Changes from 1986 to 2018 in the prevalence of obesity and overweight, metabolic control and treatment in children with type 1 diabetes mellitus in a Mediterranean area of Southeast Spain.

BACKGROUND: In recent decades, a global increase in the prevalence of childhood overweight and obesity has been observed in children and adolescents with type 1 diabetes. METHODS: This retrospective, cross-sectional, population study examined three groups (1986, 2007, and 2018) of children and adolescents aged < 16 years diagnosed with type 1 diabetes. Overweight and obesity were defined according to the World Health Organization recommendations. RESULTS: The prevalence of overweight and obesity in diabetic children and adolescents was 30.2% (95% CI: 23.1-38.3). There was a significant increase from 1986 to 2007 (11.9% to 41.7%, p = 0.002) and from 1986 to 2018 (11.9% to 34.8%, p = 0.012), but no significant differences were found from 2007 to 2018 (41.7% to 34.8%, p = 0.492). The age at diagnosis was lower in the group with excess body mass (p = 0.037). No significant differences were observed in age (p = 0.690), duration of diabetes (p = 0.163), distribution according to sex (p = 0.452), metabolic control (HbA1c, p = 0.909), or insulin units kg/day (p = 0.566), between diabetic patients with overweight or obesity and those with normal weight. From 2007 to 2018, the use of insulin analogs (p = 0.009) and a higher number of insulin doses (p = 0.007) increased significantly, with no increase in the prevalence of overweight and obesity. CONCLUSIONS: The prevalence of overweight and obesity in diabetic children and adolescents increased in the 1990s and the beginning of the twenty-first century, with stabilization in the last decade. Metabolic control and DM1 treatment showed no association with this trend.

Critical Steps for Human Gut Exfoliome RNA Profiling Analysis Using Non-Invasive Stool Samples.

INTRODUCTION: Dietary exposure and drug treatments influence gut cellular pathways and hence growth and potentially even the gut-brain-microbiome axis. Since eukaryotic mRNA presents poly-A sequence that distinguishes them from the prokaryotes mRNA, we could analyze the gene expression of human gut cells using exfoliated gut cells available in stool samples. However, the impact of the critical steps of these non-invasive methods must be analyzed. METHODS: We tested prokaryote contamination in all the steps of different procedures to analyze human exfoliome by microarrays and the influence of the fecal sampling collection process. RESULTS: The least bacterial contamination was found using RNA amplified with oligo dT from the GeneChip 3' IVT Pico Reagent Kit or using RNA purified by both Oligotex® + oligo dT. RNAlater® collection of feces affects the microarray results compared to directly frozen fecal samples, although both methods produce similar cDNA quality. CONCLUSION: This technique is a potential non-invasive diagnostic tool that can be applied to larger studies to quantify intestinal gene expression in humans with non-invasive samples, but samples should always be collected and analyzed under the same procedure.

Serial prolactin sampling as a confirmatory test for true hyperprolactinemia / Curva de prolactina para la confirmación de hiperprolactinemia real

INTRODUCTION: Hyperprolactinemia may be due to physiological or pathological causes, and may be asymptomatic or induce hypogonadism, infertility, and/or galactorrhea. It is important to take prolactin samples while avoiding stress, as this may increase prolactin levels. Therefore, our aim was to assess the value of prolactin serial sampling after brachial vein cannulation. PATIENTS AND METHODS: Sixty-six patients (34.9±11.8 years of age, 92.4% female) with an initial elevated random prolactin level were included. A prolactin sample was drawn at baseline and after a 30min rest. RESULTS: The median referral prolactin level was 37.4ng/ml (interquartile range [IQR* 23.3), the baseline prolactin level at serial sampling was 19.5ng/ml (IQR 8), and the value after a 30min rest was 17.1ng/ml (IQR 7.9). Hyperprolactinemia was not confirmed by serial sampling in 45 patients (68.2%). There were no statistically significant differences in referral prolactin levels between patients with and without confirmed hyperprolactinemia (41.2ng/ml and 36.7ng/ml respectively, p = 0.3). Galactorrhea was found in 13.6% of patients, amenorrhea or oligomenorrhea in 28.8%, infertility in 7.6%, erectile dysfunction in 4.6%, and gynecomastia in 3%, while 45.5% were asymptomatic. There were no statistical differences regarding the presence or absence of any of these symptoms and subsequent confirmed hyperprolactinemia. Fifty-seven patients (86.4%) were discharged after the results of the prolactin serial sampling were obtained. CONCLUSIONS: Prolactin serial sampling may be a useful test to detect artefactual hyperprolactinemias, thus avoiding unnecessary additional tests and treatments

INTRODUCCIÓN: La hiperprolactinemia puede ser debida a causas fisiológicas o patológicas, y puede ser asintomática o inducir hipogonadismo, infertilidad y/o galactorrea. Es importante obtener las muestras de prolactina evitando situaciones de estrés, puesto que este puede incrementar sus niveles. Por tanto, nuestro objetivo era evaluar la utilidad de la realización de curvas de prolactina mediante canalización de la vena braquial. MATERIALES Y MÉTODOS: Se incluyeron 66 pacientes (edad: 34,9±11,8 años; 92,4% mujeres) con una prolactina aleatoria inicial elevada. Se obtuvieron una muestra de prolactina basal y otra tras un reposo de 30min. RESULTADOS: La prolactina mediana inicial fue 37,4ng/ml (IQR: 23,3), la prolactina basal de la curva 19,5ng/ml (IQR: 8), y tras 30min de reposo, 17,1ng/ml (IQR: 7,9). La curva descartó una hiperprolactinemia en 45 pacientes (68,2%) No hubo diferencias estadísticamente significativas en la prolactina de derivación entre aquellos pacientes en los que se confirmó una hiperprolactinemia y aquellos que no (41,2 vs. 36,7ng/ml; p = 0,3). Un 13,6% de los pacientes presentaron galactorrea, un 28,8% amenorrea u oligomenorrea, un 7,6% infertilidad, un 4,6% disfunción eréctil y un 3% ginecomastia. El 45,5% estaban asintomáticos. No hubo diferencias estadísticamente significativas entre la presencia o ausencia de ninguno de estos síntomas y una hiperprolactinemia confirmada posteriormente. Se pudo dar de alta a 57 pacientes (86,4%) tras la obtención de los resultados de la curva de prolactina. CONCLUSIONES: La curva de prolactina puede ser una prueba útil pata detectar falsas hiperprolactinemias, evitando la realización de pruebas complementarias y tratamientos adicionales innecesarios

Serial prolactin sampling as a confirmatory test for true hyperprolactinemia.

INTRODUCTION: Hyperprolactinemia may be due to physiological or pathological causes, and may be asymptomatic or induce hypogonadism, infertility, and/or galactorrhea. It is important to take prolactin samples while avoiding stress, as this may increase prolactin levels. Therefore, our aim was to assess the value of prolactin serial sampling after brachial vein cannulation. PATIENTS AND METHODS: Sixty-six patients (34.9±11.8 years of age, 92.4% female) with an initial elevated random prolactin level were included. A prolactin sample was drawn at baseline and after a 30min rest. RESULTS: The median referral prolactin level was 37.4ng/ml (interquartile range [IQR* 23.3), the baseline prolactin level at serial sampling was 19.5ng/ml (IQR 8), and the value after a 30min rest was 17.1ng/ml (IQR 7.9). Hyperprolactinemia was not confirmed by serial sampling in 45 patients (68.2%). There were no statistically significant differences in referral prolactin levels between patients with and without confirmed hyperprolactinemia (41.2ng/ml and 36.7ng/ml respectively, p=0.3). Galactorrhea was found in 13.6% of patients, amenorrhea or oligomenorrhea in 28.8%, infertility in 7.6%, erectile dysfunction in 4.6%, and gynecomastia in 3%, while 45.5% were asymptomatic. There were no statistical differences regarding the presence or absence of any of these symptoms and subsequent confirmed hyperprolactinemia. Fifty-seven patients (86.4%) were discharged after the results of the prolactin serial sampling were obtained. CONCLUSIONS: Prolactin serial sampling may be a useful test to detect artefactual hyperprolactinemias, thus avoiding unnecessary additional tests and treatments.

Validez y confiabilidad del instrumento “Prácticas de cuidado que realizan consigo mismas y con el hijo por nacer las mujeres en la etapa prenatal" / Validity and reliability of the instrument known as

Se realizó una investigación que permitió construir un instrumento cuyo objetivo es valorar las prácticas de cuidado que realizan las mujeres en la etapa prenatal. Se aplicaron los criterios de confiabilidad y validez, que dieron lugar a un instrumento válido y confiable que puede utilizarse para el estudio de las prácticas de cuidado en el área materno prenatal, en la sublínea de investigación Prácticas del Cuidado Materno Perinatal, que desarrolla la Facultad de Enfermería de la Universidad Nacional de Colombia. Se diseñó un instrumento con escala tipo Likert con 31 ítems, el cual se aplicó a 303 mujeres de diferentes estratos socioeconómicos, procedentes Bogotá, Bucaramanga y Pereira. Para la validez de criterio se tomó como criterio externo la revisión de la evidencia científica existente sobre las seis dimensiones que tiene el instrumento. La confiabilidad se midió a través de la consistencia interna, la cual mostró un coeficiente alfa de Cronbach de 0,66. La estabilidad se midió a través del coeficiente de correlación de Pearson, y presentó una correlación general de 0,8, y la de las diferentes dimensiones osciló entre 0,5 y 0,8. El instrumento presenta una buena validez aparente, ya que al aplicarlo se encontró relación en re las preguntas y lo que se pretendía medir. Después de analizar los hallazgos se presentan las conclusiones y algunas recomenda ciones del estudio para aplicación futura.

A methodological research was carried out that enabled the researcher to build an instrument whose objective is the evaluation of the care practices performed by mothers in state of gestation on themselves and on their childs to be born among women in the prenatal stage. Norms of reliability and validity were applied, turning thus the instrument into a valid and reliable one to be used in the study of care practices in the prenatal maternal area, which is part of the Practical Research of the Perinatal Maternal Care that is made by the Nursing Faculty of the Universidad Nacional (National University of Colombia). An instrument build with a 31 items type Likert scale was de signed, which was applied to 303 women from different socioeconomic strata in Bogotá, Bucaramanga and Pereira. In vali dating the criteria, researchers used as ex ter nal source the review of existing scientific evidence on the six dimensions proper to the instrument: physical activity, prenatal stimulation, feeding, consumption of non beneficial substances, care and personal hygiene, and support systems. The validity of the content was evaluated in the study by a group of nine experts. The reliability was measured through the internal con sistency, which showed an alpha Cron bach coefficient of 0.66 for the who le instrument. The stability was measured through the Pearson's correlation coefficient, which rea ched a high 0.8, there maining dimensions ranging bet ween 0.5 and 0.8 The instrument has a good apparent validity, since when applied there was a relations hip between the questions and the issues which were in tended to measure. After analyzing the findings, we presented some conclusions and recommendations for future use.