Caracterización nutricional del paciente con síndrome metabólico: resultados preliminares / Nutritional characterization of the patient with metabolic syndrome: preliminary results

INTRODUCCIÓN: El síndrome metabólico (SM) es una entidad clínica con alteraciones vasculares y metabólicas que predisponen a la enfermedad cardiovascular (ECV). El estado nutricional es un factor predominante en la evolución del SM y el riesgo de ECV. OBJETIVO: Analizar el estado nutricional a través de indicadores antropométricos y alimentarios en pacientes con SM. MÉTODOS: Estudio observacional, de corte transversal. Participaron 41 personas de ambos sexos (20 hombres y 21 mujeres), entre 30 y 60 años, que asistieron a consulta ambulatoria del Servicio de Cardiología y Clínica Médica de la Clínica Universitaria Reina Fabiola (CURF) y del Servicio de Cardiología No Invasiva del Hospital Nacional de Clínicas (HNC), durante el periodo 2015-2016. Se realizó toma de indicadores antropométricos para determinar el estado nutricional (índice de masa corporal o IMC), circunferencia de cintura (CC), presión arterial sistólica (PAS) y diastólica (PAD). Las variables alimentarias incluidas fueron valor calórico total (VET), consumo de colesterol (CCol) y consumo de sodio (CS). El estudio cuenta con la aprobación del Comité de Ética del CURF y HNC. Para estimar el VET, el consumo de colesterol y de sodio se utilizó el programa informático Interfood v.1.3. El análisis de los datos se llevó a cabo con el programa InfoStat. Para analizar si existían diferencias por sexo, se utilizó el test de Wilcoxon para variables continuas y Kruskal Wallis para las categóricas. RESULTADOS: El 93% de los pacientes presentaron exceso de peso (el 61% con IMC superior a 30kg/mts2). En relación a CC, el 75% de las mujeres y 86% de hombres presentaron riesgo cardiovascular muy aumentado. La media de PAS fue 131,18±18,96 mmHg y la de PAD fue 79,88±12,29 mmHg. El VET fue 2828,45±1255,42 Kcal, el consumo promedio de colesterol fue 380,09±191mg y el de sodio fue 2072,26±1195,44 mg, siendo estas ingestas superiores a las recomendadas. Al analizar las comparaciones por sexo, no se encontraron diferencias estadísticamente significativas para las variables en estudio. CONCLUSIÓN: Estos resultados preliminares resaltan el perfil de riesgo para el desarrollo de ECV de los pacientes con SM. Se necesita continuar profundizando el estudio de estas poblaciones, para aportar evidencia que contribuya a la promoción de hábitos saludables y la prevención de patologías crónicas vinculadas a la alimentación y nutrición. (AU)

INTRODUCTION: the metabolic syndrome (MetS) is a clinical entity with vascular and metabolic alterations that predispose a cardiovascular disease (CVD). Nutritional status is a predominant factor in the evolution of MetS and risk of CVD. Objetive: Analyze the nutritional status through of anthropometric and food indicators in patients with MetS. METHODS: Observational studie, crosssectional. 41 people of both sex participated (20 man and 21 woman), among 30 and 60 years old, who attended outpatient consultation of Cardiology Service and Medical Clinic of Reina Fabiola University Clinic (RFUC) and Non-Inavasive Cardiology Service of National Hospital of Clinics (NHC), during the period 2015-2016. Anthropometric measure were taken to determine nutritional status, body mass index or (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP) (DBP). Included food variables were total energy value (TEV), cholesterol intake (ColC) and sodium intake (SC). The study has the approval Ethics Committee of RFUC and NHC. To estimate TEV, cholesterol and sodium intake was used computer program Interfood v.1.3. The analysis of the data was carried out with the InfoStat program. To analyze if there differences by sex, the Wilcoxon test for continuous variables and Kruskal Wallis for categorical variables were used. RESULTS: 93% of the patients presented overweight (61% with BMI higher 30 kg/m2). In relation WC, 75% of the women and 86% of men showed highly increased cardiovascular risk. The mean of BSP was 131,18±18,96 mmHg and SBP was 79,88±12,29 mmHg. The TEV was 2828,45±1255,42 Kcal, average intake of cholesterol was 380,09±191mg and the sodium was 2072,26±1195,44 mg, being these higher intakes to those recommended. When analyzing comparisons by sex, no statistically significant differences were found for the variables in study. CONCLUSIONS: these preliminary results highlight the risk profile for the development of CVD of the patients with MetS. It is necessary to continue to deepen the study of these populations, to provide evidence that contributes to the promotion of healthy habits and the prevention of chronic diseases linked to food and nutrition.

Pharmacogenetics and induction/consolidation therapy toxicities in acute lymphoblastic leukemia patients treated with AIEOP-BFM ALL 2000 protocol.

Drug-related toxicities represent an important clinical concern in chemotherapy, genetic variants could help tailoring treatment to patient. A pharmacogenetic multicentric study was performed on 508 pediatric acute lymphoblastic leukemia patients treated with AIEOP-BFM 2000 protocol: 28 variants were genotyped by VeraCode and Taqman technologies, deletions of GST-M1 and GST-T1 by multiplex PCR. Toxicities were derived from a central database: 251 patients (49.4%) experienced at least one gastrointestinal (GI) or hepatic (HEP) or neurological (NEU) grade III/IV episode during the remission induction phase: GI occurred in 63 patients (12.4%); HEP in 204 (40.2%) and NEU in 44 (8.7%). Logistic regression model adjusted for sex, risk and treatment phase revealed that ITPA rs1127354 homozygous mutated patients showed an increased risk of severe GI and NEU. ABCC1 rs246240 and ADORA2A rs2236624 homozygous mutated genotypes were associated to NEU and HEP, respectively. These three variants could be putative predictive markers for chemotherapy-related toxicities in AIEOP-BFM protocols.

Physical activity and late effects in childhood acute lymphoblastic leukemia long-term survivors.

In the present study the authors evaluated therapy-related long-term adverse effects and physical activity in a cohort of long-term survivors of childhood acute lymphoblastic leukemia (ALL), diagnosed in their center between March 1991 and August 2000, treated according to the AIEOP (Associazione Italiana di Ematologia e Oncologia Pediatrica) ALL 91 or 95 study protocol and regularly seen in the authors' long-term follow-up unit. The authors analyzed the long-term sequelae of major body systems in this cohort of subjects and administered an "ad hoc" questionnaire concerning sport. The authors found that 70 patients out of 102 (68.5%) showed no late effects, 10% presented only instrumental or neuropsychological test abnormalities, and 21.5% had 1 or more clinical late sequelae. None of the evidenced late effects represented a contraindication to do physical activity. Sixty-one percent of survivors do physical activity, most of them regularly. Sixty-one percent of males and 18.5% of females (P < .005) do competitive sport (sports rates are similar to those of the general age-matched population). Nearly all subjects spontaneously choose to do sport and think physical exercise is an important and useful resource for their health. The authors conclude that the more recent therapy regimens for leukemia treatment, excluding bone marrow transplantation, do not seem to cause such late effects as to prevent survivors from doing sport. Therefore, in the care of ALL survivors, physical activity is not only not contraindicated, but should also be promoted as much as possible. The development of specific educational programs is warranted as part of the care of cancer survivors.

Stem cell factor is not essential for cell survival and proliferation of soft tissue sarcoma of neuroectodermal origin.

BACKGROUND AND OBJECTIVE: Stem cell factor (SCF), and its receptor (c-kit) play key roles in the expansion and differentiation of hematopoietic progenitor cells, in melanoblasts and primordial germ cells, making it possible that SCF and c-kit are involved in neoplastic processes deriving from these cells. C-kit has been described to be expressed at different levels in neuroblastoma and in soft tissue sarcoma of neuroectodermal origin, and seems to be required for survival processes. In this study we investigate how c-kit expression is regulated and whether a SCF autocrine loop is essential for survival of sarcoma cell lines. DESIGN AND METHODS: C-kit modulation and internalization was evaluated incubating cells with rhSCF. Cell differentiation and proliferation experiments were performed to test whether c-kit expression is related to cell cycle progression or to differentiation processes. Cell cultures were treated with neutralizing antibody and antisense oligonucleotides in order to assess the possible significance of the SCF autocrine loop. RESULTS: In vitro SCF stimulation induces c-kit down-regulation; this phenomenon could be connected with receptor internalization, and new protein synthesis is necessary for its re-expression. The cell proliferation arrest in G0/G1 does not modify c-kit expression while down-regulation of c-kit was demonstrated after cells had been treated with differentiating agents. SCF neutralization does not influence either the S phase or apoptosis in sarcoma cell lines. INTERPRETATION AND CONCLUSIONS: In sarcoma cell lines, c-kit is regulated by differentiation processes; moreover our results suggest that c-kit activity, but probably not the SCF autocrine loop, is essential for survival of these cell lines.

NADPH-diaphorase-positive ganglion cells of the rat adrenal gland: age- and sex-related changes in their number, size, and distribution.

The rat adrenal gland contains ganglion cells able to synthesize nitric oxide (NO). This messenger molecule controls and modulates adrenal secretory activity and blood flow. The present study analyzed the number, size, and distribution of NO-producing adrenal neurons in adulthood and during postnatal development by means of beta-nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry. This method reliably visualizes the enzyme responsible for NO generation. The reactive neurons per adrenal gland were 350-400 in both male and female adult rats. The positive nerve cell bodies were mostly located in the medulla, few being detected within the cortex and the subcapsular region. Dual labeling with anti-microtubule-associated protein 2 antibody, specific for neuronal elements, confirmed this distribution. Anti-microtubule-associated protein 1b antibody identified a subset of NADPH-d-positive neurons, displaying different degrees of maturation according to their position within the adrenal gland. At birth, there were about 220 NADPH-d-labeled neurons per adrenal gland in both sexes. As confirmed by dual immunocytochemical labeling, their great majority was evenly distributed between the cortex and the subcapsular region, the medulla being practically devoid of stained neurons. After birth, the number of adrenal NADPH-d-positive ganglion cells displayed a strong postnatal increase and reached the adult-like distribution after 1-2 months. During the period of increase, there was a transient difference in the numbers of these cells in the two sexes. Thus we present here evidence of plasticity in the number, size, and distribution of NADPH-d-positive adrenal neurons between birth and adulthood; in addition, we describe transient sex-related differences in their number and distribution during the 2nd postnatal week, which are possibly related to the epigenetic action of gonadal hormones during this period.