Diagnostic Accuracy of the Triglyceride-Glucose Index (TyG), TyG Body Mass Index, and TyG Waist Circumference Index for Liver Steatosis Detection.

BACKGROUND: The triglyceride-glucose index (TyG) and a combination of body mass index (BMI) and waist circumference (WC) have been proposed as predictive scores for liver steatosis (LS). The aim of this study was to determine the diagnostic accuracy of these indices compared with controlled attenuation parameters (CAPs) and other predictive scores of LS. METHODS: A retrospective analysis of patients who attended a check-up unit in 2021 was performed. LS was determined by CAP. Anthropometric and biochemical parameters for calculating TyG, TyG-BMI, TyG-WC, fatty liver index, and hepatic steatosis index were obtained. ROC curve was used to establish the best cut-off point of each TyG index for LS detection. The accuracy was determined for all patients, as well as for overweight and diabetic patients. RESULTS: Medical records of 855 patients with a median age of 48 [IQR, 44-54] years and a BMI of 25.7 [IQR 23.4-28.1] kg/m2 were included. According to CAP, LS prevalence was 31.8% (n = 272). TyG-BMI and TyG-WC show better AUCs compared with CAP (0.82, 0.81), FLI (0.96, both), and HSI (0.93, 0.85). For diabetic patients, TyG-WC shows an AUC of 0.70. Meanwhile, TyG-BMI shows better accuracy (0.75) compared with CAP. CONCLUSIONS: TyG-BMI and TyG-WC showed a superior predictive accuracy for detecting LS compared with the TyG index.

Mercury and Selenium in Muscle and Target Organs of Scalloped Hammerhead Sharks Sphyrna lewini of the SE Gulf of California: Dietary Intake, Molar Ratios, Loads, and Human Health Risks.

Selenium and mercury were evaluated in muscle, liver, kidney, brain, and the stomach contents of juvenile scalloped hammerhead shark Sphyrna lewini. Se:Hg molar ratios were calculated. The average Hg levels in muscle ranged from 0.12 to 1.17 µg/g (wet weight); Hg was <0.39 µg/g in liver and kidneys and <0.19 µg/g in brain. The lowest value of Se was found in muscle (0.4 µg/g) and the highest in kidney (26.7 µg/g). An excess of Se over Hg was found, with Se:Hg molar ratios >1. Correlations were found for Hg in muscle with size, age, and weight, and also for Hg in liver with size, age, and weight. Hg in muscle was significantly positive correlated to Hg in brain as well as Hg in liver was correlated to Hg in kidney. The highest Hg in preys was for carangid fishes; scombrid and carangid fishes contributed with the highest Se levels. Results suggest that more than 98 % of the total Hg and 62 % of Se end up in muscle and might be affected by factors, such as geographical area, age, size, and feeding habits. The muscle of S. lewini should be consumed by people cautiously so as not to exceed the recommended intake per week.

Depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS): genetic vulnerability and sex effects.

The present study compares the occurrence of depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS) in patients of Multiplex (MS) and Simplex Schizophrenia families (SS). The Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychopathology. A total of 206 paranoid schizophrenia patients were studied according DSM-IV criteria. The Family Interview for Genetic Studies (FIGS) was used to study the families. A result in the FIGS for a positive family history of schizophrenia was referred as MS (patients); its lack as SS (patients). CDSS scores were compared among MS and SS patients and possible sex differences intra- and inter-groups were explored. In the analysis of our sample (30) 19% of the total persons with schizophrenia group was depressed. The depressive symptoms measured by the CDSS were higher in females and the MS males group. Males from MS group showed more depressive symptoms than males from SS group. No differences with females from both groups were found. Findings in this study underscore the importance of gender and family history in understanding the heterogeneity of schizophrenia. This study suggests that sex and familiar history are important to consider in studying depressive symptoms.

Impairment of emotional expression recognition in schizophrenia: a Cuban familial association study.

It is well established that schizophrenia is associated with difficulties in recognizing facial emotional expressions, but few studies have reported the presence of this deficit among their unaffected relatives. This study attempts to add new evidence of familial association on an emotional expression processing test. The study evaluated the performance of 93 paranoid schizophrenia patients, 110 first-degree relatives of probands from multiplex schizophrenia families, and 109 nonpsychiatric controls on a facial emotional recognition test using a computer morphing technique to present the dynamic expressions. The task entailed the recognition of a set of facial expressions depicting the six basic emotions presented in 21 successive frames of increasing intensity. The findings indicated that schizophrenia patients were consistently impaired for the recognition of the six basic facial expressions. In contrast, their unaffected relatives showed a selective impairment for the recognition of disgust and fearful expressions. Familial association of selective facial emotional expressions processing deficit may further implicate promising new endophenotypes that can advance the understanding of affective deficits in schizophrenia.

N400 deficits from semantic matching of pictures in probands and first-degree relatives from multiplex schizophrenia families.

Endophenotypes is one emerging strategy in schizophrenia research that is being used to identify the functional importance of genetically transmitted, brain-based deficits present in this disease. Currently, event-related potentials (ERPs) are timely used in this search. Several ERPs, including N400, present deficits in relation to schizophrenia. In order to assess the genetic liability of N400 as a possible endophenotype, a picture semantic matching task (congruent and incongruent pairs of pictures) was performed by 21 unaffected first-degree relatives of patients with schizophrenia, 21 DSM-IV diagnosed schizophrenia probands, and 21 control subjects, matched by age, gender and educational level. Probands and relatives were selected form Multiplex schizophrenia families. Significantly reduced N400 amplitude for congruent categories in N400 was found in probands and relatives in relation to controls. The latency onset and the maximum peak latency of N400 were delayed in both, relatives and probands groups compared to control. The voltage maps of incongruous-minus-congruous difference indicate a more reduced right restricted negativity in probands and relatives, when compared to a widely extended bilateral negativity in controls. No general differences were found between patients and relatives. These results demonstrate an electrophysiological deficit in semantic match processing in clinically unaffected first-degree relatives of patients with schizophrenia, suggesting a possible use of this marker as endophenotype.

Detección de inflamación en placa aterosclerosa: rol de la tomografía por emisión de positrones y de la proteína C reactiva / Detection of inflammation in an atherosclerose plaque: the role of the positron emission tomography and C reactive protein

OBJECTIVES: To demonstrate that inflammatory atheromatose carotid plaques can be visualized with positron emission tomography with 18F-fluorodeoxyglucose (18FDG PET) in symptomatic patients, in order to correlate them with systemic inflammatory markers, such as CRP. METHOD: Fifteen patients with cerebral ischemia due to atherosclerotic carotid disease were studied. 18FDG uptake with PET was considered and blood samples were taken for determining high sensibility C reactive protein (HsCRP). RESULTS: The mean age of the patients was 66 years; 11 of them were males (73%) and 4 were females (27%). 18FDG PET was positive in 12 patients (80%), while 100% of the studied population had low risk HsCRP with normal white cell count. CONCLUSIONS: 18FDG PET proves active inflammation in carotid atheromatose plaques. There was no significant correlation between the presence of ahteromatose carotid plaques, HsCRP serum levels, and 18FDG PET study.

Carotid plaque inflammation detected by 18F-fluorodeoxyglucose-positron emission tomography. Pilot study.

OBJECTIVES: Inflammation is important in both the pathogenesis and outcome of atherosclerosis. Current imaging techniques provide anatomic data but no indication of plaque inflammation. We tested the hypothesis that plaque inflammation could be assessed in vivo by (18)FDG-PET and that plaque inflammation could increase the risk of recurrent vascular events and poor response to treatment in a pilot study. PATIENTS AND METHODS: Thirteen patients (median age 66.1 years [55-82 years]) with recent carotid territory TIA or ischemic stroke and internal carotid artery (ICA) stenosis > or =50% were studied. Angiography and (18)F-fluorodeoxyglucose-positron emission tomography ((18)FDG-PET) imaging were carried out in all patients. Treatment for carotid stenosis in each patient was selected by the attending physician and consisted in medical treatment, endarterectomy or stent placement. During 6 months of follow-up, the specific end points assessed were the occurrence of any stroke, death, or re-stenosis. RESULTS: Patients with symptomatic carotid atherosclerosis were imaged using (18)FDG-PET. Strong (18)FDG uptake (SUV> or =2.7) was seen in 11 of 13 (85%) carotid lesions. Among these patients two died during follow-up, 3 had recurrent non-fatal ipsilateral ischemic stroke and 1 patient who had undergone stenting had non-symptomatic re-stenosis in control studies. There was a significant correlation between the (18)FDG uptake and degree of ICA stenosis detected by angiography. CONCLUSION: Carotid atherosclerotic plaques contain a variable degree of inflammation which can be assessed in vivo by means of FDG and PET. The prognostic value of this marker is, however, still unclear and needs further study.

[Detection of inflammation in an atherosclerose plaque: the role of the positron emission tomography and C reactive protein]. / Detección de inflamación en placa aterosclerosa: rol de la tomografía por emisión de positrones y de la proteína C reactiva.

OBJECTIVES: To demonstrate that inflammatory atheromatose carotid plaques can be visualized with positron emission tomography with 18F-fluorodeoxyglucose (18FDG PET) in symptomatic patients, in order to correlate them with systemic inflammatory markers, such as CRP. METHOD: Fifteen patients with cerebral ischemia due to atherosclerotic carotid disease were studied. 18FDG uptake with PET was considered and blood samples were taken for determining high sensibility C reactive protein (HsCRP). RESULTS: The mean age of the patients was 66 years; 11 of them were males (73%) and 4 were females (27%). 18FDG PET was positive in 12 patients (80%), while 100% of the studied population had low risk HsCRP with normal white cell count. CONCLUSIONS: 18FDG PET proves active inflammation in carotid atheromatose plaques. There was no significant correlation between the presence of ahteromatose carotid plaques, HsCRP serum levels, and 18FDG PET study.

[Experience with the use of positron emission tomography (PET) in Mexico]. / Experiencia en México de la utilización de la tomografía por emisión de positrones (PET).

BACKGROUND: Positron Emission Tomography (PET) is a non-invasive imaging diagnostic tool that allows the study of specific biochemical processes using labeled molecules that closely mimic endogenous molecules. The two radiopharmaceuticals used in our facility are 13N-Ammonia and 18F-2-deoxy-2 fluor D-glucose (18F-FDG). 18F-FDG is the most common radiopharmaceutical used both at our Unit as well as worldwide, as it allows the study of tumor activity, the heart's metabolic activity, distinguish viable from non-viable myocardium and assess cerebral metabolism, among others. OBJECTIVES: Describe the experience in the use of PET scan in our country in the fields of oncology, cardiology and neuropsychiatry. METHODS: We performed an observational, retrospective, cross-sectional, and descriptive study. RESULTS: We analyzed a total of 1,154 studies performed at the UNAM-PET-Cyclotron Unit belonging to the Faculty of Medicine at the National Autonomous University of Mexico (UNAM). From the studies, 72.1% (832) corresponded to oncology, whereas 18.5% (213) and 9.4% (109) belonged to cardiology and neuropsychiatry, respectively. CONCLUSIONS: The studies performed at the UNAM-PET-Cyclotron Unit places it as the site with the largest PET experience in our country.

Doses of systemic corticosteroids in hospitalised children with acute asthma: A systematic review.

AIM: To present the doses of systemic corticosteroids reported by clinical trials in hospitalised children with acute asthma and to assess the possible relationship between doses of corticosteroids and clinical responses. METHODS: An electronic search of MEDLINE databases (January 1949-February 2005) and Cochrane Controlled Clinical Trials Register (February 2005) was undertaken using a combination of indexing terms related to systemic corticosteroids and acute asthma. Studies were selected if they met the following criteria: (i) randomized controlled trial; (ii) children aged 1-18 years and admitted to hospital for acute asthma; and (iii) treatment group consisting of systemic corticosteroids. RESULTS: Nine trials were included for this review. There was considerable variation between the reported doses of systemic corticosteroids. Only two trials assessed clinical responses to different doses of systemic corticosteroids. Both trials failed to show any therapeutic advantage of higher doses over lower doses. The results of the two trials were not suitable for pooling. CONCLUSIONS: Current data are not sufficient for establishing dose-response relationship of systemic corticosteroids in hospitalised children with acute asthma. Larger randomized trials are needed.

Antibiotic use in community-based pediatric outpatients in southern region of Brazil.

The irrational use of antibiotics is incriminated for the escalating antimicrobial resistance problem worldwide. This cross-sectional survey was conducted to describe patterns of antibiotic use in community-based pediatric outpatients in the southern region of Brazil. A sample of children (29 days to 18 years of age) was selected from each community-based outpatient clinic. Information related to antibiotic use in the child was obtained by interview with their parents using a structured questionnaire. Of 489 children, 201 (41.1 per cent) had received at least one antimicrobial course in the previous 2 months. The most commonly prescribed antibiotic was amoxicillin (54.0 per cent) and broad-spectrum agents were used in 15.3 per cent of antimirobial courses. Acute respiratory infections were the most frequent diagnosis for antibiotic prescribing (91.2 per cent), but at least 39.5 per cent were conditions of presumed viral etiology. Antibiotic use in the previous 2 months was more likely in children younger than 2 years (PR 1.36, 95 per cent CI 1.10-1.69); with chronic diseases (PR 1.38, 95 per cent CI 1.10-1.75); with higher paternal education level (PR 1.38, 95 per cent CI 1.11-1.72); with parents' pressure on physician for antibiotics (PR 1.66, 95 per cent CI 1.05-2.64) and with parental self-prescribing habit (PR 1.47, 95 per cent CI 1.06-2.04). Antibiotic use in children increased with mother's age (p=0.03 for linear trend). In conclusion, antibiotic prescribing is very common in community-based pediatric outpatients in the southern region of Brazil and inappropriate use is frequent. The independent risk factors for antibiotic use are child's age under 2 years, the presence of chronic diseases in the child, older mother, higher paternal education level, parents' pressure on physician and parental self-prescribing habit.

Queratoplastia: resultados obtenidos en un estudio realizado entre febrero del 2001 y febrero del 2004, en el Servicio de Oftalmología del Hospital Manuel Ascunce Domenech, Camagüey

Se realizó un estudio observacional descriptivo con el objetivo de describir aspectos importantes relacionados con la Queratoplastia. Se trabajó con una muestra de 62 pacientes que fueron atendidos en el Servicio de Oftalmología del Hospital “Manuel Ascunce Domenech”, en el período comprendido desde febrero del 2001 a febrero del 2004. Se presentaron los tipos de Injertos Corneales Perforantes, de los cuales predominó el Óptico Subtotal con 29 pacientes. Se señaló el resultado visual alcanzado, donde la mayoría de los pacientes mejoraron su visión. Se mostraron las causas que conllevaron a la realización del trasplante, donde se encontró que las afecciones más frecuentes fueron el Pterigion, la Queratopatía bulosa y el Queratocono. La principal complicación postoperatoria fue el rechazo corneal para un 44,44 por ciento. Se estudiaron los Pterigion, hallándose como más frecuente el primario, con 16 pacientes y el grado II con 28. La recidiva de esta entidad fue baja(AU)

Estudo da imunidade celular em tuberculosos pulmonares bacilíferos tuberculino negativos / Cellular immunity in patients with pulmonary tuberculosis with negative tuberculin bacillus

Estudando sessenta e oito doentes portadores de Tuberculose pulmonar com Bacilos-cópia positiva, foi-nos possível determinar a prevalência de Tuberculino-negativos num índice de 61,8%. Comparando esse achado excepcional com as diferentes variáveis, concluimos que essa alta incidência de näo reatores ao P.P.D., foi ocasionada por um estado de imunodeficiência adquirida relacionado, predominantemente, à gravidade da própria doença (formas de apresentaçäo muito avançada de 90,5%)