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We report the case of a 24-year-old male presenting with obstructive renal failure, characterised by imaging evidence of a cystic lesion contingent upon the seminal vesicle and concurrent renal agenesis. Initial management involved urinary diversion, followed by outpatient monitoring and subsequent recurrence. Subsequent diagnostic assessments led to the identification of Zinner's syndrome, accompanied by retroperitoneal fibrosis. We present the clinical course, diagnostic methodology and the efficacious implementation of medical-surgical therapeutic interventions, yielding favourable outcomes. LEARNING POINTS: The value of the Internal Medicine team in the assessment of low prevalence diseases.The importance of multidisciplinary teams.Integration of the internists in the surgical teams.
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Introduction: Although it has been observed that the triglycerides and glucose (TyG) index, a biomarker of insulin resistance, is associated with severity and morbidity by COVID-19, evidence is still scarce. Therefore, the objective of this study was to determine whether the TyG index is associated with both the degree of severity and mortality by acute respiratory distress syndrome (ARDS) in patients with COVID-19. Methods: Men and women aged 20 years or more with diagnosis of COVID-19 were included in a case-control study. Exclusion criteria were pregnancy, cancer, autoimmune diseases, autoimmune treatment, and incomplete data. Patients with severe COVID-19 ARDS were allocated into the case group, and those with mild or moderate COVID-19 ARDS in the control group. COVID-19 was defined by a positive reverse transcriptase-polymerase chain reaction test for SARS-CoV-2, and ARDS was defined according to the Berlin criteria. Results: A total of 206 patients were included and allocated into the case (n = 103) and control (n = 103) groups. The logistic regression analysis adjusted by age, sex, and body mass index showed that the TyG index is significantly associated with moderate [odds ratio (OR) = 6.0; 95% confidence interval (CI): 1.1-30.6] and severe (OR = 9.5; 95% CI: 2.4-37.5) COVID-19 ARDS, and death (OR = 10.1; 95% CI: 2.2-46.5). Conclusion: The results of our study show a significant and independent association of the TyG index with ARDS and mortality in patients with COVID-19.
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Glucemia , COVID-19 , Síndrome de Dificultad Respiratoria , Triglicéridos , Humanos , COVID-19/sangre , COVID-19/complicaciones , COVID-19/diagnóstico , COVID-19/mortalidad , Masculino , Femenino , Síndrome de Dificultad Respiratoria/sangre , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/mortalidad , Persona de Mediana Edad , Estudios de Casos y Controles , Factores de Riesgo , Glucemia/análisis , Glucemia/metabolismo , Triglicéridos/sangre , Adulto , Anciano , Biomarcadores/sangre , Índice de Severidad de la Enfermedad , Resistencia a la Insulina , SARS-CoV-2RESUMEN
Ludwigia octovalvis (Jacq.) P.H. Raven is widely used in traditional medicine for different illnesses, including diabetes and hypertension. However, its impact on lipotoxicity and metabolic syndrome in vivo has not been addressed. Therefore, the aim of this study was to evaluate the effects of this plant on the metabolic syndrome parameters in a C57BL6J mouse hypercaloric diet model. L. octovalvis hydroalcoholic extract and its ethyl acetate fraction (25 mg/kg/day) were used for sub-chronic assessment (10 weeks). Additionally, four subfractions (25 mg/kg) were evaluated in the postprandial triglyceridemia test in healthy C57BL6J mice. The hydroalcoholic extract and ethyl acetate fraction significantly decreased body weight gain (-6.9 g and -1.5 g), fasting glycemia (-46.1 and -31.2 mg/dL), systolic (-26.0 and -22.5 mmHg) and diastolic (-8.1 and 16.2 mmHg) blood pressure, free fatty acid concentration (-13.8 and -8.0 µg/mL) and insulin-resistance (measured by TyG index, -0.207 and -0.18), compared to the negative control. A postprandial triglyceridemia test showed that the effects in the sub-chronic model are due, at least in part, to improvement in this parameter. L. octovalvis treatments, particularly the hydroalcoholic extract, improve MS alterations and decrease free fatty acid concentration. These effects are possibly due to high contents of corilagin and ellagic acid.
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OBJECTIVES: This study aimed to evaluate the cost-effectiveness of the triglycerides and glucose index (TyG) versus the homeostatic model assessment for insulin resistance index (HOMA-IR) for diagnosing insulin resistance. METHODS: A cost-effectiveness analysis using a decision tree based on the false-negative and false-positive tests and the true-positive and true-negative tests of both the TyG and HOMA-IR was conducted. Based on the costs and effectiveness of both tests, the average and incremental cost-effectiveness ratios were calculated. Furthermore, one-way sensitivity analysis was conducted regarding sensitivity of both indexes. Using the Monte Carlo simulation with 10 000 iterations, a probabilistic sensitivity analysis that included sensitivity, specificity, and cost of diagnostic tests was conducted. Finally, using the α and ß values obtained from the primary data, the beta distribution was used for estimation of sensitivity and specificity. RESULTS: The cost-effectiveness per test was $1.64 versus $4.26 for TyG and HOMA-IR. The effectiveness of true-positive (0.77 vs 0.74) and true-negative (0.17 vs 0.15) tests was higher for the TyG than HOMA-IR. The cost-effectiveness ratio was lower for the TyG than the HOMA-IR, for both the true-positive ($1.64 vs $4.26) and true-negative ($7.33 vs $20.70) tests. Diagnosing IR using the TyG was 61.5% lower than using the HOMA-IR. CONCLUSIONS: Our findings indicate that the TyG is a high effectiveness and cost-effective test for diagnosing insulin resistance than the HOMA-IR.
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Resistencia a la Insulina , Humanos , Glucosa , Glucemia , Análisis de Costo-Efectividad , Triglicéridos , BiomarcadoresRESUMEN
A large amount of published research points to the interesting concept (hypothesis) that magnesium (Mg) status may have relevance for the outcome of COVID-19 and that Mg could be protective during the COVID disease course. As an essential element, Mg plays basic biochemical, cellular, and physiological roles required for cardiovascular, immunological, respiratory, and neurological functions. Both low serum and dietary Mg have been associated with the severity of COVID-19 outcomes, including mortality; both are also associated with COVID-19 risk factors such as older age, obesity, type 2 diabetes, kidney disease, cardiovascular disease, hypertension, and asthma. In addition, populations with high rates of COVID-19 mortality and hospitalization tend to consume diets high in modern processed foods, which are generally low in Mg. In this review, we review the research to describe and consider the possible impact of Mg and Mg status on COVID-19 showing that (1) serum Mg between 2.19 and 2.26 mg/dL and dietary Mg intakes > 329 mg/day could be protective during the disease course and (2) inhaled Mg may improve oxygenation of hypoxic COVID-19 patients. In spite of such promise, oral Mg for COVID-19 has thus far been studied only in combination with other nutrients. Mg deficiency is involved in the occurrence and aggravation of neuropsychiatric complications of COVID-19, including memory loss, cognition, loss of taste and smell, ataxia, confusion, dizziness, and headache. Potential of zinc and/or Mg as useful for increasing drug therapy effectiveness or reducing adverse effect of anti-COVID-19 drugs is reviewed. Oral Mg trials of patients with COVID-19 are warranted.
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BACKGROUND: Among the Toll-like receptors (TLR) that are dependent of myeloid response protein (MyD88), the TLR4 and TLR2 are directly associated with low-grade chronic inflammation; however, they are not been investigated in subjects with metabolically healthy obesity (MHO). Thus, the objective of this study was to determine the association between the expression of TLR4, TLR2, and MyD88 with low-grade chronic inflammation in individuals with MHO. METHODS AND RESULTS: Men and women with obesity aged 20 to 55 years were enrolled in a cross-sectional study. Individuals with MHO were allocated into the groups with and without low-grade chronic inflammation. Pregnancy, smoking, alcohol consumption, intense physical activity or sexual intercourse in the previous 72 h, diabetes, high blood pressure, cancer, thyroid disease, acute or chronic infections, renal impairment, and hepatic diseases, were exclusion criteria. The MHO phenotype was defined by a body mass index (BMI ≥ 30 kg/m2) plus one or none of the following cardiovascular risk factors: hyperglycemia, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol. A total of 64 individuals with MHO were enrolled and allocated into the groups with (n = 37) and without (n = 27) inflammation. The multiple logistic regression analysis indicated that TLR2 expression is significantly associated with inflammation in individuals with MHO. In the subsequent analysis adjusted by BMI, TLR2 expression remained associated with inflammation in individuals with MHO. CONCLUSION: Our results suggest that overexpression of TLR2, but not TLR4 and MyD88, is associated with low-grade chronic inflammation in subjects with MHO.
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Hipertensión , Obesidad Metabólica Benigna , Femenino , Humanos , Receptor Toll-Like 2/genética , Receptor Toll-Like 2/metabolismo , Factor 88 de Diferenciación Mieloide/genética , Factor 88 de Diferenciación Mieloide/metabolismo , Estudios Transversales , Índice de Masa Corporal , Inflamación/genética , Hipertensión/metabolismo , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Factores de RiesgoRESUMEN
The aim of this study was to compare the association of the triglycerides and glucose (TyG) index and homeostatic model assessment of insulin resistance (HOMA-IR) with lipoprotein(a) (lp[a]), apolipoprotein AI (apoAI), and apoliprotein B (apoB) concentrations in children with normal-weight. Children with normal weight aged 6-10 years and Tanner 1 stage were included in a cross-sectional study. Underweight, overweight, obesity, smoking, alcohol intake, pregnancy, acute or chronic illnesses, and any kind of pharmacological treatment were exclusion criteria. According to the lp(a) levels, children were allocated into the groups with elevated concentrations and normal values. A total of 181 children with normal weight and an average age of 8.4 ± 1.4 years were enrolled in the study. The TyG index showed a positive correlation with lp(a) and apoB in the overall population (r = 0.161 and r = 0.351, respectively) and boys (r = 0.320 and r = 0.401, respectively), but only with apoB in the girls (r = 0.294); while the HOMA-IR had a positive correlation with lp(a) levels in the overall population (r = 0.213) and boys (r = 0.328). The linear regression analysis showed that the TyG index is associated with lp(a) and apoB in the overall population (B = 20.72; 95%CI 2.03-39.41 and B = 27.25; 95%CI 16.51-37.98, respectively) and boys (B = 40.19; 95%CI 14.50-65.7 and B = 29.60; 95%CI 15.03-44.17, respectively), but only with apoB in the girls (B = 24.22; 95%CI 7.90-40.53). The HOMA-IR is associated with lp(a) in the overall population (B = 5.37; 95%CI 1.74-9.00) and boys (B = 9.63; 95%CI 3.65-15.61). Conclusion: The TyG index is associated with both lp(a) and apoB in children with normal-weight. What is Known: ⢠The triglycerides and glucose index has been positively associated with an increased risk of cardiovascular disease in adults. What is New: ⢠The triglycerides and glucose index is strongly associated with lipoprotein(a) and apolipoprotein B in children with normal-weight. ⢠The triglycerides and glucose index may be a useful tool to identify cardiovascular risk in children with normal-weight.
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Glucosa , Resistencia a la Insulina , Masculino , Adulto , Femenino , Humanos , Niño , Triglicéridos , Apolipoproteína A-I , Lipoproteína(a) , Estudios Transversales , Apolipoproteínas B , Glucemia/análisis , BiomarcadoresRESUMEN
The objective of this study was to evaluate the effect of roasting coffee degree on inflammatory (NF-kß F-6 and TNF-α) and stress oxidative markers (malondialdehyde (MDA), nitric oxide (NO) end product concentrations, catalase (CAT), and superoxide dismutase (SOD) in high-fructose and saturated fat (HFSFD)-fed rats. Roasting was performed using hot air circulation (200 °C) for 45 and 60 min, obtaining dark and very dark coffee, respectively. Male Wistar rats were randomly assigned to receive a) unroasted coffee, b) dark coffee, c) very dark coffee, or distilled water for the control group (n = 8). Coffee brews (7.4 mL/per day equivalent to 75 mL/day in humans) were given by gavage for sixteen weeks. All treated groups significantly decreased NF-kß F-6 (â¼30 % for unroasted, â¼50 % for dark, and â¼ 75 % for very dark group) and TNF-α in the liver compared with the control group. Additionally, TNF-α showed a significant reduction in all treatment groups (â¼26 % for unroasted and dark groups, and â¼ 39 % for very dark group) in adipose tissue (AT) compared with the negative control. Regarding oxidative stress makers, all coffee brews exerted antioxidant effects in serum, AT, liver, kidney, and heart. Our results revealed that the anti-inflammatory and antioxidant effects of coffee vary according to the roasting degree in HFSFD-fed rats.
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Antioxidantes , Factor de Necrosis Tumoral alfa , Humanos , Ratas , Animales , Masculino , Ratas Wistar , Estrés Oxidativo , FructosaRESUMEN
Bacterial phytopathogens living on the surface or within plant tissues may experience oxidative stress because of the triggered plant defense responses. Although it has been suggested that polyamines can defend bacteria from this stress, the mechanism behind this action is not entirely understood. In this study, we investigated the effects of oxidative stress on the polyamine homeostasis of the plant pathogen Pseudomonas syringae and the functions of these compounds in bacterial stress tolerance. We demonstrated that bacteria respond to H2O2 by increasing the external levels of the polyamine putrescine while maintaining the inner concentrations of this compound as well as the analogue amine spermidine. In line with this, adding exogenous putrescine to media increased bacterial tolerance to H2O2. Deletion of arginine decarboxylase (speA) and ornithine decarboxylate (speC), prevented the synthesis of putrescine and augmented susceptibility to H2O2, whereas targeting spermidine synthesis alone through deletion of spermidine synthase (speE) increased the level of extracellular putrescine and enhanced H2O2 tolerance. Further research demonstrated that the increased tolerance of the ΔspeE mutant correlated with higher expression of H2O2-degrading catalases and enhanced outer cell membrane stability. Thus, this work demonstrates previously unrecognized connections between bacterial defense mechanisms against oxidative stress and the polyamine metabolism.
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Poliaminas , Espermidina , Poliaminas/metabolismo , Espermidina/metabolismo , Putrescina/metabolismo , Pseudomonas syringae/metabolismo , Peróxido de Hidrógeno/metabolismo , Estrés Oxidativo , Ornitina Descarboxilasa/genética , Ornitina Descarboxilasa/metabolismoRESUMEN
Ship refit and repair operations in shipyards generate aerosol emissions with high potential for environmental impacts. Metal-bearing nano-, fine and coarse particles are incidentally formed and can be released to indoor and ambient air and the aquatic environment. This work aimed to further the understanding of these impacts by characterising particle size-resolved chemical composition (15 nm - 10 µm), organophosphate esters (OPEs) content (e.g., plasticisers) and cytotoxic and genotoxic potential. Results showed that nanoparticle emissions (20-110 nm) took place in bursts, coinciding with the use of mechanical abraders and spray-painting guns. Tracers of these activities were Sc, V, Cr, Co, Ni, Cu, Rb, Nb, and Cs. Key components were V and Cu, probably sourcing from nanoadditives in the coatings. Abrasion of coatings also emitted OPEs, especially from old paints. Toxicity assessments consistently evidenced hazardous potential for the different endpoints assessed, for a number of samples. Exposures to spray-painting aerosols were linked with reduced cell viability (cytotoxicity), significant generation of reactive oxygen species (ROS), and increases in micronuclei frequency (genotoxicity). Even though spray-painting did not contribute significantly to aerosol mass or number concentrations, it was a major driver of potential health effects. Results suggest that aerosol chemical composition (e.g., content in nano-sized Cu or V) may have a larger impact on toxicity than aerosol concentration. While direct human exposures may be prevented using personal and collective protective equipment and environmental release can be minimised by enclosures and filtration systems, impacts on ambient air and the aquatic environment cannot be fully prevented. The continued use of good practices (exhaust, dilution, general ventilation systems, PPE, already in place) is encouraged to reduce inhalation exposures inside the tents. Understanding the size-resolved chemical and toxicological properties of aerosols is key to reducing human health and environmental impacts of ship refit operations in shipyards.
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Nanopartículas , Pintura , Humanos , Tamaño de la Partícula , Aerosoles/análisis , Nanopartículas/toxicidad , Nanopartículas/química , Especies Reactivas de Oxígeno , Monitoreo del Ambiente/métodosRESUMEN
Resumen Objetivo: Determinar seguridad y eficacia del marcapasos temporal mediante cable de fijación activa vía yugular y/o subclavia. Métodos: Se analizaron pacientes desde 2017 a 2021 postextracción de marcapasos dependientes de estimulación. Resultados: Se colocó estimulación temporal en 25 pacientes con una edad media de 68 ± 16 años. La media de duración de la estimulación temporal fue cinco días. No se registró mortalidad asociada a la estimulación temporal, sin embargo en un paciente se presentó desplazamiento de cable y falla de captura a los cuatro días de la colocación. Conclusiones: La estimulación temporal mediante cable de fijación activa es segura y eficaz.
Abstract Objective: To determine the efficacy and safety of temporary pacing with an active fixation lead placed trough the internal jugular vein and/or subclavian vein. Methods: We analyzed a consecutive series of 25 out of 73 patients that had a pacemaker extraction and were pacing dependent requiring temporary pacing with an active fixation lead until the new pacemaker implant, from 2017 to 2021. Results: After extraction 25 patients age 68 years ±16 years, required temporary pacing, the media for temporary pacing was 5 days. There were no mortality associated to temporary stimulation. Only one patient (4%) had a complication 4 days after the implant with capture fail due to a microdislogement requiring reintervention. Conclusion: Temporary stimulation through active fixation pacemaker lead it is safe and effective.
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Objective: To determine the efficacy and safety of temporary pacing with an active fixation lead placed trough the internal jugular vein and/or subclavian vein. Methods: We analyzed a consecutive series of 25 out of 73 patients that had a pacemaker extraction and were pacing dependent requiring temporary pacing with an active fixation lead until the new pacemaker implant, from 2017 to 2021. Results: After extraction 25 patients age 68 years ±16 years, required temporary pacing, the media for temporary pacing was 5 days. There were no mortality associated to temporary stimulation. Only one patient (4%) had a complication 4 days after the implant with capture fail due to a microdislogement requiring reintervention. Conclusion. Conclusion: Temporary stimulation through active fixation pacemaker lead it is safe and effective.
Objetivo: Determinar seguridad y eficacia del marcapasos temporal mediante cable de fijación activa vía yugular y/o subclavia. Métodos: Se analizaron pacientes desde 2017 a 2021 postextracción de marcapasos dependientes de estimulación. Resultados: Se colocó estimulación temporal en 25 pacientes con una edad media de 68 ± 16 años. La media de duración de la estimulación temporal fue cinco días. No se registró mortalidad asociada a la estimulación temporal, sin embargo en un paciente se presentó desplazamiento de cable y falla de captura a los cuatro días de la colocación. Conclusiones: La estimulación temporal mediante cable de fijación activa es segura y eficaz.
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Marcapaso Artificial , Humanos , Anciano , Estimulación Cardíaca ArtificialRESUMEN
Clinical manifestations related to hypomagnesemia and/or deficiency of vitamin D are frequent in patients with an extended course of coronavirus disease-2019 (long COVID). To evaluate hypomagnesemia and hydroxyvitamin D deficiency in patients with long COVID. A total of 125 adults with a diagnosis of long COVID were enrolled in a cross-sectional study. Participants were allocated into a risk (hypomagnesemia and hydroxyvitamin D deficiency) or control (serum magnesium and hydroxyvitamin D within normal ranges) group. Hypomagnesemia and 25-hydroxyvitamin D deficiency were defined based on serum level ≤1.8 mg/dL and <30 ng/mL, respectively. The number of clinical manifestations of long COVID were significantly higher in the risk compared to the control group. Fatigue, memory loss, attention disorders, joint pain, anxiety, sleep disorders, myalgia, and depression, all of which are related to hypomagnesemia and/or 25-hydroxyvitamin D deficiency, were among the 10 most frequent manifestations in the risk group. The adjusted odds ratio for the association between hypomagnesemia and hydroxyvitamin D deficiency during long COVID was 3.1; 95% CI 2.3-12.4, p=0.005. Our results show that patients suffering with long COVID had a deficiency in magnesium and 25-hydroxyvitamin D which correlated with the number of associated clinical manifestations.
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COVID-19 , Magnesio , Vitamina D/análogos & derivados , Adulto , Humanos , Síndrome Post Agudo de COVID-19 , Estudios Transversales , COVID-19/complicaciones , CalcifediolRESUMEN
Introducción. El tratamiento quirúrgico de las lesiones por proyectil de arma de fuego en la columna es controversial; sin embargo, el déficit neurológico es uno de los criterios para su indicación. Presentación del caso. Hombre de 21 años que ingresó al servicio de urgencias de un hospital de tercer nivel en Bogotá, Colombia, por múltiples heridas de arma de fuego, paraplejía, hipoestesia en miembros inferiores y silla de montar, e incapacidad para moverse, por lo que se realizó toracotomía y laparotomía. Ante la ausencia de fuerza muscular y reflejos, se diagnosticó lesión de la médula espinal de grado A según la American Spinal Injury Association Impairment Scale (ASIA). A las 12 horas del ingreso, se llevó al paciente a extracción quirúrgica de un proyectil (laminectomía y durotomía longitudinal) sin lograr la extracción, por lo que se utilizó fluoroscopia, en la que se observó que la bala había migrado cefálicamente al espacio intervertebral L4-L5. Se realizó laminectomía de L4-L5, exposición del saco dural y durotomía longitudinal, logrando la extracción del proyectil. A los 20 días se observó mejoría de la función motora y la fuerza muscular, contracción voluntaria de cuádriceps y grado C en ASIA.Conclusión. La extracción del proyectil en lesiones de la médula espinal se recomienda cuando hay migración de este en el canal medular. Se sugiere usar fluoroscopia antes y después de la cirugía
Introduction: Surgical treatment of spinal gunshot wounds is controversial, however, neurological deficit is one of the criteria for its indication. Case presentation: A 21-year-old man was admitted to the emergency department of a tertiary care hospital in Bogotá, Colombia, due to multiple gunshot wounds, paraplegia, hypoesthesia in the lower limbs and saddle area, and inability to move, for which thoracotomy and laparotomy were performed. Given the absence of muscle strength and reflexes, a grade A spinal cord injury was diagnosed according to the American Spinal Injury Association Impairment Scale (ASIA). Twelve hours after admission, the patient was taken to surgery for the removal of a firearm projectile (laminectomy and longitudinal durotomy) without achieving the extraction, so a fluoroscopy was carried out, in which it was observed that the bullet had migrated cephalad to the L4-L5 intervertebral space. L4-L5 laminectomy, dural sac exposure, and longitudinal durotomy were performed, leading to the removal of the projectile. After 20 days, improvement of motor function and muscle strength, voluntary contraction of quadriceps, and grade C in ASIA were reported.Conclusion: Projectile removal in spinal cord injuries is recommended when the projectile migrates into the spinal canal. Fluoroscopy is recommended before and after surgery
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Resumen ANTECEDENTES: La coexistencia de neoplasias mieloproliferativas durante el embarazo puede derivar en complicaciones para la madre y el feto, de ahí la indispensable necesidad de detectarlas oportunamente. CASO CLÍNICO: Paciente de 30 años, primigesta. En el control prenatal se detectó una elevación significativa de plaquetas y leucocitos. Luego de descartar un proceso infeccioso e interconsulta con el hematólogo se le indicó un antiagregante plaquetario. El embarazo transcurrió sin complicaciones de tipo trombótico o hemorrágico y finalizó mediante cesárea a las 40 semanas, indicada por falta de progresión del trabajo de parto. Posteriormente se inició el tratamiento específico para la enfermedad y seguimiento. METODOLOGÍA: La búsqueda de artículos publicados durante los últimos 20 años se efectuó en las bases de datos PubMed y Clínical Key con los MeSH "essential thrombocytemia AND pregnancy", "hematological neoplasms AND pregnancy". RESULTADOS: Se obtuvieron 14 artículos de los que se excluyeron 3 por no incluir a mujeres embarazadas. La revisión final fue de 11 artículos. CONCLUSIONES: El seguimiento correcto del control prenatal permite advertir las complicaciones médicas independientes del embarazo. Cuando así sucede es posible la intervención oportuna y la participación de otros especialistas que confirmen el diagnóstico para, en conjunto, tomen la mejor decisión en beneficio de la madre y su hijo por nacer.
Abstract BACKGROUND: The coexistence of myeloproliferative neoplasms during pregnancy may lead to maternal and fetal complications, and early detection is essential. CLINICAL CASE: A 30-year-old primigravida. Prenatal examination revealed a significant increase in platelets and leukocytes. After exclusion of an infectious process and consultation with the haematologist, she was prescribed an antiplatelet agent. The pregnancy proceeded without thrombotic or haemorrhagic complications and was terminated by caesarean section at 40 weeks, indicated for lack of progress in labour. Specific treatment of the disease and follow-up were then initiated. METHODOLOGY: Articles published in the last 20 years were searched in PubMed and Clinical Key databases using MeSH "essential thrombocythemia AND pregnancy", "haematological neoplasms AND pregnancy". RESULTS: We obtained 14 articles, of which 3 were excluded because they did not include pregnant women. The final review consisted of 11 articles. CONCLUSIONS: Correct follow-up of antenatal care can warn of medical complications independent of pregnancy. In this case, timely intervention and involvement of other specialists is possible to confirm the diagnosis and make the best joint decision for the benefit of the mother and her unborn child.
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BACKGROUND AND AIMS: Currently, treatments are being sought to improve the control of type II diabetes mellitus (T2DM), and inulin has been shown to be effective in reducing glucose levels and other metabolic control parameters. These effects on metabolic control may be associated with changes in the epigenetic modulation of genes of the insulin pathway. Therefore, our objective is to determine the effect of agave inulin in metabolic control parameters and in INS and IRS1 genes' methylation in T2DM patients. METHODS: This was a longitudinal experimental study with 67 Mexican participants who received an intervention of inulin agave (10 g daily) for 2 months. The methylation of the INS and IRS1 genes was determined by MSP. RESULTS: For the INS gene, we found a significant decrease in the proportions of T2DM patients with methylated DNA after inulin intervention (p = 0.0001). In contrast, the difference in the proportions of the unmethylated IRS1 gene before and after the inulin intervention was not significant (p = 0.79). On the other hand, we observed changes in the number of T2DM patients' recommended categories for metabolic control depending on the methylation of INS and IRS1 genes before and after treatment with inulin. CONCLUSION: For the first time, we report the modification in the methylation of two genes, INS and IRS1, of the insulin pathway and provide information on the possible relevant role of epigenetics as a key factor in positive changes in metabolic control parameters by inulin intake in T2DM patients.
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Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/genética , Inulina/metabolismo , Metilación , Insulina/metabolismo , México , Proteínas Sustrato del Receptor de Insulina/genética , Proteínas Sustrato del Receptor de Insulina/metabolismoRESUMEN
BACKGROUND: Neurocysticercosis (NCC) is a global public health problem. It is a complex disease to manage and a cause of great morbidity and mortality in affected patients. Conventional surgical approaches have been used for many years, but currently, minimally invasive approaches are being used with good results. The authors present a case of NCC in the anterior interhemispheric fissure that was treated with a transventricular endoscopic approach. OBSERVATIONS: A 32-year-old male patient was admitted for persistent moderate headache and dizziness. Gadolinium-enhanced magnetic resonance imaging (MRI) showed multiple parenchymal, ventricular, and subarachnoid cystic lesions, especially in the anterior interhemispheric space. A transventricular endoscopic approach was selected and applied. There were no complications during surgery. Pathological analysis confirmed the diagnosis of NCC. Control MRI demonstrated the absence of cysts in the anterior interhemispheric space. LESSONS: Minimally invasive approaches are an excellent alternative for patients with NCC, especially if a patient requires more than one surgery.
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BACKGROUND: It is well-recognized that hyperuricemia is a common abnormality among individuals with metabolic syndrome. AIMS: The objective of this study was to determine whether hyperuricemia is associated with the metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) phenotypes. METHODS: Men and women equal or greater than 18 years of age were enrolled in a cross-sectional study. Normal-weight subjects were allocated into the MONW or healthy normal-weight (HNW) groups; while obese individuals were divided into the MHO and metabolically unhealthy obese (MUO) subgroups. MONW phenotype was defined by body mass index (BMI) <25.0 kg/m2 accompanied by at least one cardiovascular risk factor (hyperglycemia, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol), and MHO phenotype was considered in obese subjects (BMI ≥30 kg/m2) without metabolic abnormalities. RESULTS: A total of 567 individuals were enrolled; of them, normal-weight subjects were allocated into the MONW (n = 101) and control (n = 72) groups, whereas obese individuals into the MHO (n = 61) and MUO (n = 333) groups. The multiple logistic regression analysis adjusted by age, gender, and body mass index revealed that hyperuricemia is significantly associated with MONW (OR = 5.14; 95% CI: 1.37-19.29) and MHO (OR = 0.34; 95% CI: 0.14-0.82) phenotypes. CONCLUSION: Results of our study showed that hyperuricemia is associated with both MONW and MHO phenotypes.