Rheological and Biological Properties of Adhesive Skin Secretions from Eupsophus vertebralis (Anura: Alsodidae).

Skin secretions from Patagonian ground frogs, Eupsophus vertebralis, have previously been reported as a potent proteinaceous adhesive with potential biomedical applications. Here, we conducted a rheological analysis indicating the mechanical robustness of these secretions, with a storage modulus ranging from 1 to 10 Pa. In addition, antimicrobial and cytotoxicity assays were performed, revealing no antimicrobial activity against both the Gram-positive and Gram-negative bacteria. The cytotoxicity results were intriguing, as three samples showed no harm, and one exhibited a severe cytotoxic effect on the human cell line MG63. These properties, as indicated by these preliminary results, reinforce their potential for practical applications in the industrial and medical sectors.

Neutralizing antibody responses to the Delta variant of SARS-CoV-2 following vaccination with Ad5-nCoV (CanSino) in the Mexican population.

During the COVID-19 pandemic, the Ad5-nCoV vaccine was applied to the Mexican population before the WHO approved it. In a transversal study, we compare the CanSino vaccine efficacy and a natural SARS-CoV-2 infection in eliciting neutralizing antibodies against the SARS-CoV-2 Delta variant in Guadalajara, Mexico. Participants between 30-60 years were included in the study and classified into three groups: 1) Natural immunity (unvaccinated), 2) Vaccine-induced immunity (vaccinated individuals without a COVID-19 history), and 3) Natural immunity + vaccine-induced immunity. These groups were matched by age and gender. We assessed the ability of individuals' serum to neutralize the Delta variant and compared the results of the different groups using a neutralization test followed by plaque-forming units. Results showed that 39% of individuals' serum with a history of COVID-19 (natural immunity, Group 1) could not neutralize the Delta variant, compared to 33% in vaccinated individuals without COVID-19 (vaccine immunity, Group 2). In contrast, only 7% of vaccinated individuals with a history of COVID-19 (natural + vaccine immunities) could not neutralize the Delta variant. We concluded that the effectiveness of the Ad5-nCoV vaccine to induce neutralizing antibodies against the Delta variant is comparable to that of natural infection (61% vs. 67%). However, in individuals with both forms of immunity (Group 3), it increased to 93%. Based on these results, despite the Ad5-nCoV vaccine originally being designed as a single-dose regimen, it could be recommended that even those who have recovered from COVID-19 should consider vaccination to boost their immunity against this variant.

Linking Acrosome Size and Genetic Divergence in an Inter-Oceanic Mussel from the Pacific and Atlantic Coasts: A Case of Incipient Speciation?

In recent years, advances in analyses of the sperm morphology and genetics of Perumytilus purpuratus have allowed to two evolutionary scenarios for this mussel to be suggested: (1) the scenario of cryptic species and (2) the scenario of incipient or in progress speciation. For a better understanding of the evolutionary history of P. purpuratus, we performed extensive sampling along a latitudinal gradient of ca. 7180 km of coastline-from the Southern Pacific Ocean to the Atlantic Ocean-and we delved deeper into the sperm morphology of P. purpuratus, exploring its association with the phylogeny and population genetics to determine whether the variability in sperm traits between the northern and southern regions was a signal of cryptic or incipient species. Overall, our results showed that sperm sizes were strongly correlated with the genetic structure in males of P. purpuratus. We identified at 37° S on the Pacific coast a coincident break of both sperm size and genetic disruption that can be explained by historical events and postglacial recolonization as causal phenomena for the observed divergences. Furthermore, evidence of genetic admixture between lineages was found at 38° S, suggesting the presence of an introgressive hybridization zone and incomplete reproductive isolation in an in fraganti or incipient speciation process.

The Mediterranean Mussel Mytilus galloprovincialis (Mollusca: Bivalvia) in Chile: Distribution and Genetic Structure of a Recently Introduced Invasive Marine Species.

The genetic characteristics of invasive species have a significant impact on their ability to establish and spread. The blue mussel (Mytilus galloprovincialis), native to the Mediterranean Sea, is a leading invasive species of intertidal coasts throughout much of the world. Here, we used mitochondrial DNA sequence data to investigate the genetic diversity and phylogeographic structure of invasive (M. galloprovincialis) versus native (Mytilus chilensis) populations of blue mussels in Chile. We evaluated whether genetic diversity in invasive populations could be explained by the genetic characteristics of the native sources from which they might be derived. A phylogenetic analysis confirmed two lineages of the invasive M. galloprovincialis, i.e., the NW Atlantic and the Mediterranean lineages. We found no evidence of genetic structure in the invasive range of M. galloprovincialis in Chile, most probably because of its recent arrival. We did, however, detect a spatial mixture of both M. galloprovincialis lineages at sampling locations along the Chilean coast, giving rise to higher levels of genetic diversity in some areas compared to the population of native M. chilensis. The coastal area of the invasion is still small in extent (~100 km on either side of two large ports), which supports the hypothesis of a recent introduction. Further expansion of the distribution range of M. galloprovincialis may be limited to the north by increasing water temperatures and to the south by a natural biogeographic break that may slow or perhaps stop its spread. The use of internal borders as a tool to minimise or prevent M. galloprovincialis spread is therefore a genuine management option in Chile but needs to be implemented rapidly.

Blue mussels of the Mytilus edulis species complex from South America: The application of species delimitation models to DNA sequence variation.

Smooth-shelled blue mussels, Mytilus spp., have a worldwide antitropical distribution and are ecologically and economically important. Mussels of the Mytilus edulis species complex have been the focus of numerous taxonomic and biogeographical studies, in particular in the Northern hemisphere, but the taxonomic classification of mussels from South America remains unclear. The present study analysed 348 mussels from 20 sites in Argentina, Chile, Uruguay and the Falkland Islands on the Atlantic and Pacific coasts of South America. We sequenced two mitochondrial locus, Cytochrome c Oxidase subunit I (625 bp) and 16S rDNA (443 bp), and one nuclear gene, ribosomal 18S rDNA (1770 bp). Mitochondrial and nuclear loci were analysed separately and in combination using maximum likelihood and Bayesian inference methods to identify the combination of the most informative dataset and model. Species delimitation using five different models (GMYC single, bGMYC, PTP, bPTP and BPP) revealed that the Mytilus edulis complex in South America is represented by three species: native M. chilensis, M. edulis, and introduced Northern Hemisphere M. galloprovincialis. However, all models failed to delimit the putative species Mytilus platensis. In contrast, however, broad spatial scale genetic structure in South America using Geneland software to analyse COI sequence variation revealed a group of native mussels (putatively M. platensis) in central Argentina and the Falkland Islands. We discuss the scope of species delimitation methods and the use of nuclear and mitochondrial genetic data to the recognition of species within the Mytilus edulis complex at regional and global scales.

Phylogeographic analysis and species distribution modelling of the wood frog Batrachyla leptopus (Batrachylidae) reveal interglacial diversification in south western Patagonia.

BACKGROUND: The evolutionary history of southern South American organisms has been strongly influenced by Pleistocene climate oscillations. Amphibians are good models to evaluate hypotheses about the influence of these climate cycles on population structure and diversification of the biota, because they are sensitive to environmental changes and have restricted dispersal capabilities. We test hypotheses regarding putative forest refugia and expansion events associated with past climatic changes in the wood frog Batrachyla leptopus distributed along ∼1,000 km of length including glaciated and non-glaciated areas in southwestern Patagonia. METHODS: Using three mitochondrial regions (D-loop, cyt b, and coI) and two nuclear loci (pomc and crybA1), we conducted multilocus phylogeographic analyses and species distribution modelling to gain insights of the evolutionary history of this species. Intraspecific genealogy was explored with maximum likelihood, Bayesian, and phylogenetic network approaches. Diversification time was assessed using molecular clock models in a Bayesian framework, and demographic scenarios were evaluated using approximate Bayesian computation (ABC) and extended Bayesian skyline plot (EBSP). Species distribution models (SDM) were reconstructed using climatic and geographic data. RESULTS: Population structure and genealogical analyses support the existence of four lineages distributed north to south, with moderate to high phylogenetic support (Bootstrap > 70%; BPP > 0.92). The diversification time of B. leptopus' populations began at ∼0.107 mya. The divergence between A and B lineages would have occurred by the late Pleistocene, approximately 0.068 mya, and divergence between C and D lineages was approximately 0.065 mya. The ABC simulations indicate that lineages coalesced at two different time periods, suggesting the presence of at least two glacial refugia and a postglacial colonization route that may have generated two southern lineages (p = 0.93, type I error: <0.094, type II error: 0.134). EBSP, mismatch distribution and neutrality indexes suggest sudden population expansion at ∼0.02 mya for all lineages. SDM infers fragmented distributions of B. leptopus associated with Pleistocene glaciations. Although the present populations of B. leptopus are found in zones affected by the last glacial maximum (∼0.023 mya), our analyses recover an older history of interglacial diversification (0.107-0.019 mya). In addition, we hypothesize two glacial refugia and three interglacial colonization routes, one of which gave rise to two expanding lineages in the south.

Comparative cytogenetics of the ground frogs Eupsophus emiliopugini Formas, 1989 and E. vertebralis Grandison, 1961 (Alsodidae) with comments on their inter- and intraspecific chromosome differentiation.

South American frogs of the genus Eupsophus Fitzinger, 1843 comprise 10 species. Two of them, Eupsophus vertebralis Grandison, 1961 and E. emiliopugini Formas, 1989 belong to the Eupsophus vertebralis group, exhibiting 2n = 28. Fundamental number differences between these species have been described using conventional chromosome staining of few specimens from only two localities. Here, classical techniques (Giemsa, C-banding, CMA3/DAPI banding, and Ag-NOR staining), and fluorescence in situ hybridization (FISH, with telomeric and 28S ribosomal probes), were applied on individuals of both species collected from 15 localities. We corroborate differences in fundamental numbers (FN) between E. vertebralis and E. emiliopugini through Giemsa staining and C-banding (FN = 54 and 56, respectively). No interstitial fluorescent signals, but clearly stained telomeric regions were detected by FISH using telomeric probe over spreads from both species. FISH with 28S rDNA probes and Ag-NOR staining confirmed the active nucleolus organizer regions signal on pair 5 for both species. Nevertheless, one E. emiliopugini individual from the Puyehue locality exhibited 28S ribosomal signals on pairs 4 and 5. Interestingly, only one chromosome of each pair showed Ag-NOR positive signals, showing a nucleolar dominance pattern. Chromosomal rearrangements, rRNA gene dosage control, mobile NORs elements, and/or species hybridization process could be involved in this interpopulation chromosomal variation.

Community richness of amphibian skin bacteria correlates with bioclimate at the global scale.

Animal-associated microbiomes are integral to host health, yet key biotic and abiotic factors that shape host-associated microbial communities at the global scale remain poorly understood. We investigated global patterns in amphibian skin bacterial communities, incorporating samples from 2,349 individuals representing 205 amphibian species across a broad biogeographic range. We analysed how biotic and abiotic factors correlate with skin microbial communities using multiple statistical approaches. Global amphibian skin bacterial richness was consistently correlated with temperature-associated factors. We found more diverse skin microbiomes in environments with colder winters and less stable thermal conditions compared with environments with warm winters and less annual temperature variation. We used bioinformatically predicted bacterial growth rates, dormancy genes and antibiotic synthesis genes, as well as inferred bacterial thermal growth optima to propose mechanistic hypotheses that may explain the observed patterns. We conclude that temporal and spatial characteristics of the host's macro-environment mediate microbial diversity.

De novo male gonad transcriptome draft for the marine mussel Perumytilus purpuratus with a focus on its reproductive-related proteins.

Perumytilus purpuratus is a marine mussel considered a bioengineer species with a broad distribution in the Pacific and Atlantic coast of South America. Studies have shown two geographically and genetically differentiated subpopulations at molecular level and in sperm morphological traits. To open avenues for molecular research on P. purpuratus, a global de novo transcriptome from gonadal tissue of mature males was sequenced using the Illumina platform. From a total of 126.38 million reads, 37,765 transcripts were successfully annotated. BUSCO analysis determined a level of 89% completeness for the assembled transcriptome. The functional gene ontology (GO) annotation indicated that, in terms of abundance, the transcripts related with molecular function were the most represented, followed by those related with biological process and cellular components. Additionally, a subset of GO annotations generated using the "sperm" term resulted in a total of 1,294 sequences where the biological process category was the more represented, with transcripts strongly associated to sperm-processes required for fertilization, and with processes where the sperm-egg interaction could be implicated. Our work will contribute to the evolutionary understanding of the molecular mechanisms related to tissue-specific functions. This work reports the first male gonad transcriptome for the mussel P. purpuratus, generating a useful transcriptomic resource for this species and other closely related mytilids.

Speciation in a biodiversity hotspot: Phylogenetic relationships, species delimitation, and divergence times of Patagonian ground frogs from the Eupsophus roseus group (Alsodidae).

The alsodid ground frogs of the Eupsophus genus are divided into two groups, the roseus (2n = 30) and vertebralis (2n = 28), which are distributed throughout the temperate Nothofagus forests of South America. Currently, the roseus group is composed by four species, while the vertebralis group consists of two. Phylogenetic relationships and species delimitation within each group are controversial. In fact, previous analyses considered that the roseus group was composed of between four to nine species. In this work, we evaluated phylogenetic relationships, diversification times, and species delimitation within the roseus group using a multi-locus dataset. For this purpose, mitochondrial (D-loop, Cyt b, and COI) and nuclear (POMC and CRYBA1) partial sequences from 164 individuals were amplified, representing all species. Maximum Likelihood (ML) and Bayesian approaches were used to reconstruct phylogenetic relationships. Species tree was estimated using BEAST and singular value decomposition scores for species quartets (SVDquartets). Species limits were evaluated with six coalescent approaches. Diversification times were estimated using mitochondrial and nuclear rates with LogNormal relaxed clock in BEAST. Nine well-supported monophyletic lineages were recovered in Bayesian, ML, and SVDquartets, including eight named species and a lineage composed by specimens from the Villarrica population (Bootstrap:>70, PP:> 0.99). Single-locus species delimitation analyses overestimated the species number in E. migueli, E. calcaratus, and E. roseus lineages, while multi-locus analyses recovered as species the nine lineages observed in phylogenetic analyses (Ctax = 0.69). It is hypothesized that Eupsophus diversification occurred during Mid-Pleistocene (0.42-0.14 Mya), with most species having originated after the Last Southern Patagonian Glaciation (0.18 Mya). Our results revitalize the hypothesis that the E. roseus group is composed of eight species and support the Villarrica lineage as a new putative species.

Mitochondrial genomes of the South American frogs Eupsophus vertebralis and E. emiliopugini (Neobatrachia: Alsodidae) and their phylogenetic relationships.

We report the sequencing and compare the mitochondrial genomes of the South American ground frogs Eupsophus vertebralis and E. emiliopugini and reconstruct phylogenetic relationships among Eupsophus species. These genomes consist of 16,156 and 16,711 bp in length, respectively and contain 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes (tRNA), and partial non-coding D-loop region. Both genomes share 94.5% identity with 879 variable sites. A phylogenetic analysis with other available mitogenomes recovered both species as the sister clade of Alsodes gargola. Sequences from D-loop, CO1, and Cyt b, amplified and sequenced with primers developed from the mitochondrial genomes, allowed us to reconstruct phylogenetic relationships among Eupsophus species. Since our report represents the first mitogenomes for the genus Eupsophus, we expect these data will be valuable for further studies on conservation genetics and on the evolution of Patagonian amphibians.

The complete mitochondrial genome of Telmatobufo australis (Amphibia: Anura: Calyptocephalellidae).

The mitochondrial (mt) genome of Telmatobufo australis is a circular molecule of 17,989 bp in length, comprising 13 protein-coding genes, 22 transfer RNA genes, and two ribosomal RNA genes. Gene order and content are identical to those previously reported from other neobatrachian mt genomes. Two protein-coding genes (COI and ATP6) presumably used GTG as start codons while COIII possessed an incomplete stop codon.

Phylogenetic relationships of a Patagonian frog radiation, the Alsodes + Eupsophus clade (Anura: Alsodidae), with comments on the supposed paraphyly of Eupsophus.

The frog clade composed of the alsodid genera Alsodes + Eupsophus is the most species-rich of the Patagonian endemic frog clades, including nearly 31 of the slightly more than 50 species of that region. The biology of this group of frogs is poorly known, its taxonomy quite complex (particularly Alsodes), and its diversity in chromosome number striking when compared with other frogs (collectively, there are species having 2n = 22, 2n = 26, 2n = 28, 2n = 30 or 2n = 34). We present a phylogenetic analysis of this Patagonian frog clade based on mitochondrial and nuclear gene sequences. We sequenced five mitochondrial genes (cytochrome b, cytochrome oxidase I, 12S, 16S, NADH dehydrogenase subunit 1) with three intervening tRNAs, and fragments of three nuclear genes (seven in absentia homolog 1, rhodopsin exon 1, RAG-1), for a maximum of 6510 bp for multiple specimens from 26 of the 31 species. We recovered Eupsophus as polyphyletic, with E. antartandicus, E. sylvaticus, and E. taeniatus in Batrachylidae, in accordance with most previous hypotheses. Based on this result, we transfer E. antartandicus and E. taeniatus back to Batrachyla, and E. sylvaticus to Hylorina (resurrected from the synonymy of Eupsophus), remediating the paraphyly of Eupsophus. Our results strongly corroborate the monophyly of Alsodes + Eupsophus (sensu stricto), the individual monophyly of these genera, and the monophyly of the species groups of Eupsophus. They also show the non-monophyly of all non-monotypic species groups of Alsodes proposed in the past. Our results expose several taxonomic problems particularly in Alsodes, and to a lesser extent in Eupsophus. This phylogenetic context suggests a rich evolutionary history of karyotypic diversification in the clade, in part corroborating previous hypotheses. In Alsodes, we predict three independent transformations of chromosome number from the plesiomorphic 2n = 26. All these, strikingly, involve increments or reductions of pairs of haploid chromosomes. Finally, the phylogenetic pattern recovered for Alsodes and Eupsophus suggests a trans-Andean origin and diversification of the group, with multiple, independent ingressions over cis-Andean regions.

Amphibian phylogeography in the Antipodes: Refugia and postglacial colonization explain mitochondrial haplotype distribution in the Patagonian frog Eupsophus calcaratus (Cycloramphidae).

Climatic oscillations, heterogeneity in elevation, topographical position, and isolation time in southwestern Patagonia have been important in promoting diversification of the biota. Geological studies have shown that this region had wide ice-free areas during periods of the last glacial maximum and provided forested refugia for the biota during Pleistocene glaciations. In this study, we sampled the endemic frog Eupsophus calcaratus from 20 localities, covering most of its distribution and including glaciated and non-glaciated regions. We collected DNA sequences for three mitochondrial regions (D-loop, cyt b, 16S), and describe patterns of variation consistent with a history of both the displacement to glacial refugia and recent recolonization to extensively glaciated regions. The inferred demographic history and divergence times of the lineages of E. calcaratus suggest that the Pleistocene had profound effects on the genetic patterns within this taxon in which some populations were able to survive in refugia within colder regions followed by demographic increases but without evidence of significant range expansion. The mtDNA gene tree recovers six major haploclades of E. calcaratus, which we consider diagnostic of species lineages. These results contribute to our understanding of how geological events, predominately glacial oscillations, have influenced current population structure of a broad-ranging, ectothermic vertebrate in the Valdivian Forest region of southern South America.

A resident research director can improve internal medicine resident research productivity.

BACKGROUND: Resident participation in research projects is felt to be an important component of internal medicine residency training, and accreditation organizations require that residency programs show that their residents and faculty participate in scholarly activity. PURPOSE: To determine the impact of a Resident Research Director (RRD) on scholarly productivity of our internal medicine residents. METHODS: We reviewed the number of presentations and publications of all residents from our institution over a 10-year study period (1992-2001). We used a historical control, comparing resident presentations and publications 5 years before (1992-1996) and after (1997-2001) implementation of the RRD position. We compared cohorts in terms of number of individuals in Alpha Omega Alpha and the number of individuals coming from a top 50 medical school as baseline measurements. We also compared these cohorts in regards to faculty to learner ratio, percentage of residents applying for fellowship, and American Board of Internal Medicine Certifying Examination performance. The Mann-Whitney U test was used for statistical inferences. Eighty-nine residents trained at our institution during the study period. RESULTS: There was a significant increase in the number of regional and national presentations as well as publications after instituting the RRD position. CONCLUSION: Our analysis suggests that an RRD can enhance resident scholarly productivity.

Military internal medicine resident performance on the American Board of Internal Medicine Certifying Examination.

The mission of military graduate medical education in internal medicine is to produce high-quality military internists prepared to practice in military environments. Board certification in internal medicine is an important outcome of internal medicine residency training. The American Board of Internal Medicine Certifying Examination (ABIMCE) first-taker pass rate of the graduates of an internal medicine residency program is a key measure of the quality of the program. We compared the ABIMCE first-taker pass rates for military and civilian internal medicine residency program graduates. Military internal medicine residency graduates had higher first-taker pass rates than their civilian counterparts. This is likely a reflection of the high-quality residents and the faculty at military programs. These results support the notion that military internal medicine residency programs continue to fulfill their mission of training high-quality internists.

Complicaciones de lupus eritematoso sistémico como primera manifestación / Systemic lupus erythematosus complications as a first manifestation

Antecedentes: el lupus eritematoso sistémico es una enfermedad crónica como manifestaciones diversas y curso impredecible. Objetivo: determinar las complicaciones más frecuentes de lupus eritematoso sistémco como primera manifestación. Material y métodos: en un estudio prospectivo se revisaron los expedientes de los pacientes con esta enfermedad que ingresaron al servicio de medicina interna del Hospital General Tacuba. Resultados: las complicaciones de los pacientes estudiados fueron tamponade, hipertensión arterial, insuficiecia renal aguda, insuficiencia cardiaca, pancreatitis, trombosis y hemorragia del sistema nervioso central. Conclusiones: las manifestaciones clínicas encontradas en este estudio son similares a las reportadas en la literatura

Incidencia de dislipidemias en un servicio de medicina interna / Dislipidemia incidence at the internal medicine service

Antecedentes: las alteraciones del metabolismo de los lípidos con importantes dada su relación con las enfermedades crónico degeneraltivas. Objetivo: determinar la incidencia de estas alteraciones y los padecimientos con que se asocian frecuentemente en un servicio de medicina interna. Material y métodos: estudio retrospectivo, descriptivo, observacional y transversal, realizado con una muestra representativa de los ingresos al servicio de medicina interna durante un año, escogiéndose al azar los meses de septiembre y noviembre de 1996 y enero de 1997. Se estudiaron las siguientes variables: edad, sexo, diagnóstico de ingreso, concentraciones séricas de colesterol, triglicéridos y lípidos totales. En el análisis estadístico se utilizaron medidas de tendencia central como promedios y porcentajes. Resultados: ingresason 189 pacientes al estudio, excluyéndose cinco por diversos motivos, por lo cual la muestra total fue de 184 pacientes, la edad promedio fue de 65 años. Dieciséis pacientes (8.69 por ciento) tenían alteraciones en lípidos, de los cuales nueve (546.26 por ciento) presentaban trastornos en triglicéridos y colesterol, y siete sólo hipercolesterolemia. En tres pacientes se encontró relación con evento vascular cerebral, ocho con diabetes mellitus y cinco con cardiopatía isquémica. Conclusiones: la incidencia de dislipidemias asociadas con enfermedades crónico degenerativas es alta, por lo que en pacientes con factores de riesgo debe realizar un perfil de lípidos en forma rutinaria

Depresión en el paciente diabético hospitalizado en un servicio de medicina interna / Depression in diabetic hospitalized patients in a internal medicine service

Antecedentes: la diabetes mellitus afecta al paciente como unidad biopsicosocial, en el que influyen factores como educación, conocimiento y aceptación de la enfermedad, repercusiones familiares y el impacto de este síndrome metabólico y sus complicaciones en una esfera poco estudiada, la psicológia y la depresión. Objetivo: determinar el grado de depresión y valorar su prevalencia en diabéticos dentro de un servicio de medicina interna. Material y métodos: en el Hospital General de Tacuba del ISSSTE se llevó a cabo un estudio prospectivo transversal, descriptivo, comparativo, en el cual se incluyeron 60 pacientes diabéticos, a los cuales se les valoró el tipo de depresión con la escala "la medición de la depresión" creada por William W.K. Zung. El grupo de estudio se comparó con un grupo control de 60 pacientes no diabéticos. Resultados: se observó que la depresión moderada a notable es frecuente en mujeres diabéticas. En 76.6 por ciento del grupo de diabetes se encontró algún tipo de depresión. Conclusiones: la depresión en el paciente diabético, mencionada en estudios previos, se ha relacionado con diversos tipos de complicaciones, lo que forma un círculo vicioso entre la enfermedad por sí misma, sus complicaciones y la depresión

Relación entre el vaciamiento gástrico y el control metabólico del paciente diabético / Relationship between gastric emptying and the metabolic control of diabetic patient

Antecedentes. Entre sus múltiples complicaciones, el síndrome metabólico diabetes mellitus afecta el sistema nervioso periférico. Objetivo. Demostrar el papel de la gastroparesia en las variaciones de la glucemia posterior a la ingestión de alimentos y su posible papel dentro del descontrol metabólico del paciente diabético. Material y métodos. Determinamos la relación entre el vaciamiento gástrico y el control metabólico, así como el papel de la gastroparesia diabética en las variaciones de la glucemia posprandial. Estudio prospectivo, observacional, para comparar el vaciamiento gástrico y la glucemia prosprandial en 10 pacientes sanos, 10 diabéticos sin gastroparesia y 10 diabéticos con gastroparesia, mediante gammagrama Tc99. Resultados. Se demostró una clara relación entre la alteración en el vaciamiento gástrico y la hiperglucemia posprandial sostenida y tardía. Conclusiones. Es posible que exista una relación entre el vaciamiento gástrico alterado y el descontrol metabólico en pacientes diabéticos con neuropatía autonómica grave