vitamin D deficiency is highly prevalent worldwide. It has been associated with heart failure (HF) given its immunoregulatory functions. In-vitro and animal models have shown protective roles through mechanisms involving procollagen-1, JNK2, calcineurin/NFAT, NF-κB, MAPK, Th1, Th2, Th17, cytokines, cholesterol-efflux, oxLDL, and GLUT4, among others. A 12-month follow-up in HF patients showed a high prevalence of vitamin D deficiency, with no seasonal variation (64.7-82.4%). A positive correlation between serum 25(OH)D concentration and dietary intake of vitamin D-rich foods was found. A significant inverse correlation with IL-1ß (R = -0.78), TNF-α (R = -0.53), IL-6 (R = -0.42), IL-8 (R = -0.41), IL-17A (R = -0.31), LDL-cholesterol (R = -0.51), Apo-B (R = -0.57), total-cholesterol (R = -0.48), and triglycerides (R = -0.32) was shown. Cluster analysis demonstrated that patients from cluster three, with the lowest 25(OH)D levels, presented the lowermost vitamin D intake, IL-10 (1.0 ± 0.9 pg/mL), and IL-12p70 (0.5 ± 0.4 pg/mL), but the highest TNF-α (9.1 ± 3.5 pg/mL), IL-8 (55.6 ± 117.1 pg/mL), IL-17A (3.5 ± 2.0 pg/mL), total-cholesterol (193.9 ± 61.4 mg/dL), LDL-cholesterol (127.7 ± 58.2 mg/dL), and Apo-B (101.4 ± 33.4 mg/dL) levels, compared with patients from cluster one. Although the role of vitamin D in the pathogenesis of HF in humans is still uncertain, we applied the molecular mechanisms of in-vitro and animal models to explain our findings. Vitamin D deficiency might contribute to inflammation, remodeling, fibrosis, and atherosclerosis in patients with HF.
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Aterosclerosis/sangre , Citocinas/sangre , Insuficiencia Cardíaca/sangre , Inflamación/sangre , Vitamina D/sangre , Animales , Femenino , Estudios de Seguimiento , Humanos , Estilo de Vida , Lipoproteínas LDL/sangre , Masculino , Persona de Mediana Edad , Triglicéridos/sangre , Deficiencia de Vitamina D/sangreRESUMEN
BACKGROUND: Adipokines and the myokine irisin, involved in mechanisms associated with obesity and metabolic syndrome (MS), are understudied in the pediatric population. OBJECTIVE: To investigate the relationship between irisin, and leptin, resistin, adiponectin, adipsin, anthropometric and cardiovascular risk factors in Mexican children. METHODS: A cross-sample of 126 Mexican children aged 6-12 years old were classified as normal weight (n = 46), obese (n = 40), and MS (n = 40) according to CDC's and Cook's age-modified criteria for obesity and MS. Anthropometric parameters and blood pressure were determined and percentiles calculated for age and gender. Irisin, leptin, adiponectin, adipsin, resistin, triglycerides, glucose, high-density lipoprotein cholesterol (HDL-c) levels, and physical activity were determined. Statistical tests for differences between groups, correlation, and multiple regression analyses were performed. RESULTS: Irisin plasma levels were significantly lower in the obese (6.08 [4.68-6.65]) and MS groups (6.46 [5.74-7.02]) compared with the normal-weight group (8.05 [7.24-8.94]) (p < 0.001). Irisin levels were not influenced by age or gender, but significant dispersion was observed in obese girls (95% CI median [2.29-6.30]). Leptin, resistin, and adipsin levels were significantly increased in the obese and MS groups. Lean-fat ratio was significantly higher in the NW group. Irisin correlated negatively with leptin (- 0.310), resistin (- 0.389), adipsin (- 0.362), BMI% (-0.472), WC% (- 0.453), BMI z-score (- 0.496), fat free mass (- 0.257), fat percentage (- 0.532), fat mass (- 0.515), triglycerides (- 0.291), the number of cardiometabolic risk factors (- 0.443) (p < 0.001); positively with lean-fat ratio (0.489) and HDL-c (0.328) (p < 0.001) and none with physical activity (p < 0.001). Following stepwise multiple linear regression analysis, the lean-fat ratio was the only determinant of irisin levels (B = 1.168, p < 0.001). CONCLUSIONS: Lean-fat ratio, more than the absolute amount of muscle or fat mass, as well as potential myokine-adipokine cross-talk mechanisms may explain the lower irisin levels in children with obesity and MS, through blunted compensatory responses interfering with tissue-dependent irisin secretion, contributing to a continuous deleterious effect cycle.
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Proinflammatory cytokines and the novel myokine irisin, a cleavage product of FNDC5, have been found to play a role in obesity and type 2 diabetes mellitus (T2DM). Irisin has been shown to increase browning of adipose tissue, thermogenesis, energy expenditure, and insulin sensitivity, yet its association with inflammatory markers is still limited. Circulating irisin has been found to be increased in obesity, while in adult subjects with T2DM decreased levels have been found. However, data establishing the association of circulating irisin in children and adolescents with T2DM has not been described in the literature. The objective of this study was to determine irisin plasma concentration and its association with metabolic and adiposity markers and with hs-CRP, a surrogate marker of inflammation used in clinical practice, in a pediatric population with T2DM. A cross-sample of 40 Mexican children and adolescents aged 7-17 were recruited, 20 diagnosed with T2DM and 20 healthy controls. Plasma irisin levels were found to be lower in the T2DM group compared with controls, which could be attributed to a reduced PGC-1α activity in muscle tissue with a consequent decrease in FNDC5 and irisin expression. Irisin concentration was found to be positively correlated with HDL-c, LDL-c, and total cholesterol, while negatively correlated with BMI, waist circumference, and triglycerides. However, after multiple regression analysis, only HDL-c correlation remained significant. hs-CRP was higher in the T2DM group and positively associated with adiposity markers, unfavorable lipid profile, insulin levels, and HOMA-IR, but no association with irisin was found. Given the favorable metabolic effects attributed to irisin, the low plasma levels found in children and adolescents with T2DM could exacerbate the inflammatory and metabolic imbalances and the intrinsic cardiovascular risk of this disease. We propose an "irisin-proinflammatory/anti-inflammatory axis" to explain the role of irisin as a metabolic regulator in obesity and T2DM.
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Proteína C-Reactiva/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/metabolismo , Fibronectinas/sangre , Adolescente , Antropometría , Índice de Masa Corporal , Niño , Femenino , Humanos , Masculino , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma/sangre , Triglicéridos/sangre , Circunferencia de la CinturaRESUMEN
Introducción: las cardiopatías congénitas son los defectos más frecuentes y primera causa de muerte en menores de un año, su etiología es multifactorial y los factores de riesgo diversos y muchos prevenibles. Objetivo: implementar un programa educativo para el desarrollo de conocimientos sobre prevención de cardiopatías congénitas en mujeres en edad fértil de dos consultorios médicos del Policlínico Docente "Samuel Fernández "del municipio Matanzas, entre enero 2015 a marzo 2016. Material y métodos: se realizó un estudio de intervención, se diagnosticó el nivel de conocimientos y necesidades educativas sentidas a través de un cuestionario al universo de mujeres en edad fértil de los consultorios médicos declarados. Para determinar la existencia de asociación entre ambas variables, se calculó el Chi cuadrado, para una confiabilidad de 99%. Se aplicó la prueba de la t de Student para comparar las medias aritméticas de la variable conocimiento antes y después de la intervención, para una confiabilidad de 99%. Resultados: el nivel de conocimiento de las féminas fue regular y las necesidades educativas sentidas altas antes de la intervención, modificándose a bien después de implementada la misma, con diferencias estadísticamente altamente significativas. Conclusiones: Se comprueba la eficacia del producto elaborado al constatarse el desarrollo de conocimientos sobre el tema (AU).
Introduction: congenital heart diseases are the most frequent defects and the first cause of death in children aged less than a year. Its etiology is multifactorial and the risk factors are diverse and many of them preventable. Objective: to put into practice an educative program for the development of knowledge on congenital heart diseases in fertile aged women from two medical consultations of the Teaching Policlinic "Samuel Fernández", municipality of Matanzas, from January 2015 to March 2016. Materials and methods: an intervention was carried out. It was diagnosed the level of knowledge and the educative necessities using an questionnaire filled in by the universe of fertile aged women from the declared medical consultations. To determine the existence of association between both variables chi-square was calculated for a reliability of 99 %. The T student test was applied to compare the arithmetic average of knowledge variable before and after the intervention, for a 99 % of reliability. Results: the women´s level of knowledge was regular and the perceived educative necessities were high before the intervention; the level of knowledge turned to good after the intervention, with significantly high statistical differences. Conclusions: the efficacy of the elaborated product was proved when development of knowledge on the theme was stated (AU).
Asunto(s)
Humanos , Femenino , Servicios Preventivos de Salud , Atención Primaria de Salud , Mujeres , Factores de Riesgo , Intervención Educativa Precoz , Fertilidad , Programas de Detección Diagnóstica , Cardiopatías Congénitas/prevención & control , Antecedentes Genéticos , Salud Materno-Infantil , Planes y Programas de Salud , Mortalidad Infantil , Educación en Salud , Epidemiología Descriptiva , Estudios Transversales , Encuestas y Cuestionarios , Estudios Controlados Antes y Después , Logros en Salud , Promoción de la Salud , Cardiopatías Congénitas/etiologíaRESUMEN
Introducción: las cardiopatías congénitas son los defectos más frecuentes y primera causa de muerte en menores de un año, su etiología es multifactorial y los factores de riesgo diversos y muchos prevenibles. Objetivo: implementar un programa educativo para el desarrollo de conocimientos sobre prevención de cardiopatías congénitas en mujeres en edad fértil de dos consultorios médicos del Policlínico Docente "Samuel Fernández "del municipio Matanzas, entre enero 2015 a marzo 2016. Material y métodos: se realizó un estudio de intervención, se diagnosticó el nivel de conocimientos y necesidades educativas sentidas a través de un cuestionario al universo de mujeres en edad fértil de los consultorios médicos declarados. Para determinar la existencia de asociación entre ambas variables, se calculó el Chi cuadrado, para una confiabilidad de 99%. Se aplicó la prueba de la t de Student para comparar las medias aritméticas de la variable conocimiento antes y después de la intervención, para una confiabilidad de 99%. Resultados: el nivel de conocimiento de las féminas fue regular y las necesidades educativas sentidas altas antes de la intervención, modificándose a bien después de implementada la misma, con diferencias estadísticamente altamente significativas. Conclusiones: Se comprueba la eficacia del producto elaborado al constatarse el desarrollo de conocimientos sobre el tema (AU).
Introduction: congenital heart diseases are the most frequent defects and the first cause of death in children aged less than a year. Its etiology is multifactorial and the risk factors are diverse and many of them preventable. Objective: to put into practice an educative program for the development of knowledge on congenital heart diseases in fertile aged women from two medical consultations of the Teaching Policlinic "Samuel Fernández", municipality of Matanzas, from January 2015 to March 2016. Materials and methods: an intervention was carried out. It was diagnosed the level of knowledge and the educative necessities using an questionnaire filled in by the universe of fertile aged women from the declared medical consultations. To determine the existence of association between both variables chi-square was calculated for a reliability of 99 %. The T student test was applied to compare the arithmetic average of knowledge variable before and after the intervention, for a 99 % of reliability. Results: the women´s level of knowledge was regular and the perceived educative necessities were high before the intervention; the level of knowledge turned to good after the intervention, with significantly high statistical differences. Conclusions: the efficacy of the elaborated product was proved when development of knowledge on the theme was stated (AU).
Asunto(s)
Humanos , Femenino , Servicios Preventivos de Salud , Atención Primaria de Salud , Mujeres , Salud Materno-Infantil , Factores de Riesgo , Intervención Educativa Precoz , Fertilidad , Antecedentes Genéticos , Programas de Detección Diagnóstica , Cardiopatías Congénitas/prevención & control , Planes y Programas de Salud , Mortalidad Infantil , Educación en Salud , Epidemiología Descriptiva , Estudios Transversales , Encuestas y Cuestionarios , Estudios Controlados Antes y Después , Logros en Salud , Promoción de la Salud , Cardiopatías Congénitas/etiologíaRESUMEN
Introducción: las gammapatías monoclonales son un grupo de desórdenescaracterizados por la proliferación de un clon de células plasmáticas que sintetizauna inmunoglobulina monoclonal, dentro de las que se encuentra como ejemplode neoplasia de células plasmáticas el mieloma múltiple, entidad que se caracterizapor la producción anormal de inmunoglobulinas.Objetivo: describir el comportamiento de las inmunoglobulinas en el seguimientode pacientes con mieloma múltiple, en el Servicio de Hematología del HospitalComandante Faustino Pérez de Matanzas.Materiales y Métodos: estudio descriptivo-prospectivo-longitudinal. El universo deestudio fue abierto y la muestra fueron todos los pacientes con mieloma múltiple dedebut, durante el período del 1ro de junio del 2013 al 31 de mayo del 2014, a loscuales se les realizó la determinación de inmunoglobulinas IgA, IgG e IgM.Resultados: los valores de IgA e IgG disminuidos presentaron una respuesta altratamiento muy buena ya desde los seis meses, aunque continuó mejorando a los12 meses. La IgM a los seis meses de tratamiento se modificó hacia valores aumentados clasificando como refractario revirtiéndose este comportamiento a los12 meses alcanzando un 13% más que antes del tratamiento.Conclusiones: los marcadores de mejor respuesta al tratamiento fueron lasinmunoglobulinas IgA e IgG (AU).
Introduction: monoclonal gammopathies are a group of disorders characterizedfor the proliferation of a clone of plasmatic cells that synthesize a monoclonalimmunoglobulin; among them, an example of plasmatic cells neoplasias is themultiple myeloma, an entity characterized by the abnormal production ofimmunoglobulins.Objective: to describe the behavior of immunoglobulins in the follow-up of patientswith multiple myeloma in the Hematology Service of the University HospitalComandante Faustino Pérez, of Matanzas.Materials and methods: longitudinal-prospective-descriptive study. The universeof study was open and the sample was all the patients with debuting multiplemyeloma, during the period from June 1st 2013 to May 31st 2014, to whom thedetermination of IgA, IgG and IgM immunoglobulins was carried out.Results: the diminished values of IgA and IgG showed a very good answer to thetreatment after six and 12 months. At the sixth months of the treatment the IgMwas modified to augmented values classifying as refractory; this behavior relapsedat the twelfth month, reaching 13 % more than before the treatment.Conclusions: the markers of better answer to the treatment were the IgA and IgGimmunoglobulins (AU).
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Humanos , Inmunoglobulinas , Atención Hospitalaria , Hematología , Mieloma Múltiple/sangre , Mieloma Múltiple/epidemiología , Inmunoglobulina A , Inmunoglobulina G , Inmunoglobulina M , Epidemiología Descriptiva , Estudios Prospectivos , Estudios LongitudinalesRESUMEN
OBJECTIVE: This study aimed to test the validity of an automatic oscillometric device to measure the blood pressure (BP) in children (n = 191) and adolescents (n = 127) aged 3 to 18 years. METHODS: Systolic BP (SBP) and diastolic BP (DBP) levels were measured simultaneous by automatic device and mercury column with Y-connection. To verify the validity, Bland-Altman plots and limits of agreement of 95% (95% LOA), specificity and sensitivity of the device, and the grade of British Hypertension Society (BHS) criteria were used. RESULTS: The monitor measurements demonstrated lower measurement bias (mean difference [95% LOA]): 1.4 (-9.9 to 12.8) mmHg in children and 4.3 (-7.8 to 16.5) mmHg in adolescents for SBP. For DBP, it was 2.2 (-7.4 to 11.7) mmHg in children and 1.4 (-8.4 to 11.1) mmHg in adolescents. The sensitivity in children was 21.4 (95% CI = 16.3-26.6), and in adolescents, it was 20.0 (95% CI = 13.2-26.8); the specificity was 95.9 (95% CI = 93.4-98.4) in children and 100.0 (95% CI = 100.0-100.0) in adolescents. The monitor-tested ratings are Grade B for SBP in children and SBP and DBP in adolescents and Grade C for DBP in children. CONCLUSIONS: The automatic monitor presented high values of specificity and lower values of sensitivity to the diagnosis of HBP; however, it can be considered accurate (lower measurement bias) and valid for epidemiological and clinical practice in accordance with BHS criteria.