Proteomic profiling of Arabidopsis nuclei reveals distinct protein accumulation kinetics upon heat stress.

Heat stress (HS) impacts the nuclear proteome and, subsequently, protein activities in different nuclear compartments. In Arabidopsis thaliana, a short exposure to 37 °C leads to loss of the standard tripartite architecture of the nucleolus, the most prominent nuclear substructure, and, consequently, affects the assembly of ribosomes. Here, we report a quantitative label-free LC‒MS/MS (Liquid Chromatography coupled to tandem Mass Spectrometry) analysis to determine the nuclear proteome of Arabidopsis at 22 °C, HS (37 °C for 4 and 24 h), and a recovery phase. This analysis identified ten distinct groups of proteins based on relative abundance changes in the nucleus before, during and after HS: Early, Late, Transient, Early Persistent, Late Persistent, Recovery, Early-Like, Late-Like, Transient-Like and Continuous Groups (EG, LG, TG, EPG, LPG, RG, ELG, LLG, TLG and CG, respectively). Interestingly, the RNA polymerase I subunit NRPA3 and other main nucleolar proteins, including NUCLEOLIN 1 and FIBRILLARIN 1 and 2, were detected in RG and CG, suggesting that plants require increased nucleolar activity and likely ribosome assembly to restore protein synthesis after HS.

Smartphone-Based Localization for Passengers Commuting in Traffic Hubs.

Passengers commute between different modes of transportation in traffic hubs, and passenger localization is a key component for the effective functioning of these spaces. The smartphone-based localization system presented in this work is based on the 3D step and heading approach, which is adapted depending on the position of the smartphone, i.e., held in the hand or in the front pocket of the trousers. We use the accelerometer, gyroscope and barometer embedded in the smartphone to detect the steps and the direction of movement of the passenger. To correct the accumulated error, we detect landmarks, particularly staircases and elevators. To test our localization algorithm, we have recorded real-world mobility data in a test station in Munich city center where we have ground truth points. We achieve a 3D position accuracy of 12 m for a smartphone held in the hand and 10 m when the phone is placed in the front pocket of the trousers.

Nuclear dynamics: Formation of bodies and trafficking in plant nuclei.

The existence of the nucleus distinguishes prokaryotes and eukaryotes. Apart from containing most of the genetic material, the nucleus possesses several nuclear bodies composed of protein and RNA molecules. The nucleus is separated from the cytoplasm by a double membrane, regulating the trafficking of molecules in- and outwards. Here, we investigate the composition and function of the different plant nuclear bodies and molecular clues involved in nuclear trafficking. The behavior of the nucleolus, Cajal bodies, dicing bodies, nuclear speckles, cyclophilin-containing bodies, photobodies and DNA damage foci is analyzed in response to different abiotic stresses. Furthermore, we research the literature to collect the different protein localization signals that rule nucleocytoplasmic trafficking. These signals include the different types of nuclear localization signals (NLSs) for nuclear import, and the nuclear export signals (NESs) for nuclear export. In contrast to these unidirectional-movement signals, the existence of nucleocytoplasmic shuttling signals (NSSs) allows bidirectional movement through the nuclear envelope. Likewise, nucleolar signals are also described, which mainly include the nucleolar localization signals (NoLSs) controlling nucleolar import. In contrast, few examples of nucleolar export signals, called nucleoplasmic localization signals (NpLSs) or nucleolar export signals (NoESs), have been reported. The existence of consensus sequences for these localization signals led to the generation of prediction tools, allowing the detection of these signals from an amino acid sequence. Additionally, the effect of high temperatures as well as different post-translational modifications in nuclear and nucleolar import and export is discussed.

Body Dissatisfaction, Distorted Body Image and Disordered Eating Behaviors in University Students: An Analysis from 2017-2022.

University students, as young adults, are at risk for Body Dissatisfaction (BD) and Distorted Body Image (DBI), which are related to Disordered Eating Behaviors (DEBs). This study aimed to assess changes in the prevalence of these three conditions over six years; and the associations between them. Data was collected through an annual online survey from 2017 to 2022 at a private university in Mexico City. Students between 18-30 years old were invited to participate. Body image-related variables were assessed by the Stunkard's Silhouettes and Body Mass Index, by self-reported height and weight. Disordered Eating Behaviors were measured by the Brief Disordered Eating Behaviors Questionnaire. A median of 250 students participated per year, with a median age of 21 years old. The prevalence was 63.5-71.7% for BD, 40.4-49.1% for DBI, and 25-38.3% for DEBs. DEBs and BD showed associations during the whole period (OR from 3.6 to 15.9, p ≤ 0.001); as well as DBI with DEBs (OR from 1.9 to 3.3, p < 0.05). Alterations in Body Image and eating behaviors are common conditions, mainly in women and in the young population. Therefore, it is important to promote screening for these conditions, as they usually remain undiagnosed, their prevalence is increasing worldwide, and their impact on physical and mental health has already been acknowledged.

Brugada syndrome unmasked by fever and paradoxical lower degree of dromotropic disturbance in the right ventricular outflow tract

Brugada syndrome (BrS) is an inherited clinical-electrocardiographic arrhythmic entity with an autosomal dominant genetic pattern of inheritance or de novo variant. The syndrome has low worldwide prevalence, but is endemic in Southeast Asian countries (Thailand, Philippines and Japan). The BrS is a subtle structural heart disease (SHD), and the diagnosis is only possible when the so-called type 1 Brugada ECG pattern is spontaneously present or induced for example with fever. Repolarization-depolarization disturbances in BrS patients can be caused by genetic mutations, abnormal neural crest cell migration, low expression of connexin-43 gap junction protein, or connexome disturbances. A recent autopsy study revealed increase in biventricular collagen with myocardial fibrosis when compared with control subjects although the main affected cardiac territory is the right ventricular outflow tract (RVOT). In this location, there is abnormally low expression of significant connexin-43 gap junction responsible for the electro-vectorcardiographic manifestations of terminal QRS conduction delay in the right standard precordial leads (V1-V2), high right precordial leads (V1H-V2H), as well as in the unipolar aVR lead ("the forgotten lead"). Based on their location, these leads reflect the electrical activity of the RVOT.

A síndrome de Brugada (SBr) é uma entidade arrítmica clínico-eletrocardiográfica hereditária com padrão genético autossômico dominante de herança ou variante de novo. A síndrome tem baixa prevalência mundial, porém sendo endêmica no Sudeste Asiático (Tailândia, Filipinas e Japão). A SBr é uma doença cardíaca minimamente estrutural, sendo o diagnóstico só possível na presença do chamado padrão ECG de Brugada tipo 1 espontâneo ou induzido, por exemplo, a febre. Os distúrbios de repolarização-despolarização em pacientes com SBr podem ser causados por mutações genéticas responsáveis pela migração anormal de células da crista neural, baixa expressão "gap junctions" conexina-43 ou distúrbios do conexoma. Um estudo recente de autópsia revelou aumento do colágeno biventricular com fibrose miocárdica quando comparado aos controles, embora o principal território cardíaco afetado seja a via de saída do ventrículo direito (VSVD). Nessa área, há menor expressão da conexina-43, o que se traduz no ECG-VCG por atraso final de condução do QRS nas derivações precordiais direitas (V1-V2), precordiais direitas altas (V1H-V2H), bem como na derivação unipolar aVR ("a derivação esquecida"). Com base em sua localização, esses eletrodos refletem a atividade elétrica da VSVD

Anaerobic RSH-dependent tellurite reduction contributes to Escherichia coli tolerance against tellurite.

BACKGROUND: Tellurium is a rare metalloid that exerts high toxicity on cells, especially on bacteria, partly due to reactive oxygen species (ROS) generation. Moreover, it has also been observed that tellurite can target free cell thiols groups (RSH) (i.e. reduced glutathione (GSH)), enhancing the cellular redox imbalance. Additionally, in vitro experiments have suggested that several enzymes can reduce tellurite (IV) to its elemental form (0); where RSH present on their active sites may be responsible for the process. Nevertheless, the mechanisms implemented by bacteria for tellurite reduction and its role in resistance have not been evaluated in vivo. RESULTS: This work shows that tellurite reduction to elemental tellurium is increased under anaerobic conditions in E. coli cells. The in vivo tellurite reduction is related to the intracellular concentration of total RSH, in the presence and absence of oxygen. This metabolization of tellurite directly contributes to the resistance of the bacteria to the oxyanion. CONCLUSIONS: We demonstrated that in vivo tellurite reduction is related to the intracellular thiol concentration, i.e. large availability of cellular RSH groups, results in a more significant reduction of tellurite. Furthermore, we observed that, when the bacterium exhibits less resistance to the oxyanion, a decreased tellurite reduction was seen, affecting the growth fitness. Together, these results let us propose that tellurite reduction and the intracellular RSH content are related to the oxyanion bacterial resistance, this tripartite mechanism in an oxygen-independent anaerobic process.

Oxaliplatin related multiple focal nodular hyperplasia mimicking metastasis from a gastric cancer.

INTRODUCTION: The FOLFOX6 scheme is a combination drug chemotherapy that contains calcium leucovorin (folinic acid), fluorouracil, and oxaliplatin, the chronic use of chemotherapy with oxaliplatin can progress to focal nodular hyperplasia (FNH), which is a benign hepatic lesion. CASE REPORT: We present a case of a 26- year-old female diagnosed with an ovarian mixed germ cell tumor with extension to the peritoneum, treated with 12 cycles in 9 months with neoadjuvant chemotherapy FOLFOX 6 scheme and oophorectomy. A three-year follow-up CT showed three nodular and hypervascular hepatic lesions suspicious of metastatic disease; an MRI with liver-specific contrast confirmed the diagnosis of FNH. MANAGEMENT AND OUTCOME: The patient continued her follow-up without other treatment and metastatic disease. DISCUSSION: While most multiple liver lesions in a patient with cancer will be suspicious of metastasis, a careful drug history should be obtained, as an oxaliplatin-related side effect to develop FNH has been reported. MRI with liver-specific contrast has a positive predictive value of 95% because of the biliary excretion through OATP1B3 transporter, expressed in functional hepatocytes and overexpressed in some liver tumors such as FNH, so it should be performed when FNH is suspected.

Positive Adult Education, Learned Helplessness and the Pygmalion Effect.

Positive education is seen as a transformative methodological approach capable of improving the act of teaching and learning and, above all, essential for the development of students' personal skills and competences. However, few studies have been carried out on this topic in the field of adult and continuing education; instead, they have been published mainly in the field of formal education and at school age. This study works with a sample of 399 people over 16 years of age and students of the Universidad Popular de Dos Hermanas in order to show the relationship between the Pygmalion effect and learned helplessness in the process of acquiring knowledge in adulthood. In this way, three tools were used: one questionnaire that showed the teachers' perceptions of the students' qualities and behaviour and two that provided information on self-concept, self-esteem, personal and social skills and other variables directly related to emotional intelligence and positive education. It shows how exposure to negative operational constraints hinders the psychosocial and socio-educational development of learners in all possible ways, while, on the other hand, it indicates the importance of positive education to compensate for this phenomenon by enhancing the development and growth of those who study and participate in non-formal education through positive reinforcement. Likewise, the factorial interrelation of both positive and negative conditioning factors and their incidence on learning is shown; the importance of neutralising the negative components and strengthening the positive reinforcement and the role played by the community and education professionals as catalysts and behavioural modulators at any stage of learning and age group for the achievement of the objectives of the student and of education itself in a broad sense.

Anaerobic RSH-dependent tellurite reduction contributes to Escherichia coli tolerance against tellurite

BACKGROUND: Tellurium is a rare metalloid that exerts high toxicity on cells, especially on bacteria, partly due to reactive oxygen species (ROS) generation. Moreover, it has also been observed that tellurite can target free cell thiols groups (RSH) (i.e. reduced glutathione (GSH)), enhancing the cellular redox imbalance. Additionally, in vitro experiments have suggested that several enzymes can reduce tellurite (IV) to its elemental form (0); where RSH present on their active sites may be responsible for the process. Nevertheless, the mechanisms implemented by bacteria for tellurite reduction and its role in resistance have not been evaluated in vivo. RESULTS: This work shows that tellurite reduction to elemental tellurium is increased under anaerobic conditions in E. coli cells. The in vivo tellurite reduction is related to the intracellular concentration of total RSH, in the presence and absence of oxygen. This metabolization of tellurite directly contributes to the resistance of the bacteria to the oxyanion. CONCLUSIONS: We demonstrated that in vivo tellurite reduction is related to the intracellular thiol concentration, i.e. large availability of cellular RSH groups, results in a more significant reduction of tellurite. Furthermore, we observed that, when the bacterium exhibits less resistance to the oxyanion, a decreased tellurite reduction was seen, affecting the growth fitness. Together, these results let us propose that tellurite reduction and the intracellular RSH content are related to the oxyanion bacterial resistance, this tripartite mechanism in an oxygen independent anaerobic process.

Mental well-being among patients with congenital heart disease and heart failure during the COVID-19 pandemic.

Patients with congenital heart disease (CHD) show increasing survival. We evaluated the influence of COVID-19 confinement on the mental well-being of patients with CHD. Descriptive, cross-sectional, observational epidemiological study in a cohort of 242 patients with CHD over 14 years old recruited consecutively from a single adolescent and adult CHD outpatient unit. Patients were sent an online questionnaire to determine clinical, demographic and the 12-element general health questionnaire (GHQ-12) data during the COVID-19 quarantine. 242 out of 407 (59%) patients with CHD, to whom the questionnaire was sent, responded to the survey. 98 (42%) patients were between 14 and 24 years old and 133 (58%) were over 25 years old. Of the total, 119 (51%) were male. 123 (51%), 88 (36%) and 31 (13%) patients with CHD had mild, moderate, and severe anatomical complexity respectively. 11 (4.5%) out of 242 patients with CC presented heart failure (HF) symptoms, requiring 18% of them admission to the hospital emergency department during the pandemic (P=0.002). In relation to the GHQ-12 questionnaire, patients with CHD and HF enjoyed less their daily activities (81% vs. 51%, P=0.043) and had less self-confidence (46% vs. 18%, P=0.041) than those without HF symptoms. In conclusion, patients with CHD and HF, during the COVID-19 quarantine, presented a lower capacity to enjoy daily activities and self-confidence than CHD without HF symptoms.

Terapia miofuncional, maloclusión y disfunción orofacial: Evaluación fotogramétrica del perfil / Myofunctional therapy, malocclusion and orofacial dysfunction: Profile photogrammetric evaluation

RESUMEN: El objetivo de este estudio observacional analítico es determinar el efecto de la Terapia Miofuncional en el perfil facial de voluntarios con maloclusión y disfunción orofacial, mediante fotogrametría. En una muestra de 15 pacientes, se midieron indirectamente mediante fotogrametría en el Software Blue Sky Plan® las siguientes variables cefalométricas: Ángulo Nasolabial, Prominencia Labial y Plano Estético. Se realizó toma de fotografías al comenzar la Terapia Miofuncional (primera sesión) y al finalizarla (décima sesión). Para comparar valores obtenidos en el mismo voluntario en cada variable cefalométrica entre principio y final de terapia, análisis estadísticos fueron realizados. Se determinó que no hay diferencia estadística en valores obtenidos en ninguna de las variables cefalométricas al comparar el inicio con el final de terapia. Por consiguiente, se concluyó que la Terapia Miofuncional no tiene un efecto significativo en estas variables de perfil facial en voluntarios con maloclusión y disfunción orofacial medidas mediante fotogrametría, pese a cambios funcionales percibidos por pacientes y evaluadores. Es fundamental poder realizar un diagnóstico riguroso y posterior derivación a Fonoaudiología, si corresponde, para lograr equilibrio funcional en los pacientes y reducir riesgo de progresión o reaparición de Anomalías Dentomaxilares.

ABSTRACT: This analytical observational study aimed to determine the effect of Myofunctional Therapy on the facial profile in volunteers with malocclusion and orofacial dysfunction, through photogrammetry. Fifteen patients were recruited, and the following cephalometric variables were measured indirectly through photogrammetry in the Blue Sky Plan Software (Blue Sky Bio®): Nasolabial Angle, Lip Prominence and Aesthetic Plane. Previous photographs were taken, at the beginning of Myofunctional Therapy (first session) and the end (tenth session). To compare the values of each variable in a volunteer between the beginning and end of therapy, statistical analyses were performed. There was no statistical difference in the values obtained in any of these variables when comparing the beginning and the end of myofunctional therapy. Therefore, it was concluded that myofunctional therapy does not have a statistically significant effect on these facial profile variables in volunteers with malocclusion and orofacial dysfunction measured by photogrammetry, despite the functional changes perceived by patients and evaluators. However, it is essential to perform a rigorous diagnosis and subsequent referral to speech therapy, if applicable, to achieve functional balance in the patients and reduce progression or recurrence risk of Dentomaxillary Abnormalities.

Sex-bias in the diagnosis of malnutrition in the elderly: a pilot study.

This research aimed to show that using different cutoff points for women and men in nutritional assessment through the Mini Nutritional Assessment (MNA) and different anthropometric variables, improves the diagnostic accuracy of malnutrition among people over 65 years. A cross-sectional study was carried out in a sample of 240 patients of 65 to 104 years in Córdoba (Spain) between 2013 and 2015. Excluded were those with disabling diseases that prevented informed consent. We assessed Nutritional status using the MNA and the Chang Method (Gold Standard). Global cut points per sex were determined for each independent variable using Receiver Operating Characteristic curves, choosing the best of each according to the highest Youden´s index (J). None of the variables studied showed high precision in the diagnosis of malnutrition in the elderly. Different cutoff points were found for all variables by sex, as well as variations in their validity indexes. The number of lymphocytes was more accurate in women (J = 0.58), being the muscular circumference of the arm the best in men (J = 0.8). Regarding MNA, the Long Form version showed higher sensitivity (S) in women (S = 76%) and short versions in men (S = 71% and 59%) at different cutoff points. The introduction of the sex variable seems determinant to achieve a more accurate diagnostic of malnutrition, avoiding biases derivate from a global study without considering its effect in the development of diseases.

Development of predictive models for nutritional assessment in the elderly.

OBJECTIVE: To propose malnutrition screening methods for the elderly population using predictive multivariate models. Due to the greater risk of nutrition deficiencies in ageing populations, nutritional assessment of the elderly is necessary in primary health care. DESIGN: This was a cross-sectional study. Multivariate models were obtained by means of discriminant analysis and binary logistic regression. The diagnostic accuracy of each multivariate model was determined and compared with the Chang method based on receiver operating characteristic curves. The optimal cut-point, sensitivity, specificity and Youden index were estimated for each of the models. SETTING: The province of Cordoba, Spain. PARTICIPANTS: Two hundred fifty-five patients over the age of 65 years from three health centres and three nursing homes. RESULTS: Fourteen models for predicting risk of malnutrition were obtained, six by discriminant multivariate analysis and eight by binary logistic regression. Sensitivity ranged from 55·6 to 93·1 % and specificity from 64·9 to 94 %. The maximum and minimum Youden indexes were 0·77 and 0·49, respectively. We finally selected a model which does not require a blood test. CONCLUSIONS: The proposed models simplify nutritional assessment in the elderly and, except for number 2 of those calculated by binary logistic regression, have better diagnostic accuracy than the Spanish version of the Mini Nutritional Assessment screening tool. The selected model, whose validation is necessary for the future with other different samples, provides good diagnostic accuracy, and it can be performed by non-medical personnel, making it an accessible, easy and rapid tool in daily clinical practice.

Novel Multi-IMU Tight Coupling Pedestrian Localization Exploiting Biomechanical Motion Constraints.

In this article, we present a novel tight coupling inertial localization system which simultaneously processes the measurements of two inertial measurement units (IMUs) mounted on the leg, namely the upper thigh and the front part of the foot. Moreover, the proposed system exploits motion constraints of each leg link; that is, the thigh and the foot. To derive these constraints, we carry out a motion tracking experiment to collect both ground truth data and inertial measurements from IMUs mounted on the leg. The performance of the tight coupling system is assessed with a data set of approximately 10 h. The evaluation shows that the average 2D-position error of the proposed tight coupling system is at least 50% better than the average 2D-position error of two state-of-the-art systems, whereas the average height error of the tight coupling system is at least 75% better than the average height error of the two state-of-the-art systems. In this work, we improve the accuracy of the position estimation by introducing biomechanical constraints in an inertial localization system. This article allows to observe, for the first time, heading errors of an inertial localization system by using only inertial measurements and without the need for using maps or repeating totally or partially the walked trajectory.

Automatic Calibration of the Step Length Model of a Pocket INS by Means of a Foot Inertial Sensor.

All non-foot-mounted inertial localization systems have a common challenge: the need for calibrating the parameters of the step length model. The calibration of the parameters of a step length model is key for an accurate estimation of the pedestrian's step length, and therefore, for the accuracy of the position estimation. In a previous work, we provided a proof of concept on how to calibrate step length models with a foot inertial navigation system (INS), i.e., an INS based on an inertial measurement unit (IMU) mounted on the upper front part of the foot. The reason is that the foot INS does not require calibration thanks to the implementation of the strapdown algorithm. The goal of this article is to automatically calibrate the parameters of a step length model of the pocket INS by means of the foot INS. The step length model of the pocket INS has two parameters: the slope and offset of a first-order linear regression that relates the amplitude of the thigh pitch with the user's step length. Firstly, we show that it is necessary to estimate the two parameters of the step length model. Secondly, we propose a method to automatically estimate these parameters by means of a foot INS. Finally, we propose a practical implementation of the proposed method in the pocket INS. We evaluate the pocket INS with the proposed calibration method and we compare the results to the state of the art implementations of the pocket INS. The results show that the proposed automatic calibration method outperforms the previous work, which proves the need for calibrating all the parameters of the step length model of the pocket INS. In this work, we conclude that it is possible to use a foot INS to automatically calibrate all parameters of the step length model of the pocket INS. Since the calibration of the step length model is always needed, our proposed automatic calibration method is a key enabler for using the pocket INS.

[Nutritional status and associated factors in ambulatory elderly patients]. / Estado nutricional y factores asociados en pacientes ancianos ambulatorios.

OBJECTIVE: To analyze the nutritional status (NS) of patients older than 65 years and establish their relationship with sociodemographic and health variables. DESIGN: Cross-sectional observational study in patients older than 65 years. LOCATION: 3 health centers. PARTICIPANTS: 255 patients: ambulatory (AP), in domiciliary care (DP) or institutionalized (IP). They completed the study 243 (response rate 95.3%). MAIN MEASUREMENTS: The Chang method was applied to determine the NS. Sociodemographic, anthropometric variables, dependence, mood, cognitive and analytical parameters were collected. Associations were analyzed applying chi-square and analysis of variance. The prevalence ratio (PR) for malnutrition was calculated. A multivariate model was applied (binary logistic regression). Significance was considered for p<0.05. RESULTS: The average age was 81.3 years (SD=7.4) and 72.0% were women. 48.9% were AP, 26.8% DP and 24.2% IP. 29.6% (95% CI: 23.9-35.8) presented malnutrition. Greater malnutrition was established in relation to living in a residence or requiring home help (PR=5.3), age over 85 (PR=4.9), presenting a moderate or higher dependency for basic activities of daily living (PR=3.9) and instrumental (PR=3.3), need help for mobility (PR=2.9) and present moderate/severe cognitive impairment (PR=2.1). The determinants of malnutrition in the multivariate model were older than 85 years old and being IP or DP. CONCLUSIONS: Emphasis should be placed on evaluating NS in patients older than 85 years of age who live in a residence or require home care, since they are the groups at greatest risk of malnutrition.

Fisiopatología de la hepatitis C y diabetes mellitus. Hacia la cura de dos epidemias en el siglo XXI / Pathophysiology of Hepatitis C and Diabetes Mellitus: Towards the cure of two epidemics in the 21 st century

Resumen La infección crónica por virus de la hepatitis C (VHC) y la diabetes mellitus (DM) son dos problemas de salud pública que impactan los sistemas de salud, con una alta carga económica global. La infección por VHC produce manifestaciones hepáticas tales como hepatitis, cirrosis y carcinoma hepatocelular; asimismo, se ha involucrado en la patogénesis de manifestaciones extrahepáticas, entre las cuales se ha asociado con alteraciones metabólicas como la DM. Estudios longitudinales y transversales han reportado mayor incidencia y prevalencia de DM en pacientes con infección crónica por VHC. La DM acelera la progresión histológica y clínica en pacientes con infección crónica por VHC y las complicaciones cardiovasculares. Recientemente se ha avanzado en el tratamiento y la introducción de nuevos medicamentos como los antivirales de acción directa, que mejoran el control glucémico en estos pacientes.

Abstract Chronic hepatitis C virus (HCV) and diabetes mellitus (DM) are two public health problems that impact health care systems with overall high costs. HCV infections cause liver manifestations such as hepatitis, cirrhosis and hepatocellular carcinoma. They have also been involved in the pathogenesis of extrahepatic manifestations among which are metabolic disorders such as DM. Longitudinal and cross-sectional studies have reported a higher incidence and prevalence of DM in patients with chronic HCV infections. DM accelerates histological and clinical progression of chronic HCV infections and leads to cardiovascular complications. Recently, progress has been made in treatment with the introduction of new medications such as direct-acting antiviral drugs that improve glycemic control in these patients.