[Effects of zinc and resveratrol as modulators of leptin response in adults with obesity]. / Efectos del zinc y resveratrol como moduladores de la respuesta a la leptina en adultos con obesidad.

INTRODUCTION: fat tissue is an organ with endocrine function, where the hormone leptin (LEP) is identified. This peptide regulates appetite, the immune system, vascular functions and insulin sensitivity. Zinc (Zn) and resveratrol (RES) have potential effects on adipose tissue. OBJECTIVE: to know if the combined administration of Zn and RES has any effect on blood leptin quantification in obese people. METHODS: longitudinal experimental study, controlled clinical trial design, randomized, double blind. Randomized formation of four groups: T1 (Zn 50 mg), T2 (control), T3 (RES 500 mg), T4 (Zn 50 mg and RES 500 mg) with a supplementation period of 60 days. Blood samples were taken and glucose (GLU), leptin (LEP) and lipids (HDL, LDL, TGL) were quantified before and after exposure to the study elements. RESULTS: age 34 (± 7) years. In T-tests, significance in GLU (p = 0.04) and LEP (p = 0.055). By exposure groups: GLU at T1 (p = 0.03) and T2 (p = 0.031); at LEP at T4 (p = 0.024). Lipids by groups: HDL at T3 (p = 0.039) and T4 (p = 0.014). ANOVA, HDL (p = 0.06). Pearson, HDL (p = 0.07) and LDL (p = 0.09). CONCLUSION: zinc and resveratrol showed promise as agents in modulating leptin and glucose signaling, confirming that they work in a proportional manner and provide benefits for cardiac health, but more exposure time is needed to see if they impact energy balance homeostasis.

Diagnóstico prenatal de vasa previa tipo 3, comunicación de un caso

La vasa previa es una patología poco frecuente en la que los vasos umbilicales se encuentran transcurriendo en las cercanías del orificio cervical interno. Habitualmente está asociada a inserción velamentosa del cordón, placenta succenturiata, inserción baja placentaria y fertilización in vitro. Tiene importantes implicancias perinatales el lograr un diagnóstico precoz en el segundo trimestre, porque se logra disminuir la mortalidad neonatal. Presentamos el primer caso de diagnóstico prenatal de vasa previa tipo 3 (una variante poco conocida) comunicado en el Perú en una gestante con placenta previa y sin diagnóstico hasta el tercer trimestre.

Vasa previa is a rare condition in which the umbilical vessels are found to run in the vicinity of the internal cervical os. It is usually associated with velamentous insertion of the umbilical cord, placenta succenturiata, low placenta insertion and in vitro fertilization. Early diagnosis in the second trimester has important perinatal implications because it reduces neonatal mortality. We present the first case of prenatal diagnosis of vasa previa type 3 (a little known variant) reported in Peru in a pregnant woman with placenta previa and undiagnosed until the third trimester.

Antioxidant and Antimicrobial Activity of Rosemary (Rosmarinus officinalis) and Garlic (Allium sativum) Essential Oils and Chipotle Pepper Oleoresin (Capsicum annum) on Beef Hamburgers.

The inclusion of natural ingredients to preserve meat and meat products has increased in recent years. This study evaluated rosemary (REO) and garlic essential oils (GEO) as well as chipotle pepper oleoresin (CPO), alone or in combination, as preservatives on beef hamburgers (BH). Six treatments were evaluated: T1 (control, without additives), T2 (GEO 1%), T3 (REO 1%), T4 (CPO 0.5%), T5 (GEO 1% + CPO 0.5%) and T6 (REO 1% + CPO 0.5%). The microbiological quality, physicochemical characteristics, sensory evaluation, and lipid oxidation of hamburgers were evaluated. REO, GEO and CPO limited the growth of aerobic microorganisms, S. aureus, Salmonella spp., B. thermosphacta, moulds and yeasts, lactic acid bacteria and coliforms (p < 0.05); however, this effect depended on time. Furthermore, lipid oxidation decreased significantly (p < 0.5) in all treatments, except for T5 (GEO 1% + CPO 0.5%). Regarding sensory acceptance, consumers preferred BH with GEO in terms of colour, odour, flavour and overall appearance (p < 0.05). It is concluded that REO, GEO and CPO, alone or in combination, improve microbiological quality and inhibit the lipid oxidation of BH.

High-intensity ultrasound as pre-treatment in the development of fermented whey and oat beverages: effect on the fermentation, antioxidant activity and consumer acceptance.

This study aimed to evaluate the effect of high-intensity ultrasound as pre-treatment in the development of fermented whey and oat beverages. Oat malt was produced, incorporated into a whey formulation (35, 50 and 65% v/v of whey) and ultrasonicated (at 40 kHz and 11 W/cm2) for 0, 3 or 10 min, prior to fermentation with L. casei 431. The treatments were identified as 35/65/0, 50/50/0, 65/35/0, 35/65/3, 50/50/3, 65/35/3, 35/65/10, 50/50/10 and 65/35/10, referring to the whey percentage, oat percentage, and the ultrasound time (min), respectively. The beverages 50/50/0 and 50/50/3 registered the highest (P < 0.05) growth with 1.96 and 2.00 log CFU ml, respectively. In general, the final average population of L. casei 431 was 7 to 8.86 log CFU/ml, being this adequate for a probiotic beverage. The highest antioxidant activity was found in the 35/65/3, 35/65/10, 50/50/3 and 50/50/10 beverages without difference (P < 0.05) among them. There was no effect of gender on the acceptance of the probiotic beverages. The best accepted beverage by women was 50/50/3 and both genders disliked the beverage 35/65/10. There was no relationship between the acceptance of the beverages and the consumers' habit by fermented milk beverages. No difference in the preference between the 50/50/0 and the 50/50/3 beverage was found. It is concluded that the probiotic beverage containing 50% whey and 50% oat and ultrasonicated for 3 min generated the highest levels of L. casei 431 growth, high antioxidant activity and good consumer acceptance and preference.

Late-life disability trajectories in Yoruba Nigerians and the Spanish population: a state space model in continuous time.

OBJECTIVES: We compared the trajectory of activities of daily living (ADL) in a nationally representative sample of older Nigerians with their Spanish peers and identified factors to explain country-specific growth models. METHODS: Data from two household multistage probability samples were used, comprising older adults from Spain (n = 2,011) and Nigeria (n = 1,704). All participants underwent assessment for ADL. Risk factors including sex, household income, urbanicity, years of education, depression, alcohol consumption and smoking were assessed using validated methods. State-space model in continuous time (SSM-CT) methods were used for trajectory comparison. RESULTS: Compared with Nigerians (µADL80=0.44, SE = 0.015, p < 0.001), Spanish older adults had higher disability scores (µADL80=1.23, SE = 0.021, p < 0.001). In SSM-CT models, the rate of increase in disability was faster in Nigerians (Nigeria: ß = 0.061, p<.01; Spain: ß = 0.028, p < 0.010). An increasing course of disability in the Spanish sample was predicted by female sex, lower education and depression diagnosis. CONCLUSION: The rate of increase in disability was faster in older Nigerians living in an economically disadvantaged context.

Global Methylome Scores Correlate with Histological Subtypes of Colorectal Carcinoma and Show Different Associations with Common Clinical and Molecular Features.

BACKGROUND: The typical methylation patterns associated with cancer are hypermethylation at gene promoters and global genome hypomethylation. Aberrant CpG island hypermethylation at promoter regions and global genome hypomethylation have not been associated with histological colorectal carcinomas (CRC) subsets. Using Illumina's 450 k Infinium Human Methylation beadchip, the methylome of 82 CRCs were analyzed, comprising different histological subtypes: 40 serrated adenocarcinomas (SAC), 32 conventional carcinomas (CC) and 10 CRCs showing histological and molecular features of microsatellite instability (hmMSI-H), and, additionally, 35 normal adjacent mucosae. Scores reflecting the overall methylation at 250 bp, 1 kb and 2 kb from the transcription starting site (TSS) were studied. RESULTS: SAC has an intermediate methylation pattern between CC and hmMSI-H for the three genome locations. In addition, the shift from promoter hypermethylation to genomic hypomethylation occurs at a small sequence between 250 bp and 1 Kb from the gene TSS, and an asymmetric distribution of methylation was observed between both sides of the CpG islands (N vs. S shores). CONCLUSION: These findings show that different histological subtypes of CRC have a particular global methylation pattern depending on sequence distance to TSS and highlight the so far underestimated importance of CpGs aberrantly hypomethylated in the clinical phenotype of CRCs.

Effect of Encapsulated Beet Extracts (Beta vulgaris) Added to Yogurt on the Physicochemical Characteristics and Antioxidant Activity.

Beet has been used as an ingredient for functional foods due to its high antioxidant activity, thanks to the betalains it contains. The effects of the addition of beet extract (liquid and lyophilized) on the physicochemical characteristics, color, antioxidant activity (AA), total betalains (TB), total polyphenols (TP), and total protein concentration (TPC) were evaluated on stirred yogurt. The treatments (T1-yogurt natural, T2-yogurt added with beet juice, T3-added extract of beet encapsulated with maltodextrin, and T4-yogurt added with extract of beet encapsulated with inulin) exhibited results with significant differences (p < 0.05). The highest TB content was observed in T2 (209.49 ± 14.91), followed by T3 (18.65 ± 1.01) and later T4 (12.96 ± 0.55). The highest AA was observed on T2 after 14 days (ABTS˙ 0.819 mM TE/100 g and DPPH˙ 0.343 mM TE/100 g), and the lowest was found on T1 at day 14 (ABTS˙ 0.526 mM TE/100 g and DPPH˙ 0.094 mM TE/100 g). A high content of TP was observed (7.13 to 9.79 mg GAE/g). The TPC varied between 11.38 to 12.56 µg/mL. The addition of beet extract significantly increased AA in yogurt, betalains being the main compounds responsible for that bioactivity.

Characterization of Beet Root Extract (Beta vulgaris) Encapsulated with Maltodextrin and Inulin.

Betalains are powerful antioxidants contained in beets. These are divided into betacyanins (red-violet) and betaxanthins (yellow-orange), and they can be used as natural colorants in the food industry. The effects of freeze-drying pure beet juice (B) and the encapsulation of beet juice with a dextrose equivalent (DE) 10 maltodextrin (M) and agave inulin (I) as carrier agents were evaluated. The powders showed significant differences (p < 0.05) in all the variables analyzed: water absorption index (WAI), water solubility index (WSI), glass transition temperature (Tg), total betalains (TB), betacyanins (BC), betaxanthins (BX), total polyphenols (TP), antioxidant activity (AA, via 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) (ABTS), and 2,2-diphenyl-1-picrylhydrazyl (DPPH)) and total protein concentration (TPC). The highest values of antioxidant activity were found in the non-encapsulated beet powder, followed by the powder encapsulated with maltodextrin and, to a lesser extent, the powder encapsulated with inulin. The glass transition temperature was 61.63 °C for M and 27.59 °C for I. However, for B it was less than 18.34 °C, which makes handling difficult. Encapsulation of beet extract with maltodextrin and inulin by lyophilization turned out to be an efficient method to increase solubility and diminish hygroscopicity.

Prevalencia de malnutrición y factores asociados en mujeres del pueblo wichí de General Ballivián, Provincia de Salta / Prevalence of Malnutrition and Associated Factors in Women of the Wichí People in General Ballivián, Province of Salta

INTRODUCCIÓN: La malnutrición (MN) es un problema mundial. Sus causas, mecanismos y consecuencias presentan particularidades económicas, biológicas y socioculturales. En la población indígena se han demostrado prevalencias de MN infantil más altas que en la población no indígena, aunque el estado nutricional de mujeres en edad reproductiva no ha sido estudiado. OBJETIVOS: Conocer la prevalencia de MN por déficit (MND) o exceso (MNE) y los factores asociados en mujeres wichí de General Ballivián, Salta. MÉTODOS: Se determinó la prevalencia de MN por antropometría. Se consideraron variables socioeconómicas, biosanitarias y alimentarias. Se estudió a 141 mujeres (wichí, de 12 años o más, no gestantes, sin discapacidad física/mental). Se hizo un estudio de casos y controles no pareados con grupo de casos 1 MNE (80), grupo de casos 2 MND (4) y grupo control: eutróficas (Eu) (57). Los datos se procesaron con SPSS Statistics 20.0. RESULTADOS: Se registró 3% de MND, 40% de Eu y 57% de MNE, con asociación estadísticamente significativa entre MND y adolescencia y entre MNE y multiparidad, ausencia de piezas dentarias, adultez y escolaridad inadecuada. Según OR (odds ratio), el riesgo de MNE es mayor en multíparas y monolingües, la MNE aumenta el riesgo de pérdida de piezas dentarias y una escolaridad inadecuada aumenta casi 13 veces el riesgo de MNE. CONCLUSIONES: La prevalencia de MNE es alta, asociada a edad, multiparidad, educación inadecuada, monolingüismo y carencia de micronutrientes.

INTRODUCTION: Malnutrition (MN) is a global problem. Its causes, mechanisms and consequences have economic, biological and socio-cultural particularities. Studies on indigenous people showed a prevalence of childhood MN higher than in non-indigenous population. However, the nutritional status of women of reproductive age has not been studied. OBJECTIVES: To know the prevalence of MN by deficit (MND) or excess (MNE) and the factors associated with it in Wichí women of General Ballivián, Salta province. METHODS: The prevalence of MN was determined by anthropometry. Socioeconomic, biohealth and food variables were considered. A total of 141 women were studied (Wichí, 12 years of age or older, non-pregnant, without physical or mental disability). A case-control study was carried out, not paired, with case group 1 MNE (80), case group 2 MND (4) and control group: eutrophic (Eu) (57). Data was processed with SPSS Statistics 20.0. RESULTS: The study showed 3% of MND, 40% of Eu and 57% of MNE, with a statistically significant association between MND and adolescence and between MNE and multiparity, absence of teeth, adulthood and inadequate schooling. According to OR (odds ratio), the risk of MNE is greater in multiparous and monolingual women, MNE increases the risk of loss of teeth and inadequate schooling increases the risk of MNE by almost 13 times. CONCLUSIONS: The prevalence of MNE is high, associated with age, multiparity, inadequate education, monolingualism and micronutrient deficiencies.

Treatment of choledochal cyst in a pediatric population. A single institution experience of 15-years. Case series.

BACKGROUND: Choledochal cyst (CC) is a rare congenital anomaly of the bile duct that approximately 75% of the patients are diagnosed in childhood. Without a standardized surgical procedure for the biliary reconstruction, we present our experience over the last 15 years and show the differences between the biliary reconstructions techniques in our population. METHODS: We did a retrospective hospital archive search for patients admitted to the pediatric surgery department with the diagnosis of a choledochal cyst from January 2000 to June 2015. RESULTS: We found 15 patients, of which, 1 was excluded because of missing data from the hospital record. Of the remaining 14, eight had hepaticojejunal (HY) anastomosis in Roux-en-Y, with a 25% rate of complications; six had hepatoduodenal (HD) anastomosis with a rate of complications of 16.6%. The average hospital length of stay in the group of HD vs. HY was 14 ± 1.6-days vs. 19 ± 8.2-days respectively. DISCUSSION: There are no standardized surgical reconstruction techniques of the biliary tract after the CC excision, there is literature that supports the biliary reconstruction with an HY and an HD without a distinct advantage over one or the other. CONCLUSION: In our series HD anastomosis represents a safe procedure with fewer complications than HY.

Fribrinolytic activity and gas production by Pleurotus ostreatus-IE8 and Fomes fomentarius - EUM1 in bagasse cane / Actividad fibrolítica y producción de gas por Pleurotus ostreatus-IE8 y Fomes fomentarius-EUM1 en bagazo de caña

Objective. To characterize the fibrolytic enzymatic activity of Pleurotus ostreatus-IE8 and Fomes fomentarius-EUM1 in sugarcane bagasse (BCA); to evaluation of the kinetics of in vitro production of BCA treated by solid fermentation (FS), crude enzyme extract (ECE) of P. ostreatus-IE8 and Fibrozyme®. Materials and methods. In fungi measured radial growth rate ( Vcr ) and biomass production in two culture media (with or without nitrogen source); activity of xylanases, cellulases and FS on BCA at 0, 7 and 15 d. The chemical analysis and kinetic analysis of in vitro gas production in 4 treatments (ECE adding enzymes obtained from the direct addition FS or FS ), witness (Fibrozyme®) and a control without addition and analyzed by a was completely randomized design. Results. Xylanases (7 d ) showed 6.32 and 5.50 UI g-1 initial substrate dry weight (SSi) for fungi P. ostreatus-IE8 and F. fomentarius-EUM1 , respectively ; P. ostreatus-IE8 scored higher activity of laccases (10.65 g-1 UI SSi) and F. fomentarius-EUM1 (1.90 UI g-1 SSi) cellulases. The ECE of P. ostreatus-IE8 and commercial enzyme did not differences (p>0.05). In the chemical composition or the gas production kinetics. The 4 treatments evaluated decreased values of the variables measured in the kinetics of gas production compared to the control (p≤0.05). Conclusions. The ECE of P. ostreatus-IE8 was similar to commercial enzyme degradation in vitro, so it is feasible to use pre-digest high fiber products.

Objetivos. Caracterizar la actividad enzimática fibrolítica de Pleurotus ostreatus-IE8 y Fomes fomentarius-EUM1 en bagazo de caña de azúcar (BCA) y evaluar la cinética de producción de gas in vitro del BCA por fermentación sólida (FS) o con extractos crudos enzimáticos (ECE) de P. ostreatus-IE8 o Fibrozyme®. Materiales y métodos. En los hongos de estudio se evaluó la velocidad de crecimiento radial (Vcr) y producción de biomasa en dos medios de cultivo (con o sin fuente de nitrógeno); actividad de xilanasas, celulasas y lacasas de la FS sobre BCA a 0, 7 y 15 d. El análisis químico y cinética de producción de gas in vitro en 4 tratamientos (proceso de FS o adición de enzimas obtenidas de ECE de la FS), un testigo (Fibrozyme®) y un control sin adición de enzimas, todo ello se analizó en un diseño completamente al azar. Resultados. Las xilanasas (7 d) mostraron 6.32 y 5.50 UI g-1 sustrato seco inicial (SSi) en P. ostreatus-IE8 y F. fomentarius-EUM1, respectivamente. P. ostreatus-IE8 mostró mayor actividad lacasa (10.65 UI g-1 SSi) y F. fomentarius-EUM1 (1.90 UI g-1 SSi) de celulasas. El ECE de P. ostreatus-IE8 y Fibrozyme® no presentaron diferencias (p>0.05) en la composición química ni en la cinética de producción de gas. Los 4 tratamientos evaluados disminuyeron los valores de las variables medidas en la cinética de producción de gas in vitro respecto al testigo (p≤0.05). Conclusiones. El ECE de P. ostreatus-IE8 fue similar a Fibrozyme® en la degradación in vitro, indicando su viabilidad y uso para pre-digerir subproductos altos en fibra.

Methylome profiling reveals functions and genes which are differentially methylated in serrated compared to conventional colorectal carcinoma.

BACKGROUND: Serrated adenocarcinoma (SAC) is a recently recognized colorectal cancer (CRC) subtype accounting for 7.5-8.7 % of CRCs. It has been shown that SAC has a worse prognosis and different histological and molecular features compared to conventional carcinoma (CC) but, to date, there is no study analysing its methylome profile. RESULTS: The methylation status of 450,000 CpG sites using the Infinium Human Methylation 450 BeadChip array was investigated in 103 colorectal specimens, including 39 SACs and 34 matched CCs, from Spanish and Finnish patients. Microarray data showed a higher representation of morphogenesis-, neurogenesis-, cytoskeleton- and vesicle transport-related functions and also significant differential methylation of 15 genes, including the iodothyronine deiodinase DIO3 and the forkhead family transcription factor FOXD2 genes which were validated at the CpG, mRNA and protein level using pyrosequencing, methylation-specific PCR, quantitative polymerase chain reaction (qPCR) and immunohistochemistry. A quantification study of the methylation status of CpG sequences in FOXD2 demonstrated a novel region controlling gene expression. Moreover, differences in these markers were also evident when comparing SAC with CRC showing molecular and histological features of high-level microsatellite instability. CONCLUSIONS: This methylome study demonstrates distinct epigenetic regulation patterns in SAC which are consistent to previous expression profile studies and that DIO3 and FOXD2 might be molecular targets for a specific histology-oriented treatment of CRC.

Apendicite aguda após trauma abdominal / Accute appendicitis after abdominal trauma

O trabalho relata um caso de apendicite após trauma abdominal contuso originando diretamente um quadro de apendicite aguda em adolescente do sexo feminino. A exploração cirúrgica confirmou a origem traumática da apendicite aguda, sendo realizada apendicectomia. A paciente evoluiu sem intercorrências e obteve alta. Podemos concluir que desenvolveu um quadro de apendicite subsequente a trauma contuso abdominal.

Attenuation of acute stroke injury in rat brain by minocycline promotes blood-brain barrier remodeling and alternative microglia/macrophage activation during recovery.

BACKGROUND: Minocycline reduces reperfusion injury by inhibiting matrix metalloproteinases (MMPs) and microglia activity after cerebral ischemia. Prior studies of minocycline investigated short-term neuroprotective effects during subacute stage of stroke; however, the late effects of minocycline against early reperfusion injury on neurovascular remodeling are less well studied. We have shown that spontaneous angiogenesis vessels in ischemic brain regions have high blood-brain barrier (BBB) permeability due to lack of major tight junction proteins (TJPs) in endothelial cells at three weeks. In the present study, we longitudinally investigated neurological outcome, neurovascular remodeling and microglia/macrophage alternative activation after spontaneous and minocycline-induced stroke recovery. METHODS: Adult spontaneously hypertensive rats had a 90 minute transient middle cerebral artery occlusion. At the onset of reperfusion they received a single dose of minocycline (3 mg/kg intravenously) or a vehicle. They were studied at multiple time points up to four weeks with magnetic resonance imaging (MRI), immunohistochemistry and biochemistry. RESULTS: Minocycline significantly reduced the infarct size and prevented tissue loss in the ischemic hemispheres compared to vehicle-treated rats from two to four weeks as measured with MRI. Cerebral blood flow measured with arterial spin labeling (ASL) showed that minocycline improved perfusion. Dynamic contrast-enhanced MRI indicated that minocycline reduced BBB permeability accompanied with higher levels of TJPs measured with Western blot. Increased MMP-2 and -3 were detected at four weeks. Active microglia/macrophage, surrounding and within the peri-infarct areas, expressed YM1, a marker of M2 microglia/macrophage activation, at four weeks. These microglia/macrophage expressed both pro-inflammatory factors tumor necrosis factors-α (TNF-α) and interleukin-1ß (IL-1ß) and anti-inflammatory factors transforming growth factor-ß (TGF-ß) and interleukin-10 (IL-10). Treatment with minocycline significantly reduced levels of TNF-α and IL-1ß, and increased levels of TGF-ß, IL-10 and YM1. CONCLUSIONS: Early minocycline treatment against reperfusion injury significantly promotes neurovascular remodeling during stroke recovery by reducing brain tissue loss, enhancing TJP expression in ischemic brains and facilitating neuroprotective phenotype alternative activation of microglia/macrophages.

Pioderma gangrenoso pós-mamoplastia redutora: relato de caso e discursão / Pyoderma gangrenosum after reduction mammaplasty: case report and discussion

We report the case of a 31-year-old woman who underwent mammoplasty and abdominoplasty and developed a rare and recurrent skin disease, of unknown etiology that was diagnosed as pyoderma gangrenosum. While the diagnosis was clinical, the treatment was empirical. An association between this disease and other systemic diseases was observed, in addition to pathergy (development of a new inflammatory lesion in are as of trauma) and changes in cellular immunity. The patient was empirically treated with antibiotics, sulfone, corticosteroids, and topical agents and experienced complete wound healing with no recurrence.

Neste artigo relata-se o caso de uma jovem de 31 anos de idade, submetida a mamoplastia e abdominoplastia, que evoluiu com uma doença cutânea rara, recorrente e de causa desconhecida: pioderma gangrenoso. O diagnóstico é clínico e o tratamento permanece empírico. Tem-se encontrado relação entre essa afecção e outras doenças sistêmicas, além de evidências do fenômeno de patergia (desenvolvimento de uma nova lesão inflamatóriana área do trauma) e de alterações da imunidade celular. A paciente foi tratada empiricamente com antibióticos, sulfona e corticoide, e com tratamento tópico, evoluindo para o fechamento completo das lesões sem apresentar recorrência.

Prácticas saludables para el cuidado materno infantil / Maternal-child care healthy practices

Esta cartilla fue elaborada por Profamilia Colombia, con el objetivo de promover y fortalecer los mensajes de salud materno-infantil del Programa Plan Hospitales que adelanta Kimberly-Clark...

Increased apparent diffusion coefficients on MRI linked with matrix metalloproteinases and edema in white matter after bilateral carotid artery occlusion in rats.

White matter (WM) injury after bilateral common carotid artery occlusion (BCAO) in rat is associated with disruption of the blood-brain barrier (BBB) by matrix metalloproteinases (MMPs). We hypothesized that WM injury as seen on magnetic resonance imaging (MRI) would correlate with regions of increased MMP activity. MRI was performed 3 days after BCAO surgery in rats. Apparent diffusion coefficients (ADC) were calculated and vascular permeability was quantified by the multiple-time graphical analysis (MTGA) method, using gadolinium-diethylenetriamine pentaacid (Gd-DTPA). After MRI, one group of animals had BBB permeability measured in the WM with (14)C-sucrose, and another had Evans blue (EB) injected for fluorescent microscopy for MMP-2, MMP-9, tight junction proteins (TJPs), and in situ zymography. We found that ADC values were increased in WM in BCAO rats compared with controls (P<0.05). WM with increased ADC had leakage of EB. MMP-2 and MMP-9 activity on in situ zymograms corresponded with leakage of EB. Although increased permeability to EB could be visualized, permeability quantification with (14)C-sucrose and Gd-DTPA failed to show increases and TJPs were intact. We propose that increased ADC, which is a marker of vasogenic edema, is related to activity of MMP-2 and MMP-9. MRI provides unique information that can be used to guide tissue studies of WM injury.

Prevalencia de malnutrición y factores asociados en mujeres del pueblo wichí de General Ballivián, Provincia de Salta / Prevalence of Malnutrition and Associated Factors in Women of the Wichí People in General Ballivián, Province of Salta

INTRODUCCIÓN: La malnutrición (MN) es un problema mundial. Sus causas, mecanismos y consecuencias presentan particularidades económicas, biológicas y socioculturales. En la población indígena se han demostrado prevalencias de MN infantil más altas que en la población no indígena, aunque el estado nutricional de mujeres en edad reproductiva no ha sido estudiado. OBJETIVOS: Conocer la prevalencia de MN por déficit (MND) o exceso (MNE) y los factores asociados en mujeres wichí de General Ballivián, Salta. MÉTODOS: Se determinó la prevalencia de MN por antropometría. Se consideraron variables socioeconómicas, biosanitarias y alimentarias. Se estudió a 141 mujeres (wichí, de 12 años o más, no gestantes, sin discapacidad física/mental). Se hizo un estudio de casos y controles no pareados con grupo de casos 1 MNE (80), grupo de casos 2 MND (4) y grupo control: eutróficas (Eu) (57). Los datos se procesaron con SPSS Statistics 20.0. RESULTADOS: Se registró 3% de MND, 40% de Eu y 57% de MNE, con asociación estadísticamente significativa entre MND y adolescencia y entre MNE y multiparidad, ausencia de piezas dentarias, adultez y escolaridad inadecuada. Según OR (odds ratio), el riesgo de MNE es mayor en multíparas y monolingües, la MNE aumenta el riesgo de pérdida de piezas dentarias y una escolaridad inadecuada aumenta casi 13 veces el riesgo de MNE. CONCLUSIONES: La prevalencia de MNE es alta, asociada a edad, multiparidad, educación inadecuada, monolingüismo y carencia de micronutrientes

Cyclooxygenase inhibition limits blood-brain barrier disruption following intracerebral injection of tumor necrosis factor-alpha in the rat.

Increased permeability of the blood-brain barrier (BBB) is important in neurological disorders. Neuroinflammation is associated with increased BBB breakdown and brain injury. Tumor necrosis factor (TNF)-alpha is involved in BBB injury and edema formation through a mechanism involving matrix metalloproteinase (MMP) up-regulation. There is emerging evidence indicating that cyclooxygenase (COX) inhibition limits BBB disruption following ischemic stroke and bacterial meningitis, but the mechanisms involved are not known. We used intracerebral injection of TNF-alpha to study the effect of COX inhibition on TNF-alpha-induced BBB breakdown, MMP expression/activity, and oxidative stress. BBB disruption was evaluated by the uptake of (14)C-sucrose into the brain and by magnetic resonance imaging utilizing gadolinium-diethylenetriaminepentaacetic acid as a paramagnetic contrast agent. Using selective inhibitors of each COX isoform, we found that COX-1 activity is more important than COX-2 in BBB opening. TNF-alpha induced a significant up-regulation of gelatinase B (MMP-9), stromelysin-1 (MMP-3), and COX-2. In addition, TNF-alpha significantly depleted glutathione as compared with saline. Indomethacin (10 mg/kg i.p.), an inhibitor of COX-1 and COX-2, reduced BBB damage at 24 h. Indomethacin significantly attenuated MMP-9 and MMP-3 expression and activation and prevented the loss of endogenous radical scavenging capacity following intracerebral injection of TNF-alpha. Our results show for the first time that BBB disruption during neuroinflammation can be significantly reduced by administration of COX inhibitors. Modulation of COX in brain injury by COX inhibitors or agents modulating prostaglandin E(2) formation/signaling may be useful in clinical settings associated with BBB disruption.

La carga de la enfermedad por rotavirus en niños menores de cinco años, Colombia, 2004 / Burden of rotavirus-related disease among children under five, Colombia, 2004

OBJETIVOS: Establecer un sistema de vigilancia intrahospitalaria de la diarrea en niños menores de 5 años, estimar la carga de la enfermedad por rotavirus e identificar los genotipos más frecuentes de rotavirus. MÉTODOS: Se incluyó en este estudio a niños hospitalizados por complicaciones graves de la diarrea en tres centros asistenciales de Santa Fe de Bogotá, Barranquilla y Cali, Colombia. Se utilizó un método de enzimoinmunoanálisis en fase sólida (ELISA) para la detección de rotavirus y un método de reacción en cadena de la polimerasa con transcripción inversa (RT-PCR) para la genotipificación. Se determinaron las frecuencias, la tendencia central y la dispersión de las variables. Se realizó un análisis estratificado y un análisis con dos variables, mediante una prueba de la ji2 o una prueba exacta de Fisher, o una prueba de la ji2 para evaluar la tendencia, según los datos. Se establecieron los riesgos relativos. Para el análisis de la tendencia, se utilizaron la regresión lineal, los coeficientes de correlación y los valores de P. RESULTADOS: Entre diciembre de 2003 y noviembre de 2004 se hospitalizó a 893 niños en los tres centros participantes en el estudio, de los cuales el 68 por ciento tenía entre 6 y 23 meses de edad. Un 2,7 por ciento de los pacientes ingresados presentaba un cuadro de choque hipovolémico y un 1,2 por ciento falleció. Solo un 57 por ciento de las madres había administrado a sus hijos una solución de rehidratación oral antes de la hospitalización. La infección por rotavirus motivó un 50 por ciento de las hospitalizaciones (coeficiente de correlación [r] > 0,8) y se relacionó con intolerancia a la vía oral (riesgo relativo [RR] = 1,45; intervalo de confianza del 95 por ciento [IC95 por ciento]: 1,24 - 1,69; P < 0,0000) y vómito incoercible (RR = 1,47; IC95 por ciento: 1,16 - 1,86; P < 0,01). La infección por rotavirus ocasionó una muerte por cada 2 000 niños; 16 hospitalizaciones por cada 1 000 niños y 631 consultas por cada 1 000 niños. Se identificó estacionalidad en los genotipos G1P[8], G2P[4] y G3P[8] de rotavirus, que no varió a pesar de la distancia geográfica y las diferencias de temperatura, humedad y precipitación entre las tres ciudades.CONCLUSIONES: La infección por rotavirus es una causa importante de morbilidad y mortalidad por diarrea, especialmente en los primeros años de vida, cuando los niños están más expuestos a las complicaciones graves. Es necesario que las estrategias de prevención tengan un alto impacto antes de los 6 meses de edad. La vacunación contra el rotavirus puede ser una buena estrategia complementaria de intervención. No se encontró en la literatura internacional ninguna descripción anterior de la estacionalidad de los genotipos de rotavirus. Es importante hacer estudios de costo-efectividad para favorecer la inversión de recursos según las necesidades de la población y continuar la vigilancia para ampliar el conocimiento del comportamiento de este virus.

OBJECTIVES: To establish an in-hospital surveillance system for diarrhea in children under five, to estimate the burden of rotavirus-related disease, and to identify the most common rotavirus genotypes. METHODS: Included in the study were children who were hospitalized for serious complications of diarrhea in three medical care facilities in Bogotá, Barranquilla, and Cali, Colombia. A solid-phase enzyme-linked immunosorbent assay (ELISA) was used to detect rotavirus, and reverse-transcriptase polymerase chain reaction (RT-PCR) was the genotyping method employed. The frequencies, central tendency, and dispersion of the variables were determined. Stratified analysis and bivariate analysis were performed by applying a chi squared test or Fisher's exact test, or a chi squared test for trends, depending on the type of data analyzed. Relative risks were established. For analyzing trends we performed linear regression and calculated correlation coefficients and P values. RESULTS: Between December 2003 and November 2004, 893 children were hospitalized in the three participating centers included in the study. Of these children, 68 percent were between 6 and 23 months of age; 2.7 percent of hospitalized patients showed clinical signs of hypovolemic shock, and 1.2 percent died. Only 57 percent of the mothers had given their children an oral rehydration solution before hospitalization. Rotavirus infection was the cause of 50 percent of hospitalizations (correlation coefficient [r] > 0.8) and was linked to an inability to hold down orally-ingested fluids (relative risk [RR] = 1.45; 95 percent confidence interval [95 percent CI]: 1.24 to 1.69; P < 0.0000) and to intractable vomiting (RR = 1.47; 95 percent CI: 1.16 to 1.86; P < 0.01). Rotavirus infection led to one death per 2 000 children; 16 hospitalizations per 1 000 children, and 631 medical visits per 1 000 children. A seasonal trend was noted for G1P[8], G2P[4], and G3P[8] rotavirus genotypes, and this did not vary as a result of geographic distance or differences in temperature, humidity, and rainfall among cities.CONCLUSIONS: Rotavirus infection is an important cause of morbidity and mortality from diarrhea, particularly during the first years of life, when children are more susceptible to serious complications. It is important for prevention strategies to have a high impact before 6 months of age, and vaccination against rotavirus can be a good complementary intervention strategy. No description was found in the international scientific literature of the seasonal variations in rotavirus genotypes. It is important to carry out cost-effectiveness studies in order to promote the investment of resources in accordance with population needs, and to continue surveillance activities so as to better understand how the virus behaves.