Modulación de marcadores de inflamación y estrés oxidativo en pacientes con diabetes tipo 1 y sobrepeso que participan en un programa de cambio de estilo de vida / Modulation of Inflammatory and oxidative stress markers in overweight type 1 Diabetes patients participating in a lifestyle change program

Introduction: Reduction in the expression of inflammatory markers and oxidative stress associated with exercise will protect against cardiovascular complications in Diabetes Mellitus (DM). Aim: The aim of this study was evaluated cardiovascular fitness (VO2 Max), interleukin-6 (IL-6), monocyte chemo-attractant protein 1 (MCP-1) and serum lipid peroxidation (TBARS) in overweight patients with Type-1 diabetes (T1DM) participating in a lifestyle-change program. Results: 20 T1DM overweight patients (43.3 ± 13.8 years), with BMI= 29.6 ± 3.5 kg/m2 , initial HbA1c 7.9 ± 0.91% and treated with multiple insulin injections, were included in this work. The lifestyle-change program consisted of: a) walking 10,000 steps/day, b) sequence of exercises of 24 minutes, 3-5 times/week, c) ¨healthy-plate¨ (and counting carbohydrates, and d) prandial insulin as blood-glucose levels. VO2 max, HbA1c, TBARS, IL6, MCP-1 were determined before starting the lifestyle-change program. Six months of adherence later, participants showed an average number of steps of 8242 ± 1834, a significant increase in VO2 max, (33.4 ±1.3 vs 36.2 ±1.5 ml.Kg-1.min-1 p= 0.008), a significant decrease in serum MCP-1 (314 ±42 vs 235 ±43 MFI p= 0.02), and less TBARS (3.01 ±0.44 vs 2.12 ±0.22 µmol/mL p= 0.015). IL-6 and HbA1c showed no significant decrease. Conclusion: Our results showed that a 6-month systemized and simple exercise plan improves cardiorespiratory fitness (VO2 max), and reduces both circulating oxidative stress and inflammation markers in overweight patients with T1DM.

Introducción: La reducción en la expresión de marcadores inflamatorios y de estrés oxidativo asociado con el ejercicio podría proteger contra las complicaciones cardiovasculares de la diabetes mellitus (DM). Objetivo: El objetivo de este estudio fue evaluar en pacientes con DM tipo1 (DMT1) y sobrepeso, la capacidad cardiorespiratoria (VO2 Max), la expresión sérica de marcadores inflamatorios (IL-6 y MCP-1) y la peroxidación lipídica sérica (TBARS), luego de participar por 6 meses de un programa de cambios de estilo de vida. Resultados: Veinte pacientes adultos (43.3 ± 13.8 años), de ambos sexos, con un Índice de Masa Corporal de 29.6 ± 3.5 kg/m2 , HbA1c inicial de 7,9% ± 0,91, en tratamiento con inyecciones múltiples de insulina participaron del estudio. Se indicó: 1) caminar 10.000 pasos/día, 2) realizar en domicilio una secuencia de ejercicios de 20 minutos, 3-5 veces/semana, 3) plato saludable (consumo de 1 fruta antes de las 3 comidas principales), 4) Insulina prandial según glucemia y conteo de carbohidratos. Se registraron parámetros antropométricos, presión arterial, se determinó VO2 max, y se midieron los niveles séricos de HbA1c, IL6, MCP-1 y TBARs. Luego de seis meses, los participantes alcanzaron un número promedio de pasos de 8242 ± 1834 y mostraron un aumento significativo en VO2 max, (33.4 ±1.3 vs 36.2 ±1.5 ml.Kg-1.min-1 p= 0.008). Además, se encontró una disminución significativa de MCP-1 (314 ±42 vs 235 ±43 MFI p=0.02) y TBARs (3.01 ±0.44 vs 2.12 ±0.22 µmol/mL p= 0.015) en comparación con el día 0. No se observaron modificaciones en los niveles de IL-6 y HbA1c. Conclusión: Nuestros resultados demuestran que el ejercicio, implementado como un plan accesible y acompañado, es adecuado para reducir los riesgos de inflamación y estado pro-oxidativo en pacientes con DM tipo1.

IgG4-related orbital disease. / Enfermedad orbitaria relacionada con Ig-G4.

CASE REPORT: The case is presented of a 64-year-old woman with bilateral palpebral swelling and dacryoadenitis, exophthalmos, and a history of chronic rhinitis and asthma. An increase in serum IgG4 was observed, and an incisional biopsy of lacrimal glands was performed, which showed fibrosis and a lymphoplasmacytic infiltrate with IgG4 producing cells. DISCUSSION: Orbital involvement in IgG4-related disease is frequent. Bilateral dacryoadenitis is the most common manifestation. Histopathology is essential for the diagnosis and to exclude malignancy.

Reproductive behavior of crossbred dairy cows grazing an intensive silvopastoral system under tropical dry forest conditions / Comportamento reprodutivo de vacas leiteiras mestiças pastando um sistema silvipastoril intensivo em condições de floresta tropical seca

It is widely accepted that selection for high milk yield in dairy cows has negatively affected their reproductive performance. After calving, dairy cows experience a nutritional imbalance due to an asynchrony in the occurrence of the lactation and dry matter intake peaks. In the tropics, this situation is exacerbated due to poor quality and/ or availability of the diet. A study was carried out to describe the nutritional and reproductive behavior of two-to-four parturition crossbred cows (Gyr (Bos indicus) x Holstein (Bos taurus)) divided in two groups according to their calving to first service interval (CFSI): Group 1: ≤50 days CFSI, n=7; Group 2: ≥50 days CFSI, n=8. Animals were grazing in an intensive silvopastoral system (ISS) based on Leucaena leucocephala and Cynodon plectostachyus and also received protein, energy and mineral supplementation. Dry matter (DMI) and nutrient intake were individually estimated and correlations between reproductive and nutritional parameters were performed. Additionally, serum progesterone concentration was monitored. Group 2 had greater forage and total DMI and milk production than Group 1 (P<0.05). Hence, Group 2 had greater nutrient intake from forages than Group 1 (P<0.05). Group 1 had a positive nutritional balance and an optimum reproductive performance compared to Group 2, which had a negative energy balance and lengthier days with open intervals (P<0.05). It was corroborated that protein and energy are required in adequate levels, to ensure that uterus undergoes involution correctly and ovarian activity starts soon in the postpartum period.(AU)

É amplamente aceito que a seleção para alta produção de leite em vacas leiteiras tem interferido no seu desempenho reprodutivo. Depois do parto, um extraordinário desafio nutritivo é experimentado pelas vacas leiteiras, devido a uma assincronia entre a ocorrência do pico de lactação e a do pico de consumo de matéria seca. Este estudo foi realizado para descrever o comportamento reprodutivo de vacas mestiças de dois a quatro partos (Gyr (Bos indicus) x Holstein (Bos taurus)), divididos em dois grupos, de acordo com seu intervalo parto ao primeiro serviço (IPPS): grupo 1: ≤ 50 dias IPPS, n = 7; grupo 2: ≥50 IPPS dias, n = 8. Os animais pastaram em um sistema silvipastoril intensivo (SSI), com base em Leucaena leucocephala e Cynodon plectostachyus, e receberam também suplementação de proteína, energia e mineral. Matéria seca (CMS) e ingestão de nutrientes foram estimadas individualmente e correlações entre parâmetros reprodutivos e nutricionais foram realizadas. Além disso, a concentração de progesterona em soro foi monitorizada. Vacas do grupo 2 apresentaram maior ingestão de forragem, de dieta total e de produção total de leite do que vacas do grupo 1 (P<0,05). Dessa forma, vacas do grupo 2 apresentaram maior consumo de nutrientes de forrageiras do que os animais do grupo 1 (P<0,05). Vacas do grupo 1 tinham um equilíbrio nutricional positivo e um ótimo desempenho reprodutivo em relação ao grupo 2, que teve um balanço energético negativo e mais longos intervalos de dias abertos (P<0,05). Foi corroborado que a proteína e a energia são necessárias em níveis adequados, assim o útero sofre involução corretamente e a atividade ovariana começa logo no período pós-parto.(AU)

Obesity decreases the oxidant stress induced by tobacco smoke in a rat model.

Obesity and emphysema are associated with low-grade systemic inflammation and oxidant stress. Assuming that the oxidant stress induced by emphysema would be decreased by obesity, we analyzed the oxidant/antioxidant state in a rat model combining both diseases simultaneously. Obesity was induced using sucrose, while emphysema by exposure to tobacco smoke. End-points evaluated were: body weight, abdominal fat, plasma dyslipidemia and malondialdehyde (MDA), insulin and glucose AUC, activities of Mn-superoxide dismutase (Mn-SOD), glutathione reductase (GR), glutathione transferase (GST) and glutathione peroxidase (GPx); lung MnSOD and 3-nitrotyrosine (3-NT) immunostaining, and expression of αV and ß6 integrin subunits. In rats with obesity, the body weight, abdominal fat, plasma triglyceride levels, glucose AUC, insulin levels, GST activity, and αV and ß6 integrin expressions were amplified. The rats with emphysema had lower values of body weight, abdominal fat, plasma insulin, triglycerides and glucose AUC but higher values of plasma MDA, GPx activity, and the lung expression of the αV and ß6 integrins. The combination of obesity and emphysema compared to either condition alone led to diminished body weight, abdominal fat, plasma insulin MDA levels, GPx and GST activities, and αV and ß6 integrin expressions; these parameters were all previously increased by obesity. Immunostaining for MnSOD augmented in all experimental groups, but the staining for 3-NT only increased in rats treated with tobacco alone or combined with sucrose. Results showed that obesity reduces oxidant stress and integrin expression, increasing antioxidant enzyme activities; these changes seem to partly contribute to a protective mechanism of obesity against emphysema development.

In vivo biocompatibility, clearance, and biodistribution of albumin vehicles for pulmonary drug delivery.

The development of clinically acceptable albumin-based nanoparticle formulations for use in pulmonary drug delivery has been hindered by concerns about the toxicity of nanomaterials in the lungs combined with a lack of information on albumin nanoparticle clearance kinetics and biodistribution. In this study, the in vivo biocompatibility of albumin nanoparticles was investigated following a single administration of 2, 20, and 390µg/mouse, showing no inflammatory response (TNF-α and IL-6, cellular infiltration and protein concentration) compared to vehicle controls at the two lower doses, but elevated mononucleocytes and a mild inflammatory effect at the highest dose tested. The biodistribution and clearance of (111)In labelled albumin solution and nanoparticles over 48h following a single pulmonary administration to mice was investigated by single photon emission computed tomography and X-ray computed tomography imaging and terminal biodistribution studies. (111)In labelled albumin nanoparticles were cleared more slowly from the mouse lung than (111)In albumin solution (64.1±8.5% vs 40.6±3.3% at t=48h, respectively), with significantly higher (P<0.001) levels of albumin nanoparticle-associated radioactivity located within the lung tissue (23.3±4.7%) compared to the lung fluid (16.1±4.4%). Low amounts of (111)In activity were detected in the liver, kidneys, and intestine at time points >24h indicating that small amounts of activity were cleared from the lungs both by translocation across the lung mucosal barrier, as well as mucociliary clearance. This study provides important information on the fate of albumin vehicles in the lungs, which may be used to direct future formulation design of inhaled nanomedicines.

Overexpression of MEOX2 and TWIST1 is associated with H3K27me3 levels and determines lung cancer chemoresistance and prognosis.

Lung cancer is the leading cause of death from malignant diseases worldwide, with the non-small cell (NSCLC) subtype accounting for the majority of cases. NSCLC is characterized by frequent genomic imbalances and copy number variations (CNVs), but the epigenetic aberrations that are associated with clinical prognosis and therapeutic failure remain not completely identify. In the present study, a total of 55 lung cancer patients were included and we conducted genomic and genetic expression analyses, immunohistochemical protein detection, DNA methylation and chromatin immunoprecipitation assays to obtain genetic and epigenetic profiles associated to prognosis and chemoresponse of NSCLC patients. Finally, siRNA transfection-mediated genetic silencing and cisplatinum cellular cytotoxicity assays in NSCLC cell lines A-427 and INER-37 were assessed to describe chemoresistance mechanisms involved. Our results identified high frequencies of CNVs (66-51% of cases) in the 7p22.3-p21.1 and 7p15.3-p15.2 cytogenetic regions. However, overexpression of genes, such as MEOX2, HDAC9, TWIST1 and AhR, at 7p21.2-p21.1 locus occurred despite the absence of CNVs and little changes in DNA methylation. In contrast, the promoter sequences of MEOX2 and TWIST1 displayed significantly lower/decrease in the repressive histone mark H3K27me3 and increased in the active histone mark H3K4me3 levels. Finally these results correlate with poor survival in NSCLC patients and cellular chemoresistance to oncologic drugs in NSCLC cell lines in a MEOX2 and TWIST1 overexpression dependent-manner. In conclusion, we report for the first time that MEOX2 participates in chemoresistance irrespective of high CNV, but it is significantly dependent upon H3K27me3 enrichment probably associated with aggressiveness and chemotherapy failure in NSCLC patients, however additional clinical studies must be performed to confirm our findings as new probable clinical markers in NSCLC patients.

The effect of obesity and tobacco smoke exposure on inflammatory mediators and matrix metalloproteinases in rat model.

Obesity is characterized by hypertrophy of adipose tissue and chronic obstructive pulmonary disease (COPD) by lung damage; both diseases are associated with systemic low-grade inflammation. There are no animal models combining obesity and COPD; therefore, these diseases were induced simultaneously in rats to analyze their effects on the expression of inflammatory mediators and enzymes involved in lung tissue remodeling. Obesity was induced with sucrose (30%) for 4 months concomitant with tobacco smoke exposure (20 cigarettes/day, 5 days/wk) for the last 2 months. Were evaluated: body weight, abdominal fat, dyslipidemia, glucose tolerance test (GTT), histology, inflammatory mediators with qPCR and enzyme-linked immunosorbent assay, matrix metalloproteinases (MMP-2), MMP-9, MMP-12, TIMP-1 and TIMP-2 through qRT-PCR, and MMP-2 and MMP-9 by gelatin zymography. The rats on a sucrose diet exhibited increased body weight, abdominal fat, triglycerides, GTT, and plasma levels of insulin, adiponectin, leptin, resistin, IL-6, IL-1ß, tumor necrosis factor-α (TNF-α) and IFN-γ, upregulated lung IL-6, IL-1ß, TNF-α and IFN-γ, showing hyperplastic bronchial and alveolar epithelium. The animals exposed to sucrose and tobacco smoke exhibited decreased body weight, abdominal fat and plasma levels of leptin, resistin, IL-1ß and IFN-γ, reducing inflammation but showing emphysematous lesions. Expression of gelatinases and MMP-12 augmented in the rats exposed to tobacco smoke alone or combined with sucrose. Zymography showed prominent gelatinases activity in all the experimental groups. These results suggest that simultaneous exposure to sucrose and tobacco smoke decreases inflammation but results in emphysematous lesions similar to those observed with tobacco smoke exposure, suggesting that obesity does not confer any protective effect against lung damage.

Clinical and biological acceptance of a fibrocollagen-coated mersylene patch for tracheal repair in growing dogs.

BACKGROUND: Collagen-covered prostheses can be used as a non-circumferential segmental tracheal replacement. However, the applicability of these implants in young subjects has not yet been reported. METHODS: In this experimental, longitudinal study, dogs aged 29-32 days underwent limited segmental tracheal replacement with a polyester prosthesis or were allocated to a control, untreated group. The dogs were evaluated clinically, endoscopically and tomographically for up to one year. RESULTS: Although there was evidence of tracheal growth in the experimental group, tomographic measurements were significantly smaller in this group than in the control group throughout the observation period. At the end of the study, there was no evidence of implant rejection, stenosis or collapse. Normal respiratory epithelium had grown across the implanted membrane in the experimental group. CONCLUSION: The homologous collagen mersylene membrane allowed for limited structural tracheal growth and was functionally integrated into the segmented tracheal wall in growing dogs.

Oxidative stress and lung injury induced by short-term exposure to wood smoke in guinea pigs.

Oxidative stress and lung injury induced by short-term exposure to wood smoke were evaluated in guinea pigs through cell profile, bronchoalveolar lavage (BAL), conventional histology and immunohistochemistry (4-hydroxynonenal, 3-nitrotyrosine, Mn-superoxide dismutase, heme oxygenase-1); malondialdehyde and 4-hydroxynonenal concentration, Mn-superoxide dismutase, glutathione reductase, glutathione peroxidase, and catalase activities in plasma, lung and BAL. Total cells increased in BAL, and the percentage of macrophages, neutrophils and lymphocytes augmented (72-96 h). Histopathological examination of lung tissues showed mild thickening of membranous bronchiole walls, infiltration of foamy macrophages and polymorphonuclear leukocytes in bronchial, bronchiolar and intraalveolar spaces. Goblet cell hyperplasia was also observed in bronchial and bronchiolar epithelia. Plasma malondialdehyde concentration was increased at all times, while 4-hydroxynonenal was increased only in plasma and BAL after 24 h. Plasma glutathione reductase activity increased at 24 and 72 h, BAL glutathione peroxidase activity decreased at 72 and 96 h, whereas catalase activity increased in plasma at 72 h, and decreased in BAL at 24 h. Immunostaining intensity to 4-hydroxynonenal, 3-nitrotyrosine, Mn-superoxide dismutase and heme oxygenase-1 was enhanced mainly in macrophages, bronchial/bronchiolar epithelial cells and type II pneumocytes after 72-96 h of wood smoke exposure. Overall, short-term exposure to wood smoke induces alterations in oxidative/antioxidant state in lung and airway injury, similar to those observed in humans with domestic exposure.

APOA5 gene expression in the human intestinal tissue and its response to in vitro exposure to fatty acid and fibrate.

BACKGROUND AND AIMS: APOA5, a key gene regulating triglyceride (TG) levels, is reported to be expressed exclusively in the liver where it may regulate TG-rich particle synthesis and secretion. Since the same lipoprotein processing occurs in the intestine, we have postulated that this organ would also express APOA5. METHODS AND RESULTS: We have detected the APOA5 gene expression in C57BL/6J mouse and in human small intestine samples. In humans, it is expressed mainly in the duodenum and colon, with messenger RNA (mRNA) levels four orders of magnitude lower than in the liver, and the protein product being one-sixth of the liver equivalent. Subsequently, we carried out in vitro experiments in TC-7/CaCo(2) human intestinal cells to analyse the expression of APOA5, APOC3, APOB and MTP genes after the incubation with long- and short-chain fatty acids, and a peroxisome proliferator-activated receptor alpha (PPARα) agonist (Wy 14643, a fibrate therapeutic agent). In the TC-7 cell line, APOA5 expression was significantly upregulated by saturated fatty acids. The short-chain fatty acid butyrate increased APOA5 expression almost fourfold while APOB was downregulated by increasing butyrate concentrations. When TC-7 cells were incubated with PPARα agonist, the APOA5 expression was increased by 60%, while the expression of APOB, MTP and APOC3 was decreased by 50%, 30% and 45%, respectively. CONCLUSION: Our results demonstrate that APOA5 is expressed in the intestine, albeit at a much lower concentration than in the liver. While it remains to be determined whether intestinal apo A-V is functional, our in vitro experiments show that its expression is modifiable by dietary and pharmacological stimuli.

Disseminated tumour cells as a prognostic biomarker in colorectal cancer.

BACKGROUND: The study was performed to determine detection rate and prognostic relevance of disseminated tumour cells (DTC) in patients receiving curatively intended surgery for colorectal cancer (CRC). METHODS: The study population consisted of 235 patients with CRC prospectively recruited from five hospitals in the Oslo region. Bone marrow (BM) aspirates were collected at the time of surgery and the presence of DTC was determined by two immunological methods; immunomagnetic selection (using an anti-EpCAM antibody) and immunocytochemistry (using a pan-cytokeratin antibody). Associations between the presence of DTC and metastasis-free, disease-specific and overall survival were analysed using univariate and multivariate methods. RESULTS: Disseminated tumour cells were detected in 41 (17%) and 28 (12%) of the 235 examined BM samples by immunomagnetic selection and immunocytochemistry, respectively, with only five samples being positive with both methods. The presence of DTC was associated with adverse outcome (metastasis-free, disease-specific and overall survival) in univariate and multivariate analyses. CONCLUSION: The presence of DTC was associated with adverse prognosis in this cohort of patients curatively resected for CRC, suggesting that DTC detection still holds promise as a biomarker in CRC.

Strategies for overcoming chemotherapy resistance in enterohepatic tumours.

When considered together, enterohepatic tumours, i.e., those affecting the liver, the biliary tree and gallbladder and the intestine, constitute the first cause of death due to cancer. Although in many cases surgery and radiotherapy are efficacious, these therapeutic strategies cannot always be implemented. Moreover, even when the removal of tumours is possible, pre- and post-operative pharmacological adjuvant regimens are often needed. However, one important limitation to the use of cytostatic drugs to treat enterohepatic tumours is that they generally exhibit marked refractivity to currently available pharmacological approaches. In addition, most of them increase their chemoresistance during treatment. In view of the high refractivity of these tumours to anti-cancer drugs and the existence of undesirable side effects, both of which are drawbacks in the available chemotherapy, several novel therapeutic approaches have been devised. The purpose of the present review is to offer some insight into the different types of strategies that have already been evaluated and incorporated into clinical practice, such as therapies based on the use of molecular targets, as well as into the approaches that are still under experimental development, such as the chemosensitization of cancer cells, genetic manipulation of tumour or host cells, and cell-specific enhancement of intracellular concentrations of the active agent by efficient targeting of pro-drugs or by using inhibitors of efflux pumps.

Métodos de evaluación del rendimiento masticatorio: una revisión / A review of different masticatory performance tests

Desde comienzos del siglo pasado han sido utilizados una amplia variedad de métodos para evaluar el rendimiento masticatorio. Existen tests que usan alimentos naturales como material de prueba, otros utilizan alimentos artificiales; además se han propuesto distintos sistemas de procesamiento del material triturado, como el tamizado fraccional, espectrofotométrico, de aire comprimido, observación de área, concentración de azúcar, fotométrico y escaneo óptico. En este trabajo se describen y discuten algunos métodos de trascendencia en la historia de la evaluación del rendimiento masticatorio.

Masticatory performance has been assessed with varying methods throughout last century. Some of them use natural food as a test material and some others use artificial components instead of food. There have also been proposed various systems of processing the crushed material, such as fractional sieving, spectrophotometric analysis, compressed air, area observation, sugar concentration, photometric and optical scanning. This paper describes and discusses some relevant methods in the history of the evaluation of masticatory performance.

Bifunctional bisphosphonate complexes for the diagnosis and therapy of bone metastases.

Easily synthesised and structurally well-defined novel imaging/therapeutic radiopharmaceutical agents for bone metastases are described.

The relative responsiveness and construct validity of the Spanish version of the DASH instrument for outcomes assessment in open carpal tunnel release.

The objective of this study was to evaluate the responsiveness and construct validity of the Spanish version of the DASH as outcome measure for carpal tunnel surgery. The study population was 42 patients with the diagnosis of carpal tunnel syndrome (CTS) based on clinical and electrophysiological criteria. The clinical design was a classic Cohort study with measures the day before and 12 weeks after open carpal tunnel release. The Spanish version of the DASH was compared to the physical exam measures as dexterity time, grip and pinch strength, range of motion of the wrist (ROM) and two-point discrimination (2PPD). The responsiveness was evaluated based on the effect size (ES) and the standardised response means (SRM). The Spanish version of the CTS questionnaire (CTQ) and the Spanish version of the 36-item short-form health survey (SF-36) were self-administered to the same study population and followed the same clinical design. The hypothesis that the DASH instrument should present a responsiveness level higher than the SF-36 and lower than the CTQ was established to demonstrate the construct validity. The DASH instrument showed an ES of 0.68 and an SRM of 1.00. Responsiveness of traditional physical exam measures were lower, running from 0.35 (SRM) for dexterity time to 0.00 (ES) for key pinch strength. The SF-36 presented a responsiveness level (range from 0.07 to 0.14) lower that the DASH. The CTQ showed the highest level of responsiveness (ES = 1.41 and 0.7) (SRM = 1.75 and 0.51). In conclusion, The DASH instrument is more sensitive in detecting clinical change than the physical exam measures for use in clinical outcome studies of CTS done at 12 weeks after surgery. The Spanish DASH showed a responsiveness lower than the CTQ and higher than the SF-36 as a proof of a good construct validity.

Prevalencia y características de la hiperglicemia incidental en niños / Prevalence and characteristics of incidental hyperglycemia in children

Se describe la hiperglicemia incidental (HI) como una elevación transitoria de los niveles plasmáticos de la glucosa producida por una enfermedad intercurrente seria o sin causa aparente. Los niños con HI tienen un mayor riesgo de diabetes tipo 1, especialmente los sin enfermedad intercurrente. Nos interesó conocer la prevalencia de HI en niños sanos y sus características clínicas. En 585 niños de 2 a 18 años de edad que consultaban por control de salud o por cuadro infeccioso menor o antes de cirugía menor electiva, previo consentimiento del apoderado, se les efectuó una glicemia en sangre capilar con una máquina Optium (Abbott). Se consideró elevada una glicemia en ayunas sobre 110 mg/dL. El peso se midió con una balanza de precisión, la talla con un cartabón, los pliegues cutáneos con un Caliper de Lange, el % de grasa corporal se calculó por la fórmula de Durnin. Se encontró que un 6.9% de los niños presentó una glicemia sobre 110 mg/dL (8.8% de varones y 4.7% de mujeres). El promedio de peso y talla de nacimiento y edad gestacional fueron normales. El % de adecuación del IMC fue de 123.4%. Los 39 niños con HI comparados con los normales no tuvieron diferencias en el peso y talla de nacimiento, en las semanas de gestación, en el % de adecuación del IMC (114 vs 112%), en el % de grasa corporal. Sus madres no tuvieron mas antecedentes de diabetes previa o gestacional. Tuvieron mayor frecuencia de acantosis nigricans (9.5% vs 0.6% p< 0.001) y de estrías cutáneas (18% vs 3.0% p <0.001). Se concluye que existe un alto porcentaje de HI en una población de niños sanos, los que no presentaron mas antecedentes de riesgo de diabetes tipo 1 que los controles, pero presentaron mas acantosis y estrías de distensión que indicarían junto a los altos niveles de exceso de peso, una mayor posibilidad de hacer resistencia a la insulina y diabetes tipo 2, lo que sería de interés investigar.

Incidental hyperglycemia (IH) is a transient elevation of plasma glucose produced by a severe illness or without a cause. Children with IH have an increased risk of type 1 diabetes (T1D), especially those without concurrent illnesses. We were interested in knowing the prevalence of IH in a population of healthy children and their clinical characteristics. A glycemia of capillary blood with an Optium machine (Abbott) was done in 585 children of both sexes, aged 2 to 18 years, going for a health control, a light infectious disease or for clinical test before minor surgery after obtaining a written consent from their parents. A fasting blood glycemia over 110 mg/dl was considered elevated. Body weight was measured with a precision scale, height with a podometer, skinfolds with a Lange Caliper and the percentage of body fat calculated by the Durnin formula. It was found that 6.9% of children presented IH (8.85% of boys and 4.7% of girls). Average birth weight and height and gestational age were normal. BMI adequacy was 123 %. Comparing the 39 children who presented IH with those who id not, they had no differences in birth weight and length, weeks of gestational age, in BMI adequacy (114% vs 112%) and in the percentage of body fat. Their mothers did not have a past history of previous diabetes or diabetes during pregnancy. IH children had increased frequency of acantosis nigricans (9.5% vs 0.6%) and dermic striae (18% vs 3.0%) when compared to control. We conclude that a high percentage of healthy children had IH without increase risk of T1D. However, increased prevalence of acantosis and striae and the increased BMI underline the possibility of developing insulin resistance and T2D which should be further investigated.

Frecuencia de factores de riesgo para adquirir toxoplasmosis en embarazadas que acuden a control prenatal en el Ambulatorio Urbano I Michelena: septiembre 2005 / Frequency of risk factors for acquiring toxoplasmosis in pregnant women attending prenatal care in the Ambulatory Urban Michelena I: september 2005

La presencia de toxoplasmosis en la embarazada, representa un riesgo importante para el desarrollo de toxoplasmosis congénita, con la finalidad de prevenir esta enfermedad, se realiza un trabajo descriptivo, de diagnóstico, transversal, en el cual se realiza una encuesta a las 30 primeras embarazadas de las 62 que para septiembre de 2005 se encontraban en control prenatal en el Ambulatorio Urbano I de Michelena Estado Táchira. Y así determinar que en esta población el 49,9 por ciento tienen bajo riesgo, el 36,6 por ciento tienen riesgo intermedio y el 13,3 por ciento tienen alto riesgo. Luego esta experiencia surge una alternativa interesante, a saber, la realización de una encuesta que sirve de filtro para las madres con riesgo de infección reciente por Toxoplasma. Preguntas simples, en términos familiares, podrían descubrir una gran proporción de madres con riesgo de toxoplasmosis.