RESUMEN
Ichthyomyini, a morphologically distinctive group of Neotropical cricetid rodents, lacks an integrative study of its systematics and biogeography. Since this tribe is a crucial element of the Sigmodontinae, the most speciose subfamily of the Cricetidae, we conducted a study that includes most of its recognized diversity (five genera and 19 species distributed from southern Mexico to northern Bolivia). For this report we analyzed a combined matrix composed of four molecular markers (RBP3, GHR, RAG1, Cytb) and 56 morphological traits, the latter including 15 external, 14 cranial, 19 dental, five soft-anatomical and three postcranial features. A variety of results were obtained, some of which are inconsistent with the currently accepted classification and understanding of the tribe. Ichthyomyini is retrieved as monophyletic, and it is divided into two main clades that are here recognized as subtribes: one to contain the genus Anotomys and the other composed by the remaining genera. Neusticomys (as currently recognized) was found to consist of two well supported clades, one of which corresponds to the original concept of Daptomys. Accordingly, we propose the resurrection of the latter as a valid genus to include several species from low to middle elevations and restrict Neusticomys to several highland forms. Numerous other revisions are necessary to reconcile the alpha taxonomy of ichthyomyines with our phylogenetic results, including placement of the Cajas Plateau water rat (formerly Chibchanomys orcesi) in the genus Neusticomys (sensu stricto), and the recognition of at least two new species (one in Neusticomys, one in Daptomys). Additional work is necessary to confirm other unanticipated results, such as the non-monophyletic nature of Rheomys and the presence of a possible new genus and species from Peru. Our results also suggest that ichthyomyines are one of the main Andean radiations of sigmodontine cricetids, with an evolutionary history dating to the Late Miocene and subsequent cladogenesis during the Pleistocene.
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Arvicolinae , Sigmodontinae , Animales , Filogenia , Evolución Biológica , PerúRESUMEN
INTRODUCTION: knee femoral condyle coronal fractures or Hoffa fractures are among the rarest fractures of the pelvic limb, being even more rare those of the medial condyle. The success in the management of these patients lies in the timely diagnosis and the consequent anatomical reduction of the femoral articular surface. CLINICAL CASE: the objective of this article is to present a patient with right medial Hoffa fracture, registered as a single case in the archives of our hospital. The patient was referred to us on November 2011, with a 10-day course after suffering a fall from horse ridding, presenting a forced varus mechanism and direct contusion of the right knee. He shows an anteroposterior and lateral knee X-rays showing a subtle solution of continuity in the coronal plane of the base of the medial condyle, corroborated with magnetic resonance imaging and was also associated with a non-surgical partial injury of both menisci and the anterior cruciate ligament. Surgical intervention was performed on 27th/11/2011, through open reduction with a medial approach and internal fixation with 7.0 mm (x2) cannulated screws. The patient was discharged with early and continuous mobilization of the knee, deferring support and rehabilitation until the 6th week. He is currently a wandering patient, asymptomatic, with complete range of motion. Because respecting the extensor apparatus through a medial approach and the articular surface with cannulated screws, it was observed in consequence an adequate evolution of our patient, being able to return to his daily activities, even remount.
INTRODUCCIÓN: las fracturas del cóndilo femoral en el plano coronal o fracturas de Hoffa se encuentran entre las fracturas más raras del miembro pélvico, pero son aún más raras las del cóndilo medial. El éxito en el manejo de estos pacientes radica en el diagnóstico oportuno y la consecuente reducción anatómica de la superficie articular del fémur. CASO CLÍNICO: el objetivo de este reporte es presentar a un paciente con el diagnóstico de fractura de Hoffa medial derecha, registrado como caso único en los archivos de nuestro hospital. El paciente acudió referido en Noviembre de 2011, con evolución de 10 días tras sufrir caída de caballo, presentando mecanismo de varo forzado y contusión directa de la rodilla derecha. Mostró radiografías anteroposterior y lateral de rodilla derecha, donde se observó de forma sutil solución de la continuidad en el plano coronal de la base del cóndilo medial, corroborado por resonancia magnética y asociado a lesiones parciales no quirúrgicas de ambos meniscos y del ligamento cruzado anterior. Se intervino quirúrgicamente el día 27 de Noviembre de 2011 mediante reducción abierta con abordaje medial y fijación interna con dos tornillos canulados de 7.0 mm. Se egresó al paciente indicando la movilización temprana y continua de la rodilla, difiriendo el apoyo y rehabilitación hasta la sexta semana. Actualmente el paciente se encuentra con posibilidad de deambulación, asintomático y con arcos de movilidad completos. El respeto del aparato extensor mediante un abordaje medial y la superficie articular con tornillos canulados se refleja en la adecuada evolución de nuestro paciente, pudiendo regresar a sus actividades diarias, incluso el montar.
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Fractura de Hoffa , Humanos , MasculinoRESUMEN
INTRODUCTION: the association of carpal tunnel syndrome with stenosing tenosynovitis of the hand is very rare, even more, if it is generated by a fibrolipoma at the carpal tunnel. The imaging study useful to detect this type of hand injuries are X-ray screening for carpal tunnel, computed tomography and magnetic resonance imaging. But these are not commonly used for the study of protocolized carpal tunnel syndrome and much less trigger finger. OBJECTIVE: the aim of this work is to report a case of a middle-aged female with carpal tunnel syndrome characteristic symptoms, associated with the third trigger finger; she was handled with the release of the median nerve by a minimally invasive approach, in addition to the A1 pulley release. CLINICAL CASE: the patient persists with both problems and at a secondary surgical review, we detected wrist locking sensation. The patient was reoperated finding an ovoid encapsulated tumor, measuring 3.0 × 2.0 × 1.0 cm, with smooth outer surface, whitish appearance, and soft rubbery consistency. The biopsy pathology outlines identified an encapsulated fibrolipoma, causing nerve compression and locking flexor tendon. CONCLUSION: the importance of this writing is in adding tumors to the etiological repertoire, which can cause compression of the median nerve and even less frequent as a cause of the flexor tendons of the hand snagging.
INTRODUCCIÓN: la asociación del síndrome del túnel del carpo con tenosinovitis estenosante de la mano es muy rara, aún más, si es generada por un fibrolipoma a nivel del túnel del carpo. El estudio de imagen para detectar este tipo de lesiones en la mano incluye: desde una radiografía con proyección para el túnel del carpo, tomografía axial computarizada y resonancia magnética nuclear; pero éstos no se utilizan habitualmente para el estudio protocolizado del síndrome del túnel del carpo y mucho menos para los dedos en gatillo. OBJETIVO: el objetivo de este trabajo es reportar un caso en el cual se presenta la sintomatología característica de un síndrome de túnel del carpo, asociada a tercer dedo en gatillo, el cual se maneja con la liberación del nervio mediano por medio de un abordaje de mínima invasión, además de la polea A1. CASO CLÍNICO: la paciente persistió con ambas alteraciones y en la revisión secundaria se detectó bloqueo a nivel de la muñeca. Se intervino nuevamente a la paciente y se encontró una tumoración encapsulada, que midió 3.0 × 2.0 × 1.0 cm, con superficie externa lisa, blanquecina, de aspecto ovoide y consistencia blanda "ahulada". El estudio anatomopatológico la identificó como un fibrolipoma encapsulado que ocasionó la compresión nerviosa y el bloqueo del tendón flexor. CONCLUSIÓN: la importancia de este reporte de caso radica en agregar los tumores al repertorio etiológico, que además pueden provocar una compresión del nervio mediano y en que sean aún menos frecuentes como causa de atrapamiento de los tendones flexores de la mano.
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Síndrome del Túnel Carpiano , Lipoma , Trastorno del Dedo en Gatillo , Persona de Mediana Edad , Humanos , Femenino , Muñeca , Síndrome del Túnel Carpiano/etiología , Síndrome del Túnel Carpiano/cirugía , Trastorno del Dedo en Gatillo/complicaciones , Trastorno del Dedo en Gatillo/diagnóstico , Dedos/cirugía , Articulación de la MuñecaRESUMEN
BACKGROUND: MiRNAs are small non-coding RNAs that regulate gene expression at the post-transcriptional level and have been associated with malignant transformation of oral epithelial precursor lesions such as oral leukoplakia. The aim was to perform a scoping review of the contemporary literature about the different roles of miRNAs during the malignant transformation of oral leukoplakia. MATERIAL AND METHODS: We conducted a systematic search with the following MeSH terms: 'oral leukoplakia', 'carcinoma in situ', 'microRNAs', 'mouth neoplasms' and 'epithelial-mesenchymal transition' in PubMed/MEDLINE, EMBASE and SpringerLink. RESULTS: Fifteen articles were included for analysis, among which in vivo and in vitro articles were included. A total of 21 different miRNAs were found to be involved in the malignant transformation process of oral leukoplakia. Regarding their possible effects, 6 miRNAs were classified as oncogenic, 5 as tumour suppressors and 10 were related to epithelial-mesenchymal transition, invasion and migration. CONCLUSIONS: Based on the current review, we concluded that miRNAs-21, 345, 181-b and 31* seem to be potential markers of malignant transformation of oral leukoplakia. However, further clinical prospective studies are needed in order to validate their utility as prognostic biomarkers.
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MicroARNs , Neoplasias de la Boca , Transformación Celular Neoplásica/genética , Humanos , Leucoplasia Bucal/genética , MicroARNs/genética , Estudios ProspectivosRESUMEN
Chagas disease caused by Trypanosoma cruzi parasite is an endemic infection in America. It is well known that T. cruzi causes a strong immunosuppression during the acute phase of infection. However, it is not clear whether T. cruzi infection is related to metabolic alterations in CD4 T cells that prevent downstream effector function. Here, we evaluated the CD4 T cell metabolic and mitochondrial profiles from non-infected (NI), acute phase (AP) and chronic phase (CP) T. cruzi infected mice. CD4 T cells from all groups showed increased glucose uptake after stimulation. Moreover, the bioenergetic analysis revealed a rise in glycolysis and a higher oxidative metabolism in CD4 T cells from the AP. These cells showed increased proton leak and uncoupling protein 3 (UCP3) expression that correlated with mitochondrial ROS (mROS) accumulation, mitochondrial membrane potential (MMP) depolarization and expression of PD-1. In addition, CD4 T cells with mitochondrial alteration displayed an activated phenotype, and were less functional and more prone to apoptosis. In contrast, mitochondrial alterations were not observed during in vivo activation of CD4 T cells in a model of OVA-immunization. The Mn-superoxide dismutase (SOD2) expression, which is involved in mROS detoxification, was increased during the AP and CP of infection. Remarkably, the apoptosis observed in CD4 T cells with MMP depolarization was prevented by incubation with N-acetyl cysteine (NAC). Thus, our results showed that infection triggered an exacerbated metabolism together with mROS production in CD4 T cells from the AP of infection. However, antioxidant availability may not be sufficient to avoid mitochondrial alterations rendering these cells more susceptible to apoptosis. Our investigation is the first to demonstrate an association between a disturbed metabolism and an impaired CD4 T cell response during T. cruzi infection.
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Enfermedad de Chagas , Trypanosoma cruzi , Animales , Apoptosis , Linfocitos T CD4-Positivos , Enfermedad de Chagas/genética , Ratones , Especies Reactivas de OxígenoAsunto(s)
Humanos , Lactante , Seudohipoparatiroidismo/diagnóstico , Seudohipoparatiroidismo/genética , Seudohipoparatiroidismo/terapia , Displasia Fibrosa Poliostótica/complicaciones , Displasia Fibrosa Poliostótica/diagnóstico , Displasia Fibrosa Poliostótica/terapia , Diagnóstico Diferencial , Obesidad Infantil/etiología , Hipocalcemia/etiologíaRESUMEN
Circulating 25-hydroxy vitamin D (25(OH)D) is related to decreased rates of gastrointestinal and ear infections in school-age children. Vitamin D-binding protein (DBP) transports 25(OH)D and exerts immunological functions; however, it is unknown whether DBP is associated with infectious morbidity in children. We quantified plasma DBP concentrations in 540 school-age children at the time of recruitment into a cohort study in Bogotá, Colombia and obtained daily information on infectious morbidity symptoms and doctor visits during the school year. We compared the incidence rates of gastrointestinal and respiratory symptoms across quartiles of DBP concentration by estimating adjusted incidence rate ratios (IRRs) with 95% confidence interval (CI). We also estimated the per cent of the associations between DBP and morbidity that were mediated through 25(OH)D using a counterfactual frame. Mean ± s.d. DBP concentration was 2650 ± 1145 nmol/l. DBP was inversely associated with the rates of diarrhoea with vomiting (IRR for quartiles 2-4 vs. 1 = 0.48; 95% CI 0.25-0.92; P = 0.03) and earache/ear discharge with fever (IRR for quartiles 2-4 vs. 1 = 0.29; 95% CI 0.12-0.71; P = 0.006). The DBP-morbidity associations were not mediated through 25(OH)D. We conclude that plasma DBP predicts lower incidence of gastrointestinal and ear infections in school-age children independent of 25(OH)D.
Asunto(s)
Gastroenteritis/epidemiología , Otitis/epidemiología , Instituciones Académicas , Estudiantes , Proteína de Unión a Vitamina D/sangre , Niño , Preescolar , Estudios de Cohortes , Colombia/epidemiología , Femenino , Gastroenteritis/inmunología , Humanos , Incidencia , Masculino , Otitis/inmunología , Plasma/química , Vitamina D/sangreRESUMEN
There is a growing demand for surgical care in South America, particularly for patients with congenital orofacial clefts (OFCs). Short-term surgical missions (STSMs) have emerged as a means to deliver surgical expertise and alleviate this demand. The aim of this study was to review the quantity and quality of peer-reviewed reports on OFC repairs performed by STSMs in South America. A literature search was conducted using the PubMed, Embase, Web of Science, and SciELO databases. The search was limited to articles published in English and Spanish. Descriptive statistics were used for the data analysis. The search yielded 65 studies related to OFCs. Eight (12.3%) were selected for full-text review. Only five (7.7%) articles met the inclusion criteria. The diverse study designs and heterogeneous types of data assessment among the selected studies hindered a comparison between them. This review found a sparse number of publications pertaining to OFC missions to South America. The articles that were included demonstrated inconsistencies in reporting patient care data. There is a need for a more efficient, streamlined method of reporting humanitarian missions for OFC repairs in order for healthcare professionals to fulfill research and ethical obligations and offer the best practices in patient-centered care.
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Labio Leporino/cirugía , Fisura del Paladar/cirugía , Misiones Médicas , Niño , Preescolar , Humanos , Lactante , Recién Nacido , América del SurRESUMEN
The male gonadal tissue can be a sensitive target to the reprogramming effects of testosterone (T) during prenatal development. We have demonstrated that male lambs born to dams receiving T during pregnancy-a model system to the polycystic ovary syndrome (PCOS)-show a decreased number of germ cells early in life, and when adult, a reduced amount of sperm and ejaculate volume. These findings are a key to put attention to the male offspring of women bearing PCOS, as they are exposed to increased levels of androgen during pregnancy which can reprogram their reproductive outcome. A possible origin of these defects can be a disruption in the expression of the anti-Müllerian hormone (AMH), due to its critical role in gonadal function at many postnatal stages. Therefore, we addressed the impact of prenatal T excess on the expression of AMH and factors related to its expression like AP2, SOX9, FSHR, and AR in the testicular tissue through real-time PCR during the peripubertal age. We also analyzed the testicular morphology and quantified the number of Sertoli cells and germ cells to evaluate any further defect in the testicle. Experiments were performed in rams at 24 wk of age, hence, prior puberty. The experimental animals (T-males) consisted of rams born to mothers receiving 30 mg testosterone twice a wk from Day 30 to 90 of pregnancy and then increased to 40 mg until Day 120 of pregnancy. The control males (C-males) were born to mothers receiving the vehicle of the hormone. We found a significant increase in the expression of the mRNA of AMH and SOX9, but not of the AP2, FHSR nor AR, in the T-males. Moreover, T-males showed a dramatic decrease in the number of germ cells, together with a decrease in the weight of their testicles. The findings of the present study show that before puberty, T-males are manifesting clear signs of disruption in the gonadal functions probably due to an alteration in the expression pattern of the AMH gene. The precise way by which T reprograms the expression of AMH gene remains to be established.
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Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Maduración Sexual/efectos de los fármacos , Ovinos/fisiología , Testículo/fisiología , Testosterona/administración & dosificación , Animales , Hormona Antimülleriana , Peso Corporal/efectos de los fármacos , Femenino , Masculino , Tamaño de los Órganos/efectos de los fármacos , Embarazo , Efectos Tardíos de la Exposición Prenatal , ARN Mensajero/genética , ARN Mensajero/metabolismo , Maduración Sexual/fisiología , Testosterona/farmacologíaRESUMEN
Cardiac hydatidosis without involvement of extracardiac organs is an uncommun condition. We report a case of a 20 years old female without any prior disease, she consult for progressive dyspnea and palpitations. Echocardiogram and cardiac MRI shows cystic lesion in apical intraventricular septum suggestive of hydatid cyst. No other organs were affected. The patient underwent surgery with successful removal of hydatid cyst and medical treatment with Albendazole, after that, the patient remains asymptomatic.
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Humanos , Femenino , Adulto , Equinococosis/complicaciones , Cardiopatías/complicaciones , Cardiopatías/parasitología , Ecocardiografía , Tomografía Computarizada por Rayos X , Albendazol/uso terapéutico , Chile , Equinococosis/tratamiento farmacológicoRESUMEN
Diabetes mellitus in canines corresponds to a pathology whose etiopathogenesis has not yet been fully understood, since it has a great similarity with human type 1 diabetes mellitus, but the same risk factors have not been found. New diagnostic methods have been investigated in recent years in diabetic murine models, among which microRNAs have been studied as early markers of type 1 and type 2 diabetes mellitus. In canines a homology has been found between microRNAs 21, microRNA 34, microRNA 29, and microRNA 146a with those studied in human and murine diabetics. This would imply that the study of these microRNAs may have a great impact on the early detection of diabetes in canines and be a model for the study of new microRNAs that may be implicated in the development of diabetes in humans.
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MicroARNs/metabolismo , Diabetes Mellitus/genética , Diabetes Mellitus/veterinaria , Enfermedades de los Perros/genética , Diagnóstico Precoz , Diabetes MellitusRESUMEN
Antecedentes: La diabetes en el embarazo se asocia a un incremento considerable en la morbimortalidad materna, fetal y perinatal. Objetivo: Determinar los desenlaces maternos, fetales y perinatales de las gestantes con diagnóstico de diabetes pre gestacional en manejo con bomba de insulina en el Hospital Universitario San Ignacio. Método: Estudio de corte transversal en 24 gestantes con diagnóstico de diabetes en manejo con bomba de insulina quienes asistieron a control por Endocrinología y Alto Riesgo Obstétrico en el Hospital Universitario San Ignacio, entre Septiembre de 2009 y Diciembre de 2015. Resultados: La complicación materna más frecuente fue la hipoglicemia sintomática (50%), en segundo lugar los trastornos hipertensivos asociados al embarazo (45,8%). Las complicaciones neonatales más frecuentes fueron el síndrome de dificultad respiratoria del recién nacido (37,5%) y la hiperbilirrubinemia (37,5%). La hemoglobina glicosilada mayor del 6% se relacionó con el 71% de pacientes con macrosomía fetal. Conclusiones: La bomba de infusión de insulina representa una estrategia relativamente nueva dentro de los protocolos de manejo de diabetes pre gestacional y embarazo. Representaría una opción de manejo segura y fácil para el control de la glicemia en pacientes con indicaciones precisas.
Background: Diabetes in pregnancy is associated to a considerable increase in the maternal, fetal and perinatal morbidity and mortality. Objective: Determine the maternal, fetal and perinatal outcomes of patients with pre gestational diabetes being treated with insulin pump at Hospital San Ignacio. Methods: Cross-sectional study of 24 patients diagnosed with diabetes being treated with insulin pump who assisted to controls made by Endocrinology and Obstetrical High-Risk units at Hospital San Ignacio from September 2009 to December 2015. Results: The most common maternal complication was symptomatic hypoglycemia (50%) followed by hypertensive disorders of pregnancy (45.8%). Most common neonatal complications were respiratory distress syndrome (37.5%) and hyperbilirubinemia (37.5%). Glycosylated hemoglobin higher than 6% was related with 71% of patients who developed fetal macrosomia. Conclusions: The insulin infusion pump is a relatively new strategy management of pre gestational diabetes and pregnancy. Representing a safe and easy option for glycemic control in patients with precise indications.
Asunto(s)
Humanos , Femenino , Diabetes Mellitus Tipo 2/complicaciones , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Colombia , Estudios Transversales , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Gestacional , Epidemiología Descriptiva , Bombas de Infusión , Insulina/administración & dosificaciónRESUMEN
BACKGROUND/OBJECTIVES: Studies in adults indicate that dietary polyunsaturated fatty acid (PUFA) composition may play a role in development of adiposity. Because adipocyte quantity is established between late childhood and early adolescence, understanding the impact of PUFAs on weight gain during the school-age years is crucial to developing effective interventions. SUBJECTS/METHODS: We quantified N-3 and N-6 PUFAs in serum samples of 668 Colombian schoolchildren aged 5-12 years at the time of recruitment into a cohort study, using gas-liquid chromatography. Serum concentrations of N-3 (alpha-linolenic acid (ALA), eicosapentaenoic acid, docosahexaenoic acid) and N-6 PUFAs (linoleic acid, gamma-linolenic acid, dihomo-gamma-linolenic acid, arachidonic acid) were determined as percentage total fatty acids. Children's anthropometry was measured annually for a median of 30 months. We used mixed-effects models with restricted cubic splines to construct population body mass index-for-age z-score (BAZ) growth curves for age- and sex-specific quartiles of each PUFA. RESULTS: N-3 ALA was inversely related to BAZ gain after adjustment for sex, baseline age and weight status, as well as household socioeconomic level. Estimated BAZ change between 6 and 14 years among children in the highest quartile of ALA compared with those in the lowest quartile was 0.45 (95% confidence interval: 0.07, 0.83) lower (P-trend=0.006). CONCLUSIONS: N-3 ALA may be protective against weight gain in school-age children. Whether improvement in PUFA status reduces adiposity in pediatric populations deserves evaluation in randomized trials.
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Índice de Masa Corporal , Dieta , Ácidos Grasos/sangre , Estado Nutricional , Obesidad Infantil/prevención & control , Aumento de Peso/efectos de los fármacos , Ácido alfa-Linolénico/sangre , Adiposidad/efectos de los fármacos , Niño , Preescolar , Estudios de Cohortes , Colombia , Grasas de la Dieta/sangre , Grasas de la Dieta/farmacología , Grasas de la Dieta/uso terapéutico , Ácidos Grasos/farmacología , Ácidos Grasos/uso terapéutico , Femenino , Humanos , Masculino , Obesidad Infantil/sangre , Ácido alfa-Linolénico/farmacología , Ácido alfa-Linolénico/uso terapéuticoRESUMEN
La enfermedad del hígado graso no alcohólica compromete de 2 a 8% de la población general; esta se relaciona con obesidad, diabetes tipo 2, síndrome metabólico y resistencia a la insulina. Objetivo: caracterizar a los pacientes con enfermedad del hígado graso no alcohólica que consultaron al servicio de hepatología del hospital de 4to nivel, entre los años 2006 y 2011. Metodología: estudio observacional descriptivo retrospectivo; la población estuvo constituida por la totalidad de los pacientes atendidos en el servicio de hepatología del hospital de 4to nivel, durante el periodo de estudio con diagnóstico de enfermedad del hígado graso no alcohólica, se excluyeron pacientes con hepatopatía de otro origen. La recolección de información se realizó por medio de las historias clínicas en un formulario de recolección de datos diseñado por los investigadores, luego fueron tabulados y analizados en el SPSS ® versión 17.0. Se calcularon medidas de tendencia central, posición y dispersión para variables cuantitativas, frecuencias absolutas y relativas para las cualitativas. Se aplicaron las pruebas de U de Mann-Whitney y chi-cuadrado según correspondiera. Resultados: el 58,5% fueron pacientes de sexo femenino. Se encontró que 52,3% del total de la muestra tenían sobrepeso según el índice de masa corporal y 72,1% mostraron hígado graso por ecografía. Conclusión: se encontró que la mayoría de los pacientes con enfermedad del hígado graso no alcohólica tienen elevado el índice de masa corporal, datos similares a los reportados en otras series.
Non-alcoholic fatty liver disease (NAFLD) affects 2% to 8% of the general population. It is associated with obesity, type 2 diabetes, metabolic syndrome and insulin resistance. Objective: The objective of this study was to characterize patients with NAFLD who were treated in the Hepatology Department of a 4th level hospital between 2006 and 2011. Methods: This was a descriptive, observational and retrospective study of a population consisting of all patients treated in the hepatology department of a 4th level hospital who had been diagnosed with NAFLD. Patients with other liver diseases were excluded. Data was collected from medical records on a form designed by the researchers. Data were then tabulated and analyzed in SPSS ® version 17.0. Measures of central tendency, position and dispersion were calculated for quantitative variables, and absolute and relative frequencies were calculated for qualitative variables. The Mann-Whitney U test and the and chi-square test were used as appropriate. Results: 58.5% of the sample were female patients. We found that 52.3% of the sample were overweight according to BMI, and 72.1% were diagnosed with fatty liver by ultrasound. Conclusion: We found that most patients with NASH have elevated body mass indices similar to reports published elsewhere.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Hígado Graso , Resistencia a la Insulina , ObesidadRESUMEN
BACKGROUND: Breast-conserving surgery (BCS) may sometimes lead to deformities in the remaining breast. Oncoplastic surgery (OPS) aims to improve our aesthetic results even in the case of major volume resections. The purpose of this study is to provide an objective evaluation of our initial experience with OPS, mainly based on the levels of satisfaction reported by both patients and surgeons. PATIENTS AND METHODS: This prospective study was performed at CECLINES in Caracas, Venezuela, between January 2011 and October 2012. It involved 107 consecutive patients in two groups: 52 patients with level II OPS versus 55 patients with 'standard' BCS (SBCS). We evaluated the level of satisfaction and cosmetic outcome at 6 and 12 months post-operation using a score from 1 (bad) to 5 (excellent). The cosmetic score was recorded during the follow-up by the surgeon, by phone calls, and photographs were reviewed by a panel of four observers. RESULTS: The participation rate in the cosmetic outcome/level of satisfaction evaluation was 100% at 6 months and 96.2% at 12 months. The average tumour size was 23 mm [standard deviation (SD): 13.5] for the OPS group versus 17.6 mm (SD: 8.3) for the SBCS group (p = 0.017). The average weight for the surgical specimen was 101 g (range: 30-512 g) in the OPS group versus 60.4 g (range: 20-135 g) in the SBCS group (p = 0.004). The OPS techniques most performed were round block 40.3% (21/52), inverted T mammoplasty 26.8% (14/52) and vertical scar mammoplasty 15.3% (8/52). Of all the patients, 51.9% (27/52) had symmetrisation procedures performed distributed according to the period of the study: 77.2% (17/22) in 2011, 56.6% (17/30) in 2012, and 18.1% (6/33) in 2013. The rate of complications was 5.7% (3/52) in the OPS group and 0% for the SBCS group (p < 0.005). The average cosmetic score at 6 months by patients in the OPS group was 4.4; patient satisfaction scores of 4 (good) and 5 (excellent) were 88.4%. In the SBCS group at 6 months, the mean score reported by patients was 4.2, with scores 4-5 being 83.4% (p = 0.644). The cosmetic score by surgeons in the OPS group at 6 months was 4.5; the surgeon satisfaction scores of 4-5 were 94.2%. In the SBCS group, the surgeons' mean score at 6 months was 4.1, with 84.5% of scores being 4 or 5 (p < 0.005). The final cosmetic score by patients in the OPS group at 12 months was 4.5; patient satisfaction scores of 4-5 were 90.4%. In the SBCS group, the final mean score at 12 months by patients was 4.2, with 77.5% of scores being 4 or 5 (p < 0.005). The final cosmetic score by surgeons in the OPS group at 12 months was 4.5; surgeon satisfaction scores of 4-5 were 92.3%. In the SBCS group, the surgeons' final mean score at 12 months was 4.1, with 84.5% of scores being 4 or 5 (p < 0.005). CONCLUSIONS: OPS provides good satisfaction rates. An SBCS when an OPS is not indicated mostly results in good satisfaction levels and cosmetic scores. Usually, the results remain stable after 6 months. The use of OPS allows the excision of bigger lesions and surgical specimens. Symmetrisation procedures are not always required. With the appropriate patient selection, the rate of complications is low for both OPS and SBCS.
RESUMEN
The in vitro leishmanicidal activity and cytotoxicity of pyrazole-containing macrocyclic polyamines 1-4 was assayed on Leishmania infantum and Leishmania braziliensis species. Compounds 1-4 were more active and less toxic than glucantime and both infection rates and ultrastructural alterations confirmed that 1 and 2 were highly leishmanicidal and induced extensive parasite cell damage. Modifications in the excretion products of parasites treated with 1-3 were also consistent with substantial cytoplasm alterations. Compound 2 was highlighted as a potent inhibitor of Fe-SOD in both species, whereas its effect on human CuZn-SOD was poor. Molecular modelling suggested that 2 could deactivate Fe-SOD due to a sterically favoured enhanced ability to interact with the H-bonding net that supports the enzyme`s antioxidant features.
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Antiprotozoarios/farmacología , Leishmania braziliensis/efectos de los fármacos , Leishmania infantum/efectos de los fármacos , Leishmaniasis/tratamiento farmacológico , Pirazoles/farmacología , Superóxido Dismutasa/efectos de los fármacos , Animales , Antiprotozoarios/química , Línea Celular , Supervivencia Celular/efectos de los fármacos , Eritrocitos/efectos de los fármacos , Femenino , Humanos , Leishmania braziliensis/enzimología , Leishmania braziliensis/ultraestructura , Leishmania infantum/enzimología , Leishmania infantum/ultraestructura , Leishmaniasis/parasitología , Compuestos Macrocíclicos/química , Compuestos Macrocíclicos/farmacología , Macrófagos/efectos de los fármacos , Ratones Endogámicos BALB C , Microscopía Electrónica de Transmisión , Modelos Moleculares , Poliaminas/química , Poliaminas/farmacología , Proteínas Protozoarias/efectos de los fármacos , Proteínas Protozoarias/metabolismo , Pirazoles/química , Superóxido Dismutasa/metabolismoRESUMEN
La discapacidad visual es un problema de salud pública que afecta a más de doscientos ochenta y cinco millones de personas alrededor del mundo, dentro de los cuales doscientos cuarenta y seis millones sufren baja visión y treinta y nueve millones ceguera primaria. Es una entidad altamente relacionada con las condiciones socioeconómicas y las posibilidades de acceder a los servicios de salud, esto explica que entre el 80 y el 90 por ciento de las personas con alteraciones visuales sean de países en vía de desarrollo, principalmente en zonas rurales. Una infinidad de casos de ceguera y baja visión son consecuencia de eventos prevenibles, entre los cuales sobresalen los defectos refractivos no corregidos tales como astigmatismo, miopía, hipermetropía y presbicia. Es por esto que la discapacidad visual se ha convertido en una prioridad para múltiples entidades a nivel mundial, que buscan disminuir la presentación de ceguera prevenible a través de una simple corrección visual bien diagnosticada...
Visual impairment is a public health problem that affects more than two hundred eighty-five million people around the world, among them two hundred forty-six million suffer low vision and thirty-nine million primary blindness. It is highly related to socio-economic conditions and the possibilities to access to health services, explained that between 80 and 90 percent of persons with visual impairments from countries developing, mainly in rural areas. An infinite number of cases of blindness and low vision are the result of events preventable, among which stand out the uncorrected refractive errors such as myopia, hyperopia, astigmatism and presbyopia. It is for this reason that visual impairment has become a priority for many organizations around the world, seeking to reduce the presentation of preventable blindness through a simple visual correction well diagnosed...
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Humanos , Baja Visión/diagnóstico , Baja Visión/epidemiología , Ceguera/diagnóstico , Ceguera/epidemiologíaRESUMEN
AIM: Objective of the study was to determine the effects of a periodized resistance training program on body composition, plasmatic levels of leptin and resistin, and muscle strength in elderly post-menopausal women. METHODS: Twenty-three post-menopausal women (age= 63.02±4.42 years; height 1.55±0.06 m; body mass 67.56±2.26 kg) were submitted to 12 months of periodized resistance training twice a week. The training program consisted of 3 sets of 6-14 repetitions maximal (RM). Body composition (DXA), muscle strength (bench press, leg press 45º and arm curl), plasmatic levels of resistin and leptin (ELISA method) were assessed before and after the training program. Paired Student's t test was used for comparison between pre- and post-training values. RESULTS: There was a significant increase in muscle strength and lean body mass; decrease in body mass, body fat percentage and fat mass after 12 months of resistance training, a part from the decrease in leptin and resistin levels. CONCLUSION: Long-term periodized resistance training prevents aging sarcopenia, decreases body fat and systemic markers of inflammation in postmenopausal elderly women.
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Distribución de la Grasa Corporal , Leptina/sangre , Fuerza Muscular/fisiología , Entrenamiento de Fuerza/métodos , Resistina/sangre , Anciano , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia/fisiologíaRESUMEN
BACKGROUND: Studies regarding the role of iron on linear growth have yielded heterogeneous results. Some trials indicate that iron supplementation of iron-replete infants leads to slower-length gain. However, little is known of the relation between iron status and linear growth in school-age children. METHODS: We quantified plasma ferritin, mean corpuscular volume (MCV), and hemoglobin in 2714 children aged 5-12 years at recruitment into a cohort study. Height was measured periodically for a median of 30 months. Height-for-age Z-scores (HAZ) were calculated using the World Health Organization growth reference. Mixed effects models with restricted cubic splines were used to construct population HAZ-for-age growth curves for sex- and age-specific quartiles of each iron status indicator. RESULTS: Ferritin and MCV were each inversely related to attained HAZ among boys after the adjustment for baseline age, baseline body mass index-for-age Z-score and socioeconomic status. There was a decreasing monotonic relation between quartiles of ferritin and estimated change in HAZ from ages 6 to 14 years (P trend=0.001); boys in the 4th quartile experienced a HAZ change that was 0.46 Z lower than that of boys in the 1st quartile (P=0.0006). Similarly, we observed smaller HAZ change among boys in the highest quartile of MCV in comparison with those in the 1st quartile (P trend=0.001). Hemoglobin was not related to linear growth in boys. None of the iron-status indicators were associated with linear growth in girls. CONCLUSIONS: Higher iron status, as indicated by ferritin and MCV, is related to slower linear growth in iron-replete school-age boys.