Brain-derived neurotrophic factor is expressed in rat and human placenta and its serum levels are similarly regulated throughout pregnancy in both species.

OBJECTIVE: Pregnancy is characterized by several metabolic changes that promote fat gain and later onset of insulin resistance. As Brain-derived neurotrophic factor (BDNF) decreases hyperglycaemia and hyperphagia, we aimed to investigate the potential role of placental and circulating BDNF levels in these pregnancy-related metabolic changes in rats and humans. DESIGN AND METHODS: We identified the mRNA and protein expression of placental BDNF and its receptor TrkB using real-time PCR, Western blot and immunohistochemical approaches in both rat and humans. Serum BDNF was measured by ELISA. We also did a longitudinal prospective cohort study in 42 pregnant women to assess BDNF levels and correlations with other metabolic parameters. RESULTS: We found that BDNF and TrkB are expressed in both rat and human placenta. In rat, both placental mRNA and serum levels are increased throughout pregnancy, whereas their protein levels are significantly decreased at the end of gestation. Serum BDNF levels in pregnant women are significantly lower in the first trimester when compared to the second and third trimester (P < 0·0148, P < 0·0012, respectively). Serum BDNF levels were negatively correlated with gestational age at birth and fasting glucose levels. CONCLUSION: Our findings suggest that both BDNF and its receptor TrkB are expressed in rodent and human placenta being regulated during pregnancy. Taken together, these findings support a role of BDNF in the regulation of several metabolic functions during pregnancy.

Tratamiento empírico de la enfermedad ácido-péptica / Empirical treatment of peptic acid disease

La enfermedad acido-péptica (EAP), comprende dos grandes grupos de enfermedades, enfermedad por reflujo gastroesofágico (ERGE) y dispepsia. En la práctica primaria el médico desconoce como debe enfocar éste grupo de pacientes y con frecuencia utiliza de manera indiscriminada la prueba terapéutica, sin tener en cuenta la alta prevalencia que existe en nuestro país de cáncer gástrico y la forma en que éstas medicaciones pueden interferir en los hallazgos endoscópicos de los pacientes. Objetivo: Estimar la prevalencia con la cual se formula la prueba terapéutica con inhibidores de la secreción ácida en los pacientes con EAP, específicamente aquellos con dispepsia y reflujo gastroesofágico, y la forma en que éstos medicamentos interfieren en los hallazgos endoscópicos. Materiales y Métodos: Se trata de un estudio de prevalencia analítico «o cross/seccional¼, en el cual se incluyeron pacientes enviados al servicio de gastroenterología para endoscópias de vías digestivas altas (EVDA) cuya indicación fuera exclusivamente EAP. Una vez el paciente ingresaba al servicio de gastroenterología era entrevistado por una enfermera la cual llenaba un formulario que contenía los siguientes datos: identificación, síntomas gastrointestinales y consumo de drogas para la EAP. Los pacientes que venían recibiendo tratamíento continuo por más de 4 semanas se incluyeron en el grupo I, y los que no recibían tratamiento se incluyeron en el grupo II, el resto eran excluidos. Posteriormente se realizó la endoscopia y se analizaron los dos grupos de acuerdo a los hallazgos endoscopicos. Resultados: En total fueron evaluados 609 pacientes con un promedio de edad de 49 años, 58% de sexo femenino. El tratamiento empírico o prueba terapéutica fue utilizado en 43% de los pacientes (grupo I). No se encontraron diferencias significativas en las principales características de los dos grupos con respecto a edad o sexo.

Empiric treatment in acid peptic disease (dyspepsiaand gerd): prevalence, endoscopic findings and impact in the clinical evolution. Carlos Lleras hospital-ISS. The acid peptic disease (APD) includes two big groups of diseases, dyspepsia and gastroesophageal reflux. In the non-specialized clinical practice, the physician ignores the way to treat these patients, and usually uses in an indiscriminate way the empiric therapy, without keepingin mind the high prevalence of gastric cancer in our country and the way these medications can interfere in the endoscopic findings of the patients. Objective: To estimate the prevalence of the empiric therapy prescription with acid secretion inhibitors in patients with APD (dyspepsia and gastroesophageal reflux)and the way interfere with the endoscopic findings. Materials and Methods: It is a study of prevalence or cross/sectional study. It included patients that were sent to the gastroenterology service for endoscopy, with the exclusive indication of APD. All the patients were interviewed by a nurse who filled out a form with the following information: identification, gastrointestinal symptoms and medications given for the APD. The patients who received continuous treatment for more than 4 weeks were included in group I and the ones who did not received any treatment were included in group II, the rest were excluded. All the patients went through an endoscopy and then the groups were analyzed according to the endoscopic findings. Results: The total of evaluated patients were 609 with a mean age of 49.5 years, 57.8% were females. The empiric treatment was used in 42.6% of the patients (group I). There were not significant differences in the main characteristics of the two groups, with regard to age and sex. 42.1% of the patients without treatment had structural findings at the endoscopy, against 24.1% of the patients.