Metabolomic Profile of Insulin Resistance Women with Systemic Lupus Erythematosus.

The aims of this study were in systemic lupus erythematosus (SLE) patients: 1) to compare the metabolomic profile of insulin resistance (IR) with controls and 2) to correlate the metabolomic profile with other IR surrogates and SLE disease variables and vitamin levels. In this cross-sectional study, serum samples were collected from women with SLE (n=64) and gender- and age-matched controls (n=71), which were not diabetic. Serum metabolomic profiling was performed using UPLC-MS-MS (Quantse score). HOMA and QUICKI were carried out. Serum 25(OH)D concentrations were measured by chemiluminescent immunoassay. In women with SLE, the metabolomic Quantose score significantly correlated with HOMA-IR, HOMA2-IR, and QUICKI. Although concentrations of IR metabolites were not different between SLE patients and controls, fasting plasma insulin levels were higher and insulin sensitivity lower in SLE women. Interestingly, the Quantose IR score was significantly correlated with complement C3 levels (r=0.7; p=0.001). 25 (OH)D did not correlate with any metabolite or the Quantose IR index. Quantose IR may be a useful tool for IR assessment. There was a possible correlation between the metabolomic profile and complement C3 levels. The implementation of this metabolic strategy may help develop biochemical insight into metabolic disorders in SLE.

RNA transcript response by an Acidithiobacillus spp. mixed culture reveals adaptations to growth on arsenopyrite.

Biooxidation of gold-bearing refractory mineral ores such as arsenopyrite (FeAsS) in stirred tanks produces solutions containing highly toxic arsenic concentrations. In this study, ferrous iron and inorganic sulfur-oxidizing Acidithiobacillus strain IBUN Ppt12 most similar to Acidithiobacillus ferrianus and inorganic sulfur compound oxidizing Acidithiobacillus sp. IBUNS3 were grown in co-culture during biooxidation of refractory FeAsS. Total RNA was extracted and sequenced from the planktonic cells to reveal genes with different transcript counts involved in the response to FeAsS containing medium. The co-culture's response to arsenic release during biooxidation included the ars operon genes that were independently regulated according to the arsenopyrite concentration. Additionally, increased mRNA transcript counts were identified for transmembrane ion transport proteins, stress response mechanisms, accumulation of inorganic polyphosphates, urea catabolic processes, and tryptophan biosynthesis. Acidithiobacillus spp. RNA transcripts also included those encoding the Rus and PetI proteins involved in ferrous iron oxidation and gene clusters annotated as encoding inorganic sulfur compound metabolism enzymes. Finally, mRNA counts of genes related to DNA methylation, management of oxidative stress, chemotaxis, and motility during biooxidation were decreased compared to cells growing without mineral. The results provide insights into the adaptation of Acidithiobacillus spp. to growth during biooxidation of arsenic-bearing sulfides.

Benign recurrent subcutaneous emphysema of the upper limbs in a teenager / Enfisema subcutáneo benigno recurrente de las extremidades superiores en una adolescente

Background: The physiological properties of the interstitial subcutaneous tissue of the limbs could bring the abnormal distribution of air coming from superficial trauma of the skin. We present the case of a young woman who developed subcutaneous emphysema after a superficial trauma and discussed the differential diagnosis and treatment. Clinical case: A teenager woman 13 years old had subcutaneous emphysema in the left arm, following the scratch produced by her cat, of two months of evolution, without signs suggestive of local or systemic infection, it was resolved spontaneously during the period of observation. During this period she also presented subcutaneous emphysema in the right arm as a complication of a peripheral venous access performed for the administration of parenteral solutions, in the same way, it resolved spontaneously within a few days. Conclusion: Benign subcutaneous emphysema is a rare clinical condition which should be considered only after the exclusion of other pathologies that require a more aggressive early medical intervention, such as necrotizing fasciitis, which, if not detected in a timely manner, could endanger life.

Introducción: las propiedades fisiológicas del tejido celular subcutáneo de las extremidades pudieran favorecer la distribución anormal de aire proveniente de traumatismos superficiales de la piel. Presentamos el caso de una joven mujer quien desarrolló enfisema subcutáneo posterior a traumatismos superficiales y discutimos el diagnóstico diferencial y tratamiento. Caso clínico: mujer de 13 años, con signos de enfisema subcutáneo en el brazo izquierdo, posterior al rasguño producido por su gato, de dos meses de evolución, sin signos sugestivos de infección local o sistémica, el cual remitió en forma espontánea durante el periodo de observación. Durante este lapso también presentó enfisema subcutáneo en el brazo derecho, como complicación de un acceso venoso periférico realizado para la administración de soluciones parenterales, igualmente remitió espontáneamente a los pocos días. Conclusión: el enfisema subcutáneo benigno es una condición clínica rara, debe considerarse únicamente después de la exclusión de otras patologías que requieren de una intervención médica temprana más agresiva como en la fascitis necrotizante, la cual de no ser detectada oportunamente pudiera poner en peligro la vida.

[Serum levels of vitamin D in systemic lupus erythematosus patients (SLE) and their relationship with disease activity: longitudinal study]. / Niveles séricos de vitamina D en pacientes con lupus eritematoso sistémico (LES) y su asociación con la actividad de la enfermedad: estudio longitudinal.

OBJECTIVE: To determine changes over time of serum levels of 25-hydroxy vitamin D (25(OH)D) in Mexican patients with SLE and their relationship with disease activity. MATERIALS AND METHODS: Longitudinal and observational study. Women with SLE were included. Serum levels of 25(OH)D were measured at baseline and after two years; the disease activity was measured with MEX-SLEDAI. Patients with initial suboptimal levels of 25(OH)D received supplements or increased doses of calcitriol. RESULTS: 105 women with SLE were included, mean age 49.4 ± 11 years. Serum levels of 25(OH)D were higher at two years (baseline 20 ± 6.8 vs. follow-up 22.7 ± 7.7; p = < 0.001). There were no differences between disease activity scores at baseline and two years (baseline 1.7 ± 1.9 vs. follow-up 1.1 ± 1.7; p = 0.7). Serum levels of 25(OH)D did not correlate with disease activity during the follow up, p = 0.7. No correlation was found between changes in MEX-SLEDAI scores and serum levels of 25(OH)D, p = 0.87. CONCLUSION: Mexican women with SLE had increased serum levels of 25(OH)D. No correlation between serum levels of 25(OH)D and disease activity was found.

Biooxidación de concentrados de arsenopirita por Acidithiobacillus ferrooxidans en erlenmeyer agitados / Biooxidation of arsenopyrite concentrates by Acidithiobacillus ferrooxidans in shake flasks

Se evaluó el proceso de biooxidación de concentrados de arsenopirita por A. ferrooxidans ATCC 23270, previa adaptación de los microorganismos al mineral y dos tamaños de partícula, pasante malla Tyler 200 (~75μm) y 325 (~45μm). También, se determinó el grado de concentración del mineral mediante DRX y MOLPP/LR, bajo norma ASTM D 2799 de 2009. Los microorganismos fueron adaptados mediante disminución gradual, en etapas sucesivas, de sulfato ferroso y posterior aumento en el contenido de arsenopirita. Finalmente, se llevó a cabo el proceso de biooxidación del mineral sin adición de Fe2+. Después de treinta días de proceso, la disolución de arsénico para la malla Tyler 200 fue de 7550 mgL-1 (18,7%) y para la malla Tyler 325 fue de 2850 mgL-1 (7,1%). Por otra parte, la curva de crecimiento bacteriano mostró que entre los días 6 y 21 de proceso la población bacteriana promedio fue de 1,70x108 cel.mL-1 y de 8,00x107 cel.mL-1 para las mallas Tyler 200 y 325, respectivamente.Por lo tanto, el tamaño de partícula jugó un papel fundamental en la cinética de adaptación de los microorganismos, sugiriendo que a menor tamaño del sustrato empleado mayor dificultad se le presenta al microorganismo para oxidar el mineral.

Arsenopyrite biooxidation process was evaluated with A. ferrooxidans ATCC 23270. The microorganisms were previously adapted to mineral and two different Tyler mesh sizes, 200 (~75μm) and 325 (~45μm). Also, the mineral concentration was made by DRX and MOLPP/LR under ASTM D 2799. The microorganisms were adapted through gradual decreasing of ferrous sulphate in successive state and subsequent arsenopyrite concentration increase. Finally, biooxidation process was carried out without Fe2+. After thirty days of process, Arsenic bioleaching was 7550 mgL-1(18,7%) and 2850 mgL-1 (7,1%) for the 200 and 325 Tyler meshes, respectively.On the other hand, bacterial growth curve showed, between 6 and 21 days of process that the average bacterial population was 1,70x108 cel.mL-1 y de 8,00x107 cel.mL-1 for 200 and 325 Tyler mesh respectively. For this reason, the particle size played an important role in the adaption kinetics of microorganism. The results showed that the microorganism oxide the larger particle size of the mineral easier.

Primary amenorrhea in two sisters: description of a Mexican family with 17α hydroxylase-17 lyase deficiency caused by arginine - stop mutation.

A rare cause of congental adrenal hyperplasia is 17α-hydroxylase deficiency. It results in sexual infantilism, primary amenorrhea in females, pseudohermaphroditism in males, hypertension, and hypokalemia. We studied two female siblings from a rural community in Mexico. The cause of consultation was primary amenorrhea. The proband had low levels of estrogen, progesterone and cortisol. Deoxycorticosterone and corticosterone levels were elevated. The proband was homozygous for a transversion of cytosine to thymine at exon 4 (CGA→TGA), causing a premature stop codon at position 239 (R239X). Analysis of family members showed the presence of this heterozygous mutation in the mother, father and one healthy sibling. In summary, we describe a Mexican family with 17α-hydroxylase deficiency due to R239X mutation.

Adenoma adrenal como etiología de síndrome de Cushing: veinte años de experiencia en un centro mexicano de tercer nivel / Adrenal adenoma as a cause of Cushing's syndrome: twenty years’ experience in a referral center in Mexico

Introducción El síndrome de Cushing (SC) incluye una amplia gama de manifestaciones clínicas y de laboratorio resultado final de la exposición crónica a glucocorticoides. Los adenomas adrenales son una causa infrecuente de SC en adultos. Objetivo Describir las características y la evolución de los pacientes con SC causados por adenomas adrenales en un hospital de tercer nivel. Métodos Se trata de un estudio retrospectivo, transversal, observacional. Se estudiaron individuos con el diagnóstico de SC causado por adenomas adrenales, en 20 años. Se describió la experiencia clínica en el diagnóstico y tratamiento. Resultados Se encontró un total de 20 pacientes, 19 mujeres y un hombre. Edad promedio 25,9 años (14 a 52). Los datos clínicos que se documentaron con mayor frecuencia fueron hirsutismo y cara de luna llena. La concentración promedio de cortisol basal fue de 2,9±10,7mcg/dl; del cortisol por la tarde 24,4±8,5mcg/dl y de corticotropina (ACTH) 24±19,4pg/ml. Sólo 4 pacientes (20%) tenían concentraciones de ACTH por debajo de 5pg/ml. Los resultados en las pruebas dinámicas con dexametasona sugirieron adenoma adrenal en el 100% de los casos. El 70% de los adenomas se encontraron en la glándula izquierda. El tamaño promedio de las lesiones fue de 2,8±0,47cm.Conclusiones En las pruebas dinámicas los criterios de no supresión con dosis altas de dexametasona estuvieron presentes en prácticamente todos los pacientes. La medición de ACTH en nuestro centro no resulta confiable para discriminar como causa de hipercortisolismo a los adenomas adrenales (AU)

Introduction Cushing's syndrome (CS) includes a wide range of clinical and laboratory abnormalities and is the final outcome of chronic glucocorticoid exposure. Adrenal adenomas are an uncommon cause of adult CS. Objective To describe the characteristics and outcome of patients with CS caused by adrenal adenomas in a referral center. Methods We performed a retrospective cross-sectional observational study of patients with a diagnosis of CS caused by adrenal adenomas managed in our center over a 20-year period. Our clinical experience in the diagnosis and treatment of this entity was analyzed.Results There were a total of 20 patients, 19 women and one man. The mean age was 25.9 years (14 to 52). The most frequently recorded clinical data were hirsutism and moon face. The mean morning cortisol level was 26.9±10.7mcg/dl, the mean afternoon level was 24.4±8.5mcg/dl and the mean corticotropin (ACTH) concentration was 24±19.4pg/ml. Only four patients (20%) had ACTH levels below 5pg/ml. The results of dynamic testing with dexamethasone suggested adrenal adenoma in 100% of the patients. Seventy percent of adenomas were found in the left gland. The mean size of the lesion was 2.8±0.47cm.Conclusions In dynamic testing, the criteria of non-suppression with high doses of dexamethasone were evident in almost all patients. ACTH measurement in our center was not reliable in identifying adrenal adenoma as a cause of CS (AU)

[Adrenal adenoma as a cause of Cushing's syndrome: twenty years' experience in a referral center in Mexico]. / Adenoma adrenal como etiología de síndrome de Cushing: veinte años de experiencia en un centro mexicano de tercer nivel.

INTRODUCTION: Cushing's syndrome (CS) includes a wide range of clinical and laboratory abnormalities and is the final outcome of chronic glucocorticoid exposure. Adrenal adenomas are an uncommon cause of adult CS. OBJECTIVE: To describe the characteristics and outcome of patients with CS caused by adrenal adenomas in a referral center. METHODS: We performed a retrospective cross-sectional observational study of patients with a diagnosis of CS caused by adrenal adenomas managed in our center over a 20-year period. Our clinical experience in the diagnosis and treatment of this entity was analyzed. RESULTS: There were a total of 20 patients, 19 women and one man. The mean age was 25.9 years (14 to 52). The most frequently recorded clinical data were hirsutism and moon face. The mean morning cortisol level was 26.9±10.7 mcg/dl, the mean afternoon level was 24.4±8.5 mcg/dl and the mean corticotropin (ACTH) concentration was 24±19.4 pg/ml. Only four patients (20%) had ACTH levels below 5 pg/ml. The results of dynamic testing with dexamethasone suggested adrenal adenoma in 100% of the patients. Seventy percent of adenomas were found in the left gland. The mean size of the lesion was 2.8±0.47 cm. CONCLUSIONS: In dynamic testing, the criteria of non-suppression with high doses of dexamethasone were evident in almost all patients. ACTH measurement in our center was not reliable in identifying adrenal adenoma as a cause of CS.