Muscle glycogen unavailability and fat oxidation rate during exercise: Insights from McArdle disease.

Carbohydrate availability affects fat metabolism during exercise; however, the effects of complete muscle glycogen unavailability on maximal fat oxidation (MFO) rate remain unknown. Our purpose was to examine the MFO rate in patients with McArdle disease, comprising an inherited condition caused by complete blockade of muscle glycogen metabolism, compared to healthy controls. Nine patients (three women, aged 36 ± 12 years) and 12 healthy controls (four women, aged 40 ± 13 years) were studied. Several molecular markers of lipid transport/metabolism were also determined in skeletal muscle (gastrocnemius) and white adipose tissue of McArdle (Pygm p.50R*/p.50R*) and wild-type male mice. Peak oxygen uptake ( V ̇ O 2 peak ${\dot V_{{{\rm{O}}_{\rm{2}}}{\rm{peak}}}}$ ), MFO rate, the exercise intensity eliciting MFO rate (FATmax) and the MFO rate-associated workload were determined by indirect calorimetry during an incremental cycle-ergometer test. Despite having a much lower V ̇ O 2 peak ${\dot V_{{{\rm{O}}_{\rm{2}}}{\rm{peak}}}}$ (24.7 ± 4 vs. 42.5 ± 11.4 mL kg-1  min-1 , respectively; P < 0.0001), patients showed considerably higher values for the MFO rate (0.53 ± 0.12 vs. 0.33 ± 0.10 g min-1 , P = 0.001), and for the FATmax (94.4 ± 7.2 vs. 41.3 ± 9.1 % of V ̇ O 2 peak ${\dot V_{{{\rm{O}}_{\rm{2}}}{\rm{peak}}}}$ , P < 0.0001) and MFO rate-associated workload (1.33 ± 0.35 vs. 0.81 ± 0.54 W kg-1 , P = 0.020) than controls. No between-group differences were found overall in molecular markers of lipid transport/metabolism in mice. In summary, patients with McArdle disease show an exceptionally high MFO rate, which they attained at near-maximal exercise capacity. Pending more mechanistic explanations, these findings support the influence of glycogen availability on MFO rate and suggest that these patients develop a unique fat oxidation capacity, possibly as an adaptation to compensate for the inherited blockade in glycogen metabolism, and point to MFO rate as a potential limiting factor of exercise tolerance in this disease. KEY POINTS: Physically active McArdle patients show an exceptional fat oxidation capacity. Maximal fat oxidation rate occurs near-maximal exercise capacity in these patients. McArdle patients' exercise tolerance might rely on maximal fat oxidation rate capacity. Hyperpnoea might cloud substrate oxidation measurements in some patients. An animal model revealed overall no higher molecular markers of lipid transport/metabolism.

Preclinical Research in Glycogen Storage Diseases: A Comprehensive Review of Current Animal Models.

GSD are a group of disorders characterized by a defect in gene expression of specific enzymes involved in glycogen breakdown or synthesis, commonly resulting in the accumulation of glycogen in various tissues (primarily the liver and skeletal muscle). Several different GSD animal models have been found to naturally present spontaneous mutations and others have been developed and characterized in order to further understand the physiopathology of these diseases and as a useful tool to evaluate potential therapeutic strategies. In the present work we have reviewed a total of 42 different animal models of GSD, including 26 genetically modified mouse models, 15 naturally occurring models (encompassing quails, cats, dogs, sheep, cattle and horses), and one genetically modified zebrafish model. To our knowledge, this is the most complete list of GSD animal models ever reviewed. Importantly, when all these animal models are analyzed together, we can observe some common traits, as well as model specific differences, that would be overlooked if each model was only studied in the context of a given GSD.

Nanometric determination of the thickness of aqueous samples for accurate molar absorption coefficients of water-soluble molecules in the mid-infrared region.

Absorption spectra of aqueous samples measured by transmission need to be acquired using very thin cells (5-50 µm) when targeting the mid-infrared (mid-IR) region due to the strong background absorbance of liquid water. The thickness of the cell used controls the pathlength of the light through the sample, a value needed to transform absorption spectra into molar absorption coefficient spectra, or to determine solute concentrations from absorption spectra. The most accurate way to determine the thickness of an empty cell (i.e., filled with air) is from the period of an interference pattern, known as interference fringes, that arises when the cell is placed perpendicular to the path of light in the spectrometer. However, this same approach is not directly applicable to determine the thickness of a cell filled with an aqueous solution, due partially to the smaller amplitude of the interference fringes but fundamentally caused by its complex waveform, with a wavenumber-dependent oscillation period. Here, using Fresnel equations, we derived analytical expressions to model interference fringes in absorption spectra obtained by transmission, which are also valid for aqueous samples. We also present a novel Fourier-based analysis of the interference fringes that, in combination with the derived analytical expressions, allowed us to determine the pathlength of aqueous samples with an error below âˆ¼ 50 nm. We implemented this novel approach to analyze interference fringes as a Live Script running in the software Matlab. As an application, we measured the absorption spectra of a 97 mM solution of MES buffer at pH 3.4 and pH 8.4 using cells of various nominal thicknesses (6, 25 and 50 µm), whose actual thicknesses were determined using the present approach. The derived molar absorption coefficient spectrum for both the acidic and basic forms of MES were virtually identical regardless of the cell, indicating that the determined thicknesses were likely very accurate. These results illustrate the utility of the present methodology in obtaining accurate molar absorption coefficient spectra of water-soluble molecules in the mid-IR region.

Acute ketone supplementation in the absence of muscle glycogen utilization: Insights from McArdle disease.

BACKGROUND & AIMS: Ketone supplementation is gaining popularity. Yet, its effects on exercise performance when muscle glycogen cannot be used remain to be determined. McArdle disease can provide insight into this question, as these patients are unable to obtain energy from muscle glycogen, presenting a severely impaired physical capacity. We therefore aimed to assess the effects of acute ketone supplementation in the absence of muscle glycogen utilization (McArdle disease). METHODS: In a randomized cross-over design, patients with an inherited block in muscle glycogen breakdown (i.e., McArdle disease, n = 8) and healthy controls (n = 7) underwent a submaximal (constant-load) test that was followed by a maximal ramp test, after the ingestion of a placebo or an exogenous ketone ester supplement (30 g of D-beta hydroxybutyrate/D 1,3 butanediol monoester). Patients were also assessed after carbohydrate (75 g) ingestion, which is currently considered best clinical practice in McArdle disease. RESULTS: Ketone supplementation induced ketosis in all participants (blood [ketones] = 3.7 ± 0.9 mM) and modified some gas-exchange responses (notably increasing respiratory exchange ratio, especially in patients). Patients showed an impaired exercise capacity (-65 % peak power output (PPO) compared to controls, p < 0.001) and ketone supplementation resulted in a further impairment (-11.6 % vs. placebo, p = 0.001), with no effects in controls (p = 0.268). In patients, carbohydrate supplementation resulted in a higher PPO compared to ketones (+21.5 %, p = 0.001) and a similar response was observed vs. placebo (+12.6 %, p = 0.057). CONCLUSIONS: In individuals who cannot utilize muscle glycogen but have a preserved ability to oxidize blood-borne glucose and fat (McArdle disease), acute ketone supplementation impairs exercise capacity, whereas carbohydrate ingestion exerts the opposite, beneficial effect.

Structural and biological engineering of 3D hydrogels for wound healing.

Chronic wounds have become one of the most important issues for healthcare systems and are a leading cause of death worldwide. Wound dressings are necessary to facilitate wound treatment. Engineering wound dressings may substantially reduce healing time, reduce the risk of recurrent infections, and reduce the disability and costs associated. In the path of engineering of an ideal wound dressing, hydrogels have played a leading role. Hydrogels are 3D hydrophilic polymeric structures that can provide a protective barrier, mimic the native extracellular matrix (ECM), and provide a humid environment. Due to their advantages, hydrogels (with different architectural, physical, mechanical, and biological properties) have been extensively explored as wound dressing platforms. Here we describe recent studies on hydrogels for wound healing applications with a strong focus on the interplay between the fabrication method used and the architectural, mechanical, and biological performance achieved. Moreover, we review different categories of additives which can enhance wound regeneration using 3D hydrogel dressings. Hydrogel engineering for wound healing applications promises the generation of smart solutions to solve this pressing problem, enabling key functionalities such as bacterial growth inhibition, enhanced re-epithelialization, vascularization, improved recovery of the tissue functionality, and overall, accelerated and effective wound healing.

3D-Printed Tumor-on-Chip for the Culture of Colorectal Cancer Microspheres: Mass Transport Characterization and Anti-Cancer Drug Assays.

Tumor-on-chips have become an effective resource in cancer research. However, their widespread use remains limited due to issues related to their practicality in fabrication and use. To address some of these limitations, we introduce a 3D-printed chip, which is large enough to host ~1 cm3 of tissue and fosters well-mixed conditions in the liquid niche, while still enabling the formation of the concentration profiles that occur in real tissues due to diffusive transport. We compared the mass transport performance in its rhomboidal culture chamber when empty, when filled with GelMA/alginate hydrogel microbeads, or when occupied with a monolithic piece of hydrogel with a central channel, allowing communication between the inlet and outlet. We show that our chip filled with hydrogel microspheres in the culture chamber promotes adequate mixing and enhanced distribution of culture media. In proof-of-concept pharmacological assays, we biofabricated hydrogel microspheres containing embedded Caco2 cells, which developed into microtumors. Microtumors cultured in the device developed throughout the 10-day culture showing >75% of viability. Microtumors subjected to 5-fluorouracil treatment displayed <20% cell survival and lower VEGF-A and E-cadherin expression than untreated controls. Overall, our tumor-on-chip device proved suitable for studying cancer biology and performing drug response assays.

Acknowledging extraordinary women in the history of medical entomology.

Throughout history, women have been actively involved in the advancement of science, while struggling to overcome challenges to participate and a lack of recognition. Prior to 1950, most women were not included in the lists of "classical" descriptions of the iconic scientific figures nor included in the most relevant historical accounts. Since the second half of the twentieth century, great efforts have been made to recognize the contributions of women to the advancement of science, especially since formal scientific careers have been dominated by men, with limited (or no) access to women. Despite these challenging social, political and cultural contexts, many women have succeeded in making significant advancements, and their contributions are now being acknowledged. Such efforts have led to the publication of recent reviews and compilations on outstanding women in biological sciences. The field of medical entomology is inherently interdisciplinary, focusing on insects and other arthropods that affect human health, with input primarily from the biological and medical sciences and a strong public health perspective. Several reviews and book chapters describing the history of medical entomology have been published over the decades, but few women are mentioned in these publications, even though many women have contributed to this field. Much of the information on these women is currently scattered throughout the published literature and historical records on a wide range of topics, including activism, virology, vector control and even acarology. Considering that there is no single available compilation of women contributors in the history of medical entomology, this review aims to provide a list of 22 women and their contributions to this field. The list includes women from diverse backgrounds, born in the late 1800s and before 1950, who directly impacted medical entomology in various ways and in different regions of the world. This compilation is far from exhaustive, but it aims to identify role models and examples of extraordinary women to motivate the evolving future of this field.

Transcriptional Profile of HCV Replicon Cells after Treatment with Acetylsalicylic Acid.

OBJECTIVE: It has been demonstrated in vitro that acetylsalicylic acid (ASA) treatment halves hepatitis C virus (HCV) expression in hepatocarcinoma cells. However, the signaling pathway that promotes this ASA-induced antiviral effect has not yet been identified. AIM: The aim of this work was to identify alterations in the transcriptional profile of Huh-7-HCV-subgenomic replicon cells with vs. without ASA treatment. This comparison sheds light onto the signaling pathways and molecular mechanisms involved in the antiviral effects of ASA. METHODS: Human hepatocellular carcinoma (Huh-7) cells that express non-structural HCV proteins (Huh-7-HCV-replicon cells) were exposed to 4 mM ASA for 0, 24, 48, and 72 hours. Total RNA was isolated, and cDNA was synthesized. Transcripts were then tagged with biotin and purified. Thereafter, they were fragmented and hybridized on HG-U133 Plus 2 Gene Expression chips. Hybridization signals were captured using a GeneChip 3000 7G Scanner and analyzed via Expression Console and dChip Software. RESULTS: When exposed to ASA, hepatocarcinoma cells with non-structural HCV proteins were found to differentially regulate genes with oxidative roles in the cell. The most upregulated genes were interleukin 8 (IL-8), cytochrome P450 (CYP450), and metallothioneins (MTs), while the most downregulated genes were ribonucleotide reductases (RRs). CONCLUSION: These results show that ASA modulates the expression of genes with antioxidant functions. This suggests that ASA induces a remodeling of the antioxidant microenvironment, which may in turn interfere with the replication of HCV.

Down regulation of tumour biomarkers in colon cancer cells with IRNA PFK-1 plus metformin.

PURPOSE: Metformin has been widely used for the treatment of Type 2 Diabetes Mellitus (T2DM), hyperglycemia and polycystic ovarian syndrome. Recent studies have suggested the potential of this substance as a cancer chemopreventive agent. We evaluated the antitumoral effect of iRNA-PFK-1 and the combined therapy iRNA-PFK-1 + metformin in RKO p53-positive cells. METHODS: mRNA levels of tumor suppressor genes AMPK, APC, and c-MYC, KRAS oncogenes were measured by qRT-PCR in RKO cells treated with 25 µM metformin alone or combined with iRNA-PFK-1, to evaluate the effect of both treatments. RESULTS: At 72 h after treatment with either 25 µM metformin, 150 nM iRNA-PFK-1, or the combined treatment, the transcriptional levels of these biomarkers were decreased by ~73% (p˂0.05), ~99.9%, (p˂0.01), and ~76% (p˂0.05), respectively. CONCLUSION: These in vitro results support the potential therapeutic role of metformin and PFK-1 in the treatment of colon cancer via down-modulation of the expression of several important cancer biomarkers.

A photoswitchable helical peptide with light-controllable interface/transmembrane topology in lipidic membranes.

The spontaneous insertion of helical transmembrane (TM) polypeptides into lipid bilayers is driven by three sequential equilibria: solution-to-membrane interface (MI) partition, unstructured-to-helical folding, and MI-to-TM helix insertion. A bottleneck for understanding these three steps is the lack of experimental approaches to perturb membrane-bound hydrophobic polypeptides out of equilibrium rapidly and reversibly. Here, we report on a 24-residues-long hydrophobic α-helical polypeptide, covalently coupled to an azobenzene photoswitch (KCALP-azo), which displays a light-controllable TM/MI equilibrium in hydrated lipid bilayers. FTIR spectroscopy reveals that trans KCALP-azo folds as a TM α-helix (TM topology). After trans-to-cis photoisomerization of the azobenzene moiety with UV light (reversed with blue light), the helical structure of KCALP-azo is maintained, but its helix tilt increased from 32 ± 5° to 79 ± 8°, indication of a reversible TM-to-MI transition. Further analysis indicates that this transition is incomplete, with cis KCALP-azo existing in a ∼90% TM and ∼10% MI mixture.

Preclinical Research in McArdle Disease: A Review of Research Models and Therapeutic Strategies.

McArdle disease is an autosomal recessive disorder of muscle glycogen metabolism caused by pathogenic mutations in the PYGM gene, which encodes the skeletal muscle-specific isoform of glycogen phosphorylase. Clinical symptoms are mainly characterized by transient acute "crises" of early fatigue, myalgia and contractures, which can be accompanied by rhabdomyolysis. Owing to the difficulty of performing mechanistic studies in patients that often rely on invasive techniques, preclinical models have been used for decades, thereby contributing to gain insight into the pathophysiology and pathobiology of human diseases. In the present work, we describe the existing in vitro and in vivo preclinical models for McArdle disease and review the insights these models have provided. In addition, despite presenting some differences with the typical patient's phenotype, these models allow for a deep study of the different features of the disease while representing a necessary preclinical step to assess the efficacy and safety of possible treatments before they are tested in patients.

Serological Test to Determine Exposure to SARS-CoV-2: ELISA Based on the Receptor-Binding Domain of the Spike Protein (S-RBDN318-V510) Expressed in Escherichia coli.

Massive worldwide serological testing for SARS-CoV-2 is needed to determine the extent of virus exposure in a particular region, the ratio of symptomatic to asymptomatic infected persons, and the duration and extent of immunity after infection. To achieve this, the development and production of reliable and cost-effective SARS-CoV-2 antigens is critical. We report the bacterial production of the peptide S-RBDN318-V510, which contains the receptor-binding domain of the SARS-CoV-2 spike protein (region of 193 amino acid residues from asparagine-318 to valine-510) of the SARS-CoV-2 spike protein. We purified this peptide using a straightforward approach involving bacterial lysis, his-tag-mediated affinity chromatography, and imidazole-assisted refolding. The antigen performances of S-RBDN318-V510 and a commercial full-length spike protein were compared in ELISAs. In direct ELISAs, where the antigen was directly bound to the ELISA surface, both antigens discriminated sera from non-exposed and exposed individuals. However, the discriminating resolution was better in ELISAs that used the full-spike antigen than the S-RBDN318-V510. Attachment of the antigens to the ELISA surface using a layer of anti-histidine antibodies gave equivalent resolution for both S-RBDN318-V510 and the full-length spike protein. Results demonstrate that ELISA-functional SARS-CoV-2 antigens can be produced in bacterial cultures, and that S-RBDN318-V510 may represent a cost-effective alternative to the use of structurally more complex antigens in serological COVID-19 testing.

Water-induced dermatosis: Aquagenic keratoderma. A case report / Dermatosis inducida por el agua: queratodermia acuagénica, a propósito de un caso

Aquagenic keratoderma is a benign entity that is characterized by producing whitish or translucent papules a few seconds after contact with water. We present the case of a 16-year-old patient with multiple asymptomatic confluent papules that appeared on both hand palms after contact with water and which disappeared after drying. The histopathological findings in a skin biopsy after water exposure showed changes in the superficial layers of the stratum corneum and dilatation of sweat gland ducts. This entity of unknown etiology has been related to neuronal and eccrine gland dysfunction. Recently it has been associated with alterations of aquaporins. The "hand-in-the-bucket" sign is a simple useful clinical tool for diagnosis, as histopathological findings may be nonspecific. Topical treatments include barrier mechanisms and botulinum toxin.

La queratodermia acuagénica es una entidad benigna, caracterizada por producir pápulas blanquecinas o traslúcidas pocos segundos después del contacto con el agua. Se presenta el caso de una paciente de 16 años de edad con aparición de múltiples pápulas confluentes y asintomáticas en ambas palmas al contacto con el agua, que desaparecían luego del secado. En el estudio de histopatología se observó dilatación de los conductos ecrinos y cambios en el estrato córneo. Esta rara condición de etiología desconocida se ha relacionado con disfunción neuronal, alteraciones de las glándulas ecrinas y, más recientemente, con alteraciones en las acuaporinas. Se puede diagnosticar con una prueba semiológica sencilla llamada 'la mano en el balde'; la sospecha clínica es fundamental para hacer el diagnóstico, ya que los hallazgos histopatológicos pueden ser sutiles e inespecíficos. El tratamiento tópico incluye mecanismos de barrera y la toxina botulínica.

Progestin-mediated activation of MAPK and AKT in nuclear progesterone receptor negative breast epithelial cells: The role of membrane progesterone receptors.

Progesterone (P4), a steroid produced during estrous cycles and gestation for maintenance of pregnancy, also plays key roles in breast development to allow lactation post-parturition. Progestins (P4 and related steroids) are also implicated in breast cancer etiology. Hormone replacement therapy containing both estrogen and progestins increases breast cancer incidence while estrogen hormone therapy lowers breast cancer risk. P4 signaling via nuclear P4 receptors (PRs) has been extensively studied in breast cancer, however, progestin signaling via non-classical membrane bound progestin receptors (MPRs and PGRMC1) remains unclear. Moreover, P4 metabolites and synthetic progestins may bind membrane progestin receptors. We hypothesized that PR-negative breast epithelial cells express non-classical progestin receptors, which activate intracellular signaling pathways differently depending on nature of progestin. Therefore, our objectives for the current study were to determine expression of MPRs and PGRMC1 in two PR-negative non-tumorigenic breast epithelial cell lines, assess progestin-mediated signaling and biological functions. We determined five MPR isoforms and PGRMC1 were present in MCF10A cells and all progestin receptors but MPRß in MCF12A cells. MCF10A and MCF12A cells were treated with P4, select P4 metabolites (5αP and 3αHP), medroxyprogesterone acetate (MPA), or a specific MPR-Agonist (MPR-Ag) and phosphorylation of ERK, p38, JNK, and AKT was characterized following treatment. To our knowledge this is the first report of ERK and JNK activation in MCF10A and MCF12A cells with P4, P4 metabolites, MPA, and MPR-Ag. Activation of ERK and JNK in cells treated with MPR-Ag implicates MPRs may serve as the receptors responsible for their activation. In contrast, p38 activation varied with cell type and with progestin treatment. P4 and MPA promoted AKT phosphorylation in the MCF12A cell line only whereas no activation was observed in MCF10A cells. Interestingly, cellular proliferation increased in MCF10A cells treated with MPA or 5αP, while MPR-Ag tended to slightly decrease proliferation. Collectively, our data highlights the importance of investigating the effects of synthetic progestins in breast cancer biology. Our results add to the understanding that various progestins have on breast epithelial cells and underscores the importance of considering both membrane bound receptors and progestin type in breast cancer development.

Dermatosis inducida por el agua: queratodermia acuagénica, a propósito de un caso / Water-induced dermatosis: Aquagenic keratoderma. A case report

Resumen La queratodermia acuagénica es una entidad benigna, caracterizada por producir pápulas blanquecinas o traslúcidas pocos segundos después del contacto con el agua. Se presenta el caso de una paciente de 16 años de edad con aparición de múltiples pápulas confluentes y asintomáticas en ambas palmas al contacto con el agua, que desaparecían luego del secado. En el estudio de histopatología se observó dilatación de los conductos ecrinos y cambios en el estrato córneo. Esta rara condición de etiología desconocida se ha relacionado con disfunción neuronal, alteraciones de las glándulas ecrinas y, más recientemente, con alteraciones en las acuaporinas. Se puede diagnosticar con una prueba semiológica sencilla llamada 'la mano en el balde'; la sospecha clínica es fundamental para hacer el diagnóstico, ya que los hallazgos histopatológicos pueden ser sutiles e inespecíficos. El tratamiento tópico incluye mecanismos de barrera y la toxina botulínica.

Abstract Aquagenic keratoderma is a benign entity that is characterized by producing whitish or translucent papules a few seconds after contact with water. We present the case of a 16-year-old patient with multiple asymptomatic confluent papules that appeared on both hand palms after contact with water and which disappeared after drying. The histopathological findings in a skin biopsy after water exposure showed changes in the superficial layers of the stratum corneum and dilatation of sweat gland ducts. This entity of unknown etiology has been related to neuronal and eccrine gland dysfunction. Recently it has been associated with alterations of aquaporins. The "hand-in-the-bucket" sign is a simple useful clinical tool for diagnosis, as histopathological findings may be nonspecific. Topical treatments include barrier mechanisms and botulinum toxin.

Web-based electronic health records improve data completeness and reduce medical discrepancies in employee vaccination programs.

A Web-based electronic health record (EHR) system was compared with traditional paper-based documentation and vaccination tracking during the 2009 H1N1 influenza pandemic. In a cohort of 8,411 healthcare network employees, EHRs improved completeness of self-reported contraindication data and reduced medical discrepancies. Vaccination program quality and accuracy are enhanced by EHRs.

Etiología y estacionalidad de las infecciones respiratorias viralesen menores de cinco años en Bucaramanga, Colombia / Etiology and seasonality of viral respiratory infections in children under 5 years of age in Bucaramanga, Colombia / Etiologia e sazonalidade das infeções respiratórias virais em menores de cinco anos em Bucaramanga, Colômbia

RESUMEN Objetivo: describir los virus asociados con infección respiratoria en niños en Bucaramanga. Materiales y métodos: estudio descriptivo con recolección prospectiva. Los participantes fueron menores de 5 años con fiebre y síntomas respiratorios de máximo 5 días de duración atendidos en dos instituciones de Bucaramanga. Se registraron los datos sociodemográficos, los antecedentes y los hallazgos del examen físico. Las muestras obtenidas por hisopado nasofaríngeo se procesaron para 15 virus respiratorios mediante una prueba múltiplex de reacción en cadena de polimerasa. Resultados: entre diciembre de 2012 y noviembre de 2013, se incluyó a 215 menores de 5 años (edad promedio: 14 meses). La positividad para al menos un virus fue 72 % y se identificó coinfección en 8,5 %. Los virus identificados con mayor frecuencia en las estaciones secas fueron el sincitial respiratorio, rinovirus A/B/C y metapneumovirus, mientras que en las estaciones lluviosas fueron parainfluenza 1/2/3, virus sincitial respiratorio e influenza. Se hallaron coronavirus y bocavirus por primera vez en este grupo de edad en Colombia. Conclusiones: una amplia variedad de virus respiratorios afecta a los niños en Bucaramanga y su ocurrencia a lo largo del año difiere de la de otras regiones de Colombia.

SUMMARY Objective: To describe viruses associated with respiratory infection in children in Bucaramanga, the main city in northeastern Colombia. Materials and methods: Descriptive study with prospective collection. Participants were children under 5 years with respiratory symptoms for a maximum of 5 days, treated at two institutions of Bucaramanga. Demographic data, medical and perinatal history and initial physical examination findings were recorded. Samples obtained with nasopharyngeal swabs were processed for 15 respiratory viruses by multiplex reaction polymerase chain test. Results: Between December 2012 and November 2013, 215 children less than 5 years (mean age 14 months) were enrolled. Positivity to at least one virus was 72 % and co-infection was detected in 8.5 %. The most frequently identified viruses in dry seasons were respiratory syncytial virus, rhinovirus A/B/C and metapneumovirus, while in the rainy seasons they were parainfluenza 1/2/3, respiratory syncytial virus and influenza. Coronavirus and bocavirus were identified for the first time in this age group in Colombia. Conclusions: A wide variety of viruses affects children in this area of Colombia, and their occurrence throughout the year is different from that reported in other regions of the country.

RESUMO Objetivo: Descrever os vírus associados com infecção respiratória em crianças em Bucaramanga. Materiais e métodos: estudo descritivo com recolecção prospectiva. Os participantes foram menores de 5 anos com febre e sintomas respiratórios de máximo 5 dias de duração atendidos em duas instituições de Bucaramanga. Se registraram os dados sócio-demográficos, os antecedentes e os resultados do exame físico. As amostras obtidas por hissopado nasofaringe se processaram para 15 vírus respiratórios mediante uma prova múltipla de reação em cadeia de polimerase. Resultados: entre dezembro de 2012 e novembro de 2013, se incluiu a 215 menores de 5 anos (idade em média: 14 meses). A positividade para pelo menos um vírus foi 72 % e se identificou co-infecção em 8,5 %. Os vírus identificados com maior frequência nas estações secas foram o sincitial respiratório, rinovírus A/B/C e metapneumovírus, enquanto que nas estações chuvosas foram parainfluenza 1/2/3, vírus sincitial respiratório e influenza. Se encontraram coronavírus e bocavírus por primeira vez neste grupo de idade na Colômbia. Conclusões: uma ampla variedade de vírus respiratórios afeta às crianças em Bucaramanga e sua ocorrência ao longo do ano difere de outras regiões da Colômbia.

Etiología viral de infección respiratoria aguda en niños menores de 5 años en las provincias Comunera y García Rovira de Santander / Etiology of acute respiratory infection in children under 5 years in the provinces Comunera and García Rovira of Santander

Introducción: La infección respiratoria aguda es una causa importante de morbimortalidad en menores de cinco años en los municipios de las provincias de Santander. La etiología viral en esos municipios no es bien conocida. Objetivo: El objetivo del estudio fue determinar la etiología viral de la infección respiratoria aguda en menores de cinco años en las provincias Comunera y García Rovira del departamento de Santander entre diciembre de 2012 y diciembre de 2013. Materiales y métodos: Estudio descriptivo en población usuaria de servicios de urgencias. Se obtuvieron muestras por hisopado nasofaríngeo y se realizó amplificación por reacción en cadena de polimerasa con el test Seeplex® RV15 OneStep ACE Detection, multiplex para 15 virus. Resultados: Participaron 64 niños, 57,8% niños de sexo masculino. El 26,6%, de los niños eran menores de un año. La positividad para virus fue del 37,5% de las muestras. El 75% de las muestras positivas fueron de la provincia Comunera y 25% de la provincia de García Rovira. Hubo co-infección por dos virus en 8,3% de las muestras positivas. Los virus más identificados fueron Rhinovirus (29%), Parainfluenza 4 (20,8%) e Influenza (12,5%). También se identificó Coronavirus, Adenovirus, Virus Sincitial Respiratorio, Metapneumovirus y otros virus Parainfluenza. Conclusiones: En las dos provincias de Santander evaluadas circula una amplia cantidad de virus respiratorios en menores de cinco años. El Rhinovirus fue identificado como el más frecuente. Se encontró presencia de Metapneumovirus y Coronavirus humano.

Introduction: Acute respiratory infection is a major cause of morbidity and mortality in children under 5 years in Santander (Colombia). Viral etiology in municipalities from this department is not well known. Objective: To determine the viral etiology of acute respiratory infection in children under five years in the provinces Comunera and García Rovira (Santander) from December 2012 to December 2013. Methodology: Descriptive study in pediatric population who attended the emergency services studied. Nasopharyngeal swab samples were obtained and a polymerase chain reaction was performed with Seeplex® OneStep RV15 ACE Detection, which is a multiplex test for 15 virus. Results: 64 children were enrolled, 57,8% being boys. 26.6% of participants were under one year. Virus positivity was present in 37.5% of the samples and 75% of the positive samples were from the province Comunera. Besides, 8.3% from positive samples were co-infected with two viruses. The most common virus were Rhinovirus (29%), Parainfluenza 4 (20.8%) and influenza (12.5%). Coronavirus, Adenovirus, respiratory syncytial virus, Metapneumovirus and other Parainfluenza virus were also identified. Conclusions: There is a wide circulation of respiratory virus in children under five in these two provinces of Santander (Colombia). Rhinovirus was the most frequent. Human Metapneumovirus and Coronavirus were also found.

Effect of the Pro12Ala polymorphism of the PPAR gamma 2 gene on response to pioglitazone treatment in menopausal women.

OBJECTIVE: To investigate the influence of the Pro12Ala polymorphism of the PPAR gamma 2 gene on metabolic and hormonal response to pioglitazone treatment in obese postmenopausal women. DESIGN: We included 102 obese (body mass index [BMI] >or=30 kg/m2) and 97 nonobese (BMI

Enfermedad de darier unilateral (nevus epidemico disqueratasico acantolico): informe de un caso y revision del tema / Unilateral darier's disease: (acantholytic dyskeratotic epidermal nevus): report of a case and review of the subject

Se presenta un caso de Enfermedad de Darier unilateral, en una mujer de 38 años, quien consultó por un cuadro de 8 años de evolución de lesiones tipo pápulas hiperqueratósicas que conformaban una placa con distribución Zosteriforme, localizada en el abdomen inferior, asintomática. A pesar de la baja frecuencia de esta enfermedad se trata de un caso cuya presentación clínica e histopatológica son muy características e importantes para el diagnóstico de la misma.

We present a case ofDarier I s disease in linear distribution, in a 38 years old woman who consulted for lesions for about 8 years ofevolution type hyperqueratosic papules in inferiorabdomen in zosteriform distribution, asymptomatic. We present this case although the low frecuency ofthis entity, because this is a case that its clinical and histopathological presentation are very charaeteristic for this disease and are important to the diagnosis.