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Type 2 diabetes mellitus (T2DM) is a complex disease that has become a major global health concern. Given the efficacy of antidiabetic drugs, pharmacological therapy is considered the first-line treatment of T2DM; however, due to their potential side effects and high costs, new and cost-effective treatments with minimal side effects are needed. Medicinal plants have been used for centuries as part of traditional medicine to treat T2DM. Among these, fenugreek, cinnamon, Curcuma longa, berberine, and Momordica charantia have demonstrated different degrees of hypoglycemic activity in clinical studies and animal models. Therefore, the aim of this review is to synthesize the mechanisms of action of five medicinal plants, as well as the experimental and clinical evidence of their hypoglycemic activity from the published literature.
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Thyroid metastasis from a neuroendocrine carcinoma (NEC) is atypical, and the most common site of origin is the lung. We present the case of a 48-year-old lady with a history of NEC in the uterine cervix, classified initially as a p16-positive high-grade endocervical adenocarcinoma with endometrioid differentiation in a cervical biopsy. The patient, after having a thyroid ultrasound due to thyroid nodules, showing a multinodular goiter and suspicious nodules, and a subsequent fine-needle aspiration with a diagnosis of papillary thyroid carcinoma, presented to our hospital for a total thyroidectomy. Histologically, there were metastatic high-grade carcinoma foci within the thyroid, consistent with metastasis from the cervical primary tumor based on the morphology and immunohistochemical stains, the tumor was re-classified as an NEC. The thyroid gland is an uncommon site for metastasis from primary sites, and a very rare site for an NEC origin; besides, this tumor type is infrequent in the uterine cervix and bears an unfavorable prognosis when present. Therefore, when encountering a high-grade metastatic tumor within the thyroid, an NEC has to be considered in the differential diagnosis for a prompt diagnosis and an appropriate treatment.
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The aim of this study was to evaluate the effect of Momordica charantia (MC) administration on anthropometric measures in patients with obesity. A randomized, double-blind, placebo-controlled pilot clinical trial was carried out in 24 patients with obesity. Twelve patients randomly received MC (2000 mg/day) for 12 weeks, and 12 patients received placebo. Body weight (BW), body mass index (BMI), waist circumference (WC), body fat percentage, as well as clinical and laboratory determinations, were evaluated before and after the intervention. Results showed that while reductions in BW, BMI, WC, and body fat percentage were observed in the MC group, these differences did not reach statistical significance. Significant decreases in triglycerides (TG) (1.9 ± 0.6 mM vs. 1.7 ± 0.7 mM, P ≤ .05) and very low-density lipoprotein (VLDL) (0.4 ± 0.1 mM vs. 0.3 ± 0.1 mM, P ≤ .05) levels were found after the intervention with MC. In contrast, significant increases in BW (83.0 ± 10.7 kg vs. 84.6 ± 9.1 kg, P ≤ .05) and BMI (31.9 ± 1.5 kg/m2 vs. 33.0 ± 1.3 kg/m2, P ≤ .05) were observed in the placebo group. In conclusion, no significant reductions in BW, BMI, WC, and body fat percentage were observed after MC administration; however, MC significantly decreased TG and VLDL levels. The protocol was registered at ClinicalTrials.gov with the identifier NCT04916379.
Asunto(s)
Momordica charantia , Índice de Masa Corporal , Peso Corporal , Humanos , Metaboloma , Obesidad/tratamiento farmacológico , Triglicéridos , Circunferencia de la CinturaRESUMEN
In myelodysplastic syndromes (MDS), the 20q deletion [del(20q)] may cause deletion of the ASXL1 gene. We studied 153 patients with MDS and del(20q) to assess the incidence, prognostic value and impact on response to azacitidine (AZA) of ASXL1 chromosomal alterations and genetic mutations. Additionally, in vitro assay of the response to AZA in HAP1 (HAP1WT ) and HAP1 ASXL1 knockout (HAP1KN ) cells was performed. ASXL1 chromosomal alterations were detected in 44 patients (28·5%): 34 patients (22%) with a gene deletion (ASXL1DEL ) and 10 patients (6·5%) with additional gene copies. ASXL1DEL was associated with a lower platelet count. The most frequently mutated genes were U2AF1 (16%), ASXL1 (14%), SF3B1 (11%), TP53 (7%) and SRSF2 (6%). ASXL1 alteration due to chromosomal deletion or genetic mutation (ASXL1DEL /ASXL1MUT ) was linked by multivariable analysis with shorter overall survival [hazard ratio, (HR) 1·84; 95% confidence interval, (CI): 1·11-3·04; P = 0·018] and a higher rate for acute myeloid leukaemia progression (HR 2·47; 95% CI: 1·07-5·70, P = 0·034). ASXL1DEL /ASXL1MUT patients were correlated by univariable analysis with a worse response to AZA. HAP1KN cells showed more resistance to AZA compared to HAP1WT cells. In conclusion, ASXL1 alteration exerts a negative impact on MDS with del(20q) and could become useful for prognostic risk stratification and treatment decisions.
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Antimetabolitos Antineoplásicos/uso terapéutico , Azacitidina/uso terapéutico , Deleción Cromosómica , Síndromes Mielodisplásicos/tratamiento farmacológico , Síndromes Mielodisplásicos/genética , Proteínas Represoras/genética , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Mutación , Síndromes Mielodisplásicos/diagnóstico , PronósticoAsunto(s)
Neoplasias Óseas , Metotrexato , Necrosis , Osteosarcoma , Adolescente , Antineoplásicos/efectos adversos , Neoplasias Óseas/tratamiento farmacológico , Doxorrubicina/uso terapéutico , Humanos , Masculino , Metotrexato/efectos adversos , Metotrexato/uso terapéutico , Necrosis/inducido químicamente , Osteosarcoma/tratamiento farmacológicoRESUMEN
Nectar of honeybee colonies has been used in order to identify heavy metals and establish the benefit of this type of studies as a tool for environmental management. For these goals, samples of nectar were obtained from Apis mellifera hives placed in the city of Córdoba (Spain) and its surroundings. Five stations (each with two hives) were selected and samples were collected from May to July of 2007, 2009 and 2010. Concentrations of Pb, Cr, Ni and Cd in nectar were determined by graphite furnace atomic absorption spectrophotometry. Substantial spatial and temporal differences were detected and compared with the values found in bee bodies in a previously published study based on samples obtained simultaneously with those presented in this work. Upper reference thresholds established for this investigation were surpassed frequently by the measures obtained, being Cr (21.43% of samples), stations S3 (22.22%) and S4 (11.12%) year 2009 (22.22%) and the month of July (23.68%) the metal, the locations and the periods that exceeded more times these references. Regarding the Cd, which was studied only in 2010, 33.33% of the nectar samples exceeded the upper reference thresholds. Comparing the biomonitoring of bee bodies and nectar, some coincidences were found, although they showed different results for highest worrisome values of metal, station and year. This suggests that both methods can give complementary information in the surveillance systems of atmospheric pollution.
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Metales Pesados/análisis , Néctar de las Plantas , Animales , Abejas , Monitoreo Biológico , Ciudades , Monitoreo del Ambiente , EspañaAsunto(s)
Bronquiolitis , Niño , Servicio de Urgencia en Hospital , Humanos , Lactante , Terapia por Inhalación de OxígenoRESUMEN
Introduction: Hereditary spastic paraplegia is a group of inherited neurological disorders with predominant manifestations of lower extremity weakness and severe spasticity. This is a genetically heterogeneous disorder very difficult to distinguish clinically with many genes described. Few patients with this condition have been previously reported. Patient and methods: We present a case of a 5 years old girl, born from consanguineous parents, with severe ataxia and progressive spasticity of low limbs. Due to the severity of the symptoms and the need for early diagnosis, next generation sequencing study of 37 genes implicated in spastic paraplegia was performed. Results: A novel pathological variant in FA2H gene was discovered. Father, mother and brother were heterozygous carriers. Conclusions: Spastic paraplegia due to mutations in FA2H is an under diagnosed condition, and it should always be considered in childhood onset of progressive pyramidal dysfunction. Next Generation Sequencing allows a simultaneous analysis of many genes, enables a fast diagnosis in complex disorders
Introducción: La paraparesia espástica es un grupo de enfermedades neurológicas hereditarias que cursan con debilidad de las extremidades inferiores y espasticidad severa. Es una enfermedad muy heterogénea, con muchos genes descritos y muy difícil de distinguir clínicamente. Hay pocos pacientes descritos con esta enfermedad. Pacientes y métodos: Se presenta un caso de una niña de 5 años, de padres consanguíneos, con una ataxia severa y espasticidad progresiva de los miembros inferiores. Dada la gravedad de la clínica y la necesidad de un diagnóstico temprano, se decide realizar un panel de secuenciación masiva de 37 genes implicados en paraparesia espástica. Resultados: Los resultados muestran una variante patológica no descrita previamente en el gen FA2H. El padre, la madre y el hermano resultan portadores heterocigotos. Conclusiones: La paraparesia espástica debida a mutaciones en el gen FA2H está infradiagnosticada y debería ser considerada siempre que aparezcan síntomas en la infancia de disfunción piramidal grave y progresiva. Los paneles de secuenciación masiva con el análisis simultáneo de varios genes están permitiendo un diagnóstico más rápido en enfermedades complejas
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Humanos , Femenino , Preescolar , Paraplejía Espástica Hereditaria/genética , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Marcadores Genéticos , /métodos , Tractos Piramidales/fisiopatologíaRESUMEN
Due to features that make them outstanding environmental bioindicator, colonies of Apis mellifera are being used to study environmental pollution. The primary objective of this research was to use honeybee colonies to identify heavy metals and determine their utility for environmental management. Five stations each with two A. mellifera hives were strategically located in urban, industrial, agricultural and forested areas within the municipality of Córdoba (Spain), and foraging bees were collected from April to December in 2007, 2009 and 2010 to analyse spatial and temporal variation in Pb, Cr, Ni and Cd pollution. Metal concentrations, in milligram per kilogram of honeybee, were determined by inductively coupled plasma-atomic emission spectrometry and graphite furnace atomic absorption spectrophotometry. Significant differences in concentrations were found among the various locations and periods. The highest number of values exceeding the upper reference thresholds proposed for this study (Pb, 0.7 mg/kg; Cr, 0.12 mg/kg; Ni, 0.3 mg/kg; and Cd, 0.1 mg/kg) was observed for Pb and Cr (6.25% respectively), station S4 (13.22%), year 2007 (20.83%) and in months of May and July (11.90% each). Regarding the Cd, which was analysed only in 2010, the highest number of values exceeding the upper reference thresholds was 40%. Biomonitoring with colonies of A. mellifera could contribute to improved surveillance and control systems for atmospheric pollution by integrating qualitative and quantitative assessments, thus facilitating prevention and readiness in the event of environmental crises.
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Abejas/química , Monitoreo del Ambiente/métodos , Contaminación Ambiental/análisis , Metales Pesados/análisis , Animales , Ciudades , Industrias , España , Espectrofotometría AtómicaRESUMEN
Millones de mujeres en todo el mundo sufren maltratos por parte de su pareja, y lo peor de todo es que muchas llegan a soportarlo e incluso hasta aceptarlo. Se trabajó con 180 mujeres que acudieron a la consulta de sanidad de lesiones del Centro Provincial de Medicina Legal durante el año 2006, las cuales fueron víctimas de agresiones físicas por parte de su pareja o expareja, obteniéndose como resultado que la mayoría de las mujeres agredidas eran jóvenes, con un nivel cultural predominantemente secundario y preuniversitario. Un por ciento elevado se encontraba separada de su pareja cuando fueron agredidas por estas y la causa principal que las lleva a no separarse y no denunciar es la dependencia económica y la falta de hogar propio donde ir. Estos casos fueron remitidos a la Casa de Orientación a la Mujer y la Familia con el objetivo de trabajar en la reinserción social de estas mujeres (AU)
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Humanos , Femenino , Maltrato Conyugal/prevención & control , Violencia/prevención & control , Estrategias de Salud Nacionales , Servicios de Salud para MujeresRESUMEN
We succeeded in establishing for the first time a conclusive spectroscopic signature for reduced single-wall carbon nanotubes (SWNT), which evolves from electron donor-acceptor interactions between SWNT and electron-donating pi-extended tetrathiafulvalene (exTTF). In particular, pi-pi interactions were employed to anchor the electron donor to the surface of SWNT. New conduction band electrons, injected from photoexcited exTTF, shift the transitions that are associated with the van Hove singularities to lower energies.
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Radicales Libres/química , Compuestos Heterocíclicos/química , Nanotubos de Carbono/química , Fotólisis , Análisis Espectral , Conductividad Eléctrica , Electrones , Iones , Propiedades de SuperficieRESUMEN
Estudio de intervención para elevar la percepción de riesgo de accidentes domésticos en madres de 4 consultorios del Policlínico 13 de Marzo, Bayamo, Granma, en el 2002. Universo: 42 madres de lactantes y preescolares de los consultorios seleccionados. Muestra: 36 madres que aceptaron participar en el estudio. Se aplicó un cuestionario grupal, previamente validado. En base a los resultados se diseñó un Programa de Comunicación de Riesgo y se evaluó la efectividad del mismo. La mayoría de las madres mostró insuficiente nivel de conocimientos antes de aplicar el programa. Este se correspondió en gran medida con los intereses de la audiencia blanco y mantuvo la retroalimentación madre-equipo de salud. Los criterios de evaluación utilizados evidenciaron que el programa fue efectivo para elevar la percepción de riesgo en las madres. Se concluye que la Comunicación de Riesgo, como proceso interactivo de intercambio de información, desempeña un rol importante en la prevención de accidentes en niños(AU)
Intervention study tu increase the risk perception of domestic accidents in mothers of for health area of 13 de Marzo policlinic Bayamo Granma, in 2002. The universe is made by mothers of 42 infant and kindergarten of the selected health area. The sample was 36 mothers that participated in the study. It was applied a previously approved group questionary. In the base of the results it was designed a Risk Communication Program and it was evaluated its effectiveness. The majurity of mothers showed insufficient level of knowledge before applying the program. Itagerce with the white audience interests and supported the feedback health team-mother. The criterion of evaluation showed that the program was effective to increase the risk perception in mothers. It is reached the conclusion that Risk Communication of interchange, plays an important role in the prevention of children accidents(AU)
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Humanos , Femenino , Accidentes Domésticos/prevención & control , Participación de la Comunidad/métodosRESUMEN
Two hundred sixty-eight subjects (198 men and 70 women) with blood-smears positive for malaria parasites, diagnosed at the Fundação Nacional de Saúde in Manaus were studied. The antthopometric evaluations of weight, height, body mass index, triceps skinfold thichness, brachial circunference and arm muscle circunference were performed an all subjects. Haematological and biochemical evaluations were performed for 121 individuals and coprological examination for parasites for 55. Despite the malaria and precarious living conditions of the patients, the anthopometric mean values were normal with the exception of triceps skinfold thickness, which was below normal. Measures of haematocrit, haemoglobin, glicose, serum iron and triglycerides were within the normal range, with total protein at the lower limit of the recomended range, and HDL cholesterol below the limit of normality. The dietary investigation revealed that the study population had acess to a well balanced diet, with frequent consumption of proteinrich food (fish, meat and eggs), abundant sources of energy (rice, bread and vegetable oil) and smalles quantities of regulators (green vegetables and fruits). Among factors aggravating the nutritional status of the malaria patients, a high incidence of multiple gastrointestinal parasitosis, precarious living conditions, low educational status, low income and high consumption of tobacco and alcohol were detected.
Foram estudados 268 indivíduos (198 homens e 70 mulheres), residentes no Amazonas, com resultados hemoscópicos positivos de malária, diagnosticados pela Fundação Nacional de Saúde FNS/Manaus. A avaliação antropométrica foi universal, envolvendo as medidas de Peso, Altura, índice de Massa Corpórea (IMC), Prega Cutânea Triciptal (PCT), Circunferência Braquial (CB) e Circunferência Muscular do Braço (CMB). O universo estudado foi ainda subamostrado para avaliação Hematológica, Bioquímica (121 indivíduos) e Parasitológica (55 indivíduos). A análise dos resultados evidencia que apesar da presença da malária e das precárias condições de vida dos doentes, constatou-se que o Peso, Altura, IMC, CB e CMB apresentaram valores médios considerados normais, excetuando-se os resultados da PCT que foram inferiores aos padrões considerados de normalidade. Os resultados de Hematócrito, Hemoglobina, Glicose, Ferro sérico e Triglicerídeos, apresentaram-se dentro dos limites de normalidade, estando a Proteína Total no limite inferior recomendado, e, o HDL colesterol abaixo do limite de normalidade. O inquérito de consumo alimentar revelou que a população estudada teve acesso a uma dieta bem estruturada, sendo frequente o consumo de alimentos construtores (peixe, carnes e ovos), abundantes os energéticos: arroz, pão, gordura vegetal (óleos), e, em menor quantidade os reguladores (verduras e frutas). Como prováveis agravantes do estado nutricional dos portadores de malária, constatou-se alto índice de parasitose gastrointestinal, predominando o poliparasitismo, precárias condições de habitação, baixo nível de escolaridade, baixa renda, alto consumo de cigarro e álcool.
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Foram estudados 268 indivíduos (198 homens e 70 mulheres), residentes no Amazonas, com resultados hemoscópicos positivos de malária, diagnosticados pela Fundação Nacional de Saúde - FNS/Manaus. A avaliação antropométrica foi universal, envolvendo as medidas de Peso, Altura, Índice de Massa Corpórea (IMC), Prega Cutânea Triciptal (PCT), Circunferência Muscular do Braço (CMB). O universo estudado foi ainda subamostrado para avaliação Hematológica, Bioquímica (121 indivíduos) e Parasitológica (55 indivíduos). A análise dos resultados evidencia que apesar da presença da malária e das precárias condições de vida dos doentes, constatou-se que o Peso, Altura, IMC, CB e CMB apresentaram valores médios considerados normais, excetuando-se os resultados da PCT que foram inferiores aos padrões considerados de normalidade. Os resultados de Hematócrito, Hemoglobina, Glicose, Ferro sérico e Triglicerídeos, apresentaram-se dentro dos limites de normalidade, estando a Proteína Total no limite inferior recomendado, e, o HDL colesterol abaixo do limite de normalidade. O inquérito de consumo alimentar revelou que a população estudada teve acesso a uma dieta bem estruturada, sendo frequente o consumo de alimentos construtores (peixe, carnes e ovos), abundantes os energéticos: arroz, pão, gordura vegetal (óleos), e, em menor quantidade os reguladores (verduras e frutas). Como prováveis agravantes do estado nutricional dos portadores de malária, constatou-se alto índice de parasitose gastrointestinal, predominando o poliparasitismo, precárias condições de habitação, baixo nível de escolaridade, baixa renda, alto consumo de cigarro e álcool
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Malaria , Evaluación NutricionalRESUMEN
Se realizó un estudio descriptivo, transversal y prospectivo con el objetivo de conocer la efectividad del tratamiento y rehabilitación de los pacientes alcohólicos del municipio Bayamo seguidos a través del autor y los grupos de autoayuda, con el uso de un enfoque integral y sitémico en la estrategia preventiva asistencial farmacológica y no farmacológica en el servicio de psiquiatría. La prevalencia de alcoholismo encontrada fue de 9 por ciento, predominando los grupos etareos de 25 a 35 y de 36 a 45 años, 85,70 por ciento de la muestra; la evolución fue satisfactoria en más de 90 por ciento de los casos a los 6 y 18 meses respectivamente y de 81 por ciento al año. Se concluye que convincentemente la terapéutica adecuada tanto desde el punto biológico, psicológico como social, así como el seguimiento a través de los grupos de autoayuda es la más efectiva en la rehabilitación de pacientes alcohólicos(AU)
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Alcoholismo/epidemiología , Alcoholismo/rehabilitación , Alcoholismo/terapia , Grupos de AutoayudaRESUMEN
El propósito del presente estudio fue identificar los factores de intervención en el no cumplimiento de los requisitos básicos para el uso de la lactancia materna como método anticonceptivo. Se realizó un estudio prospectivo, transversal, descriptivo en mujeres puérperas que estén dando de lactar de recién nacidos hasta los 6 meses de edad, en una zona periférica de la ciudad de Cochabamba, el instrumento que se utiliza es el cuestionario realizando entrevistas individuales casa por casa. Llegándose a la conclusión de que existen factores que si intervienen en la lactancia materna para su uso como método anticonceptivo
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Humanos , Anticoncepción , Lactancia MaternaRESUMEN
El propósito del presente estudio fue identificar los factores de intervención en el no cumplimiento de los requisitos básicos para el uso de la lactancia materna como método anticonceptivo. Se realizó un estudio prospectivo, transversal, descriptivo en mujeres puérperas que estén dando de lactar de recién nacidos hasta los 6 meses de edad, en una zona periférica de la ciudad de Cochabamba, el instrumento que se utiliza es el cuestionario realizando entrevistas individuales casa por casa. Llegándose a la conclusión de que existen factores que si intervienen en la lactancia materna para su uso como método anticonceptivo
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Humanos , Anticoncepción , Lactancia MaternaRESUMEN
Descreve-se um caso de esporotricose do pavilhäo auricular em menino de oito anos. Comentam-se aspectos diagnósticos e epidemiológicos desta apresentaçäo da micose
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Niño , Humanos , Masculino , Oído Externo , Esporotricosis/diagnósticoRESUMEN
Descreve-se um caso de tinha do couro cabeludo, por Microsporum canis, em mulher de 29 anos. Esta apresentaçäo desusada de dermatofitose da cabeça, após a puberdade, é comentada