Associations among environmental exposure to trace elements and biomarkers of early kidney damage in the pediatric population.

BACKGROUND: In kidney damage, molecular changes can be used as early damage kidney biomarkers, such as Kidney Injury Molecule-1 and Neutrophil gelatinase-associated lipocalin. These biomarkers are associated with toxic metal exposure or disturbed homeostasis of trace elements, which might lead to serious health hazards. This study aimed to evaluate the relationship between exposure to trace elements and early damage kidney biomarkers in a pediatric population. METHODS: In Tlaxcala, a cross-sectional study was conducted on 914 healthy individuals. The participants underwent a medical review and a socio-environmental questionnaire. Five early damage kidney biomarkers were determined in the urine with Luminex, and molybdenum, copper, selenium, nickel, and iodine were measured with ICP-Mass. RESULTS: The eGFR showed a median of 103.75 mL/min/1.73 m2. The median levels for molybdenum, copper, selenium, nickel, and iodine were 24.73 ng/mL, 73.35 ng/mL, 4.78 ng/mL, 83.68 ng/mL, and 361.83 ng/mL, respectively. Except for molybdenum and nickel, the other trace elements had significant associations with the eGFR and the early kidney damage biomarkers. Additionally, we report the association of different exposure scenarios with renal parameters. DISCUSSION: and Conclusions. Among the explored metals, exposure to Cu and iodine impairs renal function. In contrast, Se may manifest as a beneficial metal. Interactions of Mo-Se and Mo-Iodine seem to alter the expression of NGAL; Mo-Cu for CLU; Mo-Cu, Mo-Se, and Mo-iodine for Cys-C and a-1MG; and Mo-Cu and Mo-iodine for KIM-1; were noticed. Our study could suggest that trace element interactions were associated with early kidney damage biomarkers.

The muscle regeneration marker FOXP3 is associated with muscle injury in Duchenne muscular dystrophy.

BACKGROUND: In Duchenne muscular dystrophy (DMD), the immune system cells (ISC) synthesize molecules to regulate inflammation, a process needed to regenerate muscle. The relationship between those molecules and the muscle injury is unknown. Monocytes belonging to ISC are regulated by omega-3 fatty acids (ω-3 LCPUFAs) in DMD, but whether those fatty acids influence other ISC like T-cells is unknown. OBJECTIVE: We analyzed the expression of the muscle regeneration markers (FOXP3 and AREG) in circulating leukocytes of DMD patients with different lower limb muscle functions and whether ω-3 LCPUFAs regulate the expression of those markers, and the populations of circulating T-cells, their intracellular cytokines, and disease progression (CD69 and CD49d) markers. METHODS: This placebo-controlled, double-blind, randomized study was conducted in DMD boys supplemented with ω-3 LCPUFAs (n = 18) or placebo (sunflower oil, n = 13) for six months. FOXP3 and AREG mRNA expression in leukocytes, immunophenotyping of T-cell populations, CD49d and CD69 markers, and intracellular cytokines in blood samples were analyzed at baseline and months 1, 2, 3, and 6 of supplementation. RESULTS: Patients with assisted ambulation expressed higher (P = 0.015) FOXP3 mRNA levels than ambulatory patients. The FOXP3 mRNA expression correlated (Rho = -0.526, P = 0.03) with the Vignos scale score at month six of supplementation with ω-3 LCPUFAs. CD49d + CD8 + T-cells population was lower (P = 0.037) in the ω -3 LCPUFAs group than placebo at month six of supplementation. CONCLUSION: FOXP3 is highly expressed in circulating leukocytes of DMD patients with the worst muscle function. Omega-3 LCPUFAs might modulate the synthesis of the adhesion marker CD49d + CD8 + T-cells, but their plausible impact on FOXP3 needs more research.

Influence of Maternal Body Fat on Levels of Insulin, Insulin-Like Growth Factor-1, and Obestatin.

BACKGROUND: Insulin, insulin-like Growth Factor-1 (IGF-1), and obestatin in human milk originate from the circulation. There is also limited knowledge about the influence of body fat on the levels of these hormones in human milk. RESEARCH AIM: To determine (1) the influence of body fat on levels of insulin, IGF-1, and obestatin in human milk and serum/plasma during the postpartum period; (2) the changes in the levels of these hormones in human milk and serum/plasma postpartum; and (3) the presence of IGF-1 mRNA in human milk. METHODS: In this prospective, longitudinal, observational cohort study, levels of insulin, IGF-1, and obestatin were measured up to 30 days postpartum in milk and serum/plasma of 58 participants with adequate (≤ 32%) or excess (> 32%) total body fat determined by electrical bioimpedance. Student's t test and repeated-measures analysis of variance were used to evaluate the differences between groups. Pearson's test was used to analyze the associations. RESULTS: The milk from participants with excess body fat had higher insulin and IGF-1 levels and lower obestatin levels than that of participants with adequate body fat at 3-7, 14-15, and 30 days postpartum (adjusted p < .001). The levels of insulin, IGF-1, and obestatin were significantly higher in human milk than in serum/plasma (p < .05) and correlated with maternal body fat (p < .001). CONCLUSIONS: Maternal body fat was associated with elevated insulin and IGF-1 levels and decreased obestatin levels in human milk up to 30 days postpartum.

Estado de ánimo, emociones y conductas de los niños durante la pandemia de COVID-19 en la Ciudad Autónoma de Buenos Aires / Mood, emotions, and behaviors of children during the COVID-19 pandemic in Autonomous City of Buenos Aires

Introducción. Los cambios en la rutina y en el entramado social que generó la pandemia por COVID-19 afectaron a los niños, niñas y adolescentes (NNyA). El objetivo de este trabajo fue conocer el estado de ánimo, las emociones y las conductas de los NNyA durante el aislamiento por COVID-19. Población y métodos . Estudio prospectivo, descriptivo y transversal. Se preguntó a los padres y/o cuidadores de niños de 3 a 15 años de edad, de la Ciudad Autónoma de Buenos Aires, cómo percibían el estado de ánimo, las conductas y las emociones de los NNyA durante el período de aislamiento. Resultados. Se incluyeron 1080 cuestionarios. El 81 % de los padres y/o cuidadores advirtió algún cambio en la salud emocional de los NNyA. El 76 % refirió que los niños de 3-5 años se mostraban aburridos, enojados y angustiados. Además, observaron un aumento de los episodios de llanto (52 %) y regresión a comportamientos ya superados (29 %). En el grupo de 6-11 años, el 43 % presentó dificultad en mantener la concentración. En 3 de cada 10 adolescentes, de 12 a 15 años de edad, los adultos percibieron abandono de actividades que antes disfrutaban, preocupación y tristeza. Conclusión. La pandemia de COVID-19 impactó en el estado de ánimo, las conductas y las emociones de los NNyA. Predominaron los sentimientos negativos, como aburrimiento, tristeza, angustia y preocupación.

Introduction. Changes in daily routine and social fabric resulting from the COVID-19 pandemic had an effect on children and adolescents. The objective of this study was to know the mood, emotions, and behaviors of children and adolescents during the COVID-19 lockdown. Population and methods. This was a prospective, descriptive, cross-sectional study. Parents and/or caregivers of children and adolescents aged 3-15 years in the Autonomous City of Buenos Aires were asked about their perceptions of the mood, behaviors, and emotions of children and adolescents during the lockdown. Results. A total of 1080 questionnaires were included. Results showed that 81% of parents and/or caregivers observed changes in children and adolescents emotional health; 76% referred that children aged 3-5 years were bored, angry, and upset. They also observed an increase in crying spells (52%) and regression to behaviors that had been outgrown (29%). In the 6-11-year-old group, 43% showed difficulty focusing. Adults noticed that 3 out of 10 adolescents aged 12-15 years discontinued activities they used to enjoy and were sad and worried. Conclusion. The COVID-19 pandemic impacted on the mood, behaviors, and emotions of children and adolescents. Negative feelings prevailed, such as boredom, sadness, anxiety, and worry.

Mood, emotions, and behaviors of children during the COVID-19 pandemic in Autonomous City of Buenos Aires. / Estado de ánimo, emociones y conductas de los niños durante la pandemia de COVID-19 en la Ciudad Autónoma de Buenos Aires.

INTRODUCTION: Changes in daily routine and social fabric resulting from the COVID-19 pandemic had an effect on children and adolescents. The objective of this study was to know the mood, emotions, and behaviors of children and adolescents during the COVID-19 lockdown. POPULATION AND METHODS: This was a prospective, descriptive, cross-sectional study. Parents and/ or caregivers of children and adolescents aged 3-15 years in the Autonomous City of Buenos Aires were asked about their perceptions of the mood, behaviors, and emotions of children and adolescents during the lockdown. RESULTS: A total of 1080 questionnaires were included. Results showed that 81% of parents and/or caregivers observed changes in children and adolescents emotional health; 76% referred that children aged 3-5 years were bored, angry, and upset. They also observed an increase in crying spells (52%) and regression to behaviors that had been outgrown (29%). In the 6-11-year-old group, 43% showed difficulty focusing. Adults noticed that 3 out of 10 adolescents aged 12-15 years discontinued activities they used to enjoy and were sad and worried. CONCLUSIONS: The COVID-19 pandemic impacted on the mood, behaviors, and emotions of children and adolescents. Negative feelings prevailed, such as boredom, sadness, anxiety, and worry.

Introducción. Los cambios en la rutina y en el entramado social que generó la pandemia por COVID-19 afectaron a los niños, niñas y adolescentes (NNyA). El objetivo de este trabajo fue conocer el estado de ánimo, las emociones y las conductas de los NNyA durante el aislamiento por COVID-19. Población y métodos. Estudio prospectivo, descriptivo y transversal. Se preguntó a los padres y/o cuidadores de niños de 3 a 15 años de edad, de la Ciudad Autónoma de Buenos Aires, cómo percibían el estado de ánimo, las conductas y las emociones de los NNyA durante el período de aislamiento. Resultados. Se incluyeron 1080 cuestionarios. El 81 % de los padres y/o cuidadores advirtió algún cambio en la salud emocional de los NNyA. El 76 % refirió que los niños de 3-5 años se mostraban aburridos, enojados y angustiados. Además, observaron un aumento de los episodios de llanto (52 %) y regresión a comportamientos ya superados (29 %). En el grupo de 6-11 años, el 43 % presentó dificultad en mantener la concentración. En 3 de cada 10 adolescentes, de 12 a 15 años de edad, los adultos percibieron abandono de actividades que antes disfrutaban, preocupación y tristeza. Conclusión. La pandemia de COVID-19impactó en el estado de ánimo, las conductas y las emociones de los NNyA. Predominaron los sentimientos negativos, como aburrimiento, tristeza, angustia y preocupación.

Pesquisa activa para el enfrentamiento a la COVID-19 en el poblado de El Caney / Active investigation for the confrontation to COVID-19 in El Caney town

Introducción: La COVID-19 es una enfermedad infecciosa causada por el virus SARS-CoV-2. La gravedad de su transmisión a escala mundial, la ha convertido en una pandemia con grandes impactos sociales, económicos y en la salud de la población. Objetivo: Describir los resultados de la pesquisa activa como estrategia de enfrentamiento a la COVID-19 en el poblado de El Caney. Métodos: Se efectuó un estudio observacional, descriptivo y transversal en una población de 872 viviendas y 2 601 habitantes, pertenecientes a los consultorios médicos de la familia 9, 11 y 25 del Policlínico Dr. Mario Muñoz Monroy del poblado de El Caney en Santiago de Cuba, para lo cual se realizó la pesquisa activa para el enfrentamiento a la COVID-19, que contó con la participación de los estudiantes de las carreras de ciencias médicas, en el periodo febrero - abril de 2021. Resultados: La mayoría de las casas visitadas pertenecieron al Consultorio Médico de la Familia No. 25 (99,1 %); el menor número de personas pesquisadas correspondió al No. 9 (73,0 %) y el No. 11, aunque mostró el menor porcentaje de casas visitadas y pesquisadas, arrojó la mayor parte de los casos confirmados (3). Conclusiones: La pesquisa activa contribuyó a la detección temprana de los pacientes con síntomas del virus relacionado con la COVID-19, lo cual demostró una vez más el rol de la medicina en la comunidad con la incorporación de los estudiantes de la Universidad de Ciencias Médicas de la provincia.

Introduction: The COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. The seriousness of its transmission worldwide, has transformed it into a pandemic with great social, economic impacts and in the population health. Objective: To describe the results of the active investigation as confrontation strategy to COVID-19 in El Caney town. Methods: An observational, descriptive and cross-sectional study was carried out in a population of 872 houses and 2 601 inhabitants, belonging to the family doctor offices 9, 11 and 25 of Dr. Mario Muñoz Monroy Polyclinic in El Caney town from Santiago de Cuba, so the active investigation was carried out for the confrontation to COVID-19 that had the participation of the medical sciences students, during February - April, 2021. Results: Most of the houses visited belonged to the family doctor office No. 25 (99.1 %); the less number of investigated people corresponded to the No. 9 (72.99 %) and although No. 11 showed the less percentage of houses visited and investigated, it had most of the confirmed cases (3). Conclusions: The active investigation contributed to the early detection of patients with symptoms of the virus related to COVID-19, which demonstrated once again the role of medicine in the community with the incorporation of students from the University of Medical Sciences.

A poor and delayed anti-SARS-CoV2 IgG response is associated to severe COVID-19 in children.

BACKGROUND: Most children and youth develop mild or asymptomatic disease during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, a very small number of patients suffer severe Coronavirus induced disease 2019 (COVID-19). The reasons underlying these different outcomes remain unknown. METHODS: We analyzed three different cohorts: children with acute infection (n=550), convalescent children (n=138), and MIS-C (multisystem inflammatory syndrome in children, n=42). IgG and IgM antibodies to the spike protein of SARS-CoV-2, serum-neutralizing activity, plasma cytokine levels, and the frequency of circulating Follicular T helper cells (cTfh) and plasmablasts were analyzed by conventional methods. FINDINGS: Fifty-eight percent of the children in the acute phase of infection had no detectable antibodies at the time of sampling while a seronegative status was found in 25% and 12% of convalescent and MIS-C children, respectively. When children in the acute phase of the infection were stratified according disease severity, we found that contrasting with the response of children with asymptomatic, mild and moderate disease, children with severe COVID-19 did not develop any detectable response. A defective antibody response was also observed in the convalescent cohort for children with severe disease at the time of admission. This poor antibody response was associated to both, a low frequency of cTfh and a high plasma concentration of inflammatory cytokines. INTERPRETATION: A weak and delayed kinetic of antibody response to SARS-CoV-2 together with a systemic pro-inflammatory profile characterize pediatric severe COVID-19. Because comorbidities are highly prevalent in children with severe COVID-19, further studies are needed to clarify their contribution in the weak antibody response observed in severe disease. FUNDING: National Agency for Scientific and Technological Promotion from Argentina (IP-COVID-19-0277 and PMO-BID-PICT2018-2548).

Blood neutrophils from children with COVID-19 exhibit both inflammatory and anti-inflammatory markers.

BACKGROUND: Perhaps reflecting that children with COVID-19 rarely exhibit severe respiratory symptoms and often remain asymptomatic, little attention has been paid to explore the immune response in pediatric COVID-19. Here, we analyzed the phenotype and function of circulating neutrophils from children with COVID-19. METHODS: An observational study including 182 children with COVID-19, 21 children with multisystem inflammatory syndrome (MIS-C), and 40 healthy children was performed in Buenos Aires, Argentina. Neutrophil phenotype was analyzed by flow cytometry in blood samples. Cytokine production, plasma levels of IgG antibodies directed to the spike protein of SARS-CoV-2 and citrullinated histone H3 were measured by ELISA. Cell-free DNA was quantified by fluorometry. FINDINGS: Compared with healthy controls, neutrophils from children with COVID-19 showed a lower expression of CD11b, CD66b, and L-selectin but a higher expression of the activation markers HLA-DR, CD64 and PECAM-1 and the inhibitory receptors LAIR-1 and PD-L1. No differences in the production of cytokines and NETs were observed. Interestingly, the expression of CD64 in neutrophils and the serum concentration of IgG antibodies directed to the spike protein of SARS-CoV-2 distinguished asymptomatic from mild and moderate COVID-19. INTERPRETATION: Acute lung injury is a prominent feature of severe COVID-19 in adults. A low expression of adhesion molecules together with a high expression of inhibitory receptors in neutrophils from children with COVID-19 might prevent tissue infiltration by neutrophils preserving lung function. FUNDING: This study was supported by the Ministry of Science and Technology (National Agency for Scientific and Technological Promotion, IP-COVID-19-0277 and PMO BID PICT 2018-2548), and University of Buenos Aires from Argentina (20020170100573BA).

Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial.

Necrotizing enterocolitis (NEC) is an inflammatory bowel disease and a leading cause of morbidity and mortality in preterm infants. In this study, a randomized double-blind parallel-group (1:1) trial was carried out in two neonatal intensive care units of two tertiary hospitals. Two hundred and twenty-five preterm newborns with an expected functional gastrointestinal tract were recruited and received an enteral dose of 75 mg of docosahexaenoic acid (DHA)/kg body weight or high-oleic sunflower oil daily for 14 days from the first enteral feed after birth. Confirmed NEC was evaluated with Bell's scale from stage ≥ IIa. Two hundred and fourteen randomized infants were analyzed in terms of the intent-to-treat (DHA-group: n = 105; control-group: n = 109); data for two hundred infants were analysed per protocol. Confirmed NEC was lower in infants from the DHA-group compared with the control-group (0/100 vs. 7/100; p = 0.007), with RR = 0.93 (95% CI 0.881 to 0.981), risk difference = -7%, (95% CI -12.00 to -1.99), and number needed-to-treat = 15 (95% CI 8.3 to 50). Intent-to-treat analysis showed a lower level of treatment failure in the DHA-group compared with the control-group (6/105 (6%) vs. 16/109 (15%); p = 0.03, RR = 0.905, (95% CI 0.826 to 0.991)). The results after multivariate-regression analysis remained significant. Adverse events (apart from the incidence of NEC) were not different between groups. A daily dose of DHA for 14 days starting with the first enteral feed may prevent NEC in preterm infants.

Double-task exercise programmes to strengthen cognitive and vascular health in older adults at risk of cognitive decline: protocol for a randomised clinical trial.

INTRODUCTION: Cognitive and physical declines are frequent causes of disability among older adults (OAs) in Mexico that imposes significant burden on the health system and OAs' families. Programmes to prevent or delay OAs' cognitive and physical decline are scarce. METHODS AND ANALYSIS: A double-blind randomised clinical trial will be conducted. The study will aim to evaluate two 24-week double-task (aerobic and cognitive) square-stepping exercise programmes for OAs at risk of cognitive decline-one programme with and another without caregiver participation-and to compare these with an aerobic-balance-stretching exercise programme (control group). 300 OAs (100 per group) affiliated with the Mexican Institute of Social Security (IMSS) between 60 and 65 years of age with self-reported cognitive concerns will participate. They will be stratified by education level and randomly allocated to the groups. The intervention will last 24 weeks, and the effect of each programme will be evaluated 12, 24 and 52 weeks after the intervention. Participants' demographic and clinical characteristics will be collected at baseline. The outcomes will include: (1) general cognitive function; (2) specific cognitive functions; (3) dual-task gait; (4) blood pressure; (5) carotid intima-media thickness; (6) OAs' health-related quality of life; and (7) caregiver burden. The effects of the interventions on each outcome variable will be examined using a repeated-measures analysis of variance (ANOVA), with study groups as the between-subjects variable and time as the within-subject variable. ETHICS AND DISSEMINATION: The study was approved by the IMSS Ethics and Research Committees (registration number: 2018-785-095). All participants will sign a consent form prior to their participation. The study results will be disseminated to the IMSS authorities, healthcare providers and the research community. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT04068376).

Natural History of Serum Enzyme Levels in Duchenne Muscular Dystrophy and Implications for Clinical Practice.

OBJECTIVE: In Duchenne muscular dystrophy, creatine kinase and transaminases are released into the circulation, indicating muscle injury. Their usefulness in monitoring muscle injury or disease progression has not yet been fully evaluated. Thus, this study examined serum creatine kinase and transaminase concentrations at different ages in patients with Duchenne muscular dystrophy and evaluated their association with muscle injury. DESIGN: This is a prospective cohort study that included 110 patients with Duchenne muscular dystrophy categorized by age groups. Creatine kinase and transaminases were quantified in the serum; the Vignos scale evaluated the muscle function. RESULTS: Creatine kinase and transaminase levels were higher in ambulatory than that in nonambulatory patients, which significantly decreased as age increased. Serum creatine kinase and transaminase concentrations were elevated in all ages, and those aged 3-4 yrs had the highest concentrations. Age and Vignos Scale were significantly correlated with creatine kinase and transaminase concentrations. Age, creatine kinase, and transaminases explained the 42.5% of loss of muscle function. CONCLUSIONS: This study added the knowledge on the natural history of Duchenne muscular dystrophy at different ages and confirmed that creatine kinase and transaminases decrease with age and loss of muscle function, making them generally inappropriate for monitoring response to therapy, although they are useful for the clinical diagnosis.

Microbial diversity assessment of polychlorinated biphenyl-contaminated soils and the biostimulation and bioaugmentation processes.

The aim of this study was to know the biodiversity of total microorganisms contained in two polychlorinated biphenyl-contaminated aged soils and evaluate the strategies of bioaugmentation and biostimulation to biodegrade the biphenyls. Besides, the aerobic cultivable microorganisms were isolated and their capacity to biodegrade a commercial mixture of six congeners of biphenyls was evaluated. Biodiversity of contaminated soils was dominated by Actinobacteria (42.79%) and Firmicutes (42.32%) phyla, and others in smaller proportions such as Proteobacteria, Gemmatimonadetes, Chloroflexi, and Bacteroidetes. At the genus level, the majority of the population did not exceed 7% of relative abundance, including Bacillus, Achromobacter, Clostridium, and Pontibacter. Furthermore, four autochthonous bacterial cultures were possible isolates from the soils, which were identified by partial sequencing of the 16S rRNA gene, as Bacillus sp., Achromobacter sp., Pseudomonas stutzeri, and Bacillus subtilis, which were used for the bioaugmentation process. The bioaugmentation and biostimulation strategies achieved a biodegradation of about 60% of both soils after 8 weeks of the process; also, the four isolates were used as mixed culture to biodegrade a commercial mix of six polychlorinated biphenyl congeners; after 4 weeks of incubation, the concentration decreased from 0.5 mg/L to 0.23 mg/L.

Enteral Docosahexaenoic Acid and Retinopathy of Prematurity: A Randomized Clinical Trial.

BACKGROUND: Retinopathy of prematurity (ROP) is a disorder of the retina of low-birth-weight preterm infants that potentially leads to blindness. Docosahexaenoic acid (DHA), is protective in experimental models, but its administration as part of parenteral nutrition has shown inconsistent results. We test the effect of enteral DHA to prevent ROP and/or severity and to reduce hospital stay. METHODS: This was a double-blind parallel clinical trial. Preterm infants (n = 110; 55 per group) with birth weight <1500 g but ≥1000 g were recruited in a neonatal intensive care unit. Infants were randomized to receive 75 mg of DHA/kg/d (DHA group) or high oleic sunflower oil (control group) for 14 days by enteral feeding. The effect of DHA was evaluated on any stage of ROP, severe ROP (stage ≥3) incidence, and hospital stay. Groups were compared with relative risk (RR) and 95% confidence interval (CI), Fisher's exact test, Student's t-test, or Mann-Whitney U-test, as appropriate. Logistic regression was applied to adjust for confounders. RESULTS: There was no difference between the DHA and control groups in ROP risk (RR for DHA = 0.79; 95% CI, 0.49-1.27; P = 0.33). However, patients who received DHA showed lower risk for stage 3 ROP (RR for DHA = 0.66; 95% CI, 0.44-0.99; P = 0.03). After adjusting for confounders, this decreased risk remained significant (adjusted odds ratio = 0.10; 95% CI, 0.011-0.886; P = 0.04). Hospital stay was similar between groups. CONCLUSION: Enteral DHA may reduce the incidence of stage 3 ROP.

Gene polymorphisms of angiotensin-converting enzyme and angiotensinogen and risk of idiopathic ischemic stroke.

OBJECTIVE: The renin-angiotensin system (RAS) is a hormonal signaling mechanism implicated in the atherosclerosis and regulation of blood pressure. Angiotensin-converting enzyme (ACE) a key enzyme in the RAS, plays important roles in vascular remodeling atherosclerosis, and ischemic stroke. The aim of this study was to examine the possible contribution of the I/D in the ACE gene, M235T and T174M in the angiotensinogen (AGT) gene polymorphisms with ischemic stroke in young Mexican population. MATERIALS AND METHODS: A total of 224 patients with diagnosis of idiopathic ischemic stroke ≤45 years of age, and 224 controls matched by age and gender, were recruited from 2006 and 2016. The I/D, M235T and T174M polymorphisms were determined in all participants by PCR-RFLP. RESULTS: There was a significant difference in the M235T genotype distribution (p = 0.01) and allele frequency between two groups (p = 0.01). Also, we found a significant difference in the T174M genotype distribution (p = 0.01) and the allele frequency between groups; (p = 0.02). In contrast, in I/D polymorphism, there was a similar genotype distribution; (p = 0.20) and allele distribution (p = 0.20). There were independent factors for ischemic stroke: M235T and T174M polymorphisms, smoking, hypertension, and familial history of atherothrombotic disease. The AGT levels were increased in the group of patients with stroke compared with the control group, but the AGT levels were not influenced by the allele or genotype in each polymorphism. CONCLUSIONS: The M235T and T174M polymorphisms represented an increased risk for stroke in young Mexican individuals. In contrast, the I/D was not associated with in the same group of patients. The AGT levels were higher in the acute phase of stroke, but it was not determined by the polymorphisms.

Body composition and body mass index in Duchenne muscular dystrophy: Role of dietary intake.

INTRODUCTION: In Duchenne muscular dystrophy (DMD) muscle is replaced by adipose tissue. The role of dietary intake (DI) in DMD has not been evaluated. In this study we examined body composition, body mass index (BMI), and adequacy of DI in patients with DMD and evaluated the influence of DI on body composition. METHODS: Patients (n = 101; age 3-18 years; BMI 11.8-29.5 kg/m2 ) completed a dietary recall to determine DI and then underwent dual-energy X-ray absorptiometry to determine body composition. RESULTS: Preschool-age and school-age boys with DMD had high total energy intake. Protein intake per kilogram exceeded recommendations. As age increased, the percentage of boys with abnormal BMI and fat mass increased, while lean mass decreased. Dietary intake did not predict body fat or lean mass. DISCUSSION: Age-dependent changes in BD in boys with DMD may be due to endogenous metabolic factors related to the underlying disease process and to disease-related mobility impairments. Muscle Nerve 59:295-302, 2019.

Evidence of muscle loss delay and improvement of hyperinsulinemia and insulin resistance in Duchenne muscular dystrophy supplemented with omega-3 fatty acids: A randomized study.

BACKGROUND & AIMS: Duchenne Muscular Dystrophy (DMD) is the most prevalent dystrophy of childhood and is characterized by generalized motor delays due to progressive muscular weakness, leading to loss of muscle mass. Additionally, patients with DMD develop obesity, hyperinsulinemia, and Insulin Resistance (IR). Omega-3 Long-Chain PolyUnsaturated Fatty Acids (Ω-3LCPUFA) increase fat mass, decrease lean mass, and decrease hyperinsulinemia and IR. The aim of this study was to analyze the impact of Ω-3LCPUFA consumption on lean mass, fat mass, hyperinsulinemia, and IR in children with DMD. METHODS: This placebo-controlled, double-blind, randomized study was carried out in 28 patients with DMD supplemented with 2.9 g/d of Ω-3LCPUFA (n = 14) or sunflower oil (placebo, n = 14) during 6 months. Serum glucose and insulin were measured at baseline and thereafter at months 3 and 6 of the intervention to estimate IR by HOmeostasis Model Assessment. Body composition was assessed by Dual Energy X-ray Absorptiometry. RESULTS: The percentage of change in EicosaPentaenoic Acid (EPA) and DocosaHexaenoic Acid (DHA) in erythrocytes was significantly (p < 0.05) higher in boys who consumed Ω-3LCPUFA than in the placebo group. Lean mass and fat mass (both in g/kg of Body Weight [BW]) had a trend toward being higher (p = 0.07 at month 3 and p = 0.085 at month 6) and lower (p = 0.05 at month 3 and p = 0.085 at month 6) respectively, in boys with DMD supplemented with Ω-3LCPUFA compared with the placebo group. The loss of lean mass was delayed in the Ω-3LCPUFA group; it started at month 6 but, in placebo, it started at month 3 of supplementation in comparison with the baseline of each group. Fasting insulin, percentage of boys with hyperinsulinemia, and IR were similar between the placebo and Ω-3LCPUFA groups during the 6 months of supplementation. The percentage of boys with IR was significantly (p = 0.045) lower at month 6 of supplementation in the Ω-3LCPUFA group than in the placebo group. CONCLUSION: This study suggests that Ω-3LCPUFA (2.9 g/day) intake during 6 months likely slows the progression of muscle loss, decreases the fat mass, and reduces IR in boys with DMD. The findings of this study provide scientific background for conducting a randomized trial focused of confirming the possible beneficial role of Ω-3LCPUFA on the previously mentioned alterations mentioned in boys with early muscle damage (without fibrosis) DMD. This research was registered at clinicaltrials.gov (NCT018264229).

Histomorphometric reference data of transiliac bone biopsy in children from 8 to 17 years old / Datos histomorfométricos de referencia de la biopsia ósea en niños de 8 a 17 años

Abstract: Background: Histomorphometric analysis of bone samples is a key tool for studying bone metabolism; however, only a few pediatric reference data exist. The aim of the present study is to report more reference data and to investigate if histomorphometric differences exist between age and gender. Methods: We obtained 19 transiliac bone samples previously marked with tetracycline, from children between 8 and 17 years (13 were male), with normal blood test results and urine biochemical bone markers. We evaluated bone histomorphometric parameters using a digitalizing table with osteomeasure to obtain normative data of means and standard deviations, as well as median and range. Due to the small sample, a Monte Carlo simulation was applied. Structural, static, dynamic, and resorptic histomorphometric parameters were evaluated by age and gender following the American Society for Bone and Mineral Research recommendations. Results: Bone volume (in the older children) and mineral apposition rate (in the younger children), the eroded surface (in boys), and the new bone wall thickness (in girls) were significantly increased. On the trabecular area of mineralization front, the modeling and the remodeling bone formation were similar (16 and 18%). The rest of the histomorphometric bone parameters by age and gender showed no significant difference. Conclusion: In healthy children, these bone histomorphometric findings, with these techniques and for this ages could be used as reference values.

Resumen: Introducción: El análisis histomorfométrico del tejido óseo para el estudio de las enfermedades metabólicas óseas, cuando se correlacionan los hallazgos clínicos, sigue siendo la herramienta con mayor sensibilidad y especificidad para la mayoría de los diagnósticos. En los niños existen pocos reportes histomorfométricos del tejido óseo metabólico normal, por lo que nuestro propósito es reportar más datos de referencia e investigar si hay diferencias histomorfométricas entre edades y sexos. Métodos: Estudio realizado en 19 niños de 8 a 17 años (13 masculinos) sin anomalías clínicas ni bioquímicas evidentes. Se tomaron muestras de tejido óseo transilíaco marcadas con tetraciclina. Se obtuvieron medias, desviaciones y rangos histomorfométricos totales, y correlación por edad y sexo, siguiendo las recomendaciones para la histomorfometría de la American Society for Bone and Mineral Research. Se realizó una simulación Montecarlo. Resultados: El volumen óseo (en niños mayores), la velocidad de agregación del mineral (en niños menores), la erosión trabecular periférica (en niños) y el grosor de la pared ósea nueva (en niñas) exhibieron aumentos significativos. En el área trabecular del frente de mineralización, el modelado y el remodelado de la formación ósea fueron similares (16 y 18%). El resto de los parámetros histomorfométricos óseos no mostraron diferencias significativas. Conclusiones: Estos hallazgos histomorfométricos del tejido óseo de niños normales con estas técnicas y para estas edades pueden ser utilizados como valores de referencia.

Histomorphometric reference data of transiliac bone biopsy in children from 8 to 17 years old.

Background: Histomorphometric analysis of bone samples is a key tool for studying bone metabolism; however, only a few pediatric reference data exist. The aim of the present study is to report more reference data and to investigate if histomorphometric differences exist between age and gender. Methods: We obtained 19 transiliac bone samples previously marked with tetracycline, from children between 8 and 17 years (13 were male), with normal blood test results and urine biochemical bone markers. We evaluated bone histomorphometric parameters using a digitalizing table with osteomeasure to obtain normative data of means and standard deviations, as well as median and range. Due to the small sample, a Monte Carlo simulation was applied. Structural, static, dynamic, and resorptic histomorphometric parameters were evaluated by age and gender following the American Society for Bone and Mineral Research recommendations. Results: Bone volume (in the older children) and mineral apposition rate (in the younger children), the eroded surface (in boys), and the new bone wall thickness (in girls) were significantly increased. On the trabecular area of mineralization front, the modeling and the remodeling bone formation were similar (16 and 18%). The rest of the histomorphometric bone parameters by age and gender showed no significant difference. Conclusion: In healthy children, these bone histomorphometric findings, with these techniques and for this ages could be used as reference values.

Introducción: El análisis histomorfométrico del tejido óseo para el estudio de las enfermedades metabólicas óseas, cuando se correlacionan los hallazgos clínicos, sigue siendo la herramienta con mayor sensibilidad y especificidad para la mayoría de los diagnósticos. En los niños existen pocos reportes histomorfométricos del tejido óseo metabólico normal, por lo que nuestro propósito es reportar más datos de referencia e investigar si hay diferencias histomorfométricas entre edades y sexos. Métodos: Estudio realizado en 19 niños de 8 a 17 años (13 masculinos) sin anomalías clínicas ni bioquímicas evidentes. Se tomaron muestras de tejido óseo transilíaco marcadas con tetraciclina. Se obtuvieron medias, desviaciones y rangos histomorfométricos totales, y correlación por edad y sexo, siguiendo las recomendaciones para la histomorfometría de la American Society for Bone and Mineral Research. Se realizó una simulación Montecarlo. Resultados: El volumen óseo (en niños mayores), la velocidad de agregación del mineral (en niños menores), la erosión trabecular periférica (en niños) y el grosor de la pared ósea nueva (en niñas) exhibieron aumentos significativos. En el área trabecular del frente de mineralización, el modelado y el remodelado de la formación ósea fueron similares (16 y 18%). El resto de los parámetros histomorfométricos óseos no mostraron diferencias significativas. Conclusiones: Estos hallazgos histomorfométricos del tejido óseo de niños normales con estas técnicas y para estas edades pueden ser utilizados como valores de referencia.

Lic Vivian Benito Valenciano: ejemplo de la educación médica superior en el siglo XXI / Lic Vivian Benito Valenciano: an example of higher medical education in the XXI century

Se exaltan la actividad pedagógica, el quehacer científico, los reconocimientos y la labor realizada en la Misión Internacionalista de la licenciada Vivian Benito Valenciano, quien a sus 33 años de vida laboral constituye una personalidad de obligatoria consulta cuando se pretende profundizar en la historia de la Facultad Enfermería - Tecnología de Santiago de Cuba, de la cual es fundadora. Transitó por la institución desde sus estudios técnicos, cuando era Politécnico de la Salud, en el cual asumió diversas responsabilidades; actualmente se mantiene como profesora del Departamento de Informática Médica donde desempeña una meritoria labor(AU)

The pedagogic activity, scientific work, recognitions and work carried out in the Internationalist Mission by the university graduate Vivian Benito Valenciano are exalted, who with 33 years of working experience constitutes a personality of obligatory consultation when it is sought to deepen in the history of the Nursing Technology Faculty in Santiago de Cuba, of which she is founder. She was in the the institution since her technical studies, when it was Health Polytechnic, in which she assumed diverse responsibilities; at the moment she stays as a professor of the Medical Computer Science Department where she performes a meritorious work(AU)

Lic. Vivian Benito Valenciano: ejemplo de la educación médica superior en el siglo XXI / Lic. Vivian Benito Valenciano: an example of higher medical education in the XXI century

Se exaltan la actividad pedagógica, el quehacer científico, los reconocimientos y la labor realizada en la Misión Internacionalista de la licenciada Vivian Benito Valenciano, quien a sus 33 años de vida laboral constituye una personalidad de obligatoria consulta cuando se pretende profundizar en la historia de la Facultad Enfermería - Tecnología de Santiago de Cuba, de la cual es fundadora. Transitó por la institución desde sus estudios técnicos, cuando era Politécnico de la Salud, en el cual asumió diversas responsabilidades; actualmente se mantiene como profesora del Departamento de Informática Médica donde desempeña una meritoria labor

The pedagogic activity, scientific work, recognitions and work carried out in the Internationalist Mission by the university graduate Vivian Benito Valenciano are exalted, who with 33 years of working experience constitutes a personality of obligatory consultation when it is sought to deepen in the history of the Nursing Technology Faculty in Santiago de Cuba, of which she is founder. She was in the the institution since her technical studies, when it was Health Polytechnic, in which she assumed diverse responsibilities; at the moment she stays as a professor of the Medical Computer Science Department where she performes a meritorious work