Incidence of Diabetes Mellitus and Associated Factors in the Era of Antiretroviral Drugs With a Low Metabolic Toxicity Profile.

Objective: The incidence of type 2 diabetes mellitus (T2DM) has risen dramatically. Among people living with HIV (PLHIV), chronic disease (now >15 cases/1000 in the general population worldwide) and long-term exposure to antiretroviral therapy (ART) can alter metabolic processes early, favoring insulin resistance and T2DM. We retrospectively studied the incidence of T2DM and associated factors in the Cohort of the Spanish AIDS Research Network, a prospective cohort of PLHIV enrolled at diagnosis and before initiation of ART. Methods: PLHIV were aged >18 years and ART naive at inclusion. The incidence of new diagnoses of T2DM after initiation of ART (per 1000 person-years) was calculated. Predictors of a diagnosis of T2DM were identified by a Cox proportional hazards model adjusted for statistically significant and clinically relevant variables. Results: Cumulative incidence was 5.9 (95% CI, 5.1-6.7) per 1000 person-years, increasing significantly in persons aged >50 years to 14.4 (95% CI, 10.4-19.3). Median time to diagnosis of T2DM was 27 months. Only age and higher education were significant. Interestingly, higher education was associated with a 33% reduction in the incidence of T2DM. Having received tenofovir disoproxil fumarate + (lamivudine or emtricitabine) + rilpivirine was almost significant as a protective factor (hazard ratio, 0.49; 95% CI, .24-1.01; P = .05). Conclusions: The incidence of T2DM in PLHIV in Spain was high, especially in persons aged >50 years. Age was the factor most closely associated with onset, and educational level was the factor most associated with reduced risk. We highlight the lack of association between HIV-related factors and T2DM and show that, within nonnucleoside reverse transcriptase inhibitors, rilpivirine could prove more benign for metabolic comorbidities.

Diabetes Mellitus Mortality Trends in Brazil From 2000 to 2021: An In-Depth Joinpoint Analysis.

Diabetes mellitus (DM) is a public health concern in Brazil, with deleterious effects on quality of life and increasing mortality rates. The prevalence of diabetes in Brazil is on the rise, and it is imperative to understand its effects on mortality rates in the last two decades in order to effectively mitigate the detrimental impact of diabetes on public health. This study aims to analyze mortality trends related to diabetes in Brazil from 2000 to 2021, encompassing both type 1 and type 2 diabetes, across sex and various age cohorts. Using joinpoint regression analysis, temporal trends in Brazil were assessed, while also incorporating findings from previous studies and considering potential influencing factors, such as government initiatives and cuts in healthcare investment. The study revealed a general upward trend in mortality rates associated with DM1 and DM2 over the study period, in both males and females, with men showing a higher AAPC (average annual percent change), which translated into significantly increased mortality difference at the end of the study. Additionally, it revealed elevated mortality values for extreme age groups in the age cohorts studied, with the exception of middle-aged cohort groups in DM2, which showed an expected higher APC (annual percent change), considering the age of highest incidence of DM2 in those age groups. This comprehensive analysis provides critical insights into the escalating impact of diabetes on mortality rates in Brazil and highlights the urgent need for healthcare strategies. It is expected that the increased prevalence of diabetes in the Brazilian population adds an additional economic burden to healthcare expenditure by the Brazilian government, further worsening the health disparities among different social groups. Unless several political decisions to reduce healthcare expenditure are reversed, greater difficulties in accessing treatments will be detrimental for vulnerable social groups in Brazil. By understanding the nuanced patterns of diabetes-related mortality, healthcare providers and policymakers can allocate resources effectively and implement tailored interventions to better address diabetes in Brazil.

Association of blood groups/Rh and diabetes mellitus in Karachi city, Pakistan

Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-B & O, blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetics patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.

Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos B e O, sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.

Association of blood groups/Rh and diabetes mellitus in Karachi city, Pakistan / Associação de grupos sanguíneos/Rh e diabetes mellitus na cidade de Karchi, Paquistão

Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-"B" & "O", blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetic's patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.

Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados ​​para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados ​​pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos "B" e "O", sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.

Lipoxygenase-12 Levels and Biochemical Parameters in Iraqi Patients With Type 2 Diabetes With and Without Benign Prostatic Hyperplasia.

Background Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia caused by a defect in the secretion or action or both of insulin. It has a complex pathogenesis. Benign prostatic hyperplasia (BPH) refers to an increase in the size of the prostate; it is one of the most common health problems in men that manifests with age. Lipoxygenase-12 (Lipox-12) is one of the enzymes in the Lipox 12/15 family, which plays a major role in catalyzing a variety of polyunsaturated fatty acids (PUFAs) that are capable of producing different metabolites. Lipox-12 has a significant effect on arachidonic acid metabolism, with PUFA, a pro- and anti-inflammatory mediator, as one of the enzyme isoforms. It also plays a major role in modulating inflammation at multiple checkpoints as diabetes progresses. The present study aims to measure Lipox-12 levels in patients with DM type 2 (DM2) and patients with DM2 + BPH. Methodology This study was conducted in Musayyib General Hospital, south of Baghdad, where a clinical examination was performed on 50 samples from controls (healthy subjects), 50 patients with DM2, and 50 patients with DM2 + BPH after taking each patient's history. The examinations performed included fasting blood sugar (FBS), hemoglobin A1c (HbA1c), prostate-specific antigen (PSA), triglycerides (TG), cholesterol (Chol), and Lipox-12. Results The results showed that both the DM2 and DM2 + BPH groups had higher FBS, HbA1c, TG, and Chol levels than healthy subjects; in contrast, Lipox-12 levels were the lowest in the DM2 group (sensitivity = 79% and specificity = 81%) but higher in the DM2 + BPH group (sensitivity = 80%; specificity = 82%) compared to the control group. Conclusions Lipox-12 had a high sensitivity and specificity in the DM2 and DM2 + BPH groups compared to the control group, and in both cases, it was used to monitor and diagnose DM2 and BPH.

Modeling Myotonic Dystrophy Type 2 Using Drosophila melanogaster.

Myotonic dystrophy 2 (DM2) is a genetic multi-systemic disease primarily affecting skeletal muscle. It is caused by CCTGn expansion in intron 1 of the CNBP gene, which encodes a zinc finger protein. DM2 disease has been successfully modeled in Drosophila melanogaster, allowing the identification and validation of new pathogenic mechanisms and potential therapeutic strategies. Here, we describe the principal tools used in Drosophila to study and dissect molecular pathways related to muscular dystrophies and summarize the main findings in DM2 pathogenesis based on DM2 Drosophila models. We also illustrate how Drosophila may be successfully used to generate a tractable animal model to identify novel genes able to affect and/or modify the pathogenic pathway and to discover new potential drugs.

Família como suporte para gestão da Diabetes Tipo 2 - Relatório final de estágio / Family as support for managing Type 2 Diabetes - Final internship report

No âmbito do 3º semestre do 2º curso do Mestrado em Enfermagem de Saúde Familiar foi desenvolvido um relatório de natureza profissional na Unidade de Cuidados Saúde Personalizados Cuid'arte (ACeS Pinhal Litoral). Por ser um contexto de excelência para o exercício das competências do enfermeiro de família, foi realizada uma análise crítico-reflexiva das competências desenvolvidas e dificuldades vivenciadas durante o Ensino Clínico. No sentido de enquadrar a prática clínica baseada na evidência e recorrendo à metodologia científica, desenvolveu-se uma Revisão Scoping (RS), dando resposta à questão de investigação: "Qual a perceção do utente quanto ao suporte familiar na gestão da sua DM2?". Através da pesquisa em bases de dados eletrónicas da plataforma (EBSCO), entre os dias 26 dezembro 2022 e 15 janeiro 2023, foram selecionados alguns artigos, sobre a qual recai esta RS. As conclusões detêm-se no facto de que o suporte social e amigos influencia positivamente as atividades de autogestão e autocuidado. Foi constatado, que os elementos portadores de Diabetes Mellitus tipo 2 (DM2) consideravam uma mais-valia o suporte social. Compreenderam-se três domínios de suporte social: Suporte Emocional, Suporte Instrumental, considerado como essencial para realizar o controlo diário da Diabetes. Conclui-se que o suporte para a gestão da DM2 compreende, sobretudo, três domínios: o social, o emocional e o instrumental, e que, na perspetiva do elemento familiar portador da doença, é sobretudo o domínio social, nomeadamente os amigos, que exercem maior influência de suporte na autogestão da doença.

As part of the 3rd semester of the 2nd course of the Masters in Family Health Nursing, a professional report was developed at the Cuid'arte Personalized Health Care Unit (ACeS Pinhal Litoral). As it is a context of excellence for the exercise of family nurse skills, a critical-reflective analysis was carried out of the skills developed and difficulties experienced during Clinical Teaching. In order to frame clinical practice based on evidence and using scientific methodology, a Scoping Review (RS) was developed, answering the research question: "What is the user's perception regarding family support in the management of their DM2?" . Through research in the platform's electronic databases (EBSCO), between December 26, 2022 and January 15, 2023, some articles were selected, on which this RS focuses. The conclusions focus on the fact that social support and friends positively influence self-management and self-care activities. It was found that people with Type 2 Diabetes Mellitus (DM2) considered social support to be an added value. Three domains of social support were understood: Emotional Support, Instrumental Support, considered essential to carry out daily Diabetes control. It is concluded that support for the management of DM2 comprises, above all, three domains: the social, the emotional and the instrumental, and that, from the perspective of the family member who has the disease, it is above all the social domain, namely friends, who exert a greater supportive influence on self-management of the disease.

Efectos del entrenamiento de la fuerza en personas con diabetes mellitus tipo II: revisión sistemática / Effects of resistance training in people with Type II diabetes mellitus: systematic review / Efeitos do treinamento de resistência em pessoas com diabetes mellitus tipo II. revisão sistemática

El presente artículo busca analizar las evidencias aportadas del entrenamiento de la fuerza comprobando su influencia en la Diabetes Mellitus tipo II utilizando la literatura existente sobre este objeto de estudio. Se realizo una revisión sistemática siguiendo las directrices PRISMA donde el principal contexto fue el entrenamiento de la fuerza en pacientes con Mellitus II, siendo buscados en bases de datos Pubmed, Embase y Scopus donde fueron seleccionados 7 artículos. Los hallazgos señalan consistentemente que el entrenamiento de la fuerza bien programado incide gradualmente en algunos marcadores que identifican la diabetes Mellitus II al realizar intervenciones con sistemas de entrenamiento de la fuerza de forma positiva. Los autores recomiendan estudios con muestras mayores en lo posible de tipo control para verificar la incidencia del entrenamiento en las variables mencionadas en este estudio.

This Article Seeks analyzes the evidence provided by strength training, verifying its influence on Type II Diabetes Mellitus by using the existing literature on this subject of study. A systematic review was carried out following the PRISMA guidelines, where the main context was strength training in patients with Mellitus II. The search was carried out in Pubmed, Embase, and Scopus databases where 7 articles were selected. The findings consistently indicated that a well-structured strength training program gradually affected some markers that identify diabetes Mellitus II when performing interventions with strength training systems in a positive way. The authors recommend control-type studies with larger samples, if possible, to verify the incidence of training in the variables mentioned in this study.

Este artigo procura analisar as evidências fornecidas pelo treinamento de força, verificando sua influência no Diabetes Mellitus tipo II utilizando a literatura existente sobre este objeto de estudo. Foi realizada uma revisão sistemática seguindo as diretrizes PRISMA onde o principal contexto foi o treinamento de força em pacientes com Mellitus II, sendo pesquisada nas bases de dados Pubmed, Embase e Scopus onde foram selecionados 7 artigos. Os achados indicam consistentemente que o treinamento de força bem programado afeta gradualmente alguns marcadores que identificam o diabetes Mellitus II ao realizar intervenções com sistemas de treinamento de força de forma positiva. Os autores recomendam estudos do tipo controle com amostras maiores, se possível, para verificar a incidência de treinamento nas variáveis mencionadas neste estudo.

Clinical score for early diagnosis of myotonic dystrophy type 2.

INTRODUCTION: Myotonic dystrophy type 2 (DM2) is a rare, multisystemic, autosomal dominant disease with highly variable clinical presentation. DM2 is considered to be highly underdiagnosed. OBJECTIVE: The aim of this study was to determine which symptoms, signs, and diagnostic findings in patients referred to neurological outpatient units are the most indicative to arouse suspicion of DM2. We tried to make a useful and easy-to-administer clinical scoring system for early diagnosis of DM2-DM2 early diagnosis score (DM2-EDS). PATIENTS AND METHODS: Two hundred ninety-one patients with a clinical suspicion of DM2 were included: 69 were genetically confirmed to have DM2, and 222 patients were DM2 negative. Relevant history, neurological, and paraclinical data were obtained from the electronic medical records. RESULTS: The following parameters appeared as significant predictors of DM2 diagnosis: cataracts (beta = 0.410, p < 0.001), myotonia on needle EMG (beta = 0.298, p < 0.001), hand tremor (beta = 0.211, p = 0.001), positive family history (beta = 0.171, p = 0.012), and calf hypertrophy (beta = 0.120, p = 0.043). In the final DM2-EDS, based on the beta values, symptoms were associated with the following values: cataracts (present 3.4, absent 0), myotonia (present 2.5, absent 0), tremor (present 1.7, absent 0), family history (positive 1.4, negative 0), and calf hypertrophy (present 1.0, absent 0). A cut-off value on DM2-EDS of 3.25 of maximum 10 points had a sensitivity of 84% and specificity of 81% to diagnose DM2. CONCLUSION: Significant predictors of DM2 diagnosis in the neurology outpatient unit were identified. We made an easy-to-administer DM2-EDS score for early diagnosis of DM2.

Clinical and Molecular Insights into Gastrointestinal Dysfunction in Myotonic Dystrophy Types 1 & 2.

Myotonic dystrophy (DM) is a highly variable, multisystemic disorder that clinically affects one in 8000 individuals. While research has predominantly focused on the symptoms and pathological mechanisms affecting striated muscle and brain, DM patient surveys have identified a high prevalence for gastrointestinal (GI) symptoms amongst affected individuals. Clinical studies have identified chronic and progressive dysfunction of the esophagus, stomach, liver and gallbladder, small and large intestine, and rectum and anal sphincters. Despite the high incidence of GI dysmotility in DM, little is known regarding the pathological mechanisms leading to GI dysfunction. In this review, we summarize results from clinical and molecular analyses of GI dysfunction in both genetic forms of DM, DM type 1 (DM1) and DM type 2 (DM2). Based on current knowledge of DM primary pathological mechanisms in other affected tissues and GI tissue studies, we suggest that misregulation of alternative splicing in smooth muscle resulting from the dysregulation of RNA binding proteins muscleblind-like and CUGBP-elav-like is likely to contribute to GI dysfunction in DM. We propose that a combinatorial approach using clinical and molecular analysis of DM GI tissues and model organisms that recapitulate DM GI manifestations will provide important insight into defects impacting DM GI motility.

Función biológica de AMPK- ß2 en músculo esquelético y su dinámica estructural después de la activación por SC4 / Biological role of AMPK- ß2 in skeletal muscle and its structural dynamics after activation by SC4

INTRODUCCIÓN: la Proteína Quinasa Activada por AMP (AMPK), es una enzima monitora y reguladora central del estado energético celular, por tanto, es responsable de la respuesta celular al suministro y demanda de energía. El AMP actúa como activador en condiciones de déficit energético, mientras que el ATP la inactiva cuando las condiciones energéticas son más favorables. Debido a su función central en el metabolismo, la AMPK surge como un blanco proteico prometedor para el tratamiento de diferentes enfermedades como la Diabetes Mellitus tipo 2 (DM2), Síndrome Metabólico (SM), Cáncer, entre otros. Existen múltiples isoformas de AMPK que se regulan y expresan diferencialmente en todo el organismo. La isoforma AMPK­ß2 se expresa casi exclusivamente en músculo esquelético y dado que este es el órgano primario para el almacenamiento y eliminación de Glucosa, AMPK­ß2 puede dirigir su homeostasis por una ruta independiente a la Insulina. La molécula activadora SC4 tiene una gran selectividad por AMPK­ß2 y debido a su función biológica, podría servir como modelo farmacológico para coadyuvar el tratamiento de enfermedades metabólicas. OBJETIVO: análisis de la dinámica molecular de activación de la AMPK­ß2. METODOLOGÍA: en el presente estudio, se emplean herramientas bioinformáticas como Chimera 1.15 y Phyton Molecular Viewer. RESULTADOS: el análisis in silico permitió comprender varios aspectos estructurales relacionados con la acción de SC4 sobre la estructura trimérica de la AMPK, los aminoácidos con los que interacciona y cómo su estructura química le otorga gran selectividad. También fue útil para en un futuro, ampliar los criterios de extracción, identificación y/o diseño de compuestos activos a partir de fuentes naturales, con propiedades funcionales similares o aún mejores a SC4, para así poder emplearlos con un enfoque terapéutico que beneficie a nuestra población.

INTRODUCTION: protein Kinase Activated by AMP (AMPK), is a monitor enzyme and a central regulator of the energetic cellular state, therefore, it is responsible for the cellular response to the supply and demand of energy. AMP acts as an activator in conditions of energy deficit, while ATP inactivates it when energy conditions are more favorable. Due to its central role in metabolism, AMPK appears as a promising protein target for the treatment of different diseases such as Diabetes Mellitus type 2 (DM2), Metabolic Syndrome (SM), and Cancer among others. There are multiple isoforms of AMPK that are regulated and differentially expressed throughout the body. The ß2-AMPK isoform is expressed almost exclusively in skeletal muscle and since this is the primary organ for Glucose disposal and storage, ß2-AMPK has an established role as a driver of insulin-independent Glucose clearance. The activator SC4 has a high selectivity for ß2-AMPK and due to its biological function; it could serve as a pharmacological model to aid the treatment of metabolic diseases. OBJETIVE: to analize the molecular dinamic of AMPK- ß2 activation. METHODOLOGY: in the present work we employed bioinformatics, Chimera 1.15 and Phyton Molecular Viewer. RESULTS: the in silico analysis allow us to understand many many structural features related to the action of SC4 on the trimeric structure of AMPK, the specific amino acids involved in the interaction and how its chemical structure gives it high selectivity. Thus, this structural analysis will be useful in order to broaden the criteria for extraction, identification and/or design of active compounds from natural sources, with similar or even better properties than SC4, to use them in a future, with a therapeutic approach that benefits our population.

Autoimmune Diseases in Patients With Myotonic Dystrophy Type 2.

Introduction: Myotonic dystrophy type 2 (DM2) is a rare autosomal dominant multisystemic disease with highly variable clinical presentation. Several case reports and one cohort study suggested a significant association between DM2 and autoimmune diseases (AIDs). Aim: The aim of this study is to analyze the frequency and type of AIDs in patients with DM2 from the Serbian DM registry. Patients and Methods: A total of 131 patients with DM2 from 108 families were included, [62.6% women, mean age at DM2 onset 40.4 (with standard deviation 13) years, age at entering the registry 52 (12.8) years, and age at analysis 58.4 (12.8) years]. Data were obtained from Akhenaten, the Serbian registry for DM, and through the hospital electronic data system. Results: Upon entering the registry, 35 (26.7%) of the 131 patients with DM2 had AIDs including Hashimoto thyroiditis (18.1%), rheumatoid arthritis, diabetes mellitus type 1, systemic lupus, Sjogren's disease, localized scleroderma, psoriasis, celiac disease, Graves's disease, neuromyelitis optica, myasthenia gravis, and Guillain-Barre syndrome. At the time of data analysis, one additional patient developed new AIDs, so eventually, 36 (28.8%) of 125 DM2 survivors had AIDs. Antinuclear antibodies (ANAs) were found in 14 (10.7%) of 63 tested patients, including 12 without defined corresponding AID (all in low titers, 1:40 to 1:160). Antineutrophil cytoplasmic antibodies (ANCAs) were negative in all 50 tested cases. The percentage of women was significantly higher among patients with AIDs (82.9% vs. 55.2%, p <0.01). Conclusion: AIDs were present in as high as 30% of the patients with DM2. Thus, screening for AIDs in DM2 seems reasonable. Presence of AIDs and/or ANAs may lead to under-diagnosis of DM2.

Fetal Growth and Neonatal Outcomes in Pregestational Diabetes Mellitus in a Population with a High Prevalence of Diabetes.

The aim of this retrospective study, conducted in an Italian tertiary care hospital, was to evaluate maternal-fetal and neonatal clinical outcomes in a group of patients with pregestational diabetes mellitus (PGDM), such as diabetes mellitus type 1 (DM1), diabetes mellitus type 2 (DM2), and maturity onset diabetes of the young (MODY). Overall, 174 pregnant women, nulliparous and multiparous, with a single pregnancy were enrolled. Data on pregnancy, childbirth, and newborns were collected from medical records. The selected patients were divided into two groups: the PGDM group (42 with DM1, 14 with DM2, and 2 with MODY), and the control group (116 patients with a negative pathological history of diabetes mellitus). We reported an incidence of preterm delivery of 55.2% in the PGDM group, including 59.5% of those with DM1 and 42.9% of those with DM2, vs. 6% in the controls. Fetal growth disorders, such as intrauterine growth retardation, small for gestational age, and fetal macrosomia were found in 19% and 3.6% in the case and control groups, respectively. A relationship between DM2 and gestational hypertension was found.

Efectos de los agonistas del receptor de péptido similar al glucagón tipo 1 como tratamiento en pacientes con obesidad y diabetes mellitus tipo 2 / Effects of glucagon-like peptide-1 receptor antagonist in the treatment of patients with obesity and Type 2 diabetes mellitus

Introducción: Recientemente se han descubierto nuevos medicamentos para el tratamiento de la diabetes tipo 2, con novedosos mecanismos de acción y menos efectos adversos. Dentro de ellos tenemos los análogos del péptido similar al glucagón tipo 1. Objetivo: Explicar la evidencia existente sobre los efectos del tratamiento con agonistas del receptor del péptido similar al glucagón tipo 1 en las personas con obesidad y diabetes mellitus tipo 2. Material y Métodos: Se realizó una revisión sistemática que incluyó estudios de los efectos de los agonistas del receptor del péptido similar al glucagón tipo1 como tratamiento en personas mayores de 12 años con obesidad y diabetes tipo 2. Se realizó una síntesis narrativa formal de los datos recogidos, no se realizó una síntesis estadístico formal. La calidad de evidencia para cada desenlace se determinó, según la metodología Grading of Recommendations Assessmet, Developmet and Evaluation. Resultados: La evidencia disponible demuestra que los agonistas del receptor del péptido similar al glucagón tipo 1, lograron una mayor disminución del peso corporal (-7,0 por ciento vs -2 por ciento) y de las cifras de hemoglobina glucosilada (HbA1c) (-0,40 por ciento vs -0,10 %) respecto al grupo placebo. Además, de una mayor reducción de la cintura abdominal. Conclusiones: La evidencia analizada muestra que los fármacos del tipo agonistas del receptor del péptido similar al glucagón tipo 1 tienen efectos beneficiosos en el tratamiento de las personas con obesidad y diabetes, disminuyendo el peso corporal y los valores de glucemia(AU)

Introduction: New drugs with novel mechanisms of action and fewer adverse effects have recently been discovered for the treatment of type 2 diabetes. Among them are glucagon-like peptide-1 analogues. Objective: To explain the existing evidence of the effects of treatment with glucagon-like peptide-1 receptor agonists in people with obesity and type 2 diabetes mellitus. Material and Methods: We conducted a systematic review that included studies on the effects of glucagon-like peptide -1 receptor agonists for the treatment of people older than 12 years with obesity and type 2 diabetes. A formal narrative synthesis of the collected data was performed, whereas a formal statistical synthesis was not performed. The quality of evidence for each outcome was determined according to the Grading of Recommendations Assessment, Development and Evaluation method. Results: The available evidence shows that glucagon-like peptide -1 receptor agonists achieved a greater reduction in body weight (-7,0 percent vs -2 percent) and glycosylated hemoglobin (HbA1c) (-0,40 percent vs -0,10 percent) compared to the placebo group. In addition, there was a greater reduction in abdominal waist circumference. Conclusions: The evidence analyzed shows that glucagon-like peptide -1 receptor agonists have beneficial effects in the treatment of people with obesity and diabetes, reducing body weight and glycemia values(AU)

Serum miRNAs as biomarkers for the rare types of muscular dystrophy.

Muscular dystrophies are a group of disorders that cause progressive muscle weakness. There is an increasing interest for the development of biomarkers for these disorders and specifically for Duchene Muscular Dystrophy. Limited research however, has been performed on the biomarkers' development for the most rare muscular dystrophies, like the Facioscapulohumeral Muscular Dystrophy, Limb-Girdle Muscular Dystrophy and Myotonic Dystrophy type 2. Here, we aimed to identify novel serum-based miRNA biomarkers for these rare muscular dystrophies, through high-throughput next-generation RNA sequencing. We identified many miRNAs that associate with muscular dystrophy patients compared to controls. Based on a series of selection criteria, the two best candidate miRNAs for each of these disorders were chosen and validated in a larger number of patients. Our results showed that miR-223-3p and miR-206 are promising serum-based biomarkers for Facioscapulohumeral Muscular Dystrophy type 1, miR-143-3p and miR-486-3p for Limb-Girdle Muscular Dystrophy type 2A whereas miR-363-3p and miR-25-3p associate with Myotonic Dystrophy type 2. Some of the identified miRNAs were significantly elevated in the serum of the patients compared to controls, whereas some others were lower. In conclusion, we provide new evidence that certain circulating miRNAs may be used as biomarkers for three types of rare muscular dystrophies.

Timing of Complementary Feeding, Growth, and Risk of Non-Communicable Diseases: Systematic Review and Meta-Analysis.

No consensus currently exists on the appropriate age for the introduction of complementary feeding (CF). In this paper, a systematic review is conducted that investigates the effects of starting CF in breastfed and formula-fed infants at 4, 4-6, or 6 months of age (i) on growth at 12 months of age, (ii) on the development of overweight/obesity at 3-6 years of age, (iii) on iron status, and (iv) on the risk of developing (later in life) type 2 diabetes mellitus (DM2) and hypertension. An extensive literature search identified seven studies that evaluated the effects of the introduction of CF at the ages in question. No statistically significant differences related to the age at which CF is started were observed in breastfed or formula-fed infants in terms of the following: iron status, weight, length, and body mass index Z-scores (zBMI) at 12 months, and development of overweight/obesity at 3 years. No studies were found specifically focused on the age range for CF introduction and risk of DM2 and hypertension. Introducing CF before 6 months in healthy term-born infants living in developed countries is essentially useless, as human milk (HM) and formulas are nutritionally adequate up to 6 months of age.

Cutaneous findings in myotonic dystrophy.

Myotonic dystrophy types 1 and 2 are a group of complex genetic disorders resulting from the expansion of (CTG)n nucleotide repeats in the DMPK gene. In addition to the hallmark manifestations of myotonia and skeletal muscle atrophy, myotonic dystrophy also affects a myriad of other organs including the heart, lungs, as well as the skin. The most common cutaneous manifestations of myotonic dystrophy are early male frontal alopecia and adult-onset pilomatricomas. Myotonic dystrophy also increases the risk of developing malignant skin diseases such as basal cell carcinoma and melanoma. To aid in the diagnosis and treatment of myotonic dystrophy related skin conditions, it is important for the dermatologist to become cognizant of the common and rare cutaneous manifestations of this genetic disorder. We performed a PubMed search using the key terms "myotonic dystrophy" AND "cutaneous" OR "skin" OR "dermatologic" AND "manifestation" OR "finding." The resulting publications were manually reviewed for additional relevant publications, and subsequent additional searches were performed as needed, especially regarding the molecular mechanisms of pathogenesis. In this review, we aim to provide an overview of myotonic dystrophy types 1 and 2 and summarize their cutaneous manifestations as well as potential mechanisms of pathogenesis.

Myotonic Dystrophies: A Genetic Overview.

Myotonic dystrophies (DM) are the most common muscular dystrophies in adults, which can affect other non-skeletal muscle organs such as the heart, brain and gastrointestinal system. There are two genetically distinct types of myotonic dystrophy: myotonic dystrophy type 1 (DM1) and myotonic dystrophy type 2 (DM2), both dominantly inherited with significant overlap in clinical manifestations. DM1 results from CTG repeat expansions in the 3'-untranslated region (3'UTR) of the DMPK (dystrophia myotonica protein kinase) gene on chromosome 19, while DM2 is caused by CCTG repeat expansions in intron 1 of the CNBP (cellular nucleic acid-binding protein) gene on chromosome 3. Recent advances in genetics and molecular biology, especially in the field of RNA biology, have allowed better understanding of the potential pathomechanisms involved in DM. In this review article, core clinical features and genetics of DM are presented followed by a discussion on the current postulated pathomechanisms and therapeutic approaches used in DM, including the ones currently in human clinical trial phase.

Comparative Study of New Biomarkers in Iraqi DM2 with and without Complications.

Background: Recent research indicates that persistent inflammatory responses may contribute to the rise of diabetic nephropathy (DN) and diabetic cardiovascular disease (DCVD) in type 2 diabetes mellitus patients (DM2). Numerous molecules associated with inflammation and angiogenesis have been implicated in the development and progression of DN and DCVD, respectively. Methods: The subjects were separated into five groups: healthy controls (n= 25), type 2 diabetes mellitus patients (n= 30), type 2 diabetes mellitus patients with nephropathy DN (n= 30), and type 2 diabetes mellitus patients with cardiovascular disease DCVD (n= 30). The blood levels of irisin, IL-8, HbA1C, urea, and creatinine were determined. Results: In current study there was high significant increased irisin levels (p< 0.001) in DN patients than other groups and a high significant decreased IL-8 level in DCVD. Discussion: Serum IL-8 and irisin levels may serve as early indicators of DM2 problems (DN, DCVD).