Oral manifestations of eating disorders in adolescent patients. A review.

AIM: Eating disorders (ED) are a group of psychopathological disorders that affect the patient's relationship with food and his own body and that are manifested mainly in adolescence and in young-adult age. ED include anorexia nervosa (AN), bulimia nervosa (BN) and other eating disorders as classified in the DMS-V. ED can result in several oral and dental manifestations that often occur in the early stages of ED and may allow early detection. The aim of the study is to describe the different oral and dental manifestations in patients with ED in order to offer a classification for their identification during an extra/intra-oral examination. METHODS: A search on PubMed, Medline and Cochrane Library data bases has been performed. RESULTS: Oral manifestations in ED patients include a variety of signs and symptoms, which involve the oral mucosa and perioral tissues (exfoliative cheilitis, labial erythema, atrophic glossitis, glossodynia, yellow-orange colouration of the soft palate, cheek/lip biting, candidiasis), the teeth (dental erosion, tooth hypersensitivity, dental caries), periodontal diseases, and salivary manifestations (sialoadenosis, alterations in salivary flow). The oral signs are caused by a number of factors, including nutritional deficiencies and consequent metabolic changes, poor personal hygiene, altered eating habits and pharmacological therapies. There is a very specific link between oral manifestations and ED in the presence of self-induced vomiting. CONCLUSION: The paediatric dentist may be the first professional to detect the clinical signs thus improving the interception, early diagnosis, characterisation and prognosis of ED. In addition, the oral manifestations of ED can cause alterations of the oral function, discomfort, oral pain, and worsen aesthetics of the face and the quality of life.

The experience of virtual reality: are individual differences in mental imagery associated with sense of presence?

The concept of "presence" describes the quality of subjective experience in immersive virtual reality (IVR). Presence refers to a specific state of consciousness: we behave and feel as if we actually were in the virtual world even though we know there is nothing there. In their handbook of Virtual Reality, Burdea and Coiffet (Virtual reality technology, Wiley, New York, 2003) suggested that the experience of presence in IVR would emerge from the combination of three Is: Immersion or capacity to isolate from the external world, Interaction or capacity to naturally exploring the virtual environment, and Imagination or individual aptitudes with mental imagery. So far, several studies have investigated the technological and psychological factors affecting the degree of immersion and interaction. However, no study has explored the relationship between perceived presence and mental imagery. Here we aim at filling this gap through a correlational study comparing self-reports about sense of presence and mental imagery abilities. After experiencing two IVR scenarios (an art gallery and a living room), 142 male and female users were administered with questionnaires assessing the degree of presence (Igroup Presence Questionnaire), the degree of vividness (Vividness of Visual Imagery Questionnaire) and control (Test of Visual Imagery Control) of subjective mental images. Results showed a clear positive correlation between presence and vividness: the higher the vividness of mental images the stronger the reported sense of presence felt in IVR scenarios. Instead, the capacity to control mental imagery showed a weaker association with presence. We may conclude that individual differences in the degree of perceived presence and mental imagery ability are associated.

Factores asociados a glucemia alterada en ayunas en mujeres adultas no diabéticas / Glycaemic profile and its association with related factors insulin resistance in adult women without diabetes

RESUMEN Introducción: La identificación e intervención de los estados metabólicos previos a la diabetes mellitus tipo 2 (DM 2), permite evitar la aparición de la enfermedad en un alto porcentaje de los casos. Objetivo: Evaluar los factores de riesgo asociados a los valores de glucemia alterada en ayunas (GAA) en mujeres adultas no diabéticas, concurrentes a consulta nutricional en Centro Endocrinológico de la Ciudad Autónoma de Buenos Aires (CABA), Argentina. Materiales y métodos: Estudio transversal y analítico en muestra no probabilística de 316 mujeres (40 a 65 años) no diabéticas, clasificadas según la glucemia en ayunas en dos grupos (Gl <100 mg/dl y Gl ≥100 y <126 mg/dl). Se estudiaron como factores de riesgo relacionados a la GAA: circunferencia de cintura aumentada (CC) >88 cm, peso no saludable según Índice de Masa Corporal (IMC) ≥27 kg/m2, sedentarismo (menos de 150 minutos por semana de actividad física programada), hipertensión arterial (HTA: ≥140/90 mmHg) y relación TG/HDL-C elevada (≥3). Se utilizó el programa estadístico SPSS 19.0 calculando media, desvío estándar y test de Chi cuadrado. El nivel de significación estadístico se fijó en p <0,05. Resultados: La edad media fue 53,6 (DS = 6,5) años, siendo el 35,8% premenopáusicas y 64,2% postmenopáusicas. El 33,2% de la muestra presentó GAA. El 52,8% presentó peso no saludable y el 45,3% CC aumentada. El 66,5% fue sedentaria, el 21,5% HTA y el 22,2% relación TG/HDL-C elevada. La GAA se asoció significativamente con HTA (p <0,001) y relación TG/HDL-C elevada (p <0,001). Conclusiones: Los valores de HTA y la relación TG/HDL-C elevada fueron los dos factores que se asociaron con la GAA en esta muestra. Se recomienda su pesquisa como marcadores tempranos para prevenir el riesgo de DM2.

ABSTRACT Introduction: The identification and intervention of the metabolic states prior to the diabetes mellitus type 2 (DM2), allows to avoid the appearance of the disease in a high percentage of the cases. Objective: To determine the risk factors associated with the values of fasting altered glycemia (GAA) in non-diabetic adult women, concurrent to nutritional consultation at the Endocrinological Center of the Autonomous City of Buenos Aires (CABA), Argentina. Materials and methods: Cross-sectional and analytical study in a non-probabilistic sample of 316 women (40 to 65 years) without diabetes and not pregnant, who were classified according to fasting glycemia in two Groups (Gl <100 mg/dl and Gl≥100 and <126 mg/dl). They were studied as risk factors related to GAA: increased waist circumference (WC) >88 cm, unhealthy body mass index (BMI) ≥27 kg/m2, physical inactivity (less than 150 minutes a week), arterial hypertension (HT: ≥140/90 mmHg) and elevated TG/HDL-C ratio (≥3). The statistical program SPSS 19.0 was used to calculate mean, standard deviation and Chi square test. The level of statistical significance was set at p <0.05. Results: The mean age was 53.6 (SD = 6.5) years (35.8% premenopausal and 64.2% postmenopausal). 33.2% of the sample had GAA. 52.8% had unhealthy weight and 45.3% had increased BCA. 66.5% were sedentary, 21.5% had a diagnosis of hypertension and 22.2% had a high TG/HDL-C ratio. GAA was significantly associated with HTA (p<0,001) and elevated TG / HDL-C ratio (p <0,001). Conclusions: The HTA values and the elevated TG/HDL-C ratio were the two factors that in this study were associated with GAA in this sample. Their research is recommended as early markers to prevent the risk of DM2.

Effect of Denosumab on Bone Mineral Density and Markers of Bone Turnover among Postmenopausal Women with Osteoporosis.

The aim of this study was to evaluate the effect of denosumab (Dmab) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of Dmab in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 425 postmenopausal women treated with Dmab for 1 year in clinical practice conditions in specialized centers from Argentina. Participants were also divided according to previous bisphosphonate treatment into BP-naïve and BP-prior. A control group of patients treated with BP not switched to Dmab matched by sex, age, and body mass index was used. Data are expressed as mean ± SEM. After 1 year of treatment with Dmab the bone formation markers total alkaline phosphatase and osteocalcin were significantly decreased (23.36% and 43.97%, resp.), as was the bone resorption marker s-CTX (69.61%). Significant increases in BMD were observed at the lumbar spine, femoral neck, and total hip without differences between BP-naïve and BP-prior. A better BMD response was found in BP-prior group compared with BP treated patients not switched to Dmab. Conclusion. Dmab treatment increased BMD and decreased bone turnover markers in the whole group, with similar response in BP-naïve and BP-prior patients. A better BMD response in BP-prior patients versus BP treated patients not switched to Dmab was observed.

Long-term glycaemic response and tolerability of dapagliflozin versus a sulphonylurea as add-on therapy to metformin in patients with type 2 diabetes: 4-year data.

AIMS: To assess the long-term efficacy and tolerability of dapagliflozin versus glipizide as add-on to metformin in patients with inadequately controlled type 2 diabetes. METHODS: The present study was an extension of an earlier randomized, double-blind, phase III study of dapagliflozin (n = 406) vs glipizide (n = 408) to 208 weeks (4 years). Patients continued to receive their assigned medication. No statistical treatment-group comparisons were calculated. RESULTS: At 208 weeks, dapagliflozin compared with glipizide produced sustained reductions in glycated haemoglogin (HbA1c): -0.30% [95% confidence interval (CI), -0.51 to -0.09], in total body weight: -4.38 kg (95% CI -5.31 to -3.46) and in systolic blood pressure (SBP): -3.67 mmHg (95% CI -5.92 to -1.41). The HbA1c coefficient of failure was significantly lower for dapagliflozin than for glipizide: 0.19 (95% CI 0.12-0.25) versus 0.61 (95% CI 0.49-0.72, difference -0.42; p = 0.0001). Dapagliflozin was not associated with glomerular function deterioration, while this occurred more frequently in patients in the glipizide group. Fewer patients reported hypoglycaemia in the dapagliflozin compared with the glipizide group (5.4 vs 51.5%). Genital and urinary tract infections were more common with dapagliflozin than with glipizide, but their incidence decreased with time and all events responded well to antimicrobial treatment. CONCLUSIONS: In patients completing 4 years of treatment, dapagliflozin was well tolerated and associated with sustained glycaemic efficacy and greater reductions in body weight and SBP versus glipizide.

Influyen los valores de tirotrofina sobre el descenso de peso corporal en mujeres adultas con sobrepeso y obesidad? / Do thyrotropin values influence on the decrease of body weight in adult women with overweight and obesity

Introducción: . Objetivos: Estudiar si los valores de TSH influyen sobre el descenso del peso corporal en mujeres adultas con sobrepeso u obesidad. Metodología: Diseño de intervención sobre muestra no probabilística de mujeres >30 años y con IMC ≥25 Kg/m2, que asistieron a un Centro Endocrinológico de la Ciudad Autónoma de Buenos Aires. Resultados: Se estudiaron 105 mujeres (50.8±12.2 años) con un IMC medio de 30.0±4.9 Kg/m2. El 57.1% eran hipotiroideas bajo tratamiento con LT4. Según valor de TSH: Grupo A (27.6%) ≥2.5 mUI/L y Grupo B (72.4%) <2.5 mUI/L. A partir del programa de intervención, la mayoría descendió menos del 1% semanal con respecto a su peso inicial (51.7% grupo A y 56.6% Grupo B), con un grado de adherencia al tratamiento entre el 60 y 70% (51.7% grupo A y 50.1% Grupo B) sin observarse diferencias significativas entre los grupos. No se encontró asociación entre la pérdida de peso semanal con la función tiroidea (OR:0.64; IC:0.29-1.39; p:0.32) ni con valor de TSH (OR:1.21; IC:0.51-2.86; p:0.66). Se encontró correlación directa entre la pérdida de peso semanal y el grado de adherencia al tratamiento (r:0.464; p: 0.000) e inversa con el tiempo transcurrido hasta el primer control (r:-0.30; p: 0.002) y rangos del IMC (r: -0.282; p: 0.004), independientemente de la edad, la función tiroidea o el valor de TSH que presentaban las pacientes. Conclusiones: Los valores de TSH y la función tiroidea no influyeron sobre la pérdida de peso semanal. El descenso de peso se relacionó con la adherencia al tratamiento en forma directa independientemente de la edad, la función tiroidea o el valor de TSH.

Extracellular matrix inhibits structural and functional plasticity of dendritic spines in the adult visual cortex.

Brain cells are immersed in a complex structure forming the extracellular matrix. The composition of the matrix gradually matures during postnatal development, as the brain circuitry reaches its adult form. The fully developed extracellular environment stabilizes neuronal connectivity and decreases cortical plasticity as highlighted by the demonstration that treatments degrading the matrix are able to restore synaptic plasticity in the adult brain. The mechanisms through which the matrix inhibits cortical plasticity are not fully clarified. Here we show that a prominent component of the matrix, chondroitin sulfate proteoglycans (CSPGs), restrains morphological changes of dendritic spines in the visual cortex of adult mice. By means of in vivo and in vitro two-photon imaging and electrophysiology, we find that after enzymatic digestion of CSPGs, cortical spines become more motile and express a larger degree of structural and functional plasticity.

Visual depth perception in normal and deprived rats: effects of environmental enrichment.

A proper maturation of stereoscopic functions requires binocular visual experience and early disruption of sensory-driven activity can result in long-term or even permanent visual function impairment. Amblyopia is one paradigmatic case of visual system disorder, with early conditions of functional imbalance between the two eyes leading to severe deficits of visual acuity and depth-perception abilities. In parallel to the reduction of neural plasticity levels, the brain potential for functional recovery declines with age. Recent evidence has challenged this traditional view and experimental paradigms enhancing experience-dependent plasticity in the adult brain have been described. Here, we show that environmental enrichment (EE), a condition of increased cognitive and sensory-motor stimulation, restores experience-dependent plasticity of stereoscopic perception in response to sensory deprivation well after the end of the critical period and reinstates depth-perception abilities of adult amblyopic animals in the range of normal values. Our results encourage efforts in the clinical application of paradigms based on EE as an intervention strategy for treating amblyopia in adulthood.

Inhibition of matrix metalloproteinases prevents the potentiation of nondeprived-eye responses after monocular deprivation in juvenile rats.

The ocular dominance (OD) shift induced by monocular deprivation (MD) during the critical period is mediated by an initial depression of deprived-eye responses followed by an increased responsiveness to the nondeprived eye. It is not fully clear to what extent these 2 events are correlated and which are their physiological and molecular mediators. The extracellular synaptic environment plays an important role in regulating visual cortical plasticity. Matrix metalloproteinases (MMPs) are a family of activity-dependent zinc-dependent extracellular endopeptidases mediating extracellular matrix remodeling. We investigated the effects of MMP inhibition on OD plasticity in juvenile monocularly deprived rats. By using electrophysiological recordings, we found that MMP inhibition selectively prevented the potentiation of neuronal responses to nondeprived-eye stimulation occurring after 7 days of MD and potentiation of deprived-eye responses occurring after eye reopening. Three days of MD only resulted in a depression of deprived-eye responses insensitive to MMP inhibition. MMP inhibition did not influence homeostatic plasticity tested in the monocular cortex but significantly prevented an increase in dendritic spine density present after 7 days MD in layer II-III pyramids.

Percepción de la adherencia al tratamiento y descenso del peso corporal en mujeres adultas con sobrepeso y obesidad / Perception of adherence to treatment and decrease in body weight among adult women with overweight and obesity

Introducción: La eficacia real del tratamiento de la obesidad dependerá de la adherencia al mismo por parte del paciente. Objetivos: Estimar en mujeres adultas con sobrepeso u obesidad la correlación entre el descenso del peso corporal y la percepción de la adherencia al tratamiento. Metodología: Diseño experimental de seguimiento. Muestra no probabilística por conveniencia de 112 mujeres mayores de 20 años con IMC ≥25 kg/m2, que asistieron a la consulta nutricional en la Fundación para la Investigación de Enfermedades Endocrino Metabólicas de la Ciudad Autónoma de Buenos Aires, dentro del Proyecto UBACyT 2010-2012. Variable dependiente: variación peso corporal (expresada en % semanal y categorizada en <1% y ≥1%) entre consulta inicial y primer control; Variable independiente: percepción adherencia al tratamiento (expresada en % de cumplimiento respecto al plan alimentario y actividad física programada), en escala de 0 a 100 y categorizada en tres rangos: ≤50%; 60 al 70% y >70%. Se controló según grado sobrepeso (IMC: 25,0 a 29,9; 30 a 34,9 y ≥ 35 Kg/m2); edad (< 40; 40 a 65 y > 65 años) y tiempo transcurrido entre visita inicial y control (2, 3 o 4 semanas a criterio de la paciente). Se utilizó paquete estadístico SPSS 15,0 estableciendo medidas de tendencia central, X2, Prueba de Fisher y correlación de Spearman con valor p<0,05. Resultados: La percepción de la adherencia al tratamiento autoreportada por las pacientes fue del 74 ± 12%, refiriendo una adherencia superior al 70% el 47,3% de la muestra, mientras que un 46,4% reportaron entre 60 y 70%. Se encontró relación directa entre la pérdida de peso semanal y la percepción de la adherencia (r: 0,351; p< 0,001). Conclusiones: Cuanto mayor es la percepción de adherencia al tratamiento, mayor es la pérdida de peso semanal, no habiendo asociación con la edad, el IMC o el tiempo transcurrido hasta el primer control.

Transcallosal inhibition dampens neural responses to high contrast stimuli in human visual cortex.

Visual cortical areas in the two hemispheres interact via the corpus callosum, but the precise role of the callosal pathway in visual processing remains controversial. Here we have investigated the function of transcallosal projections in human primary visual cortex (V1). Visual evoked potentials (VEPs) triggered by grating stimuli of different contrasts were recorded before and after functional inactivation of the occipital cortex of one hemisphere via off-line low-frequency repetitive transcranial magnetic stimulation (rTMS; 0.5 Hz stimulation for 20 min). VEPs were recorded in V1 before (T0), immediately after (T1) and 45' following the completion of rTMS (T2). We found that low-frequency rTMS had an inhibitory effect on VEPs amplitudes at all contrasts in the treated side. Remarkably, reduction of VEP amplitudes in the inhibited hemisphere at T1 was accompanied by an increase in VEP amplitudes in the contralateral side only at mid-high contrasts (50-90%). This disinhibitory effect was observed with both central and hemifield stimulation. No changes in VEP amplitudes were observed when rTMS was applied to a cortical site more anterior with respect to V1. These data provide the first evidence that a mechanism of transcallosal inhibition dampens neural responses at high contrasts in human visual cortex.

Visual perceptual learning induces long-term potentiation in the visual cortex.

Increasing evidence suggests that plastic changes underlying skill learning may occur at early stages of neural processing. However, whether visual perceptual learning (PL) is accompanied by neuronal plasticity phenomena in the primary visual cortex (V1) is yet unknown. Here, we provide the first evidence that practice with specific visual stimuli (gratings) induces long-term potentiation (LTP) of synaptic responses in the rat V1. We report that in rats which have improved through practice their ability to discriminate between two gratings of different spatial frequency, the input/output curves of field potentials evoked in layers II-III of V1 slices by stimulation of either vertical and horizontal connections are shifted leftward compared to controls. Thus, visual PL is followed by potentiation of synaptic transmission both in vertical and horizontal connections (mimicry). We next show that this increase in intracortical connectivity gain is paralleled by LTP-like phenomena caused by the learning process: indeed, visual PL occludes further LTP (occlusion). Mimicry and occlusion are not present in the primary somatosensory cortex of rats trained with PL. These results demonstrate that LTP accompanies PL and highlight the notion that learning can occur at processing stages as early as the primary sensory cortices.

Nurturing brain plasticity: impact of environmental enrichment.

Environmental enrichment (EE) is known to profoundly affect the central nervous system (CNS) at the functional, anatomical and molecular level, both during the critical period and during adulthood. Recent studies focusing on the visual system have shown that these effects are associated with the recruitment of previously unsuspected neural plasticity processes. At early stages of brain development, EE triggers a marked acceleration in the maturation of the visual system, with maternal behaviour acting as a fundamental mediator of the enriched experience in both the foetus and the newborn. In adult brain, EE enhances plasticity in the cerebral cortex, allowing the recovery of visual functions in amblyopic animals. The molecular substrate of the effects of EE on brain plasticity is multi-factorial, with reduced intracerebral inhibition, enhanced neurotrophin expression and epigenetic changes at the level of chromatin structure. These findings shed new light on the potential of EE as a non-invasive strategy to ameliorate deficits in the development of the CNS and to treat neurological disorders.

The effects of long-term raloxifene and estradiol treatments on bone in a patient with congenital aromatase deficiency.

INTRODUCTION: In adult aromatase-deficient men, estrogen treatment has always resulted in a rapid skeletal maturation with epiphyseal closure and improved BMD. Raloxifene is a SERM with proven estrogen agonist action on bone that leads to an improvement in BMD and a reduction in bone turnover. The present study reports the effects of raloxifene and transdermal estradiol treatment, respectively, on epiphyseal closure and BMD in an aromatase-deficient man, over a 24-month follow-up, with the aim of obtaining further insight into the role of estrogens in the male skeletal homeostasis. MATERIALS AND METHODS: A 25-year-old Caucasian man with aromatase deficiency, a bone age of 15.3 years, unfused epiphyses and an impaired BMD was initially administered raloxifene (60 mg/day per os) for 12 months, while transdermal estradiol (25 microg twice weekly) was administered for the subsequent 12 months. During the follow-up, the effects of the two treatments on epiphyseal closure, BMD and bone turnover markers were investigated. An iliac crest bone biopsy was performed only before and after the raloxifene treatment, but it was not repeated after transdermal estradiol treatment. RESULTS: No changes in bone age were observed after raloxifene therapy, whereas a complete epiphyseal closure was achieved with transdermal estradiol treatment. Compared with baseline values, raloxifene treatment led to improved BMD both at the ultradistal forearm and 33% radius; the transdermal estradiol treatment resulted in a further slight increase in BMD at the 33% radius, but not at the ultradistal forearm. The baseline bone biopsy showed elevated bone remodelling in trabecular bone, while the second biopsy following raloxifene treatment revealed a decrease in remodelling. DISCUSSION: This study shows that the management of aromatase deficiency in the male cannot consider raloxifene as a first choice treatment, but should be still based on estrogen replacement treatment since in this patient the completion of bone maturation has only been obtained once estradiol substitution was performed. The present case also demonstrates that raloxifene is able to improve BMD in aromatase-deficient men.

Correlación entre el descenso del peso corporal y la disminución de la circunferencia de la cintura / Correlation between the reduction of the body weight and the reduction of the waist circumference

Introducción: Actualmente la obesidad abdominal representa un problema alarmante, tanto en clínica como en salud pública. La simple medida de la circunferencia de la cintura (CC) fue una de las variables antropométricas que ha correlacionado mejor con la cantidad de tejido adiposo visceral. Objetivos: Estimar la correlación entre el descenso del peso corporal y la disminución de la CC según el sexo, la edad, el peso corporal y tiempo transcurrido de tratamiento dietoterápico. Métodos: Diseño analítico de correlación, prospectivo y longitudinal. Muestra por conveniencia de 388 adultos que concurrieron a la consulta nutricional para buscar el descenso de peso (89,2% femenino con edad promedio de 46,4 + 13,7 años y 10,8% masculino con edad promedio de 43,4 + 14,2 años). Se realizó medición directa de Peso, Talla y CC según técnicas estandarizadas. Variable dependiente: disminución de la CC (en cm). Independientes: Descenso del peso corporal (en Kg). Edad (> 20 años). Sexo. IMC. Tiempo transcurrido de tratamiento dietoterápico (en días). El análisis estadístico se realizó con programa SPSS 11.5, con intervalo de confianza (IC) del 95%. Se utilizó coeficiente de correlación (Pearson) para las variables correspondientes con valor p<0,05. Resultados: Se obtuvo una fuerte asociación entre el descenso del peso corporal y el descenso de la CC (r: 0.747, p=0.001), no encontrándose que este valor fuera influenciado por la edad, el tiempo transcurrido en tratamiento y sexo, pero sí por el IMC. Conclusión: Es alta la correlación entre el descenso del peso corporal y la disminución de la CC en la muestra estudiada. Resulta indistinto en el monitoreo nutricional, medir primero cintura y luego el peso corporal, o a la inversa(AU)

Background: Nowadays, the abdominal obesity represents an alarming problema, as much in clinic as in public health. The simple measurement of the waist circumference (WC) was one of the anthropometrics variables that it has better correlated with the amount of visceral fat. Objectives: To estimate the correlation between the reduction of the corporal weight and the reduction of the waist circumference according to sex, age, weight and passed time on diet treatment. Methods: Analytical design; longitudinal, correlation, and who concurred to nutritional assessment for weight reduction (women 89.2%, average 46,4 +/- 14,2 uears). Direct measurement of weight, stature and WC were made according to standardized technique. Dependent variable: Reduction of the waist circumference (cm). Independent: Reduction of the weight (kg); Age (> 20 years); Sex; IMC; Passe time on diet treatment (days). The information was statistically analyzed by the SPSS 11.5 program and estimated with safety level of 95%. Coefficient of correlation (Pearson) was used for the corresponding variables with values p<0,05. Results: A strong association between body weight and decrease the decline in CC (r: 0,747, p=0,001), not found that this value was influenced by ag, time spent in treatment and sex, but by the BMI. Conclusion: It is high correlation between the decrease in body weight and decreasing the CC in the sample studied. It is indistintic the nutricional monitoring, measuring waist and then the first body weight, or viceversa(AU)

Oestradiol replacement treatment and glucose homeostasis in two men with congenital aromatase deficiency: evidence for a role of oestradiol and sex steroids imbalance on insulin sensitivity in men.

AIMS: The role of sex steroids in glucose and insulin metabolism in men remains unclear. To investigate the effects of sex steroids and oestrogen on insulin sensitivity in men, we studied two male adults with aromatase deficiency (subject 1 and subject 2). METHODS: The effects of transdermal oestradiol (tE(2)) treatment at different dosages on insulin sensitivity were studied before tE(2) treatment (phase 1), and after 6 months (phase 2) and 12 months of tE(2) treatment (phase 3) by means of homeostasis model assessment-insulin resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI), insulin tolerance test (ITT), and oral glucose tolerance test (OGTT). The latter was performed only in subject 1, as subject 2 suffered from Type 2 diabetes. RESULTS: The restoration of normal serum oestradiol led to improved insulin sensitivity, as shown by changes in HOMA-IR and QUICKI. The ITT provided evidence of improved insulin sensitivity during tE(2) treatment. Insulin secretion after OGTT was reduced during tE(2) treatment in subject 1. After 12 months of tE(2) treatment, insulin sensitivity was improved compared with in phases 1 and 2. CONCLUSIONS: The study suggests a direct involvement of oestrogens in insulin sensitivity, and supports a possible role of oestradiol : testosterone ratio, which may be as influencial as the separate actions of each sex steroid on glucose homeostasis.

Perfil antropométrico en mujeres perimenopáusicas / No disponible

Introducción: Los cambios corporales producidos durantela perimenopausia se asocian al aumento de grasaabdominovisceral, siendo un factor determinante delmayor riesgo metabólico y cardiovascular en esta etapa.Objetivos: Describir el perfil antropométrico (Índice deMasa Corporal –IMC-, Circunferencia de Cintura -CC- ,cambio de peso y talla) de las mujeres durante la transiciónperimenopáusica; correlacionar el IMC con laCC en esta etapa, y comparar este perfil entre mujeresen fase premenopáusica y mujeres postmenopáusicas.Metodología: Diseño transversal retrospectivo. Muestrapor conveniencia de 86 mujeres que concurrieron porprimera vez a la consulta nutricional (39,5% premenopáusicas(PM) con edad promedio de 46 ± 4 años y 60,5% postmenopáusicas (PoM) con edad promedio de 58 ±5 años). La edad promedio de menopausia fue de 48 ±5 años. Se realizó medición directa de Peso, Talla y CCsegún técnicas estandarizadas; el peso y talla habitualfueron referidos por la paciente, considerando para PM alvalor promedio de los últimos 5 años y para PoM al valorreferido en el momento de última menstruación. Variables:Peso saludable según IMC (<27,3; >=27,3), CC (<80 cm;>=80 cm), % cambio de peso (>=10%; <10%) y cambiode talla (>=2 cm; <2cm). El análisis estadístico se realizócon programa Epi 6.04d, con intervalo de confianza (IC)del 95%. Se utilizó coeficiente de correlación (Pearson) yChi2 para las variables correspondientes con valor p<0,05.Resultados: El 64,7% de PM (IC:46,5-80,2) presentóIMC<27,3 y el 63,5% de PoM (IC:48,9-76,4) un IMC>=27,3. El 76,5% de PM (IC:58,8-89,2) y el 80,8% de PoM(IC:67,5-90,4) presentó CC >= 80cm. El 23,5% de PM y el65,4% de PoM disminuyeron >=2 cm de su talla habitual,siendo estadísticamente significativa (p=0,0001). El 47% dePM y 77% de PoM aumentaron >= 10 % de su peso habitualsiendo estadísticamente significativo (p=0,004)...(AU)

Introduction: The corporal changes produced duringperimenopausal stage are associated to abdomino-visceralfat increasing, being a determining factor of thegreater metabolic and cardiovascular risk in this moment.Objectives: To describe the anthropometric profile (BodyMass Index –BMI-, Waist Circumference -WC -, changeof weight and stature) of the women during the menopausaltransition; to correlate the BMI with the WC inthis phase, and to compare this profile among womenin premenopausal phase and postmenopausal women.Methodology: This is a retrospective, cross-sectional designstudy. The people that participated in the study waschosen by convenience. The sample was formed of 86women who concurred for the first time to the nutricionalconsultation (39,5% in premenopausal stage (PM) withan age average of about 46 ± 4 years old, and 60,5 %postmenopausal (PoM) with an age average of 58 ± 5years old). The age average of menopause was about 48± 5 years old. Direct measurements of weight, stature andWC were made according to standardized techniques; thehabitual weight and stature were referred by the patient,considering for PM to the value average of last 5 yearsand for PoM to the value referred at the moment of lastmenstruation. Variables: Healthful weight according toBMI (< 27,3; >= 27,3), WC (< 80 cm; >= 80 cm),% ofweight change (>=10%;<10%) and % of stature change(>=2 cm;<2cm). The statistical analysis was made with Epi6.04d program, with an interval of confidence (IC) of 95%.It were used the coefficient of correlation (Pearson) and Chi2for the corresponding variables, with a value of p<0,05.Results: 64,7% of PM (IC:46,5-80,2) has a BMI<27,3and 63.5% of PoM (IC:48,9-76,4) a BMI >=27,3. 76,5%of PM (IC:58,8-89,2) and 80,8% of PoM (IC:67,5-90,4)presented a WC >=80cm. 23,5% of PM and 65,4% ofPoM has diminished >=2 cm of their habitual stature, beingstatistically significant (p=0,0001)...(AU)

Retinal functional development is sensitive to environmental enrichment: a role for BDNF.

Retina has long been considered less plastic than cortex or hippocampus, the very sites of experience-dependent plasticity. Now, we show that retinal development is responsive to the experience provided by an enriched environment (EE): the maturation of retinal acuity, which is a sensitive index of retinal circuitry development, is strongly accelerated in EE rats. This effect is present also in rats exposed to EE up to P10, that is before eye opening, suggesting that factors sufficient to trigger retinal acuity development are affected by EE during the first days of life. Brain derived neurotrophic factor (BDNF) is precociously expressed in the ganglion cell layer of EE with respect to non-EE rats and reduction of BDNF expression in EE animals counteracts EE effects on retinal acuity. Thus, EE controls the development of retinal circuitry, and this action depends on retinal BDNF expression.

Papel del calcio y de la vitamina D en la salud ósea (parte II) / Role of calcium and vitamin D in bone health (Part II)

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