Maternal Consumption of Non-Nutritive Sweeteners during Pregnancy Is Associated with Alterations in the Colostrum Microbiota.

Non-nutritive sweeteners (NNSs) provide a sweet taste to foods and beverages without significantly adding calories. Still, their consumption has been linked to modifications in adult's and children's gut microbiota and the disruption of blood glucose control. Human milk microbiota are paramount in establishing infants' gut microbiota, but very little is known about whether the consumption of sweeteners can alter it. To address this question, we sequenced DNA extracted colostrum samples from a group of mothers, who had different levels of NNS consumption, using the Ion Torrent Platform. Our results show that the "core" of colostrum microbiota, composed of the genera Bifidobacterium, Blautia, Cutibacteium, Staphylococcus, and Streptococcus, remains practically unchanged with the consumption of NNS during pregnancy, but specific genera display significant alterations, such as Staphylococcus and Streptococcus. A significant increase in the unclassified archaea Methanobrevibacter spp. was observed as the consumption frequency of NNS increased. The increase in the abundance of this archaea has been previously linked to obesity in Mexican children. NNS consumption during pregnancy could be related to changes in colostrum microbiota and may affect infants' gut microbiota seeding and their future health.

A scoping review of the methods used in patients with liver cirrhosis to assess body composition and their nutritional findings.

BACKGROUND AND OBJECTIVES: Body composition (BC) assessment in cirrhosis has a wide variety of methods with no consensus on the best tools for each body component in patients with Liver Cirrhosis (LC). We aimed to conduct a systematic scoping review of the most frequent body composition analysis methods and nutritional findings published in liver cirrhosis patients. METHODS: We searched for articles in PubMed, Scopus, and ISI Web of Science databases. Keywords selected the BC methods and parameters in LC. RESULTS: Eleven methods were found. The most frequently used were computed tomography (CT) 47.5%, Bioimpedance Analysis 35%, DXA 32.5%, and anthropometry 32.5%. Up to 15 BC parameters were reported from each method. CONCLUSIONS: The vast heterogeneity in the results found during the qualitative analysis and imaging methods must reach a consensus to achieve a better clinical practice and improve nutritional treatment, as the physiopathology in LC compromises the nutritional status directly.

Adaptación en español y validación en México de la herramienta de tamizaje nutricional STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics) / Adaptation in Spanish and validation in Mexico of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP)

Antecedentes: la desnutrición pediátrica es una de las principales causas de complicaciones en niños hospitalizados, por ello, el tamizaje nutricional al ingreso es indispensable. La Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) es una herramienta sencilla, reproducible y fácil de interpretar, sin embargo, en México no se encuentra validada. El objetivo del estudio fue validar y adaptar a la población mexicana la herramienta de tamizaje nutricional STAMP. Metodología: la validación se realizó en dos fases: en primer lugar, se realizó la traducción y adaptación cultural; y en segundo lugar, se llevó a cabo un estudio transversal comparando la herramienta STAMP con una evaluación nutricional completa (ENC). Un médico pediatra especialista en nutrición realizó la ENC con la evaluación de parámetros antropométricos, clínicos y dietéticos y, posteriormente, dos nutriólogas realizaron la misma evaluación con la herramienta STAMP. Finalmente, se tamizaron todos los pacientes en leve y moderado o grave riesgo de desnutrición. Resultados: de los 300 pacientes incluidos en el estudio, 160 fueron niños (53,3 %) y 140, niñas (46,7 %), con una media de edad de 9,44 ± 5,73 años. Las valoraciones realizadas con la herramienta STAMP tuvieron una concordancia del 100 %. Comparado con la ENC, se obtuvo un índice kappa de 0,480 (p < 0,01). La prueba STAMP mostró una sensibilidad del 92 %, una especificidad del 75 %, valor predictivo positivo (VPP) del 45 %, valor predictivo negativo (VPN) del 97 %, LR- de 3,68 y LR- de 0,10. Conclusiones: la herramienta de tamizaje STAMP cuenta con los elementos necesarios para evaluar de forma objetiva el riesgo de desnutrición en niños mexicanos y es una prueba altamente sensible y específica. (AU)

Background: pediatric malnutrition is one of the main causes of complications in hospitalized children. Nutritional screening at admission is essential. The Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) is a simple, reproducible and easy-to-interpret tool, but it is not validated in Mexico. The objective of the study was to validate and adapt the STAMP nutritional screening tool to the Mexican population. Methods: the validation was carried out in two phases: firstly, the translation and cultural adaptation was carried out; and secondly, a cross-sectional study was performed comparing the STAMP tool with a complete nutritional assessment (CNA). A pediatrician specialized in nutrition performed the CNA with the evaluation of anthropometric, clinical and dietary parameters; later, two nutritionists carried out the same evaluationwith the STAMP tool. Finally, the patients were graded as low risk and moderate or severe malnutrition risk. Results: of the 300 patients included in the study, 160 were boys (53.3 %) and 140 were girls (46.7 %), with a mean age of 9.44 ± 5.73 years. The assessments made by with the STAMP tool had a 100 % concordance. Compared with CNA, a kappa index of 0.480 (p < 0.01) was obtained. The STAMP test showed a sensitivity of 92 %, a specificity of 75 %, positive predictive value (PPV) of 45 %, negative predictive value (NPV) of 97 %, RVN of 3,68, and RVN of 0,10. Conclusions: the STAMP screening tool has the necessary elements to objectively assess the risk of malnutrition in Mexican children and is a highly sensitive and specific test. (AU)

[Adaptation in Spanish and validation in Mexico of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP]. / Adaptación en español y validación en México de la herramienta de tamizaje nutricional STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics).

Introduction: Background: pediatric malnutrition is one of the main causes of complications in hospitalized children. Nutritional screening at admission is essential. The Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) is a simple, reproducible and easy-to-interpret tool, but it is not validated in Mexico. The objective of the study was to validate and adapt the STAMP nutritional screening tool to the Mexican population. Methods: the validation was carried out in two phases: firstly, the translation and cultural adaptation was carried out; and secondly, a cross-sectional study was performed comparing the STAMP tool with a complete nutritional assessment (CNA). A pediatrician specialized in nutrition performed the CNA with the evaluation of anthropometric, clinical and dietary parameters; later, two nutritionists carried out the same evaluation with the STAMP tool. Finally, the patients were graded as low risk and moderate or severe malnutrition risk. Results: of the 300 patients included in the study, 160 were boys (53.3 %) and 140 were girls (46.7 %), with a mean age of 9.44 ± 5.73 years. The assessments made by with the STAMP tool had a 100 % concordance. Compared with CNA, a kappa index of 0.480 (p < 0.01) was obtained. The STAMP test showed a sensitivity of 92 %, a specificity of 75 %, positive predictive value (PPV) of 45 %, negative predictive value (NPV) of 97 %, RVN of 3,68, and RVN of 0,10. Conclusions: the STAMP screening tool has the necessary elements to objectively assess the risk of malnutrition in Mexican children and is a highly sensitive and specific test. test.

Introducción: Antecedentes: la desnutrición pediátrica es una de las principales causas de complicaciones en niños hospitalizados, por ello, el tamizaje nutricional al ingreso es indispensable. La Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) es una herramienta sencilla, reproducible y fácil de interpretar, sin embargo, en México no se encuentra validada. El objetivo del estudio fue validar y adaptar a la población mexicana la herramienta de tamizaje nutricional STAMP. Metodología: la validación se realizó en dos fases: en primer lugar, se realizó la traducción y adaptación cultural; y en segundo lugar, se llevó a cabo un estudio transversal comparando la herramienta STAMP con una evaluación nutricional completa (ENC). Un médico pediatra especialista en nutrición realizó la ENC con la evaluación de parámetros antropométricos, clínicos y dietéticos y, posteriormente, dos nutriólogas realizaron la misma evaluación con la herramienta STAMP. Finalmente, se tamizaron todos los pacientes en leve y moderado o grave riesgo de desnutrición. Resultados: de los 300 pacientes incluidos en el estudio, 160 fueron niños (53,3 %) y 140, niñas (46,7 %), con una media de edad de 9,44 ± 5,73 años. Las valoraciones realizadas con la herramienta STAMP tuvieron una concordancia del 100 %. Comparado con la ENC, se obtuvo un índice kappa de 0,480 (p < 0,01). La prueba STAMP mostró una sensibilidad del 92 %, una especificidad del 75 %, valor predictivo positivo (VPP) del 45 %, valor predictivo negativo (VPN) del 97 %, LR- de 3,68 y LR- de 0,10. Conclusiones: la herramienta de tamizaje STAMP cuenta con los elementos necesarios para evaluar de forma objetiva el riesgo de desnutrición en niños mexicanos y es una prueba altamente sensible y específica.

Use of Fluoxetine to Reduce Weight in Adults with Overweight or Obesity: Abridged Republication of the Cochrane Systematic Review.

INTRODUCTION: Using fluoxetine is one of many weight loss strategies. A serotonin reuptake inhibitor indicated for depression believed to impact weight control by changing an individual's appetite; however, its benefit-risk ratio is unclear. The aim of this review was to assess the efficacy and safety of fluoxetine in reducing weight in adults with overweight or obesity. METHODS: We searched Cochrane Library, MEDLINE, Embase, and other databases without language restrictions. Cochrane Collaboration tool and GRADE instrument assessed the risk of bias of randomized controlled trials and certainty of their evidence. We conducted random-effects meta-analyses and calculated the risk ratio/mean difference with 95% confidence intervals for the outcomes. RESULTS: We included 19 trials (2,216 adults) and found that fluoxetine may reduce weight by -2.7 kg (95% CI -4 to -1.4; p < 0.001) and body mass index by -1.1 kg/m2 (95% CI -3.7 to 1.4), compared with placebo; however, it would cause approximately twice as many adverse events, such as dizziness, drowsiness, fatigue, insomnia, or nausea. CONCLUSIONS: Although low-certainty evidence suggests that off-label fluoxetine may reduce weight, high-certainty research is needed to be conducted in the future to determine its effects exclusively as well as whether it is useful when combined with other agents. This article is based on a Cochrane Review published in the Cochrane Database of Systematic Reviews 2019, Issue 10, DOI: 10.1002/14651858.CD011688.pub2. Cochrane Reviews are regularly updated as new evidence emerges, and in response to feedback, it should be consulted for the most recent version of the review.

Is a Non-Caloric Sweetener-Free Diet Good to Treat Functional Gastrointestinal Disorder Symptoms? A Randomized Controlled Trial.

Background: A diet containing non-caloric sweeteners (NCS) could reduce calorie intake; conversely, some animal studies suggest that NCS consumption may increase functional gastrointestinal disorder symptoms (FGDs). This study aimed to compare the effect of consuming a diet containing NCS (c-NCS) versus a non-caloric sweetener-free diet (NCS-f) on FGDs. Methods: We conducted a randomized, controlled, parallel-group study using two different diets for five weeks: the c-NCS diet contained 50−100 mg/day NCS, whereas the NCS-f diet had less than 10 mg/day NCS. At the beginning of the study (PreTx) and at the end (PostTx), we assessed FGDs, dietary intake, and NCS consumption. Results: The percentage of participants with diarrhea (PreTx = 19% vs. PstTx = 56%; p = 0.02), post-prandial discomfort (PreTx = 9% vs. PstTx = 39%; p = 0.02), constipation (PreTx = 30% vs. PostTx = 56%; p < 0.01), and burning (PreTx = 13% vs. PostTx = 33%; p < 0.01) increased in the c-NCS diet group. Conversely, abdominal pain (PreTx = 15% vs. PostTx = 3%; p = 0.04), post-prandial discomfort (PreTx = 26% vs. PostTx = 6%; p = 0.02), burning (PreTx = 15% vs. PostTx = 0%; p = 0.02), early satiety (PreTx = 18% vs. PostTx = 3%; p < 0.01), and epigastric pain (PreTx = 38% vs. PostTx = 3%; p < 0.01) decreased in the NCS-f diet group. Conclusion: A c-NCS diet is associated with increased FGDs, including diarrhea, post-prandial discomfort, constipation, and burning or retrosternal pain. The NCS-f diet also decreased FGDs, as well as abdominal pain, post-prandial discomfort, burning or retrosternal pain, early satiety, and epigastric pain.

Coste-efectividad de la terapia avanzada con productos de cura en ambiente húmedo comparada con terapia tradicional en el tratamiento de úlceras por presión de categorías I y II / Cost-effectiveness of advanced therapy with moist environment dressings compared to traditional therapy in the treatment of Stage I and II pressure ulcers

Objetivo: Demostrar el coste-efectividad de la cura en ambiente húmedo (CAH) sobre la cura tradicional (CT) en pacientes hospitalizados con úlceras por presión (UPP) de categorías I y II. Metodología: Estudio longitudinal comparativo, aleatorizado, abierto, dividido en dos grupos, tratados y seguidos durante 4 semanas. El tamaño de la muestra se calculó con base en el metaanálisis de Heyer. Creamos un árbol de decisión para comparar el coste-efectividad de cada cura. Los datos se recopilaron directamente de los formularios de informes de casos de pacientes y los costes se extrajeron de los registros hospitalarios. Realizamos análisis de sensibilidad y costeefectividad incrementales. Resultados: El análisis mostró un dominio de la CAH sobre la CT (223,00€/0,84 vs. 298,00€/0,51), ya que fue más rentable al final del estudio. La hospitalización fue más corta en la CAH y la curación se logró en menos días que con la CT, lo que tiene un impacto en los costes relacionados con los tiempos de atención de enfermería, gasto de recursos materiales y días de hospitalización de los pacientes. Conclusiones: La CAH es más coste-efectiva que la CT cuando se aplica a pacientes hospitalizados con UPP de categorías I y II (AU)

Objective: To demonstrate the cost-effectiveness of the moist environment dressings treatment over the Traditional Cure (TC), in hospitalized patients, with Pressure Ulcers (UPP) categories I and II. Methods: This is a comparative, randomized, open-label, longitudinal study, comprising 60 patients, divided into two groups, treated and followed for four weeks. The sample size was calculated based upon the meta-analysis by Heyer. We built a decision tree to compare the cost-effectiveness of each therapy. Data were collected directly from patients' case report forms and costs extracted from hospital records. Additionally, we performed sensitivity and incremental cost-effectiveness analyses. Results: The analysis showed a dominance of advanced therapy over traditional therapy (€ 223.00/0.84 vs. € 298.00/0.51), as it was more cost-effective at the end of the study. Hospitalization was shorter in the advanced therapy and healing was achieved in fewer days than the traditional therapy. Conclusions: Advanced therapy with healing products in a humid environment is more cost-effective than traditional therapy when applied to hospitalized patients with category I and II pressure ulcers (AU)

Quantitative systematic review: Methods used for the in vivo measurement of body composition in pregnancy.

AIMS: Because of the increased overall prevalence of pre-pregnancy obesity among racial-ethnic groups, we conducted a review of published methods for body composition measurement during pregnancy considering at present there is no consensus on the best practices and type of study design that researchers should use for this purpose. DESIGN: Quantitative systematic review. DATA SOURCES: PubMed, EMBASE, Scopus, Web of Science, and Virtual Library of Health. Search dates from 1997-2016. REVIEW METHODS: Search of articles indexed in selected databases from 1997-2016. Studies were published in English, Spanish, and Portuguese. Graphs were carried out using data visualization software. RESULTS: From the 112 included studies, 70 were prospective cohorts, 30 cross-sectional studies, 10 randomized controlled trial, and two retrospective studies. Cross-sectional studies and randomized controlled trial depicted a positive correlation with significant trend. CONCLUSIONS: Although several methods for body composition measurement exist, only bioelectrical impedance analysis, displacement plethysmography, and displacement plethysmography show a significant growing trend. Use of data visualization allows understanding various associations among categorical variables, with a graphical display of their multidimensional behaviour. IMPACT: Public and private health-care institution evaluating pregnancy women. Health-care personnel, including nursing professional, dealing with measurements of body composition during pregnancy will find reading this manuscript beneficial.

Basic principles of mathematical growth modeling applied to high-grade gliomas: A brief clinical review for clinicians.

The battle against cancer has intensified in the last decade. New experimental techniques and theoretical models have been been proposed to understand the behavior, growth, and evolution of different types of brain tumors. Unfortunately, for glioblastoma multiforme (GBM), except for methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter that has some benefit in the local control of tumors using alkylating agents such as temozolomide, to date personalized treatments do not exist. In this article, we present a comprehensive review of different aspects intertwined in the mathematical growth modeling applied to high-grade gliomas. We briefly cover the following fundamental aspects related to the conventional imaging in GBM: defining the tumor regions in GBM, segmentation of the tumor regions using magnetic resonance imaging (MRI) of the brain, response assessment using the neuro-oncology response criteria versus the Macdonald criteria, availability of software for the segmentation of MRI of the brain, mathematical modeling applied to tumor growth, principles of mathematical modeling, factors involved in tumor growth models, mathematical modeling based on imaging data, most common equations used in high-grade glioma growth modeling, integration of mathematical growth models in computer simulators, tumor growth modeling as a part of brain's complex system, and challenges in mathematical growth modeling. We conclude by saying that it is the combination of biomedical imaging and mathematical modeling that allows the assembling of clinically relevant models of tumor growth and treatment response; the most appropriate model will depend on the premise and findings of each experiment.

Serum levels of interleukin-1 beta associate better with severity of simple steatosis than liver function tests in morbidly obese patients.

BACKGROUND: In high-fat diet-fed mice, interleukin-1 beta (IL-1 beta) has been shown to play a key role in hepatic steatosis. However, it remains unknown whether IL-1 beta could be associated with different grades of steatosis in obese humans. MATERIALS AND METHODS: Morbidly obese patients (n = 124) aged 18-65 years were divided into four groups: no steatosis (controls), mild steatosis, moderate steatosis, and severe steatosis using abdominal ultrasound. IL-1 beta serum levels and liver function tests were measured and significant differences were estimated by one-way ANOVA followed by Tukey test. RESULTS: IL-1 beta serum levels significantly increased in morbidly obese patients with mild (11.38 ± 2.40 pg/ml), moderate (16.72 ± 2.47 pg/ml), and severe steatosis (23.29 ± 5.2 pg/ml) as compared to controls (7.78 ± 2.26 pg/ml). Liver function tests did not significantly change among different grades of steatosis. CONCLUSION: IL-1 beta serum levels associate better with steatosis degree than liver function tests in morbidly obese population.

[Inicio del tratamiento farmacológico de la tuberculosis].

The appearance of new anti-tuberculosis drugs such as bedaquiline and delamanid makes it impossible not to remember that the first strictly controlled medical trials of tuberculosis treatment were published in two rigorously researched outstanding articles that can be qualified as historical. In 1948, streptomycin was formally studied as an efficacious anti-tuberculosis drug. In 1952, another trial compared streptomycin-paramino salicylic acid with isoniazid, by means of which the first bases of pharmacological tuberculosis treatment were established.

La aparición de nuevos fármacos antituberculosos, como la bedaquilina y el delaminid, hace inevitable recordar que los primeros ensayos estrictamente controlados del tratamiento médico de la tuberculosis se publicaron en dos artículos de excelente y rigurosa investigación científica que pueden calificarse como históricos. En 1948 se estudió formalmente la estreptomicina como medicamento antituberculoso eficaz. En 1952, en otro ensayo se comparó estreptomicina-ácido paraaminosalicílico con isoniacida, con lo que se establecieron las primeras bases del tratamiento farmacológico de la tuberculosis.

Infliximab ameliorates tumor necrosis factor-alpha-induced insulin resistance by attenuating PTP1B activation in 3T3L1 adipocytes in vitro.

Insulin resistance is the inability to respond to insulin and is considered a key pathophysiological factor in the development of type 2 diabetes. Tumor necrosis factor-alpha (TNF-alpha) can directly contribute to insulin resistance by disrupting the insulin signalling pathway via protein-tyrosine phosphatase 1B (PTP1B) activation, especially in adipocytes. Infliximab (Remicade® ) is a TNF-alpha-neutralizing antibody that has not been fully studied in insulin resistance. We investigated the effect of infliximab on TNF-alpha-induced insulin resistance in 3T3L1 adipocytes in vitro, and examined the possible molecular mechanisms involved. Once differentiated, adipocytes were cultured with 5 mmol L-1 2-deoxy-D-glucose-3 H and stimulated twice with 2 µmol L-1 insulin, in the presence or absence of 5 ng/mL TNF-alpha and/or 10 ng/mL infliximab. Glucose uptake was measured every 20 minutes for 2 hour, and phosphorylated forms of insulin receptor (IR), insulin receptor substrate-2 (IRS-2), protein kinase B (AKT) and PTP1B were determined by Western blotting. TNF-alpha-treated adipocytes showed a significant 64% decrease in insulin-stimulated glucose uptake as compared with control cells, whereas infliximab reversed TNF-alpha actions by significantly improving glucose incorporation. Although IR phosphorylation remained unaltered, TNF-alpha was able to increase PTP1B activation and decrease phosphorylation of IRS-2 and AKT. Notably, infliximab restored phosphorylation of IRS-2 and AKT by attenuating PTP1B activation. This work demonstrates for the first time that infliximab ameliorates TNF-alpha-induced insulin resistance in 3T3L1 adipocytes in vitro by restoring the insulin signalling pathway via PTP1B inhibition. Further clinical research is needed to determine the potential benefit of using infliximab for treating insulin resistance in patients.

Effect of metformin on the survival of patients with ALL who express high levels of the ABCB1 drug resistance gene.

BACKGROUND: In acute lymphoblastic leukemia (ALL), high ABCB1 gene expression has been associated with treatment resistance, which affects patient prognosis. Many preclinical reports and retrospective population studies have shown an anti-cancer effect of metformin. Therefore, the objective of this study was to assess the effect of metformin on the treatment regimen in patients with ALL who exhibited high levels of ABCB1 gene expression and to determine its impact on overall survival. METHODS: A total of 102 patients with ALL were recruited; one group (n = 26) received metformin, and the other received chemotherapy (n = 76). Measurement of ABCB1 transcript expression was performed using qRT-PCR prior to treatment initiation. Survival analysis was performed using Kaplan-Meier curves. The impact of both the type of treatment and the level of expression on the response (remission or relapse) was analyzed by calculating the odds ratio. RESULTS: The survival of patients with high ABCB1 expression was lower than those with low or absent ABCB1 gene expression (p = 0.030). In the individual analysis, we identified a benefit to adding metformin in the group of patients with high ABCB1 gene expression (p = 0.025). In the metformin user group, the drug acted as a protective factor against both therapeutic failure (odds ratio [OR] 0.07, 95% confidence interval [CI] 0.0037-1.53) and early relapse (OR 0.05, 95% CI 0.0028-1.153). CONCLUSION: The combined use of metformin with chemotherapy is effective in patients with elevated levels of ABCB1 gene expression. Trial registration NCT 03118128: NCT.

High-Density Lipoprotein Reduction Differentially Modulates to Classical and Nonclassical Monocyte Subpopulations in Metabolic Syndrome Patients and in LPS-Stimulated Primary Human Monocytes In Vitro.

The effect of metabolic syndrome on human monocyte subpopulations has not yet been studied. Our main goal was to examine monocyte subpopulations in metabolic syndrome patients, while also identifying the risk factors that could directly influence these cells. Eighty-six subjects were divided into metabolic syndrome patients and controls. Monocyte subpopulations were quantified by flow cytometry, and interleukin- (IL-) 1ß secretion levels were measured by ELISA. Primary human monocytes were cultured in low or elevated concentrations of high-density lipoprotein (HDL) and stimulated with lipopolysaccharide (LPS). The nonclassical monocyte (NCM) percentage was significantly increased in metabolic syndrome patients as compared to controls, whereas classical monocytes (CM) were reduced. Among all metabolic syndrome risk factors, HDL reduction exhibited the most important correlation with monocyte subpopulations and then was studied in vitro. Low HDL concentration reduced the CM percentage, whereas it increased the NCM percentage and IL-1ß secretion in LPS-treated monocytes. The LPS effect was abolished when monocytes were cultured in elevated HDL concentrations. Concurring with in vitro results, IL-1ß serum values significantly increased in metabolic syndrome patients with low HDL levels as compared to metabolic syndrome patients without HDL reduction. Our data demonstrate that HDL directly modulates monocyte subpopulations in metabolic syndrome.

Serum Levels of Interleukin-13 Increase in Subjects with Insulin Resistance but Do Not Correlate with Markers of Low-Grade Systemic Inflammation.

Experimental evidence in mice suggests a role for interleukin- (IL-) 13 in insulin resistance and low-grade systemic inflammation. However, IL-13 serum levels have not been assessed in subjects with insulin resistance, and associations of IL-13 with parameters of low-grade systemic inflammation are still unknown. Our main goal was to examine the systemic levels of IL-13 in patients with insulin resistance, while also studying the relationship of IL-13 with anthropometric, metabolic, and low-grade systemic inflammatory markers. Ninety-two participants were included in the study and divided into insulin-resistant patients and noninsulin-resistant controls. Blood levels of IL-13, glucose, insulin, triglycerides, cholesterol, tumor necrosis factor-alpha (TNF-α), IL-10, proinflammatory (Mon-CD11c+CD206-), and anti-inflammatory (Mon-CD11c-CD206+) monocytes, as well as anthropometric parameters, were measured in all volunteers. Insulin-resistant patients showed 2.5-fold higher serum levels of IL-13 than controls (P < 0.0001) and significantly increased values of TNF-α and Mon-CD11c+CD206-, with concomitant reductions in IL-10 and Mon-CD11c-CD206+. Increased IL-13 was extraordinarily well associated with hyperglycemia (r = 0.7362) and hypertriglyceridemia (r = 0.7632) but unexpectedly exhibited no significant correlations with TNF-α (r = 0.2907), IL-10 (r = -0.3882), Mon-CD11c+CD206- (r = 0.2745) or Mon-CD11c-CD206+ (r = -0.3237). This study demonstrates that IL-13 serum levels are elevated in patients with insulin resistance without showing correlation with parameters of low-grade systemic inflammation.

La consejería de enfermería disminuye la sintomatología y recaídas en pacientes pediátricos con rinitis alérgica / The counseling of nursing decreases symptomatology and relapses in pediatric patients with allergic rhinitis

Resumen: Introducción: La rinitis alérgica (RA) es considerada como un problema de salud pública, por lo tanto, es indispensable poner a prueba estrategias de educación para la salud como la consejería de enfermería (CE) dirigida a grupos poblacionales como niños con rinitis alérgica y sus tutores. Este trabajo tuvo como objetivo medir durante un año los beneficios en la salud de población infantil con esta enfermedad. Métodos: Estudio longitudinal, aleatorio, comparativo, con una muestra de 100 pacientes pediátricos de ambos sexos, con edades de 6 a 12 años, con diagnóstico de rinitis alérgica, con consejería (grupo estudio) y sin consejería (grupo control). En ambos grupos se obtuvo carta de consentimiento informado firmada por ambos tutores, además de cédulas de conocimiento y de valoración; la segunda incluyó escala de sintomatología y de Morisky Green (adherencia al tratamiento). Los niños del grupo estudio recibieron intervención basada en educación personalizada, material didáctico, apoyo del grupo multidisciplinario en caso necesario (médico, dermatólogo y psicólogo). El grupo control recibió atención habitual. En ambos grupos se hizo seguimiento vía telefónica, lo que permitió identi"car el número de recaídas en un año. Resultados: Para la comparación de los resultados se aplicó la prueba de Wilcoxon rank-sum (Mann-Whitney); la presencia de recaídas en el grupo control comparado con el grupo estudio se encontró estadísticamente significativa. Conclusiones: Se encontró que la población infantil que recibe CE, tiene como beneficio mejor control de la sintomatología y disminución de recaídas al año.

Abstract: Background: Allergic rhinitis (AR) is considered to be a public health problem, therefore it is essential to test health education strategies such as nursing counseling (NC) aimed at population groups such as children with allergic rhinitis and their tutors. This study aimed to measure the health benefits of children with this disease for a year. Methods: Longitudinal, randomized, comparative study with a sample of 100 pediatric patients of both sexes, aged 6 to 12 years, with diagnosis of allergic rhinitis, with counseling (study group) and without counseling (control group). In both groups, an informed consent letter signed by both tutors was obtained, in addition to knowledge and assessment papers; the latter included a scale of symptomatology and Morisky Green (adherence to treatment). The children in the study group received intervention based on personalized education, didactic material, support of the multidisciplinary group if necessary (doctor, dermatologist and psychologist). The control group received usual care. In both groups, telephone follow-up was performed, which allowed the number of relapses to be identified in one year. Results: The Wilcoxon rank-sum test (Mann-Whitney) was used to compare the results; the presence of relapses in the control group was statistically significant compared to the study group. Conclusions: It was found that the infant population that receives NC, has as a better benefit the control of the symptomatology and decrease of relapses per year.

[The counseling of nursing decreases symptomatology and relapses in pediatric patients with allergic rhinitis]. / La consejería de enfermería disminuye la sintomatología y recaídas en pacientes pediátricos con rinitis alérgica.

BACKGROUND: Allergic rhinitis (AR) is considered to be a public health problem, therefore it is essential to test health education strategies such as nursing counseling (NC) aimed at population groups such as children with allergic rhinitis and their tutors. This study aimed to measure the health benefits of children with this disease for a year. METHODS: Longitudinal, randomized, comparative study with a sample of 100 pediatric patients of both sexes, aged 6 to 12 years, with diagnosis of allergic rhinitis, with counseling (study group) and without counseling (control group). In both groups, an informed consent letter signed by both tutors was obtained, in addition to knowledge and assessment papers; the latter included a scale of symptomatology and Morisky Green (adherence to treatment). The children in the study group received intervention based on personalized education, didactic material, support of the multidisciplinary group if necessary (doctor, dermatologist and psychologist). The control group received usual care. In both groups, telephone follow-up was performed, which allowed the number of relapses to be identified in one year. RESULTS: The Wilcoxon rank-sum test (Mann-Whitney) was used to compare the results; the presence of relapses in the control group was statistically significant compared to the study group. CONCLUSIONS: It was found that the infant population that receives NC, has as a better benefit the control of the symptomatology and decrease of relapses per year.

Anorexia nerviosa en el anciano: mito o realidad / Anorexia nervosa in the elderly: myth or reality?

El crecimiento mundial de la población geriátrica es un fenómeno relacionado con mayor esperanza de vida que permite una diversidad de manifestaciones de la senectud. El envejecimiento conlleva un declive natural de funciones, entre ellas, disminución del apetito que resulta en pérdida de peso, pero que a veces tiene orígenes patológicos. La anorexia nerviosa en el anciano es una entidad cuyo reconocimiento se ha omitido sistemáticamente en la práctica médica, debido a que el clínico la relaciona solamente con adolescentes y su identificación en la vejez es esporádica con referencias anecdóticas en la literatura médica. La importancia del tema radica en que se desconoce la historia natural de este trastorno alimentario crónico y de baja mortalidad en el paciente mayor, por lo que debemos preguntarnos si existe la anorexia nerviosa en el anciano, y si es así, si se trata de recaídas del problema del adolescente o es una aparición tardía de la enfermedad

The worldwide growth of the ageing population has resulted from greater life expectancy and in turn has led to a wide spectrum of clinical alterations in the elderly. This process encompasses a gradual loss of body functions, such as appetite loss. Loss of appetite is a frequent finding in this group and is related to weight loss; nevertheless, weight loss can sometimes be a consequence of concomitant diseases rather than of ageing itself. Anorexia nervosa in the elderly is consistently overlooked in general practice as clinicians associate it only with adolescents. Diagnosis in the elderly is sporadic and reports in the literature are rare. The importance of the subject lies in the lack of knowledge of the natural history of this chronic eating disorder, which has low mortality in the elderly. Questions that should be asked are whether anorexia nervosa occurs in the elderly and, if so, whether the patient is experiencing a relapse of anorexia in adolescence or late onset of the disorder