Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients.

Gender and sex differences affect women with kidney failure (KF) negatively at all stages of the disease. This study assessed gender differences in self-care, hemodialysis symptoms, and quality of life in a sample of 102 adult KF patients treated with hemodialysis, from two clinical centers in Mexico. Self-care agency, quality of life, and the symptoms related to hemodialysis were evaluated through questionnaires, and sociodemographic and laboratory variables were obtained from the clinical records. Compared to male patients, female patients reported similar self-care, lower quality of life subscales (symptoms, physical functioning, pain, and overall health), and higher prevalence and intensity of hemodialysis symptoms. There were gender differences regarding the correlation between self-care and quality of life, symptoms intensity, and symptoms prevalence. In conclusion, women with KF treated with hemodialysis perceived a higher impact of hemodialysis and reported a lower quality of life than men. Despite having a similar self-care agency, the self-care correlations with quality of life and hemodialysis symptoms appeared different between men and women treated with chronic hemodialysis. Such differences may be important in future nursing interventions to improve self-care and quality of life among KF patients.

Contributions of Latin American researchers in the understanding of the novel coronavirus outbreak: a literature review.

This article aimed to give the visibility of Latin American researchers' contributions to the comprehension of COVID-19; our method was a literature review. Currently, the world is facing a health and socioeconomic crisis caused by the novel coronavirus, SARS-CoV-2, and its disease COVID-19. Therefore, in less than 4 months, researchers have published a significant number of articles related to this novel virus. For instance, a search focused on the Scopus database on 10 April 2020, showed 1,224 documents published by authors with 1,797 affiliations from 80 countries. A total of 25.4%, 24.0% and 12.6% of these national affiliations were from China, Europe and the USA, respectively, making these regions leaders in COVID-19 research. In the case of Latin America, on 10 April 2020, we searched different databases, such as Scopus, PubMed and Web of Science, finding that the contribution of this region was 2.7 ± 0.6% of the total publications found. In other words, we found 153 publications related to COVID-19 with at least one Latin American researcher. We summarized and processed the information from these 153 publications, finding active participation in topics like medical, social and environmental considerations, bioinformatics and epidemiology.

Admission hyperglycemia and radiological findings of SARS-CoV2 in patients with and without diabetes.

Diabetes emerged as major risk factor for severe acute respiratory syndrome (SARS) and adverse outcome in patients with the coronavirus disease 2019 (COVID-19). Nevertheless, the role of admission hyperglycemia in patients with COVID-19 has not been well-explored, yet. With this retrospective analysis, we report for the first time that hyperglycemia on day-1 is the best predictor of radiographic imaging of SARS-CoV2, regardless of the past medical history of diabetes. Admission hyperglycemia should not be overlooked, but adequately treated to improve the outcomes of COVID-19 patients with our without diabetes.

Abdominoplasty in Hemodialysis Patients Before Transplant.

Morbid obesity in patients with chronic kidney disease is a contraindication for inclusion on the kidney transplant waitlist.Despite intentional weightloss,the persistence of the abdominal adipose panniculus poses postoperative risks, such as infection of the surgical site and seromas. We describe 2 cases of patients on hemodialysis who had a body mass index greater than 35 kg/m² who underwent abdominoplasty before transplant without perioperative complications. One patient received a living-related kidney transplant (donor was the brother) without complications.

Clostridium butyricum population balance model: Predicting dynamic metabolic flux distributions using an objective function related to extracellular glycerol content.

BACKGROUND: Extensive experimentation has been conducted to increment 1,3-propanediol (PDO) production using Clostridium butyricum cultures in glycerol, but computational predictions are limited. Previously, we reconstructed the genome-scale metabolic (GSM) model iCbu641, the first such model of a PDO-producing Clostridium strain, which was validated at steady state using flux balance analysis (FBA). However, the prediction ability of FBA is limited for batch and fed-batch cultures, which are the most often employed industrial processes. RESULTS: We used the iCbu641 GSM model to develop a dynamic flux balance analysis (DFBA) approach to predict the PDO production of the Colombian strain Clostridium sp IBUN 158B. First, we compared the predictions of the dynamic optimization approach (DOA), static optimization approach (SOA), and direct approach (DA). We found no differences between approaches, but the DOA simulation duration was nearly 5000 times that of the SOA and DA simulations. Experimental results at glycerol limitation and glycerol excess allowed for validating dynamic predictions of growth, glycerol consumption, and PDO formation. These results indicated a 4.4% error in PDO prediction and therefore validated the previously proposed objective functions. We performed two global sensitivity analyses, finding that the kinetic input parameters of glycerol uptake flux had the most significant effect on PDO predictions. The other input parameters evaluated during global sensitivity analysis were biomass composition (precursors and macromolecules), death constants, and the kinetic parameters of acetic acid secretion flux. These last input parameters, all obtained from other Clostridium butyricum cultures, were used to develop a population balance model (PBM). Finally, we simulated fed-batch cultures, predicting a final PDO production near to 66 g/L, almost three times the PDO predicted in the best batch culture. CONCLUSIONS: We developed and validated a dynamic approach to predict PDO production using the iCbu641 GSM model and the previously proposed objective functions. This validated approach was used to propose a population model and then an increment in predictions of PDO production through fed-batch cultures. Therefore, this dynamic model could predict different scenarios, including its integration into downstream processes to predict technical-economic feasibilities and reducing the time and costs associated with experimentation.

Latency and amplitude changes in cognitive event related potentials due to hemodialysis.

Chronic kidney disease impacts the cognitive abilities of patients, and yet few works have analyzed functional electroencephalographic changes on event-related potentials before and after an hemodialysis session. This work shows that, as a consequence of hemodialysis, cognitive potential waveforms suffer changes, occurring with reduced latency $( \sim 50$ ms) and with larger amplitude $( \sim 0.128\mathrm {a}$.u.) after the treatment session. While only a limited sample of five patients is reported herein, the observed changes immediately after hemodialysis could be a sign of central nervous system alterations that are not clinically evaluated. Signs like these could entail an early indicator of possible evolution into some neuropathology.

Gut microbiome modulation during treatment of mucositis with the dairy bacterium Lactococcus lactis and recombinant strain secreting human antimicrobial PAP.

Mucositis is an inflammatory condition of the gut, caused by an adverse effect of chemotherapy drugs, such as 5-fluorouracil (5-FU). In an attempt to develop alternative treatments for the disease, several research groups have proposed the use of probiotics, in particular, Lactic Acid Bacteria (LAB). In this context, the use of recombinant LAB, for delivering anti-inflammatory compounds has also been explored. In previous work, we demonstrated that either Lactococcus lactis NZ9000 or a recombinant strain expressing an antimicrobial peptide involved in human gut homeostasis, the Pancreatitis-associated Protein (PAP), could ameliorate 5-FU-induced mucositis in mice. However, the impact of these strains on the gut microbiota still needs to be elucidated. Therefore, in the present study, we aimed to characterize the effects of both Lactococci strains in the gut microbiome of mice through a 16 S rRNA gene sequencing metagenomic approach. Our data show 5-FU caused a significant decrease in protective bacteria and increase of several bacteria associated with pro-inflammatory traits. The Lactococci strains were shown to reduce several potential opportunistic microbes, while PAP delivery was able to suppress the growth of Enterobacteriaceae during inflammation. We conclude the strain secreting antimicrobial PAP was more effective in the control of 5-FU-dysbiosis.

Development of a Chlamydomonas reinhardtii metabolic network dynamic model to describe distinct phenotypes occurring at different CO2 levels.

The increase in atmospheric CO2 due to anthropogenic activities is generating climate change, which has resulted in a subsequent rise in global temperatures with severe environmental impacts. Biological mitigation has been considered as an alternative for environmental remediation and reduction of greenhouse gases in the atmosphere. In fact, the use of easily adapted photosynthetic organisms able to fix CO2 with low-cost operation is revealing its high potential for industry. Among those organism, the algae Chlamydomonas reinhardtii have gain special attention as a model organism for studying CO2 fixation, biomass accumulation and bioenergy production upon exposure to several environmental conditions. In the present study, we studied the Chlamydomonas response to different CO2 levels by comparing metabolomics and transcriptomics data with the predicted results from our new-improved genomic-scale metabolic model. For this, we used in silico methods at steady dynamic state varying the levels of CO2. Our main goal was to improve our capacity for predicting metabolic routes involved in biomass accumulation. The improved genomic-scale metabolic model presented in this study was shown to be phenotypically accurate, predictive, and a significant improvement over previously reported models. Our model consists of 3726 reactions and 2436 metabolites, and lacks any thermodynamically infeasible cycles. It was shown to be highly sensitive to environmental changes under both steady-state and dynamic conditions. As additional constraints, our dynamic model involved kinetic parameters associated with substrate consumption at different growth conditions (i.e., low CO2-heterotrophic and high CO2-mixotrophic). Our results suggest that cells growing at high CO2 (i.e., photoautotrophic and mixotrophic conditions) have an increased capability for biomass production. In addition, we have observed that ATP production also seems to be an important limiting factor for growth under the conditions tested. Our experimental data (metabolomics and transcriptomics) and the results predicted by our model clearly suggest a differential behavior between low CO2-heterotrophic and high CO2-mixotrophic growth conditions. The data presented in the current study contributes to better dissect the biological response of C. reinhardtii, as a dynamic entity, to environmental and genetic changes. These findings are of great interest given the biotechnological potential of this microalga for CO2 fixation, biomass accumulation, and bioenergy production.

Clostridium butyricum maximizes growth while minimizing enzyme usage and ATP production: metabolic flux distribution of a strain cultured in glycerol.

BACKGROUND: The increase in glycerol obtained as a byproduct of biodiesel has encouraged the production of new industrial products, such as 1,3-propanediol (PDO), using biotechnological transformation via bacteria like Clostridium butyricum. However, despite the increasing role of Clostridium butyricum as a bio-production platform, its metabolism remains poorly modeled. RESULTS: We reconstructed iCbu641, the first genome-scale metabolic (GSM) model of a PDO producer Clostridium strain, which included 641 genes, 365 enzymes, 891 reactions, and 701 metabolites. We found an enzyme expression prediction of nearly 84% after comparison of proteomic data with flux distribution estimation using flux balance analysis (FBA). The remaining 16% corresponded to enzymes directionally coupled to growth, according to flux coupling findings (FCF). The fermentation data validation also revealed different phenotype states that depended on culture media conditions; for example, Clostridium maximizes its biomass yield per enzyme usage under glycerol limitation. By contrast, under glycerol excess conditions, Clostridium grows sub-optimally, maximizing biomass yield while minimizing both enzyme usage and ATP production. We further evaluated perturbations in the GSM model through enzyme deletions and variations in biomass composition. The GSM predictions showed no significant increase in PDO production, suggesting a robustness to perturbations in the GSM model. We used the experimental results to predict that co-fermentation was a better alternative than iCbu641 perturbations for improving PDO yields. CONCLUSIONS: The agreement between the predicted and experimental values allows the use of the GSM model constructed for the PDO-producing Clostridium strain to propose new scenarios for PDO production, such as dynamic simulations, thereby reducing the time and costs associated with experimentation.

Brief cognitive behavioural intervention for depression and anxiety symptoms improves quality of life in chronic haemodialysis patients.

OBJECTIVES: Psychological treatment of depression in end-stage renal disease (ESRD) has focused on severely depressed patients. We designed and tested a brief (5 weeks) cognitive behavioural intervention (CBI) to reduce mild and moderate depression and anxiety symptoms in patients with ESRD. DESIGN: For the purpose of this study, a single-blind, randomized controlled design was used to compare patients with ESRD under haemodialysis treatment with and without the CBI. METHODS: Depression and anxiety symptoms were screened in 152 subjects (18-60 years old, 84 male). Sixty participants (age 41.8 ± 14.7, 29 males) with mild or moderate scores of depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) were randomly assigned to CBI or the control group. CBI techniques consisted of positive self-reinforcement, deep breathing, muscle relaxation, and cognitive restructuring. Depression, anxiety, quality of life (QoL), and cognitive distortion scores were evaluated at baseline, after 5 weeks (end of treatment) and after 4-week follow-up. All scores were compared by ANOVA for repeated measures with post-hoc tests adjusted by Bonferroni's method (p < .05 was considered significant). RESULTS: At follow-up, depression, anxiety, and cognitive distortions had decreased, and QoL had increased in the intervention group, and there were no changes in the control group. Clinical utility was 33% for depression and 43% for anxiety. CONCLUSIONS: A brief CBI of 5 weeks is effective for decreasing mild or moderate depression and anxiety symptoms and improving QoL in ESRD haemodialysis patients. PRACTITIONER POINTS: A brief, systematic and structured cognitive behavioural intervention (CBI) decreases anxiety and depression symptoms and improves quality of life in patients with end-stage renal disease (ESRD) who are being treated with haemodialysis. These benefits are not achieved when anxiety and depression symptoms are identified but not treated psychologically. This CBI consisted of cognitive restructuring of the distorted thoughts (perfectionism, catastrophic thinking, negative self-labelling, and dichotomous thinking) that are correlated with depression and anxiety symptoms and that can be assessed by a validated questionnaire designed for patients with ESRD. The handbooks that were developed for this study are structured and systematic. They could be valuable in supporting the efforts and participation of non-specialized health professionals in CBI such as nurses, physicians, social workers, and psychologists, raising the possibility of further application in a variety of clinical populations. Both the therapy and the client workbooks are available in Spanish upon request.

Investing in a surgical outcomes auditing system.

Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care.

A comparative study of facial asymmetry in philippine, colombian, and ethiopian families with nonsyndromic cleft lip palate.

Objective. To compare the asymmetry displayed by Philippine, Colombian, and Ethiopian unaffected parents of patients with nonsyndromic cleft palate (NSCLP) and a control population. Methods. Facial measurements were compared between unaffected parents of NSCLP patients and those in the control group for three populations from South America, Asia, and Africa by anthropometric and photographic measurements. Fluctuating and directional asymmetries, height and width proportions, were analyzed and compared. Results. Fluctuating asymmetries (ear length, middle line to Zigion perpendicular for left and right sides) and variations in the facial thirds demonstrated statistical significance in the study group of unaffected parents from Colombia and Philippines, while increased interorbital distance was evident in the unaffected Ethiopian parents of NSCLP patients. Conclusions. The facial differences in unaffected parents could indicate an underlying genetic liability. Identification of these differences has relevance in the understanding of the etiology of NSCLP.

Desarrollo y validación de un instrumento para la evaluación de distorsiones cognitivas en pacientes con insuficiencia renal crónica terminal / Development and validation of a questionnaire for the assessment of cognitive distortions among Mexican patients with end-stage renal disease

Background Psychological disturbances are common in patients with chronic renal failure (CRF). From the cognitive-behavioral theoretical perspective, they may be due largely to specific cognitive distortions (CD) that are likely to be modified by brief interventions. The aim of this study was to develop and validate an instrument for evaluation of specific CD among patients with CRF. Method A questionnaire with an encouraging phrase for each of five categories of CD (catastrophizing, dichotomous thinking, outside self-worth, negative self-labeling, and perfectionism) was developed. This was applied to 21 patients with CRF (11 women and 10 men). Based on the technique of natural semantic networks, a set of responses (defining words) with greater semantic weight to each sentence stimulus (core network) were identified and a pilot instrument was developed. This one was applied along with Beck's inventories of anxiety and depression among 255 patients with CRF (118 women, 137 men) attended in four different hospitals. Results The pilot questionnaire was composed of 46 items with greater semantic weight between 343 original defining words. Sixteen items were discarded for lack of ability to discriminate (1), low internal reliability (8) and duplicated in more than one factor (7). The final instrument of 30 items had an internal consistency of 0.93 for the total scale and more than 0.75 in all subscales. The five factors correlated positively and significantly with each other and with symptoms of anxiety and depression. Conclusions The instrument that is presented is a valid and reliable measure to assess five CD associated with depression and anxiety in Mexican patients with CRF. It is suggested as a useful tool for the design and evaluation of cognitive behavioral interventions for depression and anxiety among patients with CRF.

Antecedentes Las alteraciones psicológicas son frecuentes en los pacientes con insuficiencia renal crónica terminal (IRC). Desde la perspectiva teórica cognitivo-conductual, éstas pueden deberse en gran medida a distorsiones cognitivas específicas (DC), que son susceptibles de ser modificadas mediante intervenciones breves. El objetivo del presente estudio fue desarrollar y validar un instrumento de evaluación de las DC de pacientes con IRC. Método Se integró un cuestionario con una frase estímulo para cada una de cinco categorías de DC: catastrofismo, pensamiento dicotómico, autovalorización externa, autoetiquetización negativa y perfeccionismo. Éste se aplicó a 21 pacientes con IRC (11 mujeres y 10 hombres). Con base en la técnica de redes semánticas naturales, se identificó el conjunto de respuestas (palabras definidoras) con mayor peso semántico para cada frase estímulo (núcleo de la red), con las que se construyó el instrumento piloto. Éste se aplicó junto con los Inventarios de Ansiedad y Depresión de Beck a 255 pacientes con IRC (118 mujeres, 137 hombres) de cuatro centros hospitalarios. Resultados El cuestionario piloto se integró con 46 reactivos con mayor peso semántico de entre 343 palabras definidoras originales. Se descartaron 16 reactivos por falta de capacidad de discriminación (1), baja confiabilidad interna (8) y duplicidad en más de un factor (7). El instrumento final de 30 reactivos tuvo una consistencia interna de 0.93 para el total y mayor a 0.75 en todas las subescalas. Los cinco factores se correlacionaron positiva y significativamente entre sí y con los síntomas de ansiedad y depresión. Conclusiones El instrumento que se presenta es una medida válida y confiable para evaluar cinco DC asociadas con depresión y ansiedad en pacientes mexicanos con IRC. La medida se sugiere útil para el diseño y valoración de intervenciones cognitivo-conductuales para la depresión y ansiedad de los pacientes con IRC.

A Cross-sectional Comparison of Cleft Lip Severity in 3 Regional Populations.

OBJECTIVE: The purpose of this cross-sectional study was to compare the severity of unilateral cleft lips in populations of Asia, Sub-Saharan Africa, and Northern Africa and the Middle East. We hypothesize that severity of unilateral cleft lips shows significant variation between these populations. METHODS: Medical photographs of 780 patients with primary unilateral cleft lips treated by Operation Smile during November 2007 were reviewed. Photographs of 352 patients from Asia (China, Philippines, Vietnam, Laos, and Cambodia), 112 patients from the Middle East and North Africa (Jordan, Egypt, and Morocco), and 316 patients from Sub-Saharan Africa (Ethiopia, Kenya, and Madagascar) were analyzed. The severity of cleft lips was determined using the Fisher method, which measures the columellar angle as a deviation of the columella from its normal vertical position. The angle was measured using a protractor with its base positioned along a line joining the lateral canthi. An analysis of variance calculated statistical differences between each region and their respective countries. RESULTS: The Asian region was found to have the greatest severity of unilateral cleft lip deformity (P < .05). Analysis-of-variance tests show a significant difference between Asia and other regions studied. When stratifying the data by country, the Philippines and Vietnam showed the highest severity. CONCLUSIONS: The results suggest a heterogeneous pattern of global severity. Unilateral cleft lips with the highest severity were predominant in the Asian region. The observed phenotypical differences can be used in future studies of gene variability or environmental factors to determine the cause of this significant disparity.

Surgical outcomes auditing systems in humanitarian organizations.

BACKGROUND: Operation Smile is a humanitarian volunteer-based organization that provides cleft care around the world. Successful primary surgery is the key to improving the quality of life of patients with oral clefts. A cleft surgery outcomes database and evaluation system has been developed and implemented. METHODS: During Operation Smile's "World Journey of Smiles" in November 2007, a total of 4100 patients were operated on during a 10-day period at 40 simultaneous missions in 25 countries. Photographs taken before surgery, right after surgery, and at the follow-up consultations were entered in a database and used as media to evaluate surgical outcomes objectively by independent unbiased evaluators. Data about complications collected during the postoperative consultations were also entered. RESULTS: A postoperative consultation, 6 months to 1 year after surgery was conducted at 24 sites, 19 of which sent back postoperative images; and most returned postoperative examination forms. At those 19 sites, 703 of 1917 patients returned for a 6- to 9-month postoperative visit, for a 36.67% return rate. After matching before and after pictures, 562 patients were able to be entered into the database, allowing 580 procedures to be evaluated. Feedback reports have been sent to 134 volunteer surgeons around the world. Results were compared among sites and locations; and the places where future actions were needed to improve the quality of surgery were identified. CONCLUSIONS: The current outcomes evaluation system has proven beneficial in tracking patient outcomes, auditing surgical performance, and providing feedback to surgeons and other team members. Challenges are discussed.

Lobomycosis in man and lobomycosis-like disease in bottlenose dolphin, Venezuela.

We report 1 case of lobomycosis caused by Lacazia loboi in a fisherman and 1 case of lobomycosis-like disease in a bottlenose dolphin (Tursiops truncatus) along the coast of Venezuela. These findings suggest that the marine environment is a likely habitat for L. loboi and a reservoir for infection.

Síndrome metabólico en adolescentes con sobrepeso y obesidad / Metabolic syndrome in overweight and obese adolescents

Objetivo: Conocer y cuantificar la presencia de síndrome metabólico en una población adolescente que presenta sobrepeso y obesidad. Diseño: Estudio clínico. Lugar: Servicio de Endocrinología. Hospital Nacional Dos de Mayo. Participantes: Adolescentes. Intervenciones: Se estudió una muestra de 195 adolescentes comprendidos entre los 10 a 19 años. El criterio de inclusión fue que presentasen sobrepeso u obesidad, de acuerdo al índice de masa corporal (IMC). Para ello, se hizo uso de la población de referencia de Must y col, con los siguientes criterios diagnósticos: de 85 a 95 percentil, sobrepeso; y mayor del 95 percentil, obesos. El peso, la talla y la circunferencia de la cintura (CC) fueron tomados siguiendo las recomendaciones internacionales. El síndrome metabólico fue definido mediante la recomendación de Cook (triglicéridos mayor que 110, colesterol HDL menor que 40 mg/dL, glicemia mayor que 110 mg/dL y CC menor que 90 percentil), la presencia de tres o más de estos criterios indicó síndrome metabólico. Principales medidas de resultados: Síndrome metabólico, sobrepeso, obesidad. Resultados: En 8,8 por ciento de la muestra estudiada existió la presencia de síndrome metabólico. Los obesos presentaron mayor prevalencia de síndrome metabólico que los con sobrepeso (22,9 y 3 por ciento, respectivamente); el género masculino (24,1 por ciento) más que el femenino (2,9 por ciento). Los de 15 años y más tuvieron un 9,7 por ciento, con relación a los menores, 7,4 por ciento. Conforme se incrementaba la CC, la presencia de síndrome metabólico fue mayor. Conclusiones: El síndrome metabólico se encuentra presente en la población adolescente, si bien con prevalencias bajas, pero que están íntimamente relacionadas al estado nutricional (sobrepeso y obesidad). La tendencia de estas alteraciones nutricionales es a incrementarse y como consecuencia mucho más adolescentes presentaran el síndrome metabólico, lo que lleva implícito un riesgo para su salud.

Objective: To determine the presence of metabolic syndrome in overweight and obese adolescent population. Design: Clinical study. Setting: Endocrinology service. Hospital Nacional Dos de Mayo. Participants: Adolescents. Interventions: We studied 195 adolescents between 10 to 19 year-old. Inclusion criteria was that they should be overweight or obese. We used the reference population of Must et al. with the following diagnosis criteria: 85 to 95 percentile, overweight; higher than 95 percentile, obese. Weight, height and waist circumference (WC) were taken following international recommendations. Metabolic syndrome determination followed Cook recommendations (TG major 110, cholesterol HDL minor 40 mg/dL, glycemia mayor 110 mg/dL y WC major 90 percentile), the presence of three or more of these criteria indicated metabolic syndrome. Main outcome measures: Setabolic syndrome, overweight, obesity. Results: Metabolic syndrome was present in 8,8 por cent of the studied population. Those with obesity presented a higher prevalence of metabolic syndrome than those overweight (22,9 and 3 por cent, respectively). It occurred more in the male gender (24,1 por cent) than in the female (2,9 por cent) and in those 15 year-old and over, 9,7 por cent compared with the other younger group, 7,4 por cent. As WC increased, metabolic syndrome also increased. Conclusions: Metabolic syndrome is present in the adolescent population, although with low prevalence, but intimately related to nutritional status (overweight and obesity). Tendency of these nutritional alterations is to increase and as a consequence more and more adolescents will have metabolic syndrome that implies health risk.

Association of MSX1 with nonsyndromic cleft lip and palate in a Colombian population.

OBJECTIVE: To evaluate the association between MSX1 CA polymorphism and nonsyndromic cleft lip with or without cleft palate (CL+/-P) in a group of patients from Operation Smile Colombia. DESIGN: Four alleles from MSX1 CA microsatellite sequence were analyzed. Polymerase chain reaction was carried out. The amplifications were performed by Short Tandem Repeats (STRs) in ABI PRISM 310 genetic analyzer. Chi-square and odds ratio tests were used to determine the association between genotype frequencies and the risk to the cleft lip/palate in a Colombian group population. SETTING: Operation Smile Colombia. PARTICIPANTS: Ninety-four affected patients (49 men and 45 women with CL+/-P) and 93 control individuals (43 men and 50 women). RESULTS: A significant statistical difference (p<.0106) was found between the patients who carried allele 3 and CL+/-P. In addition, allele 4 (heterozygous and homozygous form) was the most frequent in CL+/-P (74%) patients and in the control group (82%). CONCLUSIONS: These findings show a positive association between the MSX1 CA polymorphism and CL+/-P in a Colombian group population.