Negative CG dinucleotide bias: An explanation based on feedback loops between Arginine codon assignments and theoretical minimal RNA rings.

Theoretical minimal RNA rings are candidate primordial genes evolved for non-redundant coding of the genetic code's 22 coding signals (one codon per biogenic amino acid, a start and a stop codon) over the shortest possible length: 29520 22-nucleotide-long RNA rings solve this min-max constraint. Numerous RNA ring properties are reminiscent of natural genes. Here we present analyses showing that all RNA rings lack dinucleotide CG (a mutable, chemically instable dinucleotide coding for Arginine), bearing a resemblance to known CG-depleted genomes. CG in "incomplete" RNA rings (not coding for all coding signals, with only 3-12 nucleotides) gradually decreases towards CG absence in complete, 22-nucleotide-long RNA rings. Presumably, feedback loops during RNA ring growth during evolution (when amino acid assignment fixed the genetic code) assigned Arg to codons lacking CG (AGR) to avoid CG. Hence, as a chemical property of base pairs, CG mutability restructured the genetic code, thereby establishing itself as genetically encoded biological information.

Estudio migración de recursos humanos en salud Costa Rica: segundo avance / Migration study of human resources in health Costa Rica: second progress

La Ley General de Migración y Extranjería contempla dos tipos de residencia para los extranjeros: residentes permanentes y residentes temporales. Para obtener el estado de residente permanente, el extranjero debe cumplir con los siguientes requisitos: - Solicitud del interesado al Director General de Migración, presentada en las oficinas del Consulado de Costa Rica de su país de origen o residencia. En el mismo, debe designarse un apoderado residente en Costa Rica e indicarse las razones o motivos por los cuales el solicitante desea residir permanentemente en el país y señalar casa u oficina dentro del perímetro judicial en la Provincia de San José en donde recibir notificaciones. -Aportar certificación de nacimiento, antecedentes penales, de matrimonio si el solicitante fuese casado, títulos académicos y de estudios realizados o de idoneidad para el ejercicio de otras actividades. La certificación de nacimiento deberá contener el nombre de los progenitores. - Presentar fotocopia certificada del Pasaporte incluyendo todas sus hojas. -Aportar certificación de nacimiento de cada uno de los hijos menores amparados por su solicitud. -Aportar cuatro fotografías de fecha reciente, tamaño pasaporte

First report of acariasis by Caparinia tripilis in African hedgehogs, (Atelerix albiventris), in Costa Rica.

The African hedgehog is one of the newly imported exotic pets which have been observed with increasing regularity in veterinary clinics in Costa Rica. Despite their popularity, information about their diseases is scarce. Within skin diseases of hedgehogs, mange caused by Caparinia spp. is a common diagnosis in other countries. Two adult African hedgehogs, one male and one female, were brought to a private clinic in Heredia, Costa Rica, with chronic pruritic dermatitis, scabs, nearly complete loss of spines, lethargy, dehydration, and weight loss. During physical exam, deposits of dry seborrhea were taken and processed for diagnosis. Microscopic examination revealed psoroptid mites identified as Caparinia tripilis. This is the first report of the presence of Caparinia tripilis in Costa Rica and, to the authors' knowledge, the rest of Central America.

First report of acariasis by Caparinia tripilis in African hedgehogs, (Atelerix albiventris), in Costa Rica / Primeiro relato de acariasis por Caparinia tripilis em ouriços africanos, (Atelerix albiventris), na Costa Rica

The African hedgehog is one of the newly imported exotic pets which have been observed with increasing regularity in veterinary clinics in Costa Rica. Despite their popularity, information about their diseases is scarce. Within skin diseases of hedgehogs, mange caused by Caparinia spp. is a common diagnosis in other countries. Two adult African hedgehogs, one male and one female, were brought to a private clinic in Heredia, Costa Rica, with chronic pruritic dermatitis, scabs, nearly complete loss of spines, lethargy, dehydration, and weight loss. During physical exam, deposits of dry seborrhea were taken and processed for diagnosis. Microscopic examination revealed psoroptid mites identified as Caparinia tripilis. This is the first report of the presence of Caparinia tripilis in Costa Rica and, to the authors' knowledge, the rest of Central America.

O ouriço africano é um dos animais de estimação exótico, recém-importado que tem sido observado com maior regularidade nas clínicas veterinárias da Costa Rica. Apesar da sua popularidade, informações sobre suas doenças são escassas. Dentre as doenças de pele de ouriços, a sarna causada por Caparinia spp. é um diagnóstico comum nos outros países. Dois adultos ouriços africanos, um macho e uma fêmea, foram levados para uma clínica particular, em Heredia, Costa Rica, com a dermatite pruriginosa crônica, crostas, perda quase completa de espinhos, letargia, desidratação e perda de peso. Ao exame físico, os depósitos de seborreia seca foram retirados e processados para o diagnóstico. O exame microscópico revelou ácaros (psoroptidae) identificados como Caparinia tripilis. Esse é o primeiro relato da presença de Caparinia tripilis na Costa Rica e, para conhecimento dos autores, o resto da América Central.

¿Qué medida antropométrica de exceso de peso discrimina mejor el riesgo cardiovascular? / Which of the anthropometric measures to define excess weight is the best discriminator of cardiovascular risk?

No disponible

No disponible

Micro-RNAs: viral genome and robustness of gene expression in the host.

For comparing RNA rings or hairpins with reference or random ring sequences, circular versions of distances and distributions like those of Hamming and Gumbel are needed. We define these circular versions and we apply these new tools to the comparison of RNA relics (such as micro-RNAs and tRNAs) with viral genomes that have coevolved with them. Then we show how robust are the regulation networks incorporating in their boundary micro-RNAs as sources or new feedback loops involving ubiquitous proteins like p53 (which is a micro-RNA transcription factor) or oligopeptides regulating protein translation. Eventually, we propose a new coevolution game between viral and host genomes.

RNA relics and origin of life.

A number of small RNA sequences, located in different non-coding sequences and highly preserved across the tree of life, have been suggested to be molecular fossils, of ancient (and possibly primordial) origin. On the other hand, recent years have revealed the existence of ubiquitous roles for small RNA sequences in modern organisms, in functions ranging from cell regulation to antiviral activity. We propose that a single thread can be followed from the beginning of life in RNA structures selected only for stability reasons through the RNA relics and up to the current coevolution of RNA sequences; such an understanding would shed light both on the history and on the present development of the RNA machinery and interactions. After presenting the evidence (by comparing their sequences) that points toward a common thread, we discuss a scenario of genome coevolution (with emphasis on viral infectious processes) and finally propose a plan for the reevaluation of the stereochemical theory of the genetic code; we claim that it may still be relevant, and not only for understanding the origin of life, but also for a comprehensive picture of regulation in present-day cells.

Strict control of modifiable cardiovascular risk factors in patients with type 2 diabetes mellitus.

BACKGROUND AND OBJECTIVE: To assess the effect of a strict control of modifiable cardiovascular risk factors on coronary risk (CR) in patients with type 2 diabetes mellitus (T2DM) in clinical practice. PATIENTS AND METHOD: Longitudinal, open and observational study in 530 patients with T2DM. Fasting plasma glucose (FPG), glycated haemoglobin (HbA 1C), postprandial capillary glucose (PCG), total cholesterol, high-density lipoprotein-cholesterol, triglycerides, systolic (SBP) and diastolic (DBP) blood pressure were measured; low-density lipoprotein-cholesterol and body mass index were calculated; and 10 years CR was predicted before and after 6 months of therapy implementation. The percentage of patients who reached the targets, according to published guidelines, and the use of insulin and various cardioprotective medications were compared before and after therapy implementation. RESULTS: There was a significant decrease in mean HbA 1C, FPG, PCG, total cholesterol, triglycerides, SBP, DBP, and CR after intervention. The percentage of patients who reached the HbA 1C, FPG, PCG, total cholesterol, triglycerides, SBP, DPB, and CR targets, and the number of subjects taking insulin and cardioprotective drugs increased significantly after intervention. CONCLUSIONS: This study shows that a strict control of modifiable cardiovascular risk factors in patients with T2DM in clinical practice has a beneficial effect over predicted CR.

Control estricto de los factores de riesgo cardiovascular modificables en pacientes con diabetes mellitus tipo 2 / Strict control of modifiable cardiovascular risk factors in patients with type 2 diabetes mellitus

Fundamento y objetivo: Valorar en la práctica clínica qué efecto tiene, en pacientes con diabetes mellitus tipo 2 (DM2), el control estricto de los factores de riesgo cardiovascular modificables sobre el riesgo coronario (RC). Pacientes y método: Se ha realizado un estudio longitudinal, abierto y observacional. En 530 pacientes con DM2 se midieron la glucosa plasmática en ayunas (GPA), hemoglobina glucosilada (HbA1C), glucosa capilar posprandial (GCP), colesterol total, colesterol unido a lipoproteínas de alta densidad, triglicéridos, presión arterial sistólica (PAS) y diastólica (PAD); además se calcularon el colesterol unido a lipoproteínas de baja densidad, el índice de masa corporal y el RC a 10 años, antes y 6 meses después de intensificar el tratamiento. Se compararon el porcentaje de pacientes que alcanzaron los objetivos, de acuerdo con las guías publicadas, y la utilización de insulina y de medicaciones cardioprotectoras antes y 6 meses después de la intervención. Resultados: Después de la intervención se observó una disminución significativa de los valores de HbA1C, GPA, GCP, colesterol total, triglicéridos, PAS, PAD y RC, así como un incremento significativo del porcentaje de pacientes que alcanzaron los objetivos de HbA1C, GPA, GCP, colesterol total, triglicéridos, PAS, PAD y RC, y del número de sujetos en tratamiento con insulina y medicamentos cardioprotectores. Conclusiones: Este estudio de práctica clínica muestra que el control estricto de los factores de riesgo cardiovascular modificables en pacientes con DM2 se traduce en efectos beneficiosos sobre el RC

Background and objective: To assess the effect of a strict control of modifiable cardiovascular risk factors on coronary risk (CR) in patients with type 2 diabetes mellitus (T2DM) in clinical practice. Patients and method: Longitudinal, open and observational study in 530 patients with T2DM. Fasting plasma glucose (FPG), glycated haemoglobin (HbA1C), postprandial capillary glucose (PCG), total cholesterol, high-density lipoprotein-cholesterol, triglycerides, systolic (SBP) and diastolic (DBP) blood pressure were measured; low-density lipoprotein-cholesterol and body mass index were calculated; and 10 years CR was predicted before and after 6 months of therapy implementation. The percentage of patients who reached the targets, according to published guidelines, and the use of insulin and various cardioprotective medications were compared before and after therapy implementation. Results: There was a significant decrease in mean HbA1C, FPG, PCG, total cholesterol, triglycerides, SBP, DBP, and CR after intervention. The percentage of patients who reached the HbA1C, FPG, PCG, total cholesterol, triglycerides, SBP, DPB, and CR targets, and the number of subjects taking insulin and cardioprotective drugs increased significantly after intervention. Conclusions: This study shows that a strict control of modifiable cardiovascular risk factors in patients with T2DM in clinical practice has a beneficial effect over predicted CR

Evolution and RNA relics. a systems biology view.

The genetic code has evolved from its initial non-degenerate wobble version until reaching its present state of degeneracy. By using the stereochemical hypothesis, we revisit the problem of codon assignations to the synonymy classes of amino-acids. We obtain these classes with a simple classifier based on physico-chemical properties of nucleic bases, like hydrophobicity and molecular weight. Then we propose simple RNA (or more generally XNA, with X for D, P or R) ring structures that present, overlap included, one and only one codon by synonymy class as solutions of a combinatory variational problem. We compare these solutions to sequences of present RNAs considered as relics, with a high interspecific invariance, like invariant parts of (t)RNAs and micro-RNAs. We conclude by emphasizing some optimal properties of the genetic code.

A possible circular RNA at the origin of life.

The increasing volume of sequenced genomes and the recent techniques for performing in vitro molecular evolution have rekindled the interest for questions on the origin of life. Nevertheless, a gap continues to exist between the research on prebiotic chemistry and molecule generation, on one hand, and the study of molecular fossils preserved in genomes, on the other. Here we attempt to fill this gap by using some assumptions about the prebiotic scenario (including a strong stereochemical basis for the genetic code) to determine the RNA sequences more likely to appear and subsist. A set of minimal RNA rings is exhaustively determined; a subset of them is then selected through stability arguments, and a particular ring ("AL ring") is finally singled out as the most likely winner of this prebiotic game. The rings happen to have several structural and statistical properties of modern genes: a repeated AUG codon appears spontaneously (and is thus made available for becoming a start signal), the form AUG/STOP emerges, and frequency patterns resemble those of present genes. The whole set of rings was also compared to a database of tRNAs, considering the conserved positions (located in the free parts of the molecule, essentially the loops); the ring that most closely matched tRNA sequences-and matched, in fact, the consensus of tRNA at all the aligned positions-was AL, the same ring independently selected before. The unselected emergence of gene-like features through two simple selection steps and the close similarity between the finally selected ring and tRNA (including some remarkable features of the resulting alignment) suggest a possible link between the prebiotic world and the first biological molecules, which is amenable for experimental testing. Even if our scenario is partially wrong, the unlikely coincidences should provide useful hints for other efforts.

Efecto, en la práctica clínica, de la fluvastatina de liberación prolongada en los lípidos séricos en pacientes con diabetes tipo 2 y dislipemia / Effect of long-acting fluvastatin on serum lipids in type 2 diabetic patients with dyslipidemia, in clinical practice

Introducción. La reducción del colesterol unido a lipoproteínas de baja densidad (cLDL) con estatinas se asocia a una disminución de las complicaciones macrovasculares en pacientes con diabetes mellitus tipo 2 (DM2). La fluvastatina de liberación prolongada (FLP) presenta una absorción más lenta y una acción más duradera que otras estatinas. Objetivo. Valorar en la práctica clínica el efecto de la FLP en los lípidos séricos (LS), en pacientes con DM2 y dislipemia, en los que dosis máximas de otras estatinas no consigan los objetivos de buen control. Material y método. De 452 pacientes con DM2 y dislipemia tratados con dosis máximas de lovastatina, simvastatina, pravastatina o atorvastatina, se seleccionó a 84 que presentaban un cLDL > 2,97 mmol/l (> 115 mg/dl). Se les midió el colesterol total (CT), el colesterol unido a lipoproteínas de alta densidad (cHDL) y los triglicéridos (TG), se calculó el cLDL y se comparó el porcentaje de ellos que cumplían los objetivos de control para los LS antes y a los 9 meses de sustituir las estatinas que tomaban por una dosis de 80 mg de FLP. Resultados. A los 9 meses del tratamiento con FLP, el 57% de los pacientes alcanzó el objetivo del cLDL (p = 0,000), y se observó una disminución del CT y el cLDL (p = 0,000 para ambos) y un incremento del cHDL (p = 0,000). Conclusiones. En la práctica clínica, la FLP consiguió los objetivos de control para el cLDL en más de la mitad de los pacientes con DM2 y dislipemia de la población estudiada, que no lo habían conseguido con otras estatinas. Esto, unido al incremento del cHDL observado, pone de manifiesto la importancia de la FLP en el tratamiento de pacientes con DM2 y dislipemia (AU)

Introduction. The decrease of low density lipoprotein- cholesterol (LDLc) produced by statins is associated with a reduction in macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Long-acting fluvastatin (LAF) has a slower absorption and longer action time than other statins. Objective. To assess, in clinical practice, the effect of LAF on serum lipids (SL) in T2DM patients in whom maximum doses of other statins failed to achieve the recommended goals. Material and method. Of 452 patients with T2DM and dyslipidemia who were on maximum doses of simvastatin, lovastatin, pravastatin or atorvastatin, 84 with LDLc levels > 2.97 mmol/l (> 115 mg/dl) were selected. Total cholesterol (TC), high density lipoprotein-cholesterol (HDLc), triglycerides (TGs) and LDLc were measured. The percentage of patients achieving recommended goals for SL before and 9 months after switching from the previous statin treatment to LAF 80 mg/day was compared. Results. After 9 months of LAF treatment, 57 % of the patients achieved the LDLc target (P = 0.0000). Mean TC and LDLc significantly decreased (P = 0.000, for both) while HDLc significantly increased (P = 0.000). Conclusions. In clinical practice, LAF treatment achieved the LDLc target in more than 50 % of the patients with T2DM in whom maximum doses of other statins failed to achieve the recommended goals. In addition to this effect, the increase in HDLc observed after LAF treatment shows the importance of this statin in the treatment of T2DM patients with dyslipidemia (AU)

An open issue: the inner mitochondrial membrane (IMM) as a free boundary problem.

The inner mitochondrial membrane (IMM) is structured in cristae, which contributes to the best functioning of ions and adenylates exchange between the matrix and the intermembrane space. The central hypothesis of this paper is that the cristae structure favours a minimal mean free path of adenylates between translocation sites (translocase/ANT sites) and metabolic sites (ATPase sites). We propose a mathematical model and then give simulations. Based on simple hypotheses about cristae growth, they show that we can account for the major features of the IMM organization and functioning by minimizing the mean interdistance between ADP/ATP translocation and transformation sites.

Efectos beneficiosos de la adición de ezetimiba a dosis máximas de estatinas en el control de los lípidos séricos en pacientes con diabetes mellitus tipo 2 / Beneficial effects of adding ezetimibe to maximum- dose statins on serum lipid control in patients with type 2 diabetes mellitus

Introducción: La coadministración de ezetimiba, un inhibidor de la absorción de colesterol, y estatinas ha demostrado en ensayos clínicos reducir el colesterol unido a lipoproteínas de baja densidad (cLDL) un 20% con respecto a estatinas en monoterapia. Pero, ¿ocurre lo mismo en la práctica clínica? Objetivo: Valorar en la clínica diaria, los efectos de la adición de ezetimiba en el cLDL y en el grado de control de los lípidos séricos (LS), en pacientes con diabetes mellitus tipo 2 (DM2) en los que dosis máximas de estatinas no consigan los objetivos de buen control. Pacientes y métodos: A 66 pacientes con DM2 de 13,4 ± 9,8 años de evolución (27 hombres y 39 mujeres) de 64,8 ± 10,3 años de edad, con dislipidemia tratada con dosis máximas de atorvastatina, fluvastatina, pravastatina o simvastatina, y un cLDL > 100 mg/dl, se les administró, conjuntamente con la dosis máxima de estatina, una dosis diaria de 10 mg de ezetimiba en la cena. A todos se les determinó el colesterol total (CT), el colesterol unido a lipoproteínas de alta densidad (cHDL) y los triglicéridos (TG), y se calculó el cLDL antes y a los 9 meses de añadir ezetimiba a la estatina. Además, se comparó el porcentaje de pacientes que cumplían los objetivos de buen control para los LS según la American Diabetes Association (ADA), antes y a los 9 meses de añadir ezetimiba. Resultados: A los 9 meses de añadir ezetimiba, el 58 % de los pacientes alcanzaron un cLDL < 100 mg/dl (p = 0,000). Asimismo, se observó una disminución significativa del CT (p = 0,000), cLD (p = 0,000) y TG (p = 0,01), y un incremento del cHDL (p = 0,025). Conclusiones: En la práctica clínica habitual, la adición de ezetimiba consiguió los objetivos de buen control para el cLDL en casi el 60% de los pacientes con DM2 y dislipidemia de la población estudiada, que no lo habían conseguido con dosis máximas de estatinas en monoterapia. Este efecto, unido al incremento del cHDL y a la disminución del CT y de los TG observado, ponen de manifiesto la importancia de ezetimiba coadministrada con estatinas en el tratamiento de pacientes con DM2 y dislipidemia (AU)

Introduction: Clinical trials have shown that the addition of ezetimibe, a selective inhibitor of cholesterol absorption, to statins reduces low-density lipoprotein-cholesterol (cLDL) by an additional 20% over statin monotherapy. However, the question of whether the same is true in clinical practice remains to be determined. Objective: To assess the effect of the addition of ezetimibe on cLDL and its action on other serum lipids (SL) in clinical practice in patients with type 2 diabetes mellitus (T2DM) in whom maximum-dose of statins failed to achieve the recommended goals. Patients and methods: Sixty-six patients with T2DM (27 men and 39 women) with dyslipidemia treated with maximum-dose atorvastatin, fluvastatin, pravastatin or simvastatin and with cLDL > 100 mg/dl, were included in this study. Disease duration was 13.4 ± 9.8 years and age was 64.8 ± 10.3 years. In all patients, we measured total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) levels and calculated cLDL before and 9 months after adding an evening dose of 10 mg of ezetimibe to a maximum-dose statin. The percentage of patients who reached the SL targets according to the American Diabetes Association recommendations before and 9 months after adding ezetimibe treatment was compared. Results: After 9 months of adding ezetimibe, 58% of patients achieved the cLDL target of < 100 mg/dl (P=.000). There was also a significant decrease in mean TC (P=.000), cLDL (P=.000) and TG (P=.01) and an increase in HDL-C (P=.025). Conclusions: In clinical practice, the addition of ezetimibe achieved the cLDL target in almost 60% of the patients with T2DM and dyslipidemia in the population studied, in whom maximum-dose statin monotherapy failed to achieve the recommended goals. In addition to this effect, the increase in HDL-C and the decrease in TC and TG observed reveal the importance of the addition of ezetimibe to statins in the treatment of T2DM patients with dyslipidemia (AU)

Grado de control de la presión arterial en un grupo de pacientes con diabetes mellitus tipo 2 / Blood pressure control in a group of patients with type 2 diabetes mellitus

Objetivo: Valorar el grado de control de la presión arterial en una población con diabetes mellitus tipo 2 (DM2). Pacientes y métodos: Estudio transversal en 758 pacientes con DM2 tratados con antidiabéticos orales o insulina. De acuerdo con las recomendaciones de la Asociación Americana de Diabetes se aplicaron una presión arterial sistólica (PAS) < 130 mmHg y una diastólica (PAD) < 80 mmHg como objetivos de buen control. Se evaluó también la prescripción de inhibidores de la enzima de conversión de la angiotensina (IECA), antagonistas de los receptores de la angiotensina II (ARA II) y bloqueadores beta. Resultados: La media de edad fue de 65,4 ± 12,2 años; el 44% de los pacientes eran varones. El 49% eran tratados con insulina, el 51% con antidiabéticos orales (ADOS), y el 18% presentaba cardiopatía isquémica. De ellos, el 64% estaba tratado con IECA o ARA II y el 18% con bloqueadores beta. Sólo el 35% de los pacientes presentaba valores de PAS < 130 mmHg, mientras que el 76% alcanzó una PAD < 80 mmHg. Los tratados con insulina presentaron unos valores de PAS superiores a los de aquellos que tomaban ADOS (p = 0,01). Si consideramos sólo a los pacientes en tratamiento con IECA o ARA II el porcentaje que alcanzó la PAD < 80 mmHg fue superior en los tratados con insulina (p = 0,01). Conclusiones: A pesar del elevado consumo de IECA y ARA II, en la población estudiada existe un control pobre de la PAS. Estos datos reflejan la necesidad de tratar más intensivamente la hipertensión arterial en los pacientes con DM2 para alcanzar los objetivos recomendados, y reducir el riesgo de mortalidad y complicaciones relacionadas con la DM2 (AU)

Objective: To assess the degree of blood pressure control in patients with type 2 diabetes mellitus (DM2). Patients and methods: We performed a cross-sectional study of 758 patients with DM2 treated with oral agents and/or insulin. The following parameters were used to define optimal control, based on the recommendations of the American Diabetes Association (ADA): systolic blood pressure (SBP) < 130 mmHg and diastolic blood pressure (DBP) < 80 mmHg. The use of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs) and beta-blockers was also evaluated. Results: The mean age was 65.4 ± 12.2 years; 44% were male. Forty-nine percent of the patients were receiving insulin therapy and 51% were taking oral hypoglycemic agents. Eighteen percent had a history of ischemic heart disease. Overall, 64% were on ACEIs or ARB therapy, and 18% were on beta-blockers. Only 35% of the patients achieved the SBP target, although 76% reached the DBP target. Insulin users had higher SBP (p = 0.01) than patients taking oral agents. The percentage of patients treated with ACEIs or ARBs who met the recommended ADA target for DBP was higher among subjects receiving insulin therapy than in those taking oral agents (p = 0.01). Conclusions: Despite the large number of patients taking IECAs or ARBs, there was poor control of SBP in the population studied. These data support the need for more aggressive treatment of hypertension in patients with T2DM to achieve the recommended goals and to reduce mortality and complications in these patients (AU)

Glucemia posprandial y riesgo cardiovascular / Posprandial glycemia and cardiovascular risk

La arteriosclerosis es la causa más frecuente de morbilidad y mortalidad cardiovascular en pacientes con diabetes mellitus tipo 2. En los últimos años, estudios epidemiológicos y de intervención han identificado el estado posprandial, caracterizado por un aumento rápido y prolongado de los valores de glucosa en sangre, como un factor de riesgo directo e independiente de arteriosclerosis que contribuye al desarrollo de la enfermedad cardiovascular. La hiperglucemia posprandial podría tener un efecto tóxico directo sobre el endotelio vascular mediado por el estrés oxidativo, lo que favorecería el desarrollo de la disfunción endotelial, una condición protrombótica y proinflamatoria, a través de la producción de radicales libres. Este efecto es independiente de otros factores de riesgo cardiovascular, como la hiperlipidemia. El control y la corrección de los valores de glucemia posprandial es una estrategia muy importante en la prevención de la enfermedad cardiovascular asociada a la diabetes. En esta revisión se han examinado los estudios epidemiológicos y de intervención que asocian la hiperglucemia posprandial con el riesgo de enfermedad cardiovascular, los mecanismos involucrados en estos efectos y las diferentes estrategias terapéuticas para controlar la hiperglucemia posprandial, que incluyen cambios en el estilo de vida y fármacos como los secretagogos de corta duración, los inhibidores de las alfaglucosidasas intestinales, los análogos de insulina de acción rápida y nuevos agentes en desarrollo, como el análogo de amilina, pramlintida; la hormona insulinotrópica GLP-1 y sus homólogos como la exendina, los inhibidores de la dipeptidilpeptidasa IV (DPPIV) o la insulina inhalada (AU)

Atherosclerosis is the most frequent cause of the increased cardiovascular morbidity and mortality observed in type 2 diabetic patients. Over the past few years, epidemiological and preliminary intervention studies have identified that the posprandial state, characterized by a rapid and large increase in blood glucose levels, is a direct and independent risk factor for atherosclerosis and a contributing factor to the development of cardiovascular disease. Posprandial hyperglycemia may have a direct toxic effect on the vascular endothelium, mediated by oxidative stress, which favors the development of endothelial dysfunction, a prothrombotic and proinflammatory condition, through the production of free radicals. This effect is independent of other cardiovascular risk factors such as hyperlipidemia. The control and correction of posprandial glucose levels is an important strategy in the prevention of diabetes-related cardiovascular disease. In this review, epidemiological and intervention studies that associate posprandial hyperglycemia with cardiovascular risk, the mechanisms involved in this effect, and the distinct therapeutic strategies to control posprandial hyperglycemia are reviewed. These therapeutic strategies include life-style changes, drugs such as short-acting secretagogues, alpha-glucosidase inhibitors, fast-acting insulin analogues, and new agents under development, such as the synthetic human amylin analogue pramlintide, the insulinotropic hormone GLP-1, a homologue of GLP-1-exendin, dipeptidylpeptidase IV inhibitors (DPPIV) and inhaled insulin formulations (AU)

Comparison of anthropometric parameters as predictors of serum lipids in premenopausal women.

No single anthropometric parameter has yet been generally accepted as being superior to others in assessing the metabolic risk associated with abdominal obesity. To compare waist circumference (WC) with waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), regarding their association with serum lipids, we studied 166 women aged 20 to 48 yr; 53 were obese [body mass index (BMI) 30-39.9 Kg/m2], 50 were overweight (BMI 25-29.9 Kg/m2) and 63 normal weight (BMI 18.5-24.9 Kg/m2). Height, body weight, waist and hip circumferences, total serum cholesterol (Ch), low (LDL) and high density lipoprotein (HDL)-Ch and triglyceride (TG) concentrations were measured. The correlation coefficients between the concentration of serum lipid fractions and each anthropometric parameter did not differ significantly for any lipid variable when WC, WHR and WHtR were compared in the 166 women. The same applied for the obese and the overweight group, whereas in normal weight women there was significant association only between WC and LDL-Ch and between WHR and Ch/HDL-Ch ratio. Stepwise regression analysis showed that the proportion of variance in serum lipids did not change significantly when WHR or WHR+WHtR were added to WC into the regression model (18%, 18% and 18% for Ch; 13%, 18% and 18% for HDL-Ch; 18%, 18% and 12% for LDL-Ch; 35%, 35% and 37% for TG, respectively). These results indicate that WC is the main parameter associated with serum lipid levels and that the ratios studied do not provide additional substantial information in women who need weight management.

Cardiovascular risk factors in patients with type 2 diabetes. Do we follow the guidelines?

OBJECTIVE: To assess the degree of control of modifiable cardiovascular risk factors (CRFs) in type 2 diabetic patients. STUDY DESIGN AND METHODS: Cross-sectional study in 501 patients with type 2 diabetes mellitus. The following parameters were used to define optimal control: glycated haemoglobin (HbA(1C)) <7.0%, fasting plasma glucose (FPG) <7.2 mmol/l, postprandial capillary glucose (PCG) <10.0 mmol/l, high-density lipoprotein cholesterol (HDL-C) >1.1 mmol/l, low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/l, triglyceride levels (TG) <1.7 mmol/l, systolic blood pressure (SBP) <130 mmHg, diastolic blood pressure (DBP) <80 mmHg, body mass index (BMI) <25 kg/m2, waist circumference (WC) <88 cm in women and <102 cm in men, and current non-smoking status. The use of various cardioprotective medications was also evaluated. RESULTS: Mean (+/-S.D.) age was 65.4 +/- 11.9 years, 218 (44%) were male. Ninety-six (19%) met coronary artery disease (CAD). Two hundred seven patients (41%) had an HbA(1C) <7.0%, 134 (27%) a FPG <7.2 mmol/l and 231 of 353 (65%) a PCG <10.0 mmol/l. Only 206 (41%) achieved an LDL-C <2.6 mmol/l, but 370 (74%) and 308 (62%) reached an HDL-C >1.1 mmol/l and a TG levels <1.7 mmol/l, respectively. In 359 (72%) patients DBP was <80 mmHg, but in only 136 (27%) was SBP <130 mmHg. Sixty four (13%) achieved a BMI <25 kg/m2, and 420 (84%) were non-smokers. Forty three (15%) women and 104 (48%) men had a WC <88 or <102 cm, respectively. None of the patients had optimal control of all CRFs. CONCLUSIONS: These data demonstrate poor control of modifiable CRFs in the population studied, and support the need for great effort to achieve the recommended goals.

TIP: protein backtranslation aided by genetic algorithms.

UNLABELLED: Several applications require the backtranslation of a protein sequence into a nucleic acid sequence. The degeneracy of the genetic code makes this process ambiguous; moreover, not every translation is equally viable. The usual answer is to mimic the codon usage of the target species; however, this does not capture all the relevant features of the 'genomic styles' from different taxa. The program TIP ' Traducción Inversa de Proteínas') applies genetic algorithms to improve the backtranslation, by minimizing the difference of some coding statistics with respect to their average value in the target. AVAILABILITY: http://www.cmm.uchile.cl/genoma/tip/