Ultrasound assessment of muscle mass and correlation with clinical outcomes in critically ill patients: a prospective observational study.

PURPOSE: Muscular atrophy implies structural and functional alterations related to muscular force production and movement. This condition has been reported to be the main reason for generalized muscle weakness; it reflects the severity of the disease and can have a profound impact on short- and long-term clinical outcomes. The purpose of this study was to determine whether muscle atrophy ultrasound parameters early predict muscle weakness, morbidity, or 28-days mortality. METHODS: This was a prospective, observational single center cohort study. Ultrasound was used to determine the cross-sectional area and muscle thickness of the rectus femoris on the first and third day of ICU stay. The main outcome was the incidence of significant muscle atrophy (≥ 10%). RESULTS: Ultrasound measurements were made in 31 patients, 58% (18/31) of which showed significant muscle atrophy. The relative loss of muscle mass per day was 1.78 at 5% per day. The presence of muscle atrophy presents increased risk for limb muscle weakness and handgrip weakness. The 28-days mortality rate was similar in both subgroups. CONCLUSION: The presence of muscle atrophy presents an increased clinical risk for the development of limb ICUAW and handgrip, although these observations were not statistically significant. The results could be used to plan future studies on this topic.

Clinical, paraclinical, and genetic profile of patients with cystic fibrosis from Colombian Caribbean.

Background: Cystic fibrosis (CF) is a serious autosomal recessive disorder. Early diagnosis, comorbidity prevention, and control are cornerstones for a quality life and for improving life expectancy. In Colombian Caribbean, where there is a genetically admixed population, CF is an orphan disease affecting children and adults, and it remains a challenging issue to be addressed carefully. This work describes the genetic, clinical, and paraclinical profiles of CF patients from Cartagena de Indias, Colombia. Methods: Thirty-six patients were included in the study. The subjects were identified and evaluated through the Regional Program for CF patients. CFTR gene mutations, anthropometric parameters, microbiological infections, and pulmonary function were analyzed. Data on demographic parameters, pharmacological treatments, and comorbidities were reported. Frequency and percentages were established for the categorical variables and mean or median for the quantitative variables. In addition, comparisons were made by sex. Results: The average age of the patients was 11.9 ± 5.3 years and the median age at diagnosis was 14 months. 55.5% were women and 44.5% were men. The mean values for weight, height, and body mass index were 35 ± 17.6 kg, 139.9 ± 28 cm, and 16.5 ± 2.9 kg/m2, respectively. The clinical manifestations that occurred more frequently were steatorrhea (65.4%) and recurrent pneumonia (46.2%). Chronic airway infection with Pseudomonas aeruginosa was identified in 71.4% of the cases and the p.F508del mutation was found in 47.2% of the subjects. Conclusion: The current profile of CF patients from the Colombian Caribbean showed some concerning features, such as nutritional status; however, progress in early diagnosis and clinical follow-up could contribute to improve the general conditions of patients. It is necessary to continue efforts to increase the life expectancy and quality of life of the patients.

Demographic, clinical, and radiological characteristics of cleidocranial dysplasia: A systematic review of cases reported in south America.

Introduction: Cleidocranial dysplasia (CCD) is a rare disease characterized by craniofacial, skeletal, and oral anomalies. The disease prevalence is estimated to be 1 per million inhabitants; thus, only a few studies have described large cohorts of CCD patients. This study reviewed the clinical-radiological and demographic characteristics of patients with CCD in South America. Methods: We conducted a systematic review of all cases of CCD reported in South America following the PRISMA guidelines. Demographic information (sex, age at diagnosis, origin, reason for consultation, and family history) was also recorded. CCD signs were divided into "craniofacial" and "skeletal" categories. Results: A total of 72 cases were included. We found that oral anomalies were the most common reason for consultation leading to a diagnosis in patients, with a median age at diagnosis of 14 years. Fifty percent of the patients were women. Open fontanels or cranial sutures, the presence of at least one of the typical CCD facies (frontal bossing, brachycephaly, hypertelorism, or depression of the nasal bridge), and supernumerary teeth were reported in 92%, 85%, and 88% of cases, respectively. Clavicular dysplasia was present in 98.6% of cases, and other skeletal abnormalities such as scoliosis, pubic symphysis diastasis, and flat feet were found; short stature was present in 71% of cases, and one case presented cognitive deficits. Conclusion: Although the phenotypic spectrum of CCD is variable, clavicular dysplasia, open fontanels or cranial sutures, dental anomalies, and at least one of the typical CCD facies are present in at least 80% of cases.

Molecular Modeling and Bioinformatics Analysis of Drug-Receptor Interactions in the System Formed by Glargine, Its Metabolite M1, the Insulin Receptor, and the IGF1 Receptor.

INTRODUCTION: Insulin and insulin-like growth factor type 1 (IGF1) regulate multiple physiological functions by acting on the insulin receptor (IR) and insulin-like growth factor type 1 receptor (IGF1R). The insulin analog glargine differs from insulin in three residues (GlyA21, ArgB31, ArgB32), and it is converted to metabolite M1 (lacks residues ArgB31 and ArgB32) by in vivo processing. It is known that activation of these receptors modulates pathways related to metabolism, cell division, and growth. Though, the structures and structural basis of the glargine interaction with these receptors are not known. AIM: To generate predictive structural models, and to analyze the drug/receptor interactions in the system formed by glargine, its metabolite M1, IR, and IGF1R by using bioinformatics tools. METHODS: Ligand/receptor models were built by homology modeling using SWISSMODEL, and surface interactions were analyzed using Discovery Studio® Visualizer. Target and hetero target sequences and appropriate template structures were used for modeling. RESULTS: Our glargine/IR and metabolite M1/IR models showed an overall symmetric T-shaped conformation and full occupancy with four ligand molecules. The glargine/IR model revealed that the glargine residues ArgB31 and ArgB32 fit in a hydrophilic region formed by the α-chain C-terminal helix (αCT) and the cysteine-rich region (CR) domain of this receptor, close to the CR residues Arg270-Arg271-Gln272 and αCT residue Arg717. Regarding IGF1R, homologous ligand/receptor models were further built assuming that the receptor is in a symmetrical T-shaped conformation and is fully occupied with four ligand molecules, similar to what we described for IR. Our glargine/IGF1R model showed the interaction of the glargine residues ArgB31 and ArgB32 with Glu264 and Glu305 in the CR domain of IGF1R. CONCLUSION: Using bioinformatics tools and predictive modeling, our study provides a better understanding of the glargine/receptor interactions.

Identification of a protein unique to the genus Plasmodium that contains a WD40 repeat domain and extensive low-complexity sequence.

Proteins containing WD40 domains play important roles in the formation of multiprotein complexes. Little is known about WD40 proteins in the malaria parasite. This report contains the initial description of a WD40 protein that is unique to the genus Plasmodium and possibly closely related genera. The N-terminal portion of this protein consists of seven WD40 repeats that are highly conserved in all Plasmodium species. Following the N-terminal region is a central region that is conserved within the major Plasmodium clades, such as parasites of great apes, monkeys, rodents, and birds, but partially conserved across all Plasmodium species. This central region contains extensive low-complexity sequence and is predicted to have a disordered structure. Proteins with disordered structure generally function in molecular interactions. The C-terminal region is semi-conserved across all Plasmodium species and has no notable features. This WD40 repeat protein likely functions in some aspect of parasite biology that is unique to Plasmodium and this uniqueness makes the protein a possible target for therapeutic intervention.

Identification of Plasmodium falciparum HSP70-2 as a resident of the Plasmodium export compartment.

The malarial parasite remodels the host erythrocyte following invasion. Well-known examples are adhesive proteins inserted into the host erythrocyte membrane, which function as virulence factors. The modification of the host erythrocyte may be mediated by a specialized domain of the endoplasmic reticulum, or Plasmodium export compartment (PEC). Previously, monoclonal antibodies recognizing the PEC were generated and one of these monoclonal antibodies recognize a 68 kDa parasite protein. In this study, the 68 kDa protein was affinity purified and analyzed by peptide mapping using mass spectrometry. The results demonstrate that the 68 kDa protein is the P. falciparum homolog of the endoplasmic reticulum resident HSP70 called PfHSP70-2. This finding is consistent with the PEC being a domain of the endoplasmic reticulum and suggests a role for PfHSP70-2 in the export of Plasmodium proteins into the host erythrocyte.

A colorimetric bioassay for quantitation of both basal and insulin-induced glucose consumption in 3T3-L1 adipose cells.

INTRODUCTION: The quantitation of glucose consumption in animal cell cultures is mainly based on the use of radiolabeled or fluorescent analogues, resulting in expensive and tedious procedures, requiring special equipment and, sometimes, with potential health and environmental risks. OBJECTIVES: The objective of this work was to evaluate the application of a blood plasma colorimetric assay to quantify glucose consumption in in vitro cultures of adipose cells. METHODS: We worked with 3T3-L1 adipose cells differentiated by 7-8 days, which were exposed to different initial glucose concentrations (5.5, 2.8 and 1.4 mM) for variable times, either in the absence or the presence of 100 nM insulin. Using a commercial colorimetric glucose assay, extracellular glucose was determined, and glucose uptake was calculated as the difference between the initial and final glucose concentration. RESULTS: The colorimetric assay allowed us to quantify glucose uptake in our cell model, observing a linear response over time (r 2 ≥0.9303) to the different glucose concentrations, both in the basal and insulin-induced condition. The insulin-stimulated glucose consumption was higher than basal consumption at all glucose concentrations evaluated, but significant differences were observed at 120-, 360- and 480-min in glucose 5.5 mM (p ≤ 0.01, n = 5), and 240 min in glucose 1.4 mM (p ≤ 0.01, n = 5). A V max of 4.1 and 5.9 nmol/ml/min (basal and insulin-induced, respectively) and a K m of 1.1 mM (same in basal vs insulin-stimulated) were calculated. The bioassay was also useful in a pharmacological context: in glucose 1.4 mM, glucose consumption showed an effect that depended on insulin concentration, with a calculated EC50 of 18.4 ± 1.1 nM. CONCLUSIONS: A simple and low-cost bioassay is proposed to quantify glucose consumption in 3T3-L1 adipose cells.

A Common Variation in the Caveolin 1 Gene Is Associated with High Serum Triglycerides and Metabolic Syndrome in an Admixed Latin American Population.

BACKGROUND: The caveolin 1 (CAV1) gene has been associated with metabolic traits in animal models and human cohorts. Recently, a prevalent variant in CAV1 has been found to be related to metabolic syndrome in Hispanics living in North America. Since Hispanics represent an admixed population at high risk for cardiovascular diseases, in this study a Latin American population with a similar genetic background was assessed. OBJECTIVE: To analyze a genetic association between CAV1 and metabolic traits in an admixed Latin American population. METHODS: A cross-sectional study was carried out with adults from the Colombian Caribbean Coast, selected in urban clusters and work places through a stratified sampling to include diverse ages and socioeconomic groups. Blood pressure and waist circumference were registered. Serum concentrations of glucose, triglycerides, and high-density lipoprotein cholesterol were measured from an 8-hr fasting whole-blood sample. Two previously analyzed CAV1 single nucleotide polymorphisms were genotyped (rs926198 and rs11773845). A logistic regression model was applied to estimate the associations. An admixture adjustment was performed through a Bayesian model. RESULTS: A total of 605 subjects were included. rs11773845 was associated with hypertriglyceridemia [odds ratio (OR) = 1.33, p = 0.001] and the metabolic syndrome (OR = 1.53, p = 0.02). When admixture adjustment was performed these genetic associations preserved their statistical significance. There were no significant associations between rs926198 and metabolic traits. CONCLUSIONS: The CAV1 variation rs11773845 was found to be consistently associated with high serum triglycerides and the metabolic syndrome. This is the first report of a relationship between CAV1 variants and serum triglycerides in Latin America.

Frequency of common polymorphisms in Caveolin 1 (CAV1) gene in adults with high serum triglycerides from Colombian Caribbean Coast / Frecuencia de polimorfismos comunes en el gen de Caveolina 1 (CAV1) en adultos con hipertrigliceridemia en el Caribe Colombiano

Abstract Background: Caveolin 1 gene (CAV1) has been associated with insulin resistance, metabolic syndrome and hypertension in humans. Also, it has been related to high serum triglycerides in rodents, however there is little evidence of this relation in humans. Aim: To describe frequencies of common variations in CAV1 in adults with high serum triglycerides. Methods: A case-control study was carried out with adults from Colombian Caribbean Coast. A whole blood sample was employed to measure serum concentrations of triglycerides, glucose, total cholesterol and HDLc. Six common Single Nucleotide Polymorphism (SNP) in CAV1 were genotyped (rs926198, rs3779512, rs10270569, rs11773845, rs7804372 and rs1049337). Allelic and genotypic frequencies were determined by direct count and Hardy-Weinberg Equilibrium (HWE) was assessed. Case and control groups were compared with null-hypothesis tests. Results: A total of 220 cases and 220 controls were included. For rs3779512 an excess in homozygotes frequency was found within case group (40.4% (GG), 41.3% (GT) and 18.1% (TT); Fis=0.13, p=0.03). Another homozygotes excess among case group was found in rs7804372 (59.5% (TT), 32.3% (TA) and 8.2% (AA); Fis= 0.12, p= 0.04). In rs1049337, cases also showed an excess in homozygotes frequency (52.7% (CC), 35.0% (CT) and 12.3% (TT); Fis= 0.16, p= 0.01). Finally, for rs1049337 there were differences in genotype distribution between case and control groups (p <0.05). Conclusion: An increased frequency of homozygote genotypes was found in subjects with high serum triglycerides. These findings suggest that minor alleles for SNPs rs3779512, rs7804372 and rs1049337 might be associated to higher risk of hypertriglyceridemia.

Resumen Introducción: En humanos, el gen Caveolina 1 (CAV1) ha sido asociado con resistencia a la insulina, síndrome metabólico e hipertensión. Además, ha sido relacionado con hipertrigliceridemia en roedores, sin embargo existe poca evidencia de esta relación en humanos. Objetivo: Describir la frecuencia de variaciones comunes del gen CAV1 en adultos con hipertrigliceridemia. Métodos: Se realizó un estudio de casos y controles con adultos del Caribe Colombiano. Fue usada una muestra de sangre venosa periférica para medir las concentraciones séricas de triglicéridos, glucosa, colesterol total y colesterol HDL. Fueron genotipificados seis Polimorfismos de Nucleótido Simple (SNP) en CAV1 (rs926198, rs3779512, rs10270569, rs11773845, rs7804372 y rs1049337). Las frecuencias alélicas y genotípicas se determinaron por conteo directo y se evaluó el equilibrio de Hardy-Weinberg. Los grupos de casos y controles se compararon con pruebas de hipótesis nula. Resultados: Se incluyeron un total de 220 casos y 220 controles. Para rs3779512 se encontró un exceso de homocigotos en el grupo de casos (40.4% (GG), 41.3% (GT) y 18.1% (TT); Fis= 0.13, p= 0.03). Fue encontrado otro exceso de homocigotos en el grupo de casos al analizar el rs7804372 (59.5% (TT), 32.3% (TA) y 8.2% (AA); Fis= 0.12, p= 0.04). En rs1049337, los casos también tuvieron un exceso en la frecuencia de homocigotos (52.7% (CC), 35.0% (CT) y 12.3% (TT); Fis= 0.16, p= 0.01). Finalmente, hubo diferencias en la distribución genotípica del rs1049337 entre los grupos de casos y controles (p <0.05). Conclusiones: Se encontró una elevada frecuencia de homocigotos en los sujetos con hipertrigliceridemia. Estos hallazgos sugieren que los alelos menores de los SNPs rs3779512, rs7804372 y rs1049337 podrían estar asociados con trigliceridemia elevada.

Frequency of common polymorphisms in Caveolin 1 ( CAV1 ) gene in adults with high serum triglycerides from Colombian Caribbean Coast.

BACKGROUND: Caveolin 1 gene (CAV1) has been associated with insulin resistance, metabolic syndrome and hypertension in humans. Also, it has been related to high serum triglycerides in rodents, however there is little evidence of this relation in humans. AIM: To describe frequencies of common variations in CAV1 in adults with high serum triglycerides. METHODS: A case-control study was carried out with adults from Colombian Caribbean Coast. A whole blood sample was employed to measure serum concentrations of triglycerides, glucose, total cholesterol and HDLc. Six common Single Nucleotide Polymorphism (SNP) in CAV1 were genotyped (rs926198, rs3779512, rs10270569, rs11773845, rs7804372 and rs1049337). Allelic and genotypic frequencies were determined by direct count and Hardy-Weinberg Equilibrium (HWE) was assessed. Case and control groups were compared with null-hypothesis tests. RESULTS: A total of 220 cases and 220 controls were included. For rs3779512 an excess in homozygotes frequency was found within case group (40.4% (GG), 41.3% (GT) and 18.1% (TT); Fis=0.13, p=0.03). Another homozygotes excess among case group was found in rs7804372 (59.5% (TT), 32.3% (TA) and 8.2% (AA); Fis= 0.12, p= 0.04). In rs1049337, cases also showed an excess in homozygotes frequency (52.7% (CC), 35.0% (CT) and 12.3% (TT); Fis= 0.16, p= 0.01). Finally, for rs1049337 there were differences in genotype distribution between case and control groups (p <0.05). CONCLUSION: An increased frequency of homozygote genotypes was found in subjects with high serum triglycerides. These findings suggest that minor alleles for SNPs rs3779512, rs7804372 and rs1049337 might be associated to higher risk of hypertriglyceridemia.

INTRODUCCIÓN: En humanos, el gen Caveolina 1 (CAV1) ha sido asociado con resistencia a la insulina, síndrome metabólico e hipertensión. Además, ha sido relacionado con hipertrigliceridemia en roedores, sin embargo existe poca evidencia de esta relación en humanos. OBJETIVO: Describir la frecuencia de variaciones comunes del gen CAV1 en adultos con hipertrigliceridemia. MÉTODOS: Se realizó un estudio de casos y controles con adultos del Caribe Colombiano. Fue usada una muestra de sangre venosa periférica para medir las concentraciones séricas de triglicéridos, glucosa, colesterol total y colesterol HDL. Fueron genotipificados seis Polimorfismos de Nucleótido Simple (SNP) en CAV1 (rs926198, rs3779512, rs10270569, rs11773845, rs7804372 y rs1049337). Las frecuencias alélicas y genotípicas se determinaron por conteo directo y se evaluó el equilibrio de Hardy-Weinberg. Los grupos de casos y controles se compararon con pruebas de hipótesis nula. RESULTADOS: Se incluyeron un total de 220 casos y 220 controles. Para rs3779512 se encontró un exceso de homocigotos en el grupo de casos (40.4% (GG), 41.3% (GT) y 18.1% (TT); Fis= 0.13, p= 0.03). Fue encontrado otro exceso de homocigotos en el grupo de casos al analizar el rs7804372 (59.5% (TT), 32.3% (TA) y 8.2% (AA); Fis= 0.12, p= 0.04). En rs1049337, los casos también tuvieron un exceso en la frecuencia de homocigotos (52.7% (CC), 35.0% (CT) y 12.3% (TT); Fis= 0.16, p= 0.01). Finalmente, hubo diferencias en la distribución genotípica del rs1049337 entre los grupos de casos y controles (p <0.05). CONCLUSIONES: Se encontró una elevada frecuencia de homocigotos en los sujetos con hipertrigliceridemia. Estos hallazgos sugieren que los alelos menores de los SNPs rs3779512, rs7804372 y rs1049337 podrían estar asociados con trigliceridemia elevada.

Construcción de un modelo animal de fibrosis pulmonar inducido por Bleomicina / Making an animal model of Bleomycin-induced pulmonary fibrosis

La fibrosis pulmonar es una enfermedad crónica, progresiva y letal, cuya etiología se desconoce. El modelo de fibrosis pulmonar inducida por Bleomicina en ratas es útil para ilustrar la patobiología in vivo de la enfermedad, así como para identificar nuevos blancos farmacológicos y estimar la eficiencia de nuevas moléculas o procedimientos Objetivo: El objetivo de este trabajo fue construir un modelo animal de fibrosis pulmonar secundaria a Bleomicina, en ratas Wistar, como herramienta que pueda servir de base para futuros diseños experimentales. Materiales y métodos: Se trabajó con dos grupos de ratas Wistar para la administración del medicamento por vía intratraqueal. El grupo experimental recibió una dosis única (2.0 U/Kg) de Bleomicina, mientras que el grupo control recibió un volumen equivalente de solución salina. A los 14 o 28 días se realizó un lavado broncoalveolar con recuento total y diferencial celular y análisis histopatológico pulmonar. Resultados: La histología de una parte del grupo experimental tratado con Bleomicina y sacrificado a los 14 días reveló daño pulmonar caracterizado por inflamación aguda, hemorragia intraalveolar y proliferación fibroblástica intersticial incipiente; en el resto del grupo experimental la histología a 28 días reveló además alteración de la arquitectura pulmonar debida a fibrosis y aumento en el número de macrófagos intraalveolares e inflamación linfocitaria. Conclusiones: Se implementó satisfactoriamente un modelo de fibrosis pulmonar inducido farmacológicamente por Bleomicina en ratas Wistar.

Pulmonary fibrosis is a chronic, progressive and fatal disease, whose etiology is unknown. The model of Bleomycininduced pulmonary fibrosis in rats is useful to illustrate the pathobiology of the disease in vivo as well as to identify new drug targets and to estimate the efficacy of new promising molecules or procedures. Objective: The aim of this work was to make an animal model of pulmonary fibrosis secondary to bleomycin, in Wistar rats, as a tool that can serve as a basis for future experimental designs. Materials and methods: We worked with two groups of Wistar rats which were anesthetized and intubated for intratracheally drug administration. The experimental group received a single dose (2.0 U / kg) of Bleomycin, while the control group received an equivalent volume of saline. At 14 or 28 days after treatment, a bronchoalveolar lavage with total and differential cellular count were performed. Additionally, the lungs were dissected for histopathogical analysis. Results: In the experimental group treated with Bleomycin and sacrificed at 14 days, histology revealed lung damage characterized by acute inflammation, intra-alveolar hemorrhage and fibroblast proliferation; in sacrificed animals at 28 days, alteration of lung architecture due to fibrosis evidenced by trichrome stain, increase in the alveolar macrophages number and lymphocytic chronic inflammation were observed. Conclusions: In this study, a model of pharmacologically induced pulmonary fibrosis by Bleomycin has been successfully implemented.

Anthropometric parameters' cut-off points and predictive value for metabolic syndrome in women from Cartagena, Colombia.

Objective. To estimate anthropometric parameters' (APs) cut-off points and association for metabolic syndrome (MetS). Materials and methods. A cross-sectional study was carried out with a total of 434 adult women from Cartagena de Indias, Colombia, in 2012. APs measured were waist circumference (WC), body mass index (BMI), body adiposity index (BAI), waist-hip ratio (WHR) and waist-height ratio (WHtR). Cut-off points were estimated by a receiver operating characteristic curve (ROC). Logistic regression was applied to estimate possible associations. Results. Cut-off points for WC, BMI, BAI, WHR and WHtR were 85 cm, 28 kg/m(2), 39%, 0.80 and 56, respectively. Only WHtR was associated to MetS (OR=1.11, CI95% [1.07-1.15]). Conclusion. WC cut-off point was higher than those proposed for Latin-American women by the Joint Interim Statement (JIS). WHtR had a low predictive value for MetS.

Susceptibilidad antimicrobiana y genotipificación de Pseudomonas aeruginosa de pacientes con fibrosis quística y otras patologías en Cartagena (Colombia) / Antimicrobial susceptibility and genotypification of Pseudomonas aeruginosa from cystic fibrosis patients and other diseases in Cartagena (Colombia)

Objetivo: el objetivo de este estudio fue analizar el genotipo y susceptibilidad antimicrobiana de Pseudomonas aeruginosa de pacientes con fibrosis quística y otras patologías. Materiales y métodos: se analizaron 20 aislados de pacientes con fibrosis quística y 20 de pacientes con otras enfermedades por medio de la prueba de susceptibilidad antimicrobiana por microdilución en caldo y técnica del ADN polimorfo amplificado aleatorio. Resultados: se observó que los aislados de pacientes con fibrosis quística presentaron mayor resistencia (56 %) en comparación con aislados de pacientes sin fibrosis quística (25 %). Los antimicrobianos más efectivos en ambos grupos fueron cefepima, ceftriaxona y meropenem. Desde el punto de vista genotípico, se observa heterogeneidad entre las cepas de pacientes con fibrosis quística y dos grupos con cepas idénticas de origen hospitalario, lo que sugiere una posible transmisión cruzada. Conclusión: Concluimos que los porcentajes de resistencia de Pseudomonas aeruginosa en este estudio son altas, y este hallazgo se acentúa en el caso de pacientes con fibrosis quística, lo cual deja muy pocas opciones de tratamiento. La tipificación por técnica del ADN polimórfico amplificado aleatorio permitió conocer la variabilidad de genotipos para tener control sobre la transmisión de cepas, lo cual constituye un tópico de importancia en el sistema de salud y el mejoramiento de la calidad de vida de los pacientes.

Objective: Our aim was to analyze genotype and antimicrobial susceptibility of Pseudo-monas aeruginosa from cystic fibrosis patients and other diseases. Materials and methods: We analyzed 20 isolates from cystic fibrosis patients and 20 from patients with other diseases by dilution antimicrobial susceptibility test and random amplified polymorphic DNA technique. Results: We found that isolates from cystic fibrosis patients had higher resistance (56 %) than isolates from patients without cystic fibrosis (26 %). The most effective antimicrobi-als in both groups were cefepime, ceftriaxone and meropenem. With regard to the geno-type, we observed heterogeneity between strains from cystic fibrosis patients and two clus-ters with identical strains from hospital origin, suggesting a possible cross transmission. Conclusion: We concluded that the resistance rate of Pseudomonas aeruginosa in this study was high and this finding is accentuated in patients with cystic fibrosis, leaving few treatment options. Typification by random amplified polymorphic DNA technique allowed us to know the variability of genotypes to control strain transmission; this is an important topic to optimize health services and the quality of life of our patients.

Anthropometric parameters' cut-off points and predictive value for metabolic syndrome in women from Cartagena, Colombia / Puntos de corte y valor predictivo de medidas antropométricas para el síndrome metabólico en Cartagena, Colombia

Objective. To estimate anthropometric parameters' (APs) cut-off points and association for metabolic syndrome (MetS). Materials and methods. A cross-sectional study was carried out with a total of 434 adult women from Cartagena de Indias, Colombia, in 2012. APs measured were waist circumference (WC), body mass index (BMI), body adiposity index (BAI), waist-hip ratio (WHR) and waist-height ratio (WHtR). Cut-off points were estimated by a receiver operating characteristic curve (ROC). Logistic regression was applied to estimate possible associations. Results. Cut-off points for WC, BMI, BAI, WHR and WHtR were 85 cm, 28 kg/m², 39%, 0.80 and 56, respectively. Only WHtR was associated to MetS (OR=1.11, CI95% [1.07-1.15]). Conclusion. WC cut-off point was higher than those proposed for Latin-American women by the Joint Interim Statement (JIS). WHtR had a low predictive value for MetS.

Objetivo. Estimar los puntos de corte y asociación de las medidas antropométricas para obesidad con el síndrome metabólico (SMet). Material y métodos. Se realizó un estudio de corte transversal con 434 mujeres adultas, en Cartagena de Indias, Colombia, durante 20I2. Se midieron la circunferencia abdominal (CA), el índice de masa corporal (IMC), el índice de adiposidad corporal (IAC) y las razones cintura-cadera (RCC) y cintura-talla (RCT). Los puntos de corte fueron determinados mediante la curva ROC. La fuerza de asociación se estimó por regresión logística. Resultados. Los puntos de corte para CA, IMC, IAC, RCC y RCT fueron, respectivamente, 85 cm, 28 kg/m², 39%, 0.80 y 56. De los parámetros evaluados sólo RCT se asoció con SMet (OR= 1.11, IC95% [1.07-1.15]). Conclusión. El punto de corte para circunferencia abdominal fue superior al reportado en América Latina, según el criterio de declaración provisional conjunta (JIS). La asociación de RCT con SMet fue baja.

Comparación de métodos de extracción de ADN en tejidos parafinados y utilidad para amplificación por PCR / Comparison of DNA extraction methods from formalin-fixed paraffin sections for RCP amplification

Los tejidos fijados en formol e incluidos en parafina son una fuente de material para hallazgos moleculares en el ámbito clínico y científico, demostrándose que el ADN extraído de éstos, es adecuado para amplificación a través de la reacción en cadena de la polimerasa (RCP). En este estudio, se ensayaron tres métodos de extracción de ADN en tejidos incluidos en parafina, con el objetivo de comparar la eficiencia de estos para obtener ADN adecuado, además se analizó su utilidad en amplificación por RCP. Se emplearon tres muestras, correspondientes a una biopsia de pulmón, legrado endometrial y ganglio linfático, todas fijadas en formaldehido al 10% e incluidas en parafina. Utilizándose tres métodos diferentes de extracción de ADN (extracción por salting out, método modificado de Sambrook y kit comercial) El ADN obtenido se cuantificó por espectrofotometría, además se realizó electroforesis en gel de agarosa al 1%, para comprobar si el ADN era de buena calidad y se realizó RCP para el exón 3 del gen caveolina 1. Todos los métodos dieron como resultado una buen producto de ADN genómico, observándose mayor cantidad y pureza en los métodos de salting out y kit comercial, asimismo se obtuvo amplificación del producto esperado por estos dos métodos, no hubo buenos resultados con el ADN extraído por el método modificado "Preparation of Genomic DNA from Mouse Tails y Other Small samples, según Sambrook". El ADN obtenido a partir de tejidos FFIP puede ser amplificado por varios métodos, entre estos, la extracción por salting out es útil y con poca toxicidad, permite obtener ADN de buena calidad para amplificación por RCP.

Formalin-fixed and paraffin-embedded tissues are a source of important molecular findings in clinical and scientific, demonstrating that the DNA extracted from these is suitable for amplification by polymerase chain reaction (PCR). In this study, we tested three methods of DNA extraction, in order to compare the efficiency of these DNA for RCP amplification. Three samples were used, corresponding to a lung biopsy, endometrial curettage and lymph node, all fixed in 10% formaldehyde and embedded in paraffin. Three different methods were used for DNA extraction (extraction by salting out, modified Sambrook method and commercial kit) The DNA obtained was analyzed by spectrophotometry, and gel electrophoresis was performed in 1% agarose to check if the DNA was amplifiable. PCR was performed for exon 3 of caveolin-1 gene. All methods resulted in a good product of genomic DNA, obtaining more quality and purity in the salting out and commercial kit methods. Also, we obtained amplification of the product by these two methods, without favorable results with the DNA extracted by the modified "Preparation of Genomic DNA from Mouse Tails and Other Small samples, according to Sambrook et al." The DNA obtained from FFPE can be amplified by several methods, among them, salting out extraction is an easy, effective and low toxicity for obtaining good quality DNA for PCR amplification.

[Agreement between Five Definitions of Metabolic Syndrome: Cartagena, Colombia]. / Concordancia entre cinco definiciones de síndrome metabólico: Cartagena, Colombia.

BACKGROUND: During last decade the metabolic syndrome has been defined by five different guidelines. Discrepancies in such definitions could influence syndrome predictive ability over cardiovascular diseases. The aim of this study was to determine the degree of agreement between these five guidelines, in population from Cartagena (Colombia). METHODS: A cross sectional study was conducted in adults from urban zone. Sample size was estimated based on 2005 DANE census, which included 670 individuals. The prevalence of metabolic syndrome was determined through the WHO (World Health Organization), AHA/NHLBI (American Heart Association/National Heart Lung and Blood Institute), ATP III (Adult Treatment Panel III), IDF (International Diabetes Federation) and JIS (Joint Interim Statement) guidelines. Frequencies obtained were compared through Cohen's kappa index. RESULTS: According to JIS, IDF, ATPIII, AHA/NHBLI and WHO guidelines, metabolic syndrome prevalence was 36.3% [32.6 - 39.9], 35.1%, 30.3%, 24.2% and 4.9%. Agreement between JIS and IDF was 0.893, while index for these two guidelines with AHA/NHLBI was 0.778 y 0.750, respectively. ATPIII had a lower agreement with JIS and IDF (0.711 and 0.645, respectively), however with AHA/NHLBI agreement was 0.863. WHO presented a agreement with the others guidelines between 0.14 and 0.16. CONCLUSIONS: Significant agreement was found between the four most recent guidelines. Abdominal obesity cut-off points might support differences agreement differences.

Coexistencia de Pseudomonas aeruginosa y Candida albicans en infecciones nosocomiales en Cartagena de Indias (Colombia) / Coexistence of Pseudomonas Aeruginosa and Candida albicans in hospital-acquired infections in Cartagena (Colombia)

Las infecciones nosocomiales constituyen un importante problema de salud, cuyos factores de riesgo son hospitalizaciones prolongadas, procedimientos invasivos y tratamientos antimicrobianos de amplio espectro. Pseudomonas aeruginosa y Candida albicans son microorganismos frecuentemente aislados del tracto respiratorio de pacientes gravemente enfermos. Se ha demostrado que estos patógenos pueden tener una interacción de gran significancia en donde las características morfológicas y de virulencia de cada microorganismo se modulan mutuamente aumentando significativamente el riesgo y la severidad de las infecciones urinarias y respiratorias produciendo una alta morbimortalidad. El objetivo de este trabajo fue ilustrar las características microbiológicas y clínicas que son resultado de la presencia conjunta de P. aeruginosa y C. albicans en pacientes gravemente enfermos en hospitales de Cartagena de Indias (Colombia). En todos los casos se destaca un proceso bacteriano inicial, en este caso causado por P. aeruginosa, que fue tratado de acuerdo a la susceptibilidad antimicrobiana encontrada y al disminuir el agente bacteriano responsable se dio lugar al crecimiento de C. albicans y al desarrollo de una nueva infección que empeoró la condición clínica de estos pacientes. Las infecciones conjuntas entre P. aeruginosa y C. albicans siempre se deben sospechar en un paciente hospitalizado, especialmente en unidades de cuidados intensivos y cuando hagan uso de sondas, catéteres y otros materiales para estudios invasivos, pues estos microorganismos son de naturaleza oportunista y claramente pueden empeorar el pronóstico y llevar a complicaciones a pacientes que han sido hospitalizado por causas diferentes o enfermedades de baja complejidad, prolongando el tiempo de hospitalización y aumentando costos.

Body Mass Index and its correlation with pulmonary function in patients with cystic fibrosis from Cartagena (Colombia) / Indice de Masa Corporal y su correlación con la función pulmonar en pacientes con fibrosis quística en Cartagena (Colombia)

Background. Sinus-pulmonary manifestations are a major concern in CF patients. Pulmonary function shows a strong relationship with nutritional status. In Colombia, malnutrition is a public health issue; however there are no reports that fully analyze nutritional status and lung function in CF children. Materials and Methods. A cross-sectional study was developed conducted with 32 patients registered in the CF Attention Program. Measurements were performed following the NIOSH Spirometry Training Guide. Body Mass Index (Z-Score) was calculated according to Onis.et.al. Correlation was determined by a regression model. Results. 14 children were able to perform the test with criteria for the study, mean for age 12.4 ± 3.4 years. % Forced Expiratory Volume1 and % Forced Vital Capacity means were 66.7 ± 28.5 and 69.5 ± 2.0, respectively. Body Mass Index (Z-score) mean was -1.17. BMI-regression for % Forced Expiratory Volume1, r2=0.31(P<0.01); % Forced Vital Capacity, r2=0.22(P<.01). Conclusions. Results demonstrated a correlation between Body Mass Index and Lung Function. This correlation persists, even in populations with notorious nutritional deficit such as this group. Special nutritional therapies should be implemented for this group and similar populations.

Introducción: Las manifestaciones sinopulmonares son de gran interés en pacientes con fibrosis quística. La función pulmonar se ha correlacionado con el estado nutricional en estos pacientes. En Colombia, la malnutrición es un problema de importancia para la salud pública; sin embargo, no se han publicado reportes que analicen el estado nutricional y la función pulmonar en pacientes con fibrosis quística. Materiales y métodos: Se disenó un estudio transversal con 32 pacientes registrados en el Programa de Atención Integral para Pacientes con Fibrosis Quística y sus familias. Los exámenes se realizaron siguiendo la guía de entrenamiento de la NIOSH. El índice de Masa Corporal (Z-Score) fue calculado siguiendo las recomendaciones de Onis et al. El grado de correlación fue determinado por un modelo de regresión. Resultados: 14 ninos fueron incluidos para realizar las pruebas con los criterios del estudio; la edad media fue 12,4±3,4anos; para %Volumen Expiratorio Forzado y %Capacidad Vital Forzada las medias fueron 66,7±28,5 y 69,5±22,0 respectivamente. La media del índice de Masa Corporal (Z-score) fue -1,17. La regresión del índice de Masa Corporal para %Volumen Expiratorio Forzado1 fue r²=0,31(P<0,01), y para %Capacidad Vital Forzada, r²=0,22(P<0,01). Conclusiones: Los resultados demostraron correlación entre el índice de Masa Corporal y la función pulmonar. Esta correlación persistió incluso en poblaciones con un notorio déficit nutricional como la de este estudio. Una terapia nutricional específica debería ser implementada en este grupo y poblaciones similares.

Parámetros hematológicos de pacientes con fibrosis quística de la costa caribe colombiana: análisis y asociación con aislamiento de pseudomonas aeruginosa / Hematological parameters of patients with cystic fibrosis from the Colombian Caribbean coast: analysis and association with isolation of pseudomonas aeruginosa

El hemograma es una herramienta fundamental en el control de pacientes con fibrosis quística porque múltiples factores podrían alterar sus parámetros. El objetivo de éste estudio fue analizar y describir los parámetros hematológicos de pacientes con fibrosis quística y determinar su asociación con la infección causada por Pseudomonas aeruginosa y administración de micronutrientes. A 19 pacientes con historia clínica de fibrosis quística se les realizó un hemograma convencional, cultivo de esputo y examen físico. Siete pacientes (36,8%) presentaron anemia, fue sintomática en un solo caso y leve en los demás. Cuatro pacientes (21%) recibían inadecuada administración de micronutrientes. No hubo asociación significativa entre la presencia de anemia y el régimen de administración de micronutrientes con RR 0,63 IC 95% (0,18–3,81). Cuatro (21%) presentaron leucocitosis, dos (10,5%) presentaron eosinofilía. Se aisló Pseudomonas aeruginosa en 8 pacientes (42%), encontrándose una asociación significativa entre anemia e infección causada por este patógeno, con un RR de 8,25 IC 95% (1,22–12,06), no siendo significativa la relación entre ésta y los valores de leucocitos. La prevalencia de anemia, probablemente de clase ferropénica, fue mayor que la reportada en la literatura y puede relacionarse quizás con la infección por Pseudomonas aeruginosa, mientras que la administración de micronutrientes posiblemente no se relaciona. La administración crónica de medicamentos puede ser uno de los factores importantes que influyan en los parámetros hematológicos.