Genetic risk score for insulin resistance based on gene variants associated to amino acid metabolism in young adults.

Circulating concentration of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine and valine are increased in subjects with insulin resistance, which could in part be attributed to the presence of single nucleotide polymorphisms (SNPs) within genes associated with amino acid metabolism. Thus, the aim of this work was to develop a Genetic Risk Score (GRS) for insulin resistance in young adults based on SNPs present in genes related to amino acid metabolism. We performed a cross-sectional study that included 452 subjects over 18 years of age. Anthropometric, clinical, and biochemical parameters were assessed including measurement of serum amino acids by high performance liquid chromatography. Eighteen SNPs were genotyped by allelic discrimination. Of these, ten were found to be in Hardy-Weinberg equilibrium, and only four were used to construct the GRS through multiple linear regression modeling. The GRS was calculated using the number of risk alleles of the SNPs in HGD, PRODH, DLD and SLC7A9 genes. Subjects with high GRS (≥ 0.836) had higher levels of glucose, insulin, homeostatic model assessment- insulin resistance (HOMA-IR), total cholesterol and triglycerides, and lower levels of arginine than subjects with low GRS (p < 0.05). The application of a GRS based on variants within genes associated to amino acid metabolism may be useful for the early identification of subjects at increased risk of insulin resistance.

World Health Organization myth busters and indigenous perceptions of COVID-19: Quechua and Shipibo communities.

When the COVID (SARS-V2) pandemic swept across the world, it impacted Indigenous communities more than others. This is due to a variety of reasons: socioeconomic injustice and racialization, lack of access to equitable healthcare, and linguistic discrimination. As a result, several communities and community types demonstrated this effect when perceptions of inferences or other COVID-related information were measured. This paper reports on a participatory collaborative study with two Indigenous communities in rural Peru-ten Quechua-speaking communities in Southern Cuzco and three Shipibo-speaking communities in Ucayali regions. We investigate the communities' level of preparedness for the crisis by eliciting answers based on the World Health Organization COVID 'MythBusters' in a form of a semi-structured interview. Interviews were transcribed, translated, and analyzed in search of the effect of three variables: gender (male/female), language group (Shipibo/Quechua), and proficiency in the Indigenous language (from 0 to 4). Data reveal that all three variables have some effect on the target comprehension of COVID-related messages. Additionally, we explore other possible explanations.

Prevalence of adiposity-based chronic disease and its association with anthropometric and clinical indices: a cross-sectional study.

The present study aimed to determine the prevalence of adiposity-based chronic disease (ABCD) and its association with anthropometric indices in the Mexican population. A cross-sectional study was conducted in 514 adults seen at a clinical research unit. The American Association of Clinical Endocrinology/AACE/ACE criteria were used to diagnose ABCD by first identifying subjects with BMI ≥ 25 kg/m2 and those with BMI of 23-24·9 kg/m2 and waist circumference ≥ 80 cm in women or ≥ 90 cm in men. The presence of metabolic and clinical complications associated with adiposity, such as factors related to metabolic syndrome, prediabetes, type 2 diabetes, dyslipidaemia and arterial hypertension, were subsequently evaluated. Anthropometric indices related to cardiometabolic risk factors were then determined. The results showed the prevalence of ABCD was 87·4 % in total, 91·5 % in men and 86 % in women. The prevalence of ABCD stage 0 was 2·4 %, stage 1 was 33·7 % and stage 2 was 51·3 %. The prevalence of obesity according to BMI was 57·6 %. The waist/hip circumference index (prevalence ratio (PR) = 7·57; 95 % CI 1·52, 37·5) and the conicity index (PR = 3·46; 95 % CI 1·34, 8·93) were better predictors of ABCD, while appendicular skeletal mass % and skeletal muscle mass % decreased the risk of developing ABCD (PR = 0·93; 95 % CI 0·90, 0·96; and PR = 0·95; 95 % CI 0·93, 0·98). In conclusion, the prevalence of ABCD in our study was 87·4 %. This prevalence increased with age. It is important to emphasise that one out of two subjects had severe obesity-related complications (ABCD stage 2).

Sequential development of embryoblast-like memory entities in human cancer tissues: an evolutionary self-repair structure with pluripotentiality.

Hidden collective organization of cancer cells can partially or completely return to embryoid genotype-phenotype with the plasticity to transform their morphology on cell embryoblast-like memory entities by expression of dormant genes that arise from embryogenesis. After hundreds of driver mutations, cancer cells gain new abilities or attributes and recapitulate early stages of embryogenesis. Our findings document how malignant tissues reactivated ancestral storage memory and elaborate inside tumor glands spiral-pyramidal-fractal chiral crystals (Tc) as geometric attractor proteins and biomimicry the primitive cellular blastocyst embryoblast fluid-filled cavity. The resultant evolutionary embryoblast-like entity has higher survivability and spatial cephalic-caudal growth organization with pluripotentiality that carry the correct DNA instructions to repair, and regenerate. The isolation and manipulation of these order structures can guide and control the regenerative pathway mechanism in human tumors as follows: modify and reprogram the phenotype of the tumor where these entities are generated, establish a reverse primordial microscopic mold to use the swirlonic collective behavior of cellular building blocks to regenerate injured tissues, convert cancer cells to a normal phenotype through regeneration using the organizational level and scale properties of reverse genetic guidance, global control of mitotic activity and morphogenetic movements avoiding their spread and metastasis, determining a better life prognosis for patients who incubate these entities in their tumors compared to those who do not express them. An emergent self-repair order structure, biological template can develop targeted therapeutic alternatives not only in cancer but also in treatment of autoimmune, viral diseases, and in regenerative medicine and rejuvenation.

Effect of the BCAT2 polymorphism (rs11548193) on plasma branched-chain amino acid concentrations after dietary intervention in subjects with obesity and insulin resistance.

Branched-chain amino acids (BCAA) are considered markers of insulin resistance (IR) in subjects with obesity. In this study, we evaluated whether the presence of the SNP of the branched-chain aminotransferase 2 (BCAT2) gene can modify the effect of a dietary intervention (DI) on the plasma concentration of BCAA in subjects with obesity and IR. A prospective cohort study of adult subjects with obesity, BMI ≥ 30 kg/m2, homeostatic model assessment-insulin resistance (HOMA-IR ≥ 2·5) no diagnosed chronic disease, underwent a DI with an energy restriction of 3140 kJ/d and nutritional education for 1 month. Anthropometric measurements, body composition, blood pressure, resting energy expenditure, oral glucose tolerance test results, serum biochemical parameters and the plasma amino acid profile were evaluated before and after the DI. SNP were assessed by the TaqMan SNP genotyping assay. A total of eighty-two subjects were included, and fifteen subjects with a BCAT2 SNP had a greater reduction in leucine, isoleucine, valine and the sum of BCAA. Those subjects also had a greater reduction in skeletal muscle mass, fat-free mass, total body water, blood pressure, muscle strength and biochemical parameters after 1 month of the DI and adjusting for age and sex. This study demonstrated that the presence of the BCAT2 SNP promotes a greater reduction in plasma BCAA concentration after adjusting for age and sex, in subjects with obesity and IR after a 1-month energy-restricted DI.

Monitoring Sexually Transmitted Infections in Cervicovaginal Exfoliative Samples in Mexican Women.

BACKGROUND: Globally, Sexually Transmitted Infections (STIs) are a major cause of morbidity in sexually active individuals, having complications in reproduction health and quality of life. In concordance with the Sustainable Development Goals (SDG), the study aimed to investigate the prevalence of Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, HSV, and Mycoplasma spp. from cervicovaginal samples and to correlate them with the gynecological history of the patients. METHODS: Our analytical, prospective, and cross-sectional study included 377 women who participated in a reproductive health campaign during 2015-2016. Anthropometric and gynecological variables were obtained. Cervicovaginal specimens were collected and analyzed with a multiplex in-house PCR to detect Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, HSV, Mycoplasma spp., and Chlamydia trachomatis. RESULTS: The positive cases were 175/377 (46.4%) to at least one of the microorganisms. The most frequent pathogen detected in this population was Ureaplasma spp. (n = 111, 29.4%), followed by Mycoplasma spp. (n = 56, 14.9%) and Candida spp. (n = 47, 12.5%); 33.7% of the positive cases were single infections, whereas 12.7% had coinfection. The multiplex PCR assay was designed targeting nucleotide sequences. CONCLUSIONS: Our data demonstrated that monitoring STIs among asymptomatic patients will encourage target programs to be more precisely and effectively implemented, as well as make these programs more affordable, to benefit society by decreasing the prevalence of STIs.

Immunomodulation and Antioxidant Activities as Possible Trypanocidal and Cardioprotective Mechanisms of Major Terpenes from Lippia alba Essential Oils in an Experimental Model of Chronic Chagas Disease.

In the late phase of Trypanosoma cruzi infection, parasite persistence and an exaggerated immune response accompanied by oxidative stress play a crucial role in the genesis of Chronic Chagasic Cardiomyopathy (CCC). Current treatments (Benznidazole (BNZ) and Nifurtimox) can effect only the elimination of the parasite, but are ineffective for late stage treatment and for preventing heart damage and disease progression. In vivo trypanocidal and cardioprotective activity has been reported for Lippia alba essential oils (EOs), ascribed to their two major terpenes, limonene and caryophyllene oxide. To investigate the role of antioxidant and immunomodulatory mechanisms behind these properties, chronic-T. cruzi-infected rats were treated with oral synergistic mixtures of the aforementioned EOs. For this purpose, the EOs were optimized through limonene-enrichment fractioning and by the addition of exogenous caryophyllene oxide (LIMOX) and used alone or in combined therapy with subtherapeutic doses of BNZ (LIMOXBNZ). Clinical, toxicity, inflammatory, oxidative, and parasitological (qPCR) parameters were assessed in cardiac tissue. These therapies demonstrated meaningful antioxidant and immunomodulatory activity on markers involved in CCC pathogenesis (IFN-γ, TNF-α, IL-4, IL-10, and iNOS), which could explain their significant trypanocidal properties and their noteworthy role in preventing, and even reversing, the progression of cardiac damage in chronic Chagas disease.

Disagreement between PCR and serological diagnosis of Trypanosoma cruzi infection in blood donors from a Colombian endemic region. / Desacuerdo entre la PCR y la serología en el diagnóstico de la infección por Trypanosoma cruzi en donantes de una región endémica de Colombia

INTRODUCTION: Chagas' disease is the leading cause of infectious myocarditis worldwide. This infection caused by Trypanosoma cruzi is usually life-long and asymptomatic; however, the third part of infected people can develop severe or even fatal cardiomyopathy. As the parasitemia in the chronic phase is both low-grade and intermittent, T. cruzi infection is principally detected by serology, although this method has sensitivity and specificity limitations. OBJECTIVE: To determine the level of agreement between serologic and molecular tests in 658 voluntary blood donors from six provinces in the Colombian department of Santander. MATERIALS AND METHODS: We evaluated an array of diagnostic technologies by cross-section sampling performing a serological double diagnostic test for T. cruzi antibody detection (Chagas III ELISA™, BiosChile Group, and ARCHITECT Chagas CMIA™, Abbott), and DNA detection by polymerase chain reaction (PCR). We collected the demographic, clinical, and epidemiological information of participants. The sample size was calculated using Epidat™ and the statistical analysis was done with Stata 12.1™. RESULTS: PCR was six times more sensitive in detecting T. cruzi infection than ELISA/CMIA with prevalence values of 1.8% (12/658) and 0.3% (2/658), respectively, and kappa=0.28 (95%CI: -0.03 - 0.59). In contrast, serology showed a sensitivity of 16.7% (95%CI: 2.09 - 48.4) and a specificity of 100% (95%CI: 99.4 - 100). All seropositive samples were found to be positive by PCR. CONCLUSIONS: The implementation of PCR as a complementary method for screening donors could reduce the probability of false negative and the consequent risk of transfusional-transmission of Chagas' disease, especially in endemic regions.

Introducción. La enfermedad de Chagas constituye la principal causa de miocarditis infecciosa en el mundo. Causada por Trypanosoma cruzi, la infección puede persistir toda la vida de manera asintomática y silenciosa, pero un tercio de los infectados desarrolla cardiomiopatía grave. Debido a que la parasitemia en la fase crónica es baja e intermitente, el diagnóstico se hace principalmente mediante la detección de anticuerpos (serología), método que tiene limitaciones de sensibilidad y especificidad. Objetivo. Determinar la concordancia entre el diagnóstico serológico y molecular de T. cruzi en 658 donantes voluntarios de sangre del departamento de Santander, Colombia. Materiales y métodos. Se hizo un estudio de evaluación de tecnologías diagnósticas con muestreo transversal, utilizando un doble diagnóstico serológico para la detección de anticuerpos anti-T. cruzi (Chagas III ELISA™, BiosChile Group, y ARCHITECT Chagas CMIA™, Abbott) y la de ADN por PCR. Se recolectó la información demográfica, clínica y epidemiológica de los participantes. El tamaño de la muestra se estimó utilizando Epidat™ y el análisis estadístico se hizo mediante Stata 12.1™. Resultados. La sensibilidad de la PCR fue seis veces mayor que la de las pruebas de ELISA/CMIA, con prevalencias de 1,8 % (12/658) y 0,3 % (2/658), respectivamente, y kappa de 0,28 (IC95% -0,03 - 0,59). La sensibilidad serológica fue de 16,7 % (IC95% 2,09 - 48,4) y la especificidad de 100 % (IC95% 99,4 - 100). Todas las muestras seropositivas fueron positivas también en la PCR. Conclusiones. El uso de la PCR como método complementario para la tamización de donantes podría reducir el riesgo de falsos negativos y disminuir los casos de transmisión transfusional de la enfermedad de Chagas, especialmente en regiones endémicas.

Caracterización de la plaquetopenia, leucopenia y aumento del hematocrito en la evolución y gravedad de los pacientes con diagnóstico de dengue / Characterization of thrombocytopenia, leukopenia and increased hematocrit in the evolution and severity of patients with dengue diagnosis

El virus del dengue (DENV) ha frecuentado nuestro planeta por más de tres siglos. La picadura del Aedes aegypti causa el DENV. El diagnóstico clínico y laboratorial son importantes para el manejo del dengue. Objetivo: caracterizar la presencia de la plaquetopenia, leucopenia y aumento del hematocrito con la evolución y gravedad de los pacientes con Dengue, en el Hospital Univalle, en la ciudad de Cochabamba, Bolivia. Material y métodos: estudio retrospectivo, longitudinal y analítico, desde el 2017 al 2020. Resultados: se identificaron 235 pacientes, 83% el 2020; el 65% entre 19 a 45 años; 54% de sexo masculino, 80% provienen de Cercado-Cochabamba, siendo más del 95% de la zona sud. La prueba de detección de la proteína NS1Ag (AccuBio Tech Co, Ltd.) se usó en 71%; 56% se hospitalizaron; más del 50% presentaron sintomatología entre el 2do y 5to día. Dentro la clasificación del dengue, el 75% perteneció a dengue sin signos de alarma (p= 45% en varones, presentando más de 5 días de hospitalización (p=0,023). Conclusiones: plaquetopenia, leucopenia y el aumento del hematocrito son biomarcadores de severidad clínica y estancia hospitalaria, asociados a un diagnóstico precoz, empleando la sintomatología y pruebas rápidas disponibles; siendo necesario considerar la presencia de pacientes autóctonos de la zona sud de Cochabamba, Cercado.

Dengue virus (DENV) has haunted our planet for more than three centuries. The Aedes aegypti bite causes DENV. Clinical and laboratory diagnosis are important for the management of dengue. Objective: to characterize the presence of plaquetopenia, leukopenia and increased hematocrit with the evolution and severity of patients with Dengue, Hospital Univalle. Material and methods: retrospective, longitudinal and analytical study, 2017 to 2020. Results: 235 patients were identified, 83% in 2020; 65% between 19 to 45 years old; the male sex with 54%. 80% come from Cercado-Cochabamba, of these more than 95% from the southern area. The test with the detection of the NS1Ag protein (AccuBio Tech Co, Ltd.) was used in 71%; 56% were hospitalized; more than 50% presented symptoms between the 2nd and 5th day; Within the dengue classification, 75% belonged to dengue without warning signs (p = 45% in men and represented more than 5 days of hospitalization (p = 0,023). Conclusions: Plaquetopenia, leukopenia and increased hematocrit are biomarkers of clinical severity, hospital stay, associated with an early diagnosis, using the symptoms and rapid tests available; finally, consider the presence of autochthonous patients from the southern area of Cochabamba, Cercado.

Perspective-Taking With Deictic Motion Verbs in Spanish: What We Learn About Semantics and the Lexicon From Heritage Child Speakers and Adults.

In English, deictic verbs of motion, such as come can encode the perspective of the speaker, or another individual, such as the addressee or a narrative protagonist, at a salient reference time and location, in the form of an indexical presupposition. By contrast, Spanish has been claimed to have stricter requirements on licensing conditions for venir ("to come"), only allowing speaker perspective. An open question is how a bilingual learner acquiring both English and Spanish reconciles these diverging language-specific restrictions. We face this question head on by investigating narrative productions of young Spanish-English bilingual heritage speakers of Spanish, in comparison to English monolingual and Spanish dominant adults and children. We find that the young heritage speakers produce venir in linguistic contexts where most Spanish adult speakers do not, but where English monolingual speakers do, and also resemble those of young monolingual Spanish speakers of at least one other Spanish dialect, leading us to generate two mutually-exclusive hypotheses: (a) the encoding of speaker perspective in the young heritage children is cross-linguistically influenced by the more flexible and dominant language (English), resulting in a wider range of productions by these malleable young speakers than the Spanish grammar actually allows, or (b) the young Spanish speakers are exhibiting productions that are in fact licensed in the grammar, but which are pruned away in the adult productions, being supplanted by other forms as the lexicon is enriched. Given independent evidence of the heritage speakers' robust Spanish linguistic competence, we turn to systematically-collected acceptability judgments of three dialectal varieties of monolingual adult Spanish speakers of the distribution of perspective-taking verbs, to assess their competence and adjudicate between (a) and (b). We find that adults accept venir in contexts in which they do not produce it, leading us to argue that (a) venir is not obligatorily speaker-oriented in Spanish, as has been claimed, (b) adults may not produce venir in these contexts because they instead select more specific motion verbs, and (c) for heritage bilingual children, the more dominant language (English) may support the grammatically licensed but lexically-constrained productions in Spanish.

Immediate feeding tolerance in patients with mild acute biliary pancreatitis.

ANTECEDENTES: La pancreatitis aguda leve es una inflamación local del páncreas sin complicaciones locales ni falla orgánica. Su manejo consiste en tres elementos básicos: hidratación, analgesia y ayuno. La realimentación se inicia cuando el paciente no tiene dolor y refiere apetito, pero el momento exacto para iniciarla no está previamente documentado. OBJETIVO: Determinar la tolerancia a la alimentación oral inmediata (8 horas posterior al inicio del manejo) en comparación con la alimentación temprana (48 horas) en los pacientes con pancreatitis aguda biliar leve. MÉTODO: Se incluyeron pacientes con pancreatitis aguda biliar leve y se aleatorizaron en dos grupos: A) alimentación temprana a las 48 horas (30 pacientes) y B) alimentación inmediata a las 8 horas de inicio del manejo (29 pacientes). Fueron evaluados por un tercer observador ciego (no involucrado en el estudio) para documentar síntomas como náusea, vómito, reactivación del dolor abdominal, síndrome de respuesta inflamatoria sistémica, tolerancia alimentaria y estancia hospitalaria. RESULTADOS: No se encontraron diferencias significativas entre los grupos en cuanto a datos clínicos y bioquímicos. La estancia hospitalaria disminuyó significativamente en el grupo B (5.4 vs. 7.8 días; p < 0.003). CONCLUSIÓN: La alimentación inmediata en las primeras 8 horas del manejo de los pacientes con pancreatitis aguda biliar leve es bien tolerada y segura, y reduce la estancia hospitalaria. BACKGROUND: Mild acute pancreatitis is defined as pancreatic edema, without organic failure and without local complications. Its management consists in three basic elements: hydration, analgesia and fasting. Start refeeding when the patient haven´t pain and referring hungry, but exact time for this is not previously documented. OBJECTIVE: To determine the tolerance to immediate oral feeding (8 hours after the start of management) compared to early feeding (48 hours) in patients with mild acute biliary pancreatitis. METHOD: Included all patient with mild acute biliary pancreatitis, and they were randomized in to two groups: A) early oral feeding (n = 30) and B) immediate oral feeding (n = 29). They were evaluated by a third blind observer (not involved in the study) for documented symptoms like nausea, vomiting, reactivation of abdominal pain, systemic inflammatory response syndrome, food tolerance and hospital stay. RESULTS: There were no significant differences between both groups in the clinical data or in the biochemical studies. The hospital stay was significantly less in the group B (5.4 vs. 7.8 days; p < 0.003). CONCLUSION: Immediate oral feeding is well tolerated and secure in patients with mild acute biliary pancreatitis.

Serum amino acid concentrations are modified by age, insulin resistance, and BCAT2 rs11548193 and BCKDH rs45500792 polymorphisms in subjects with obesity.

BACKGROUND & AIMS: The amino acid profile of young adults is modified by sex, body mass index (BMI) and insulin resistance (IR). However, we do not know if age or the presence of specific polymorphisms in the genes of BCAT2 and BCKDH contribute to changes in the amino acid profile, especially in subjects with obesity. Therefore, we have evaluated the effect of age, the presence of IR and the polymorphisms of BCAT2 rs11548193 and BCKDH rs45500792 on the concentration of amino acids in subjects with obesity. METHODS: This was a cross-sectional study conducted with 487 subjects with obesity. Participants underwent a physical examination in which their clinical history was obtained and a blood sample was taken for biochemical, hormonal, and DNA analysis. RESULTS: Adults <30 years old with obesity had higher levels of alanine, arginine, aspartate, histidine, leucine, lysine, methionine, phenylalanine, proline, serine and valine than adults ≥30 years old. Interestingly, regardless of age, we found that arginine, aspartate, serine decreased, while proline and tyrosine increased in the presence of IR; tyrosine and sum of branched-chain amino acids (∑BCAA) were the amino acids that increased in the presence of BCAT2 rs11548193 and BCKDH rs45500792 polymorphisms. CONCLUSIONS: We found that the amino acid profiles of subjects with obesity are differentially modified by age, the presence of IR, and the presence of the BCAT2 rs11548193 and BCKDH rs45500792 polymorphisms.

Prevalence and correlation of human papillomavirus genotypes with clinical factors in cervical samples from Mexican women.

IMPACT STATEMENT: We are submitting data regarding the prevalence and type distribution of the HPV infection and the risk factors associated with it, which may provide a valuable reference to reinforce screening strategies, and to maintain HPV genotype surveillance in Mexico. We discuss the overall prevalence of HPV infection as detected in normal cytological samples stratified by age, different types of infection, and oncogenic capacity. One of the most important findings was that common HPV genotypes detected in healthy women were the genotype numbers: 6, 31, 16, and 56, likewise, smoking and having a history of more than three sexual partners over their lifetime, represented the main risk factors in this study. Furthermore, we found a low frequency of cytological abnormalities and CIN 1-3 in women with HR-HPV.

Enhanced methane production and organic matter removal from tequila vinasses by anaerobic digestion assisted via bioelectrochemical power-to-gas.

In this study, showed a strategy to generate methane and remove organic matter removal from tequila vinasses through of anaerobic digestion assisted via bioelectrochemical power to-gas. Specific methanogenic activity (SMA) assays in batch mode were tested and a single-stage bioelectrochemical upflow anaerobic sludge blanket reactor (UASB) was evaluated to generate methane during tequila vinasses treatment. The results showed that the methane production in the bioelectrochemical UASB reactor applied at low voltage of 0.5 V and under HRT of 7 d was higher than the in the conventional UASB reactor. The specific methane production rate in bioelectrochemical UASB reactor was up to 2.9 NL CH4/L d, with a maximum methane yield of 0.32 NL CH4/g CODremoved. Similar COD removals were observed in the bioelectrochemical UASB reactor and conventional reactors (92-93%). High carbon dioxide reduction and hydrogen production were observed in the bioelectrochemical UASB reactor.

Effect of the intake of dietary protein on insulin resistance in subjects with obesity: a randomized controlled clinical trial.

PURPOSE: We compared the effect of diets with different amounts and sources of dietary protein on insulin sensitivity (IS) in subjects with obesity and insulin resistance (IR). METHODS: Eighty subjects with obesity (BMI ≥ 30 kg/m2) and IR (Matsuda index < 4.3 and HOMA-IR ≥ 2.5) over 18 years old were randomized to four groups for a one-month period: a normal protein diet (< 20%) with a predominance of animal protein (Animal NP) or vegetable protein (Vegetable NP) and a high-protein diet (25-30%) with a predominance of animal protein (Animal HP) or vegetable protein (Vegetable HP). Baseline and final measurements of body weight, body composition, biochemical parameters, blood pressure (BP), resting energy expenditure and plasma amino acid profiles were performed. RESULTS: Body weight, BMI and waist circumference decreased in all groups. Interestingly, the IS improved more in the Animal HP (Matsuda index; 1.39 vs 2.58, P = 0.003) and in the Vegetable HP groups (Matsuda index; 1.44 vs 3.14, P < 0.0001) after one month. The fat mass, triglyceride levels, C-reactive protein levels and the leptin/adiponectin index decreased; while, the skeletal muscle mass increased in the Animal and Vegetable HP groups. The BP decreased in all groups except the Animal NP group. CONCLUSION: Our study demonstrates that a high-protein hypocaloric diets improves IS by 60-90% after one month in subjects with obesity and IR, regardless of weight loss and the source of protein, either animal or vegetable. TRIAL REGISTRATION: The trial is registered at clinicaltrials.gov (NCT03627104), August 13, 2018.

Genistein stimulates insulin sensitivity through gut microbiota reshaping and skeletal muscle AMPK activation in obese subjects.

OBJECTIVE: Obesity is associated with metabolic abnormalities, including insulin resistance and dyslipidemias. Previous studies demonstrated that genistein intake modifies the gut microbiota in mice by selectively increasing Akkermansia muciniphila, leading to reduction of metabolic endotoxemia and insulin sensitivity. However, it is not known whether the consumption of genistein in humans with obesity could modify the gut microbiota reducing the metabolic endotoxemia and insulin sensitivity. RESEARCH DESIGN AND METHODS: 45 participants with a Homeostatic Model Assessment (HOMA) index greater than 2.5 and body mass indices of ≥30 and≤40 kg/m2 were studied. Patients were randomly distributed to consume (1) placebo treatment or (2) genistein capsules (50 mg/day) for 2 months. Blood samples were taken to evaluate glucose concentration, lipid profile and serum insulin. Insulin resistance was determined by means of the HOMA for insulin resistance (HOMA-IR) index and by an oral glucose tolerance test. After 2 months, the same variables were assessed including a serum metabolomic analysis, gut microbiota, and a skeletal muscle biopsy was obtained to study the gene expression of fatty acid oxidation. RESULTS: In the present study, we show that the consumption of genistein for 2 months reduced insulin resistance in subjects with obesity, accompanied by a modification of the gut microbiota taxonomy, particularly by an increase in the Verrucomicrobia phylum. In addition, subjects showed a reduction in metabolic endotoxemia and an increase in 5'-adenosine monophosphate-activated protein kinase phosphorylation and expression of genes involved in fatty acid oxidation in skeletal muscle. As a result, there was an increase in circulating metabolites of ß-oxidation and ω-oxidation, acyl-carnitines and ketone bodies. CONCLUSIONS: Change in the gut microbiota was accompanied by an improvement in insulin resistance and an increase in skeletal muscle fatty acid oxidation. Therefore, genistein could be used as a part of dietary strategies to control the abnormalities associated with obesity, particularly insulin resistance; however, long-term studies are needed.

Caracterización de niños menores de 5 años con sibilancias / Characterization of children under five years with wheezing

RESUMEN Fundamento: La sibilancia se presenta con frecuencia en las edades pediátricas; algunas características presentes en los niños con sibilancia nos pueden ayudar a predecir su evolución en la mayoría de los pacientes. Objetivo: Caracterizar a niños menores de 5 años con sibilancias. Metodología: Se realizó un estudio observacional descriptivo en Guáimaro entre junio de 2015 y diciembre de 2016, en 329 niños menores de 5 años los cuales presentaron sibilancias. La información se obtuvo mediante un cuestionario aplicado a los padres de los niños. Resultados: En 62.3 % la sibilancia comenzó antes del año de vida, 55.1 % eran masculinos, 65.3 % fueron ocasionales y 38.9 % presentaron rasgo atópico. La causa en 41.9 % de los niños fue la bronquiolitis y en 36.8 % la alérgica. El 49.8 % de niños con sibilancias asociadas a infecciones respiratorias comenzaron antes del año y el 27.9 % de las no vinculadas a estas infecciones comenzaron después del año. El 80.5 % de los sibilantes ocasionales habían comenzado antes del año de vida y 71.9 % de los recurrentes después del año. El rasgo atópico estuvo presente en 79.8 % de los recurrentes y 17.2 % de los ocasionales. Conclusiones: Las características de los niños con sibilancia fueron: predominio de los niños menores de 1 año, masculinos, sibilantes ocasionales y no tuvieron rasgo atópico. Las sibilancias asociadas a infecciones respiratorias fueron más frecuentes. La mayoría de los sibilantes ocasionales tuvieron su primer episodio antes del año de vida y no presentaron rasgo atópico asociado, y los sibilantes recurrentes presentaron su primer episodio obstructivo después del año y tenían rasgo atópico asociado.

ABSTRACT Background: Wheezing occurs frequently in pediatric ages; some characteristics present in children with wheezing can help us to predict its evolution in most patients. Objective: To characterize children under five years with wheezing. Methodology: A descriptive observational study was conducted in Guáimaro from June 2015 to December 2016, in 329 children under 5 years who presented wheezing. The information was obtained through a questionnaire applied to the children´s parents. Results: In 62.3 %, wheezing began before the year of life, 55.1 % were male, 65.3 % were occasional and 38.9 % atopic. The cause in 41.9 % of the children was bronchiolitis and in 36.8 % allergic. 49.8 % of children with wheezing associated with respiratory infections started before the year and 27.9 % of those not related to these infections started after the year. 80.5 % of the occasional sibilants had begun before the year of life and 71.9 % of the recurrent ones after the year. The atopic trait was present in 79.8 % of the recurrent and 17.2 % of the occasional ones. Conclusions: The characteristics of children with wheezing were: predominance of children under 1 year old, male, occasional wheezing and had no atopic trait. Wheezing associated with respiratory infections was more frequent. Most occasional sibilants had their first episode before the year of life and did not present associated atopic trait, and recurrent sibilants presented their first obstructive episode after the year and had associated atopic trait.

Caracterización de niños menores de 5 años con sibilancias / Characterization of children under five years with wheezing

RESUMEN Fundamento: La sibilancia se presenta con frecuencia en las edades pediátricas; algunas características presentes en los niños con sibilancia nos pueden ayudar a predecir su evolución en la mayoría de los pacientes. Objetivo: Caracterizar a niños menores de 5 años con sibilancias. Metodología: Se realizó un estudio observacional descriptivo en Guáimaro entre junio de 2015 y diciembre de 2016, en 329 niños menores de 5 años los cuales presentaron sibilancias. La información se obtuvo mediante un cuestionario aplicado a los padres de los niños. Resultados: En 62.3 % la sibilancia comenzó antes del año de vida, 55.1 % eran masculinos, 65.3 % fueron ocasionales y 38.9 % presentaron rasgo atópico. La causa en 41.9 % de los niños fue la bronquiolitis y en 36.8 % la alérgica. El 49.8 % de niños con sibilancias asociadas a infecciones respiratorias comenzaron antes del año y el 27.9 % de las no vinculadas a estas infecciones comenzaron después del año. El 80.5 % de los sibilantes ocasionales habían comenzado antes del año de vida y 71.9 % de los recurrentes después del año. El rasgo atópico estuvo presente en 79.8 % de los recurrentes y 17.2 % de los ocasionales. Conclusiones: Las características de los niños con sibilancia fueron: predominio de los niños menores de 1 año, masculinos, sibilantes ocasionales y no tuvieron rasgo atópico. Las sibilancias asociadas a infecciones respiratorias fueron más frecuentes. La mayoría de los sibilantes ocasionales tuvieron su primer episodio antes del año de vida y no presentaron rasgo atópico asociado, y los sibilantes recurrentes presentaron su primer episodio obstructivo después del año y tenían rasgo atópico asociado.

ABSTRACT Background: Wheezing occurs frequently in pediatric ages; some characteristics present in children with wheezing can help us to predict its evolution in most patients. Objective: To characterize children under five years with wheezing. Methodology: A descriptive observational study was conducted in Guáimaro from June 2015 to December 2016, in 329 children under 5 years who presented wheezing. The information was obtained through a questionnaire applied to the children´s parents. Results: In 62.3 %, wheezing began before the year of life, 55.1 % were male, 65.3 % were occasional and 38.9 % atopic. The cause in 41.9 % of the children was bronchiolitis and in 36.8 % allergic. 49.8 % of children with wheezing associated with respiratory infections started before the year and 27.9 % of those not related to these infections started after the year. 80.5 % of the occasional sibilants had begun before the year of life and 71.9 % of the recurrent ones after the year. The atopic trait was present in 79.8 % of the recurrent and 17.2 % of the occasional ones. Conclusions: The characteristics of children with wheezing were: predominance of children under 1 year old, male, occasional wheezing and had no atopic trait. Wheezing associated with respiratory infections was more frequent. Most occasional sibilants had their first episode before the year of life and did not present associated atopic trait, and recurrent sibilants presented their first obstructive episode after the year and had associated atopic trait.

DPP-4 Levels Are Increased in Subjects with Poor Sleep Quality.

Background: Up to 30% of the population has sleep disturbances, generating a negative health impact, a situation that is often not known and no medical attention is sought. It has been observed that after a total deprivation of sleep, the levels of dipeptidyl peptidase 4 (DPP-4) tend to increase. The aim of this study was to compare serum levels of DPP-4 in healthy subjects, with adequate and poor-quality sleep needing medical/pharmacological treatment. Materials and Methods: Cross-sectional study of subjects scheduled for elective surgery with low cardiometabolic risk. Subjects between 18-70 years of age were included, without previous diagnosed pathology (diabetes mellitus type 2; neoplasm; nephropathy; and liver disease) and major amputations, and who signed informed consent. The study protocol was aproved in the Local Committee for Ethics and Research, number 45-16. Anthropometry was performed (% body fat; waist and neck circumferences), and sleep quality assessment (Pittsburgh Sleep Quality Index [PSQI]) to classify them as worthy or not worthy of medical/pharmacological care. Serum DPP-4 was determined by Enzime Linked Immunosorbent Assay (ELISA). The statistical analysis was done in RStudio Software. Results: Fifty seven subjects (2017-2018) were included, with a combined frequency of overweight/obesity of 66.6% and with abdominal circumference values of 93.2 ± 13.6, higher than that proposed by the International Diabetes Federation. The PSQI was 8.3 ± 4.1, and 56.1% were classified as worthy of medical/pharmacological attention. When comparing the levels of DPP-4, these were higher in this group 2385.0 ± 2082.0 versus not worthy 1716.7 ± 1261.7 pg/mL, being statistically significant (P = 0.035). Conclusions: The elevated levels of DPP-4 in person with poor quality sleep worthy of medical/pharmacological treatment could be an early indicator of metabolic disorders, which need to be evaluated in depth.

Realidad Virtual como Tratamiento para la Fobia Específica a las Arañas: Una Revisión Sistemática / Virtual Reality as a Treatment for Spider Phobia: A Systematic Review

Resumen El creciente interés que ha traído el estudio de las fobias y entre ellas la fobia específica, ha dado lugar al uso diverso de tratamientos, que incluyen la realidad virtual como técnica innovadora. El presente estudio tuvo como objetivo evaluar el impacto de la Realidad Virtual (RV) como tratamiento para la fobia específica a las arañas, a través de una revisión sistemática de investigaciones que hayan sido publicadas en los últimos 10 años (2008 a 2018) en la base de datos Scopus. La revisión sistemática se realizó bajo los lineamientos de la metodología PRISMA. Inicialmente, se identificaron 309 artículos que contaban con los términos de búsqueda en título, resumen y palabras clave, posteriormente, se seleccionaron 109 estudios experimentales ya culminados, se excluyeron otras fobias específicas y otros tipos de tecnologías, siendo seleccionados 10 artículos para análisis a texto completo, incluyendo así solo 5 artículos para la revisión, que usaban la realidad virtual como tratamiento. Acorde a los resultados se encontró evidencia que sugiere que este tipo de intervenciones pueden ser relativamente eficaces para abordar esta problemática, ya que los resultados indican disminución significativa en indicadores clínicos, pero existen también varias limitaciones de orden metodológico. Se espera que esta revisión sistemática promueva investigaciones que usen la realidad virtual como tratamiento para la fobia específica a las arañas, mejorando las limitaciones identificadas en el estudio.

Abstract The growing interest that has brought the study of phobias and among them the specific phobia, has given rise to the diverse use of treatments, which include virtual reality as an innovative technique. The objective of this study was to evaluate the impact of Virtual Reality (VR) as a treatment for spider-specific phobia, through a systematic review of research that has been published in the last 10 years (2008 to 2018) in the Scopus database. The systematic review was carried out under the guidelines of the PRISMA methodology, which were thus excluded; taking into account the search terms in title, summary and keywords, 309 articles were identified, 109 experimental studies were already completed, other specific phobias and other types of technologies were excluded, 10 articles were selected for full-text analysis, including so only 5 articles for the review, which used virtual reality as a treatment. According to the results, evidence was found that suggests that this type of treatment may be relatively effective in addressing this problem, since the results indicate a significant decrease in clinical indicators, but there are also several methodological limitations. It is expected that this systematic review will promote Research that uses virtual reality as a treatment for spider-specific phobia, improving the limitations identified in the study.