Dietary Iron, Anemia Markers, Cognition, and Quality of Life in Older Community-Dwelling Subjects at High Cardiovascular Risk.

Anemia causes hypo-oxygenation in the brain, which could lead to cognitive disorders. We examined dietary iron intake as well as anemia markers (i.e., hemoglobin, hematocrit, mean corpuscular volume) and diabetes coexistence in relation to neuropsychological function and quality of life. In this study, 6117 community-dwelling adults aged 55-75 years (men) and 60-75 years (women) with overweight/obesity and metabolic syndrome were involved. We performed the Mini-Mental State Examination (MMSE), the Trail Making Test parts A and B (TMT-A/B), Semantic Verbal Fluency of animals (VFT-a), Phonological Verbal Fluency of letter P (VFT-p), Digit Span Test (DST), the Clock Drawing Test (CDT), and the Short Form-36 Health Survey (SF36-HRQL test). Dietary iron intake did not influence neuropsychological function or quality of life. However, anemia and lower levels of anemia markers were associated with worse scores in all neurophysiological and SF36-HRQL tests overall, but were especially clear in the MMSE, TMT-B (cognitive flexibility), and the physical component of the SF36-HRQL test. The relationships between anemia and diminished performance in the TMT-A/B and VFT tasks were notably pronounced and statistically significant solely among participants with diabetes. In brief, anemia and reduced levels of anemia markers were linked to inferior cognitive function, worse scores in different domains of executive function, as well as a poorer physical, but not mental, component of quality of life. It was also suggested that the coexistence of diabetes in anemic patients may exacerbate this negative impact on cognition. Nevertheless, dietary iron intake showed no correlation with any of the outcomes. To make conclusive recommendations for clinical practice, our findings need to be thoroughly tested through methodologically rigorous studies that minimize the risk of reverse causality.

Hiperemesis en mujer gestante portadora de banda gástrica / Hyperemesis in a pregnant woman with a gastric band

El 50-90% de las embarazadas tiene náuseas y vómitos a partir de la quinta, sexta semana de la gestación que habitualmente desaparecen en la semana 20. Sin embargo, en un 15-20% los síntomas continúan durante el tercer trimestre y en un 5% hasta el parto. La herniación gástrica tras la colocación de una banda gástrica ajustable cursa con una primera fase de pirosis por reflujo hasta desarrollar una intolerancia alimentaria total que se soluciona, sobre todo, en fases incipientes, abriendo el paso del estoma. Presentamos el caso de una gestante portadora de una banda gástrica con cuadro de vómitos e intolerancia oral, compatible clínicamente con el diagnóstico de “hiperemesis gravídica, en relación con herniación gástrica” (AU)

Nausea and vomiting occurs in 50-90% of pregnancies, usually beginning by 5-6 weeks of gestation and resolving by week 20. However, symptoms may persist through the third trimester in 15-20% and even until childbirth in 5%. The first phase of gastric herniation, as a complication of adjustable gastric lap band placement, is characterized by pyrosis due togastroesophageal reflux until complete feeding intolerance occurs. Improvement of this condition, mainly in the incipient phases, is achieved by complete band decompression. We present the case of a pregnant woman who underwent laparoscopic adjustable gastric banding who presented with nausea, vomiting and oral intolerance, a clinical picture compatible with hyperemesis gravidarum, related to gastric herniation (AU)

Probables fuentes de infección en dermatofitosis / Probable infection sources in dermatophytosis

Objetivo: Determinar el rol que desempeña la ropa de pacientes con dermatofitosis como probable fuente de infección. Material y métodos: Se estudiaron 32 pacientes con diagnóstico previo de tiña corporis, capitis o cruris. Se utilizó el método de impresión directa con placas tipo RODAC (Replicating Organism Direct Agar Contact) para el aislamiento de dermatofitos en ropa silla, mesa y/o suelo de dichos pacientes. Resultados: Los dermatofitos aislados de pacientes fueron: T. tonsurans en 14 casos, T. rubrum en 12 y M. canis en 6. El dermatofito que dió el mayor número de colonias por paciente y de placas positivas fue M.canis. En total se tomaron para el estudio 320 muestras ambientales en igual número de placas; fueron positivas 71.4 por ciento de las provenientes de la ropa en contacto con la lesión y 13.4 por ciento de otras áreas diferentes de la ropa. Los muebles y el suelo que rodeaban al paciente al momento de la toma de muestra, no recibieron un inóculo muy grande. Conclusiones: La ropa de los pacientes con dermatofitosis podría ser considerada como fuente de infección de algunos dermatofitos.